Abstract 185P
Background
We aimed to examine receipt of NADJ and types of surgery received by pts diagnosed with early stage HR+/HER2- BC, and measure association between surgery type received and pts’ HRQoL.
Methods
A multinational (USA, Germany, UK) survey of pts diagnosed with stage I-III HR+/HER2- BC receiving adjuvant therapy was conducted from June to October 2019. Physicians provided data on pts’ treatment history and invited them to complete a questionnaire that included patient-reported HRQoL measures. Multivariable linear regression analyses were conducted to assess the association between HRQoL measures and surgery received (mastectomy: simple, radical, modified radical; or breast-conserving surgery: lumpectomy, quadrantectomy, sentinel node biopsy, axillary node clearance). Descriptive differences and regression coefficients are reported where p-values <0.05.
Results
Questionnaires were completed by 518 pts of mean age 59 years, current tumour grade: 1 46%, 2 40%, 3 9%, unknown 5%; 74% node negative; 78% currently receiving adjuvant therapy; 22% under surveillance post-adjuvant therapy. Regional variation occurred in receipt of NADJ (USA 25%, Germany 18%, UK 9%), mastectomy (USA 31%, Germany 49%, UK 27%) and breast-conserving surgery (USA 82%, Germany 59%, UK 84%). On average, pts who only received mastectomy reported lower HRQoL than pts who only received breast-conserving surgery, with all differences statistically significant at <0.05 level and most exceeding MID (Table). Adjusted regression analysis showed that receiving mastectomy was associated with 5.9 and 3.8 point decreases in FACT-B TOI and FWB scores, respectively. Table: 185P
| HRQoL measure | Mastectomy only (n=150) | Breast-conserving surgery only (n=306) | Difference |
| EQ-5D-3L UI | 0.733 | 0.808 | 0.075 |
| EQ-VAS | 68.1 | 76.0 | 7.9† |
| FACT-B | 91.3 | 105.8 | 14.5† |
| FACT-G | 66.0 | 77.8 | 11.8† |
| FACT-B TOI | 58.0 | 68.5 | 10.5† |
| FACT-B BC | 25.4 | 28.2 | 2.8† |
| FACT-B PWB | 20.1 | 22.6 | 2.5† |
| FACT-B SWB | 19.2 | 21.0 | 1.8 |
| FACT-B EWB | 14.1 | 16.4 | 2.3† |
| FACT-B FWB | 12.5 | 17.8 | 5.3† |
BC, breast cancer subscale; EQ-5D-3L, EuroQol 5 dimension 3 level; FACT-B, functional assessment of cancer – breast; EWB, emotional wellbeing, FWB, functional wellbeing; G, general; PWB, physical wellbeing; SWB, social wellbeing; TOI, trial outcome index; VAS, visual analogue scale† - difference exceeds the MID threshold to be considered clinically meaningful
Conclusions
Receipt of mastectomy was associated with pts having clinically meaningful lower HRQoL than receipt of breast-conserving surgery. There may be an opportunity to improve the HRQoL of pts with early BC if the frequency of mastectomy is reduced through broader use of NADJ.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Adelphi Group.
Funding
Adelphi Group.
Disclosure
A. Rider, R. Williams, L. Gillespie-Akar: Financial Interests, Personal, Full or part-time Employment, Full-time employee: Adelphi Real World. B. Bennett, A. Gogate: Financial Interests, Personal, Full or part-time Employment, Full-time employee: Bristol Myers Squibb.