The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Medicine, The Hospital of The University of Pennsylvania, Philadelphia, PA, USA.
Breast Cancer Res Treat. 2019 Feb;173(3):701-708. doi: 10.1007/s10549-018-5028-z. Epub 2018 Nov 7.
Breast cancer survivors face numerous challenges after diagnosis and treatment. Several models have been developed to attempt to improve quality of care. Here, we describe characteristics and outcomes of patients who participated in survivorship visits (SV) at Johns Hopkins (JH).
We retrospectively reviewed charts of breast cancer patients who participated in an optional SV 1-3 months after completing locoregional therapy and initial systemic therapy. We report patient demographics, comorbidities, tumor characteristics, treatments, and responses to symptom questionnaires. We compared the characteristics of SV participants to stage I-III analytical cases in the 2010-2015 JH Cancer Registry (JHCR).
We identified 87 women with stage I-III breast cancer who participated in SVs from 2010 to 2016. Compared to patients in the JHCR (n = 2942), 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. They were more likely to have received chemotherapy and radiation therapy. They also have similar recurrence rates despite the SV cohort's shorter median follow-up time. Among SV participants, the prevalence of comorbidities including peripheral neuropathy, anemia, lymphedema, anxiety, deep vein thrombosis, and depression increased significantly from time of diagnosis to most recent follow-up.
Compared to the JHCR cohort, SV participants had higher risk cancers and a high frequency of comorbidities potentially associated with breast cancer and therapy. These high-risk patients may benefit most from specific interventions targeting survivorship care, and their experiences may help improve care delivery models.
乳腺癌患者在诊断和治疗后面临诸多挑战。已经开发出几种模型来试图改善护理质量。在这里，我们描述了在约翰霍普金斯大学（JH）接受生存访问（SV）的患者的特征和结局。
我们回顾性地审查了在完成局部区域治疗和初始系统治疗后 1-3 个月参加可选 SV 的乳腺癌患者的病历。我们报告了患者的人口统计学特征、合并症、肿瘤特征、治疗方法以及对症状问卷的反应。我们比较了 SV 参与者的特征与 2010-2015 年 JH 癌症登记处（JHCR）的 I-III 期分析病例。
我们确定了 87 名患有 I-III 期乳腺癌的女性，她们于 2010 年至 2016 年参加了 SV。与 JHCR 中的患者（n=2942）相比，SV 参与者更年轻，更可能是非洲裔美国人，更可能有更高的 TNM 分期、激素受体阴性疾病和 HER2 阳性疾病。他们更有可能接受化疗和放疗。尽管 SV 队列的中位随访时间较短，但他们的复发率相似。在 SV 参与者中，从诊断时到最近的随访时，合并症的患病率（包括周围神经病变、贫血、淋巴水肿、焦虑、深静脉血栓形成和抑郁）显着增加。
与 JHCR 队列相比，SV 参与者的癌症风险更高，且合并症的频率更高，这些合并症可能与乳腺癌和治疗有关。这些高危患者可能最受益于针对生存护理的特定干预措施，他们的经验可能有助于改善护理提供模式。
