Retrospective study of the effect of disease progression on patient reported outcomes in HER-2 negative metastatic breast cancer patients

Mark S Walker,Edward J Stepanski,Yeun Mi Yim,Lee S Schwartzberg,Murad Hasan,Elaine Yu

doi:10.1186/1477-7525-9-46

Mark S Walker, Edward J Stepanski + Show 4 more

Open Access

https://doi.org/10.1186/1477-7525-9-46

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Abstract

BackgroundThis retrospective study evaluated the impact of disease progression and of specific sites of metastasis on patient reported outcomes (PROs) that assess symptom burden and health related quality of life (HRQoL) in women with metastatic breast cancer (mBC).MethodsHER-2 negative mBC patients (n = 102) were enrolled from 7 U.S. community oncology practices. Demographic, disease and treatment characteristics were abstracted from electronic medical records and linked to archived Patient Care Monitor (PCM) assessments. The PCM is a self-report measure of symptom burden and HRQoL administered as part of routine care in participating practices. Linear mixed models were used to examine change in PCM scores over time.ResultsMean age was 57 years, with 72% of patients Caucasian, and 25% African American. Median time from mBC diagnosis to first disease progression was 8.8 months. Metastasis to bone (60%), lung (28%) and liver (26%) predominated at initial metastatic diagnosis. Results showed that PCM items assessing fatigue, physical pain and trouble sleeping were sensitive to either general effects of disease progression or to effects associated with specific sites of metastasis. Progression of disease was also associated with modest but significant worsening of General Physical Symptoms, Treatment Side Effects, Acute Distress and Impaired Performance index scores. In addition, there were marked detrimental effects of liver metastasis on Treatment Side Effects, and of brain metastasis on Acute Distress.ConclusionsDisease progression has a detrimental impact on cancer-related symptoms. Delaying disease progression may have a positive impact on patients' HRQoL.

Highlights

IntroductionBreast cancer is the most common cancer among women in the United States (excluding skin cancer) and the second leading cause of cancer death in women (second to lung cancer)[1]
Breast cancer is the most common cancer among women in the United States and the second leading cause of cancer death in women[1]
The primary goal of this research was to evaluate the impact on health related quality of life (HRQoL) of disease progression in general, and of specific sites of metastasis, in a HER-2 negative metastatic breast cancer (mBC) population

Summary

Introduction

Breast cancer is the most common cancer among women in the United States (excluding skin cancer) and the second leading cause of cancer death in women (second to lung cancer)[1]. Few women (6%) diagnosed with breast cancer are initially diagnosed with distant metastases Of those who are, 27.1% are alive after 5 years,[3] a rate considerably lower than the 5-year survival rate for women diagnosed with regional (84%) or localized (98%) disease[4]. Given the high incidence of breast cancer, these data suggest that a substantial and growing number of women diagnosed with advanced disease will experience an extended period of survival. This retrospective study evaluated the impact of disease progression and of specific sites of metastasis on patient reported outcomes (PROs) that assess symptom burden and health related quality of life (HRQoL) in women with metastatic breast cancer (mBC)

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