Abstract
To better understand the impact of cancer and treatment on outcomes and guide program development, we evaluated breast cancer survivors at risk for long-term medical and psychosocial issues who participated in survivorship care visits (SVs) at Johns Hopkins Hospital. We conducted a prospective survey study of women with stage I-III breast cancer who participated in SVs from 2010-2016. The same 56-item questionnaire administered at SV and follow-up included an assessment of symptoms, social factors, demographics, anxiety, depression, and comorbidities. We added the Godin Exercise questionnaire to the follow-up. In 2018, 74 participants were identified as disease-free and mailed a follow-up survey; 52 (70.3%) completed the survey. At a median follow-up time of 3.1years after diagnosis, participants were less likely to be employed (54% vs. 67%) than at the SV. About two-thirds were sedentary, and this was associated with high body mass index (p = 0.02). Sufficiently active participants (≥ 150min per week of moderate-intensity activity) were less likely to report pain (p = 0.02) or fatigue (p = 0.001). Although 19% had moderate/severe anxiety or depression at follow-up, participants who reported employment satisfaction were less likely to be depressed (p = 0.02). Awareness of issues faced by survivors is critical for enhancing care and developing models to identify patients who might benefit most from targeted long-term interventions. Interventions to address physical activity, persistent symptoms, and mental health are critical for breast cancer survivors.
Highlights
Implications for Cancer Survivors: Interventions to address physical activity, persistent symptoms and mental health are critical for breast cancer survivors
Compared to those in the breast cancer registry, survivorship care visits (SVs) participants were younger, more likely to be African American, and more likely to have a higher TNM stage, hormone receptor-negative disease, and HER2-positive disease. They were more likely to have received chemotherapy and radiation therapy. We report on their long-term follow up outcomes based on subsequent review of medical records and a follow-up survey
Participants who primarily received adjuvant chemotherapy and were subsequently referred by their medical oncology providers for a single SV were included in this follow up survey study
Summary
In 2006, the Institute of Medicine proposed standardizing practices for survivorship care by improving patient education and facilitating communication between providers with a survivorship care plan (SCP).4 While these treatment summaries and plans for follow-up care were intended to standardize communication among cancer and non-cancer providers as well as patients, implementation has encountered barriers including time, reimbursement, and, most important, evidence of effectiveness.. Our group previously reported on a cohort of JHH breast cancer patients, most of whom received adjuvant chemotherapy and were subsequently referred by their medical oncology providers for a single SV.. Our group previously reported on a cohort of JHH breast cancer patients, most of whom received adjuvant chemotherapy and were subsequently referred by their medical oncology providers for a single SV.8 Compared to those in the breast cancer registry, SV participants were younger, more likely to be African American, and more likely to have a higher TNM stage, hormone receptor-negative disease, and HER2-positive disease. We report on their long-term follow up outcomes (employment, physical activity, symptoms, comorbidities and mental health) based on subsequent review of medical records and a follow-up survey
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
