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Symptoms after breast cancer treatment: are they influenced by patient characteristics?

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Abstract

Purpose

This study examines the burden of symptoms by treatment type and patient characteristics in a population-based sample of newly diagnosed breast cancer patients.

Methods

Using the Los Angeles County SEER Registry Rapid Case Ascertainment, we identified a cohort of breast cancer patients in 2000 and conducted telephone surveys in English and Spanish among participants.

Results

We completed interviews of 1,219 breast cancer patients and found almost half (46%) had at least one severe symptom (any of the following: nausea/vomiting, arm problems, hot flashes, vaginal dryness, difficulty sleeping) that interfered with her daily functioning or mood. Multi-variate analysis controlling for patient characteristics and treatment showed that older (OR = 0.90; P < 0.000), black (OR = 0.50; P < 0.000), Hispanic Spanish-speaking (OR = 0.37; P < 0.000), widowed or never married (OR = 0.68; P = 0.049), and working (OR = 0.72; P = 0.024) women were less likely to report severe symptoms than other women. Number of comorbid conditions (OR = 1.21; P < 0.000) and receipt of chemotherapy (OR = 1.48; P = 0.040) were positively associated with reporting symptoms.

Conclusion

These findings estimate the prevalence of several mutable symptoms in breast cancer patients that can be addressed by appropriate treatments. Comorbidity is a significant predictor of symptoms, especially amongst those receiving chemotherapy. Variation in symptom reporting occurred by race/ethnicity and other sociodemographic characteristics, raising questions of different thresholds for reporting symptoms or truly fewer symptoms for some sociodemographic groups. Population-based estimates of the probability of symptoms in women with incident breast cancer can be used to provide patient education about potential outcomes following the treatment of breast cancer.

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Acknowledgements

We would like to acknowledge Dennis Deapen, MD, Donna Morell, and Ann Hamilton for assistance in using the Los Angeles County SEER Rapid Case Ascertainment (RCA) program. National Cancer Institute Grant no. R01 CA 81338-01A1. Dr. Ganz was also supported by an American Cancer Society Clinical Research Professorship award. Dr. Malin was supported by a CI-10 Damon Runyon-Lilly Clinical Investigator Award from the Damon Runyon Cancer Research Foundation.

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Authors and Affiliations

  1. School of Public Health, Health Services, University of California at Los Angeles, Box 951772, Los Angeles, CA, 90095-1722, USA

    Jean Yoon

  2. Amgen, Thousand Oaks, CA, USA

    Jennifer L. Malin

  3. Valley Radiotherapy Associates Medical Group, El Segundo, CA, USA

    May Lin Tao

  4. School of Medicine, Division of General Internal Medicine and Health Services Research, University of California at Los Angeles, 911 Broxton Avenue, Box 951736, Los Angeles, CA, 90095-1736, USA

    Diana M. Tisnado & Katherine L. Kahn

  5. RAND, Santa Monica, CA, USA

    John L. Adams, Martha J. Timmer & Katherine L. Kahn

  6. Jonsson Comprehensive Cancer Center at UCLA, Los Angeles, CA, USA

    Patricia A. Ganz

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  1. Jean Yoon
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  2. Jennifer L. Malin
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Corresponding author

Correspondence to Katherine L. Kahn.

Additional information

Originality of the work/previous presentations, reports or publications: this manuscript represents original work and original materials. Part of the manuscript was previously presented as a poster presentation to Academy Health Annual Meeting, Seattle, WA, June 2006 and as a poster presentation to Society of General Internal Medicine Meeting, Los Angeles, CA, April 2006.

Appendix

Appendix

Table 5 Severe symptom prevalence by patient characteristics (n = 1,219)
Full size table
Table 6 Predictors for number of severe symptoms if any (n = 577)
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Table 7 Predictors for having any severe symptoms for treatment-specific cohorts
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Table 8 Predictors for number of severe symptoms if any symptoms for treatment-specific cohorts
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Yoon, J., Malin, J.L., Tao, M.L. et al. Symptoms after breast cancer treatment: are they influenced by patient characteristics?. Breast Cancer Res Treat 108, 153–165 (2008). https://doi.org/10.1007/s10549-007-9599-3

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  • DOI: https://doi.org/10.1007/s10549-007-9599-3

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