Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts.
Adult and Child Center for Outcomes Research and Delivery Science (ACCORDS), University of Colorado Anschutz Medical Center, Aurora, Colorado.
J Surg Res. 2024 Aug;300:272-278. doi: 10.1016/j.jss.2024.05.019. Epub 2024 Jun 2.
As outcomes for breast cancer patients improve, addressing the side effects and distress of treatment can optimize survivorship. Although distress in breast cancer is well known in literature, there is a lack of information on how these concerns change through the phases of the cancer care continuum. Therefore, this study investigates the longitudinal trajectory of worry in patients with nonmetastatic breast cancer.
Female patients with newly diagnosed stage I-III breast cancer comprised a mixed-methods, longitudinal study at a cancer center from June 2019 to June 2023. Patients completed an open-ended survey regarding their top three concerns. Responses were obtained before surgery and two weeks, three, six, nine months, and one year postoperatively. Responses were qualitatively coded and analyzed to determine themes of cancer-related distress.
Participants (n = 262) were aged an average 57.53 y (±12.54), 65.8% had stage I disease at diagnosis, and 91.1% were White. Responses revealed that patients' top three sources of concerns varied by treatment phase. Overall, patients were worried about their cancer diagnosis and the risk of recurrence. Preoperatively, patients were worried about treatment timeline, while postoperative concerns transitioned to physical appearance and surgical side effects.
Breast cancer patients consistently reported worries about cancer diagnosis, recurrence, and metastasis as well as the side effects and fear of treatments. However, patient worry appeared to be intrinsically linked with their treatment phase. Therefore, support and interventions should be catered to reflect the changing patterns of patients' sources of distress to optimize breast cancer patients' quality of life.
随着乳腺癌患者的治疗效果改善，解决治疗的副作用和困扰可以优化生存质量。尽管乳腺癌患者的困扰在文献中已有广泛报道，但对于这些问题如何随癌症治疗连续体的不同阶段而变化的信息却相对较少。因此，本研究旨在调查非转移性乳腺癌患者担忧的纵向轨迹。
本研究为癌症中心的一项混合方法、纵向研究，纳入了 2019 年 6 月至 2023 年 6 月期间新诊断为 I-III 期乳腺癌的女性患者。患者在术前及术后 2 周、3 个月、6 个月、9 个月和 1 年完成了一份关于他们最关注的三个问题的开放性调查。对回答进行定性编码和分析，以确定与癌症相关的困扰的主题。
参与者（n=262）的平均年龄为 57.53 岁（±12.54），65.8%在诊断时为 I 期疾病，91.1%为白人。结果显示，患者最关注的三个问题的来源因治疗阶段而异。总的来说，患者担心癌症诊断和复发的风险。术前，患者担心治疗时间安排，而术后则更关注身体外观和手术副作用。
乳腺癌患者持续报告对癌症诊断、复发和转移以及治疗副作用和恐惧的担忧。然而，患者的担忧似乎与其治疗阶段密切相关。因此，支持和干预措施应根据患者痛苦来源的变化模式进行调整，以优化乳腺癌患者的生活质量。
