Abstract P2-12-01: Is Cancer-Specific Distress Correlated with Time to Definitive Surgery in Breast Cancer Patients?
Publication
, Journal Article
Daup, MB; Lush, EL; Dedert, E; McMasters, KM; Sephton, SE; Chagpar, AB
Published in: Cancer Research
INTRODUCTION: A number of studies have investigated factors influencing delay in seeking medical care for self-detected breast symptoms. Few, however, have sought to understand factors that are correlated with the time interval between diagnostic imaging and definitive surgery. We sought to determine factors that may influence this time interval. METHODS: From May 2005 to January 2009, a prospective study of 59 breast cancer patients was performed in which patients’ cancer-related distress was evaluated using the Impact of Events Scale (IES). After patients undergoing neoadjuvant chemotherapy and those who did not have imaging or surgery were excluded, the remaining 43 patients formed the cohort of interest for this analysis. The effect of clinicopathologic and psychological factors on the time between diagnostic imaging and definitive surgery was evaluated using non-parametric statistics (SPSS, Version 18.0).RESULTS: The median time between diagnostic imaging and definitive surgery in this cohort was 43 days (range; 4-200). In 25 patients (58.1%), this interval was less than 45 days. Patient age, largest tumor size on imaging, and previous history of breast or other cancers did not appear to be related to time to surgery. Similarly, race, marital status, education, income and insurance status were not significant predictors of time to surgery. Patients who had a longer time interval between imaging and surgery scored higher on the avoidance and total distress subscales of the IES (median 19.5 vs. 12.0, p=0.016 and 37.0 vs. 29.0, p=0.028, respectively). In particular, patients with a longer time between imaging and surgery were more likely to report that they “tried not to think about it” (p= 0.040), “tried not to talk about it” (p=0.039) and “stayed away from reminders of it” (p=0.001).CONCLUSION: Psychological distress associated with a diagnosis of cancer is significantly correlated with the time to definitive surgery in breast cancer patients. Avoidance behaviors tend to be associated with a delay in surgery. Early psychosocial support aimed at reducing such distress may shorten time to definitive treatment in such patients; alternatively, shorter times to surgery may reduce cancer-specific distress.Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P2-12-01.
