Identification and management of side effects and supportive care needs arising from treatment is essential for treatment adherence and quality of life of breast cancer patients.
A retrospective audit of 160 women with early breast cancer who received treatment at a single breast service in Melbourne was performed. Information was retrieved from medical and nursing survivorship planning consultations. Data extracted included all symptoms/issues recorded and referrals/services offered. Symptoms were categorised into six domains. McNemar's test was performed to analyse the differences.
Mean±SD age at diagnosis was 60±11 years. The majority of patients were postmenopausal (76%), had breast-conserving surgery (83%), and received radiotherapy (72%) and endocrine therapy (92%). A substantial incidence of issues/symptoms was recorded: 76% menopause/hormonal therapy-related, 58% psychosocial-related, 67% lifestyle-related, 22% bone health-related, 37% sexuality-related and 2% fertility-related. Nurses were more likely to record symptoms than doctors: menopausal/hormonal therapy 74% vs 52% (p<.001); psychosocial/mental health 56% vs 11% (p<.001); lifestyle 62% vs 19% (p<.001); bone health 21% vs 11% (p<.001); sexuality 37% vs 4% (p<.001); and fertility 8% vs 4% (cells too small to analyse), respectively. Nurses were significantly more likely than doctors to refer patients for follow-up for psychosocial/mental health (p<.001), lifestyle (p<.001) and sexuality (p<.001) issues, respectively.
Side effects and other issues are common after breast cancer treatment. Overall, nurses are significantly more likely to identify/report symptoms and make referrals. The findings highlight the need to identify and address unmet needs and the value of a multidisciplinary approach to the long-term management of women with early breast cancer.