Dermatologic adverse events (dAEs) and emotional quality of life (QoL) in patients (pts) with breast cancer: A mixed-methods study.

Abstract

12076 Background: dAEs are a common and impactful aspect of QoL and have an emotional impact. However, its measurement relating to cancer care is limited. Validated tools focus on dermatology or chemotherapy but can be disconnected. Our pilot study utilized several validated tools to assess overall dAEs and their impact. Methods: Mixed methods consisting of a cross-sectional survey with qualitative interviews was conducted on pts with breast cancer who recently completed (<1 year) chemotherapy (acute) or completed chemotherapy ≥1 year ago (longitudinal). A panel of dermatologic and oncologic patient-reported outcome measures (PROMs) was: PRO Version of the Common Terminology Criteria for AEs (PRO-CTCAE), Skindex-16 (S-16), Fear of Cancer Recurrence–Short Form (FCR-SF), and Impact of Events–Intrusive Thoughts subscale (IES). Semi-structured interviews were done to elicit responsiveness to this panel. Results: 64 pts were screened & 60 enrolled (mean age: 63.0±19.1). Pts were Female and insured (100%), White (78.3%) & Black (20%). Pts were treated with radiation (70%), surgery (66.7%), hormone therapies (23%), targeted or immunotherapies (15%). Common symptoms were xerosis (73.3%), alopecia (66.7%), pruritus (58.3%). Mean total S-16 score was 19.4 (range: 0 (no impact) to 75.5 (most impact)); PRO-CTCAE 22.2 (0, 48.5); FCR-SF 43.2 (0, 97.2); IES 20.8 (0, 65.6). S-16 scores demonstrated moderate correlations with PRO-CTCAE (r=0.60, CI=0.41-0.74, p<0.001), indicating related but nonredundant constructs. The S-16 didn’t correlate with the FCR-SF or IES, suggesting distinct emotional burdens on pts with cancer. There was no significant difference in survey scores between acute and longitudinal groups. Qualitative analyses revealed this combination of surveys encapsulated QoL and emotional experiences related to dAEs. Several pts were unaware of the dAEs they could experience as well as how to treat them. Conclusions: This is a novel assessment of dAEs in QoL, implementing and comparing cancer-specific PROMs to common dermatologic PROMs. Results indicate that dAEs significantly impact QoL and oncological psychometric outcomes are not fully captured with current dermatologic PROMs. Correlations between PROM scores. Instrument Pair Correlation (r) 95% CI P-value PRO-CTCAE total S-16 total S-16 symptoms S-16 emotional S-16 functioning 0.600.650.480.40 0.41 to 0.740.48 to 0.780.26 to 0.660.17 to 0.60` <.001<.001<.0010.001 FCR-SF total S-16 total S-16 symptoms S-16 emotional S-16 functioning PRO-CTCAE total IES total -0.15-0.08-0.17-0.14-0.060.06 -0.39 to 0.11-0.32 to 0.18-0.40 to 0.09-0.38 to 0.12-0.31 to 0.20-0.20 to 0.31 0.2520.5620.2070.2950.6460.657 IES total S-16 total S-16 symptoms S-16 emotional S-16 functioning PRO-CTCAE total 0.14-0.030.190.190.24 -0.12 to 0.38-0.28 to 0.23-0.07 to 0.42-0.07 to 0.42-0.01 to 0.47 0.2870.8450.1480.1420.062