TY - JOUR
T1 - Impact of symptom burden on work-related abilities in patients with locally recurrent or metastatic breast cancer
T2 - Results from a substudy of the VIRGO observational cohort study
AU - Cleeland, Charles S.
AU - Mayer, Musa
AU - Dreyer, Nancy A.
AU - Yim, Yeun Mi
AU - Yu, Elaine
AU - Su, Zhaohui
AU - Mun, Yong
AU - Sloan, Jeff A.
AU - Kaufman, Peter A.
N1 - Publisher Copyright:
© 2014.
PY - 2014/12/1
Y1 - 2014/12/1
N2 - Limited data exist on the association of symptom burden, daily activity impairment, and work productivity (WP) in patients with advanced breast cancer. This cross-sectional analysis evaluated baseline patient-reported outcomes (PROs) in patients with locally recurrent or metastatic breast cancer (MBC) receiving first-line hormonal therapy or chemotherapy and/or targeted therapy in the VIRGO observational study. The primary PRO study endpoint, symptom severity and interference score, was measured using the MD Anderson Symptom Inventory (MDASI). Secondary endpoints included Activity Level Scale (ALS), health-related quality of life (HRQOL), and Work Productivity and Activity Impairment Questionnaire (WPAI:SHP) scores. Overall, 152 patients (chemotherapy cohort, 104; hormonal therapy cohort, 48) answered questionnaires. Fatigue, decreased sexual interest, disturbed sleep, emotional distress, and drowsiness were the most common severe symptoms, and were of moderate-to-severe intensity in 38.8%-52.0% of patients. Mean percent daily activity impairment was 30% for study patients, and WP impairment ranged from 20% to 40% across indices in employed patients (. n, 58). Significant positive correlations existed for MDASI severity and interference scores with activity impairment and WP indices (Pearson correlation coefficients [. R]=0.47-0.82; p<0.0001). ALS and overall HRQOL correlated negatively with these indices (. R=-0.41 to-0.60; p≤0.001). After adjustment for potential confounders, MDASI symptom interference and ALS were significant predictors of activity and WP impairment. Our results indicate patients receiving treatment for MBC are symptomatic with significant daily activity and/or WP impairment. Symptom severity and interference, functional status, and overall HRQOL were moderately correlated with perceived work-related ability.
AB - Limited data exist on the association of symptom burden, daily activity impairment, and work productivity (WP) in patients with advanced breast cancer. This cross-sectional analysis evaluated baseline patient-reported outcomes (PROs) in patients with locally recurrent or metastatic breast cancer (MBC) receiving first-line hormonal therapy or chemotherapy and/or targeted therapy in the VIRGO observational study. The primary PRO study endpoint, symptom severity and interference score, was measured using the MD Anderson Symptom Inventory (MDASI). Secondary endpoints included Activity Level Scale (ALS), health-related quality of life (HRQOL), and Work Productivity and Activity Impairment Questionnaire (WPAI:SHP) scores. Overall, 152 patients (chemotherapy cohort, 104; hormonal therapy cohort, 48) answered questionnaires. Fatigue, decreased sexual interest, disturbed sleep, emotional distress, and drowsiness were the most common severe symptoms, and were of moderate-to-severe intensity in 38.8%-52.0% of patients. Mean percent daily activity impairment was 30% for study patients, and WP impairment ranged from 20% to 40% across indices in employed patients (. n, 58). Significant positive correlations existed for MDASI severity and interference scores with activity impairment and WP indices (Pearson correlation coefficients [. R]=0.47-0.82; p<0.0001). ALS and overall HRQOL correlated negatively with these indices (. R=-0.41 to-0.60; p≤0.001). After adjustment for potential confounders, MDASI symptom interference and ALS were significant predictors of activity and WP impairment. Our results indicate patients receiving treatment for MBC are symptomatic with significant daily activity and/or WP impairment. Symptom severity and interference, functional status, and overall HRQOL were moderately correlated with perceived work-related ability.
KW - Breast neoplasms
KW - Quality of life
KW - Symptom assessment
KW - Work
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U2 - 10.1016/j.breast.2014.08.004
DO - 10.1016/j.breast.2014.08.004
M3 - Article
C2 - 25193423
AN - SCOPUS:84921955473
SN - 0960-9776
VL - 23
SP - 763
EP - 769
JO - Breast
JF - Breast
IS - 6
ER -