Christopher J Coroneos1, Yu-Li Lin2, Chris Sidey-Gibbons3, Malke Asaad4, Brian Chin5, Stefanos Boukovalas4, Margaret S Roubaud4, Makesha Miggins6, Donald P Baumann4, Anaeze C Offodile7. 1. Division of Plastic Surgery, Department of Surgery, McMaster University, Ontario, CA; Department of Health Research Methods, Evidence and Impact, McMaster University, Ontario, CA. 2. Department of Health Services Research, University of Texas MD Anderson Cancer Center, Houston, TX. 3. Department of Symptom Research, University of Texas MD Anderson Cancer Center, Houston, TX. 4. Department of Plastic Surgery, University of Texas MD Anderson Cancer Center, Houston, TX. 5. Division of Plastic Surgery, Department of Surgery, McMaster University, Ontario, CA. 6. Department of Breast Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX. 7. Department of Health Services Research, University of Texas MD Anderson Cancer Center, Houston, TX; Department of Plastic Surgery, University of Texas MD Anderson Cancer Center, Houston, TX; Baker Institute for Public Policy, Rice University, Houston, TX. Electronic address: acoffodile@mdanderson.org.
Abstract
BACKGROUND: The relationship between treatment-related, cost-associated distress "financial toxicity" (FT) and quality-of life (QOL) in breast cancer patients remains poorly characterized. This study leverages validated patient-reported outcomes measures (PROMs) to analyze the association between FT and QOL and satisfaction among women undergoing ablative breast cancer surgery. METHODS: This is a single-institution cross-sectional survey of all female breast cancer patients (>18 years) who underwent lumpectomy or mastectomy between January 2018 and June 2019. FT was measured via the 11-item COmprehensive Score for financial Toxicity (COST) instrument. The BREAST-Q and SF-12 were used to asses condition-specific and global QOL respectively. Responses were linked with demographic and clinical data. Pearson correlation coefficient and multivariable regression were used to examine associations. RESULTS: 532 patients comprised our analytical sample; mean age 58, mostly white (76.7%), employed (63.7%), married/committed (73.7%), with 64.3% undergoing reconstruction. Median household income was $80,000-120,000/year, and mean COST score 28.0. Following multivariable adjustment, a positive relationship for all outcomes was noted; lower COST (greater cost-associated distress) was associated with lower BREAST-Q and SF-12 scores. This relationship was strongest for BREAST-Q psychosocial well-being where we observed a 0.89 (95%CI:0.76-1.03) change per unit change in COST score. CONCLUSIONS: Financial toxicity captured in this study correlates with statistically significant and clinically important differences in BREAST-Q psychosocial well-being, and patient satisfaction with reconstructed breasts, and SF-12 global mental and physical quality of life. Treatment costs should be included in the shared decision-making for breast cancer surgery. Future prospective outcomes research should integrate COST.
BACKGROUND: The relationship between treatment-related, cost-associated distress "financial toxicity" (FT) and quality-of life (QOL) in breast cancerpatients remains poorly characterized. This study leverages validated patient-reported outcomes measures (PROMs) to analyze the association between FT and QOL and satisfaction among women undergoing ablative breast cancer surgery. METHODS: This is a single-institution cross-sectional survey of all female breast cancerpatients (>18 years) who underwent lumpectomy or mastectomy between January 2018 and June 2019. FT was measured via the 11-item COmprehensive Score for financial Toxicity (COST) instrument. The BREAST-Q and SF-12 were used to asses condition-specific and global QOL respectively. Responses were linked with demographic and clinical data. Pearson correlation coefficient and multivariable regression were used to examine associations. RESULTS: 532 patients comprised our analytical sample; mean age 58, mostly white (76.7%), employed (63.7%), married/committed (73.7%), with 64.3% undergoing reconstruction. Median household income was $80,000-120,000/year, and mean COST score 28.0. Following multivariable adjustment, a positive relationship for all outcomes was noted; lower COST (greater cost-associated distress) was associated with lower BREAST-Q and SF-12 scores. This relationship was strongest for BREAST-Q psychosocial well-being where we observed a 0.89 (95%CI:0.76-1.03) change per unit change in COST score. CONCLUSIONS:Financial toxicity captured in this study correlates with statistically significant and clinically important differences in BREAST-Q psychosocial well-being, and patient satisfaction with reconstructed breasts, and SF-12 global mental and physical quality of life. Treatment costs should be included in the shared decision-making for breast cancer surgery. Future prospective outcomes research should integrate COST.
Authors: Richard Huan Xu; Ling-Ling Wang; Ling-Ming Zhou; Eliza Lai-Yi Wong; Dong Wang Journal: Support Care Cancer Date: 2022-01-27 Impact factor: 3.603
Authors: Nicholas L Berlin; Paul Abrahamse; Adeyiza O Momoh; Steven J Katz; Reshma Jagsi; Ann S Hamilton; Kevin C Ward; Sarah T Hawley Journal: Cancer Date: 2021-11-30 Impact factor: 6.860
Authors: Abbas M Hassan; Huan T Nguyen; Joseph P Corkum; Jun Liu; Sahil K Kapur; Carrie K Chu; Nina Tamirisa; Anaeze C Offodile Journal: Ann Surg Oncol Date: 2022-09-09 Impact factor: 4.339