Abstract
PurposeAlthough treatment for early breast cancer improved prognosis greatly, it can have significant long-term consequences, which must be considered during treatment decision.Methods453 patients with neoadjuvant or adjuvant treatment intention were recruited into the MaTox project within the prospective, multicentre, population-based German TMK cohort study (Tumour Registry Breast Cancer) between 2008 and 2009. Patient-reported outcomes (PROs) on 26 treatment-related symptoms were assessed via a specifically designed questionnaire at 4 weeks, 6 months, 18 months and 3 years after start of systemic treatment.ResultsThe results show that alterations in smell, taste and appetite were clearly improved 3 years after treatment. In contrast, post-surgical symptoms, restrictions in memory/attention, musculoskeletal system and polyneuropathy worsened substantially over time and were persistent after 3 years: 78% of the patients recorded impairment in memory, 73% muscle pain, 67% pain at the operated site and 57% paraesthesia in fingers or toes. A logistic regression model showed that risk factors for developing persistent paraesthesia symptoms were age, early paraesthesia symptoms and taxane-based therapy.ConclusionsOur data show that most patients with breast cancer have persistent impairments negatively influencing their daily life even 3 years after treatment. Furthermore, we highlight areas requiring special attention in follow-up care.
Highlights
In women, breast cancer is the most common cancer in the world and the second most common cause of cancer death after lung cancer in more developed regions [1]
Our data show that most patients with breast cancer have persistent impairments negatively influencing their daily life even 3 years after treatment
We present data from the MaTox project, a patient-reported outcomes survey within the clinical cohort study TMK (Tumour Registry Breast Cancer), which evaluated the frequency, severity, and persistence of typical symptoms in patients with breast cancer in routine practice using a questionnaire designed for this purpose
Summary
Breast cancer is the most common cancer in the world and the second most common cause of cancer death after lung cancer in more developed regions [1]. Lymphedema of hand, arm or shoulder are common side effects of breast cancer surgery and radiotherapy, affecting 10–50% of patients within the first three years after diagnosis [8, 10, 11]. Other long-term side effects related to local breast cancer therapy comprise numbness or tightness, and stretching or pulling in arms, shoulders, or the chest wall [7]. Both surgery and radiotherapy can lead to nerve damage resulting in chronic pain [11, 12] which may affect 25–60% of survivors after breast cancer treatment [8]. There is little evidence from longterm follow-up of patients with breast cancer receiving taxanes [11, 15]
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