Burden of symptoms associated with development of metastatic bone disease in patients with breast cancer
Open accessAbstract
PURPOSE: Women with breast cancer frequently develop painful bone metastases. This retrospective study was designed to longitudinally characterize patterns of patient-reported symptoms among patients with breast cancer relative to the diagnosis of bone metastases. METHODS: Patient records were identified from the Oncology Services Comprehensive Electronic Records (OSCER) database which includes outpatient oncology practices across the USA. Symptom burden was assessed by Patient Care Monitor (PCM) assessments, which are administered as part of routine care in a subset of these practices. Eligible patients were women diagnosed with breast cancer (ICD-9-CM 174.xx) who developed bone metastases (ICD-9-CM 198.5) and had ≥1 PCM assessment between January 2007 and December 2012. The pre-specified endpoint was the occurrence of moderate to severe symptom burden, defined as PCM score ≥4 (0-10 scale). RESULTS: One thousand one hundred five women (median age, 61) met the eligibility criteria. Worsening of symptoms, particularly fatigue and pain, occurred in the months leading up to the diagnosis of bone metastases. After bone metastases diagnosis, the rate of increase in the proportion of patients experiencing moderate/severe symptoms slowed, but continued to climb during follow-up. Median time to moderate/severe symptoms was 0.9 month for fatigue, 1 month for pain, 2.9 months for trouble sleeping, and 7.7 months for numbness/tingling. Half of the patients received bone-targeted agents after diagnosis of bone metastases. CONCLUSIONS: Symptom burden, especially pain and fatigue, increased both before and after the diagnosis of bone metastases, highlighting the need for proactive monitoring and management of symptoms in breast cancer patients.
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Many advanced cancer patients have symptoms that interfere with functioning.
“Many advanced cancer patients have symptoms that interfere with functioning.1–3”
From Symptom experiences in advanced cancer: Relationships to acceptance and commitment therapy constructs (2021) · cites this paper as [2]
The Discussion reports that pain and fatigue affected a majority of patients after the onset of bone metastases and notes the potential for bone destruction to cause loss of mobility. This supports substantial symptoms with a functional consequence in advanced breast cancer, but the paper does not establish the claim for advanced cancer patients generally or measure how often symptoms interfered with functioning. (LLM, conf=0.82)
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Self-citation
- Authors
- Cleeland, C., von Moos, R., Walker, M. S., Wang, Y., Gao, J., Chavez-MacGregor, M., Liede, A., Arellano, J., Balakumaran, A., & Qian, Y.
- Affiliations
- The University of Texas MD Anderson Cancer Center (US)
- Vector Oncology (United States) (US)
- IQVIA (United States) (US)
- Amgen (United States) (US)
- Corresponding author
- Cleeland, Charles
- Venue
- Supportive Care in Cancer
- Published
- 2016-03-29
- Volume
- 24
- Issue
- 8
- Pages
- 3557-3565
- ISSN
- 0941-4355 (ISSN-L)
- 1433-7339
- PMC
- PMC4917575
- OpenAlex
- W2335598274
- Cited by
- 41
- References
- 34
- Citations by year
- 2025: 5 · 2024: 3 · 2023: 3 · 2022: 6 · 2021: 8 · 2020: 4 · 2019: 9 · 2018: 1 · 2017: 2
- FWCI
- 2.16
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Supportive Care in Cancer (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Funders
- Amgen Inc
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Oncology › Bone health and treatments
- Health Sciences › Medicine › Surgery › Management of metastatic bone disease
- Keywords
- breast cancer, bone metastasis, symptom burden, fatigue, pain, sleep disorders, numbness and tingling, patient-reported symptoms, symptom onset timing, bone-targeted therapy, symptom monitoring
- MeSH terms
- Patient Reported Outcome Measures, Aged, Bone Neoplasms, Breast Neoplasms, Female, Humans, Middle Aged, Retrospective Studies
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