M. Heins (Utrecht, Netherlands)
Netherlands Institute of Health Services ResearchAuthor Of 1 Presentation
134P_PR - Towards tailored follow-up care for breast cancer survivors: cluster analyses based on symptom burden
Abstract
Background
Breast cancer survivors may experience multiple co-existing symptoms that affect their health-related quality of life. Insight into symptom clustering can contribute to better targeted follow-up. We aimed to identify subgroups of breast cancer survivors based on clusters of symptom burden, and patient and treatment characteristics associated with these subgroups.
Methods
We selected surgically treated stage I-III breast cancer survivors 1-5 years post-diagnosis from the Netherlands Cancer Registry (N=876). We assessed experienced burden for fatigue, nausea, pain, dyspnea, insomnia, appetite, constipation, diarrhea, financial burden, and emotional and cognitive symptoms through the EORTC-QLQ-C30 on a scale 0-100. We determined subgroups of survivors using Latent class Cluster Analyses (LCA) based on patterns of co-existing symptom burden. We compared patient and treatment characteristics of the subgroups by multinomial logistic regression and compared their symptom burden to the age and sex matched general reference population.
Results
From 404 participating survivors (46%), 3 subgroups of survivors were identified: low symptom burden (n=116/404, 28.7%) intermediate symptom burden (n=224/404, 55.4%), and high symptom burden (n=59/404, 14.6%). The low subgroup reported a lower symptom burden compared to the general population. The intermediate subgroup experienced burden similar to the general population, although scores for fatigue, insomnia, and cognitive symptoms were slightly worse (small-medium clinically relevant differences). The high subgroup had worse symptom burden than the general population (medium-large clinically relevant differences). Compared to the intermediate subgroup, one (relative risk ratio (RRR): 2.75; CI: 1.22-6.19; p=0.015) or more (RRR: 9.19; CI: 3.70-22.8; p=<0.001) comorbidities were significantly associated with membership to the high subgroup. We found no associations between patient or treatment characteristics and subgroups.
Conclusions
We identified different subgroups of breast cancer survivors based on symptom burden. This may indicate the relevance of personalized follow-up care and should be explored in future research.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.