High Distress Portends Worse Patient-Reported Outcomes Among Newly Diagnosed Breast Cancer Patients

Abstract

INTRODUCTION: New cancer diagnoses may lead to heightened levels of distress, which may affect quality of life (QoL). In this study, we aimed to evaluate the relationship between high distress and patient-reported outcomes (PRO) among newly diagnosed breast cancer patients. METHODS: Patients evaluated for stage 0–III breast cancer at an academic breast center were offered a cancer distress screening survey which measures 4 domains of distress: emotional, health, social, and practical. High distress was defined as a score greater than 5 of 10 in any domain. Immediately after their initial appointment, patients were invited to complete the Breast-Q module, a validated PRO scale evaluating QoL across 4 domains: satisfaction with breasts (SB), psychosocial wellbeing (PsW), physical wellbeing (PhW), and sexual wellbeing (SW). The primary outcomes were scores for each Breast-Q domain. Groups were compared by t-tests, Mann–Whitney U tests, and multiple regression models. RESULTS: A total of 111 patients completed both the distress screen and the PRO survey. Sixty-seven patients (60%) had high distress, whereas 44 patients (40%) did not have high distress. In the univariate analysis (Figure), patients with high distress had lower SB (p < 0.01), PsW (p < 0.01), PhW (p = 0.03), and SW (p < 0.01) scores. In the multiple regression, high distress was an independent predictor of lower score for SB (p = 0.02), PsW (p = 0.02), and SW (p = 0.03). CONCLUSION: Breast cancer patients with high distress at diagnosis report worse QoL compared with their peers. Early intervention should be provided to improve QoL in this patient population.Figure