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Study: Nearly half of breast cancer patients experience a severe side effect after treatment

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Contents

At a glance In-depth
Findings     Limitations                             
Clinical trials Resources
Questions for your doctor  


STUDY AT A GLANCE

This study is about:

Documenting the frequency, severity, and burden of side effects (including nausea/vomiting, diarrhea, constipation, pain, arm swelling, difficulty breathing, and breast skin irritation) that women experience after treatment for (I or II) invasive breast cancer.

Why is this study important?

Few studies have looked at the full spectrum of side effects that women experience after treatment for breast cancer. It is important that health care providers are aware of the side effects that breast cancer patients can experience after treatment so they can incorporate this information into their treatment and survivorship plans with patients and provide early intervention when necessary.

Study findings: 

  1. 45% of breast cancer patients reported at least one “severe” or “very severe” side effect after treatment.
  2. Factors associated with a more severe side effect after treatment were:
    • Receiving chemotherapy alone or in combination with radiation
    • Latina ethnicity

What does this mean for me?

This study showed that a substantial number of women experience side effects after breast cancer treatment. More work needs to be done to better understand and characterize the side effects associated with treatment. In the meantime, patients who experience side effects or who are about to start treatment should discuss their symptoms and /or concerns with their health care providers.

Posted 4/11/17

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References

Friese CR, Harrison JM, Janz NK, et al. “Treatment-Associated Toxicities Reported by Patients with Invasive Breast Cancer.” Cancer.  Published online first on January 24, 2017. 

This article is relevant for:

People diagnosed with early stage breast cancer

This article is also relevant for:

men with breast cancer

people with triple negative breast cancer

people with ER/PR + cancer

people with Her2-positive cancer

people with a genetic mutation linked to cancer risk

people with breast cancer

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IN DEPTH REVIEW OF RESEARCH

Study background:

Health care providers always take care to ensure that a treatment is greater than its potential risks, but treatment can be more difficult with drugs such as cancer treatments where the dose needed often causes side effects.

While information is available regarding treatment side effects from clinical trial studies and health care claims, few studies have thoroughly examined the side effects that breast cancer patients experience after treatment outside of those settings. Additionally, participants of these studies are typically patients with breast cancer. Christopher Friese and colleagues from the University of Michigan School of Nursing and other institutions published research in 2017 in the journal Cancer that studied the side effects of women who were treated for their breast cancer.

Researchers of this study wanted to know:

What are the side effects, severity of those side effects, and patient burden associated with treatment for (I or II) invasive breast cancer?   

Population(s) looked at in the study:

This study used data from 1,884 women, ages 20-79, with (I or II) invasive breast cancer of any type.  Women who had III or IV cancer or tumors bigger than 5 cm were excluded. The data was taken from the Los Angeles County and Georgia Surveillance, Epidemiology, and End Results () programs. Among the participants, 1,057 women were white, 321 were black, 315 were Latina, 141 were Asian and 50 were of unknown race or ethnicity. The patients received primary breast surgery (, unilateral or mastectomy) and may or may not have had radiation, chemotherapy, or both radiation and chemotherapy.

The researchers mailed surveys about two months after each woman’s surgery, asking patients to rank the severity of their side effects, including nausea/vomiting, diarrhea, constipation, pain, arm swelling, difficulty breathing, and breast skin irritation. Patients were also asked to fill out a survey about their physical health (the measure) and health care services they used because of side effects.  This allowed the researchers to measure the patient burden of side effects after treatment.

Study findings: 

  1. 45% of breast cancer patients reported that they experienced at least one “severe” or “very severe” side effect after treatment.
  2. Factors associated with a more severe side effect were:
    • Receiving chemotherapy alone or in combination with radiation
    • Latina ethnicity
  3. An association was observed between patients’ score (measure of physical health) and side effects experienced. Patients who did not experience side effects had higher scores, indicating better physical health, while patients who did experience side effects had lower scores, indicating worse physical health.
  4. 9% of women reported unscheduled visits to their health care providers to manage their side effects; 5% of women visited an emergency department or hospital for their side effects.

Limitations:

This study was conducted through patient surveys; researchers did not have access to patients’ health records.  Studies such as these that rely solely on patients’ memories can include errors due to patients’ recall (for example, not remembering a side effect experienced or remembering it as more or less severe than it would be classified by a health care provider). Additionally, while the researchers recruited a fairly diverse group of women, because the study was limited to two geographic regions (Los Angeles and Georgia), the study conclusions may not be applicable to other areas. Finally, this study only included women with breast cancer; most had ER+/HER2- tumors. Additional work is needed to examine the effect in more advanced breast cancers. The researchers’ analysis did not separate breast cancers into different subtypes—depending on a patient’s subtype, individuals may have received different treatments compared to other patients, so the results may not be widely applicable to all patients.

Conclusions:

This study suggests that almost half of women with invasive breast cancer experience at least one severe or very severe side effect after treatment. The study authors identified many clinical implications from this study, writing: “The burden faced by patients may be greater than acknowledged by clinicians, and warrants routine assessment during and between clinical visits. Differential patterns identified in this diverse, population-based sample of women may help clinicians when they review the risks and benefits of breast cancer treatment options.”

Posted 4/11/17

Share your thoughts on this review by taking our brief our brief survey

Questions To Ask Your Doctor
Questions To Ask Your Doctor

  • Who should I call if I experience a side effect?
  • Do all women experience side effects after breast cancer treatment?
  • What are potential side effects I may have after breast cancer treatment?
  • What are ways to alleviate the side effects that I may experience after breast cancer treatment?

Open Clinical Trials
Open Clinical Trials

The following studies are looking at management of side effects: 

Multiple cancers

Breast cancer

Colorectal cancer

Endometrial cancer

Ovarian cancer

  • NCT04533763: Living WELL: A Web-Based Program for Ovarian Cancer Survivors. This studies a group-based and web-delivered tool for ovarian cancer survivors in increasing quality of life and decreasing stress, depressive mood, anxiety, and fatigue across a 12-month period.
  • NCT05047926: Prehabilitation for Advanced Ovarian Cancer Patients. Prehabilitation may improve peri-operative outcomes in patients undergoing cancer surgery. This study will look at structured activity for women undergoing chemotherapy to improve their physical state prior to surgical intervention and thus improve outcomes.

cancer

Updated: 02/15/2023

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