A substantial proportion of breast cancer survivors experience physical and psychosocial challenges in the months after active treatment, new research led by Dana-Farber Cancer Institute indicates. The findings were presented today at the 41st Annual San Antonio Breast Cancer Symposium. While the study found that women who received chemotherapy with bevacizumab, a targeted agent, did no worse from a quality of life perspective when compared to those who only received chemotherapy, there was a trend among those patients participating in the study who underwent mastectomy, as opposed to breast conserving surgery, being associated with poorer quality of life.
“Given increasing rates of mastectomy in the United States, particularly bilateral mastectomy, understanding the quality of life impact of surgery is of critical importance,” said Shoshana Rosenburg, ScD, MPH, a cancer epidemiologist at Dana-Farber Cancer Institute. “Since we did see modest differences that favored breast conserving surgery vs. mastectomy, our findings underscore the importance of attention to both physical and psychosocial health not only during but also following active breast cancer treatment, particularly among those who undergo more extensive surgery.”
The study involved more than 400 patients who were followed as part of a Phase III randomized clinical trial (ECOG-ACRIN E5103) who had undergone breast cancer surgery – either a mastectomy or breast-conserving surgery – prior to a chemotherapy regimen and were randomized to receive either bevacizumab or a placebo. In follow-up, participants were surveyed about various factors related to quality of life; the results reported represent data collected at 18 months after enrollment on to the trial
More than half of the patients – 58 percent – reported having at least some pain or discomfort, and 38 percent reported symptoms of anxiety or depression. Those who had a mastectomy were more likely report having problems with normal activities than were those who had breast-conserving surgery, and generally had lower quality-of-life scores, researchers found.
The results suggest that even though quality-of-life issues are common among women who have undergone breast cancer surgery and follow-up chemotherapy, many of their symptoms are of a kind that may respond to interventions such as physical rehabilitation and counseling.