SABCS: Adverse Effects of Breast RT Under-Recognized

TUESDAY, Dec. 15, 2020 — Patient-reported outcomes are important as physicians often under-recognize adverse effects of radiotherapy (RT) in breast cancer patients, according to a study presented at the annual San Antonio Breast Cancer Symposium, held virtually from Dec. 8 to 11.

Reshma Jagsi, M.D., D.Phil., from the University of Michigan in Ann Arbor, and colleagues enrolled breast cancer patients who received RT after lumpectomy at 29 practices to examine recognition of symptoms. Data were included for 9,941 of 13,725 patients who completed RT between Jan. 1, 2012, and March 31, 2020, and who completed at least one patient-reported outcomes questionnaire. The proportion of patients with under-recognition of symptoms by physicians was examined.

The researchers found that 34.5, 30.6, 23.9, and 24.9 percent of the patients reported substantial breast pain, frequent bother from pruritis, frequent bother from edema, and severe fatigue, respectively. Under-recognition was evaluated in 9,868 patients, with 37,593 independent paired observations of patient and physician reports. Under-recognition existed in 30.9, 36.7, 51.4, and 18.8 percent of observations of patient-reported moderate/severe pain, patient-reported frequent pruritis, patient-reported frequent edema, and patient-reported severe fatigue, respectively. For 53.2 percent of the patients who reported at least one substantial symptom during RT, under-recognition of at least one of the four symptoms occurred at least once during the patient’s treatment.

“Improving symptom detection may be a targetable mechanism to reduce disparities in cancer treatment experiences and outcomes, at least in the setting of breast radiation therapy,” Jagsi said in a statement.

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