Late Effects in a High-Risk Population of Breast Cancer Survivors

Abstract Purpose: To better understand the impact of cancer and treatment on outcomes and guide program development, we evaluated breast cancer survivors at risk for long-term medical and psychosocial issues who participated in survivorship care visits (SVs) at Johns Hopkins Hospital.Methods: We conducted a prospective survey study of women with stage I-III breast cancer who participated in SVs from 2010-2016. The same 56-item questionnaire administered at SV and follow-up included an assessment of symptoms, social factors, demographics, anxiety, depression, and comorbidities. We added the Godin Exercise questionnaire to the follow-up. Results: In 2018, 74 participants were identified as disease-free and mailed a follow up survey; 52 (70.3%) completed the survey. At a median follow-up time of 3.1 years after diagnosis, participants were less likely to be employed (54% vs. 67%) than at the SV. About two thirds were sedentary, and this was associated with high body mass index (p=0.02). Sufficiently active participants (≥150 minutes per week of moderate intensity activity) were less likely to report pain (p=0.02) or fatigue (p=0.001). Although 20% had moderate/severe anxiety or depression at follow up, participants who reported employment satisfaction were less likely to be depressed (p=0.02). Conclusions: Awareness of issues faced by survivors is critical for enhancing care and developing models to identify patients who might benefit most from targeted long term interventions.Implications for Cancer Survivors: Interventions to address physical activity, persistent symptoms and mental health are critical for breast cancer survivors.