TY - JOUR
T1 - Patient-reported outcomes in ductal carcinoma in situ
T2 - A systematic review
AU - King, Madeleine T.
AU - Winters, Zoë E.
AU - Olivotto, Ivo A.
AU - Spillane, Andrew J.
AU - Chua, Boon H.
AU - Saunders, Christobel
AU - Westenberg, A. Helen
AU - Mann, G. Bruce
AU - Burnett, Petrina
AU - Butow, Phyllis
AU - Rutherford, Claudia
PY - 2017/1/1
Y1 - 2017/1/1
N2 - Ductal carcinoma in situ (DCIS) is a pre-invasive breast cancer with excellent prognosis but with potential adverse impacts of diagnosis and treatment on quality of life and other patient-reported outcomes (PROs). We undertook a systematic review to synthesise current evidence about PROs following diagnosis and treatment for DCIS. We searched five electronic databases (from database inception to November 2015), cross-referenced and contacted experts to identify studies that reported PROs after DCIS treatment. Two reviewers independently applied inclusion and quality criteria, and extracted findings. Of 2130 papers screened, 23 were eligible, reporting 17 studies. Short- and long-term PRO evidence about differences between DCIS treatment options was lacking. Evidence pooled across treatments indicated core aspects of quality of life (physical, role, social, emotional function, pain, fatigue) and psychological distress (anxiety, depression) were impacted significantly initially, with most aspects returning to population norms by 6–12 months, and all by 2 years post-operatively. Fears of recurrence and dying from breast cancer were exaggerated, occurred early and persisted for many years. Sexuality and body image impacts were generally low and resolved within 1–3 months after surgery. A minority of women experienced considerable impact, including depression and sexual issues associated with body image problems. Well-powered PRO studies are required to track recovery trajectories and long-term impacts of the range of contemporary and emerging local and systemic treatments for DCIS. PRO data would enable care providers to prepare patients for short-term sequelae and enable patients who have treatment options to exercise preferences in choosing among them.
AB - Ductal carcinoma in situ (DCIS) is a pre-invasive breast cancer with excellent prognosis but with potential adverse impacts of diagnosis and treatment on quality of life and other patient-reported outcomes (PROs). We undertook a systematic review to synthesise current evidence about PROs following diagnosis and treatment for DCIS. We searched five electronic databases (from database inception to November 2015), cross-referenced and contacted experts to identify studies that reported PROs after DCIS treatment. Two reviewers independently applied inclusion and quality criteria, and extracted findings. Of 2130 papers screened, 23 were eligible, reporting 17 studies. Short- and long-term PRO evidence about differences between DCIS treatment options was lacking. Evidence pooled across treatments indicated core aspects of quality of life (physical, role, social, emotional function, pain, fatigue) and psychological distress (anxiety, depression) were impacted significantly initially, with most aspects returning to population norms by 6–12 months, and all by 2 years post-operatively. Fears of recurrence and dying from breast cancer were exaggerated, occurred early and persisted for many years. Sexuality and body image impacts were generally low and resolved within 1–3 months after surgery. A minority of women experienced considerable impact, including depression and sexual issues associated with body image problems. Well-powered PRO studies are required to track recovery trajectories and long-term impacts of the range of contemporary and emerging local and systemic treatments for DCIS. PRO data would enable care providers to prepare patients for short-term sequelae and enable patients who have treatment options to exercise preferences in choosing among them.
KW - Anxiety
KW - Body image
KW - Carcinoma, intraductal, noninfiltrating
KW - Depression
KW - Pain
KW - Patient outcome assessment
KW - Quality of life
KW - Sexuality
KW - Stress, psychological
UR - http://www.scopus.com/inward/record.url?scp=85007170696&partnerID=8YFLogxK
U2 - 10.1016/j.ejca.2016.09.035
DO - 10.1016/j.ejca.2016.09.035
M3 - Review article
C2 - 27987454
AN - SCOPUS:85007170696
SN - 0959-8049
VL - 71
SP - 95
EP - 108
JO - European Journal of Cancer
JF - European Journal of Cancer
ER -