Year: 2026
Type: dissertation
Study design: Observational Study
Abstract: Background: Ten-year breast cancer survival currently exceeds 85%. However, therapies are intensive and may result in long-term treatment-related sequalae including lymphedema, peripheral neuropathy (PN) and cardiac problems. These conditions contribute to unmet needs into survivorship. Compounding unmet needs can result in increased morbidity and decreased wellbeing. Methods: The Carolina Breast Cancer Study 3 is a population-based study of female breast cancer survivors diagnosed between 2008 to 2013 in North Carolina. Black and younger (<50 years at diagnosis) women were oversampled. Using data across 10-years of follow-up, we examined the prevalence differences (PD) and 95% confidence intervals (CI) of treatment-related sequelae and ≥5 unmet needs in relation to demographics, breast cancer characteristics, and treatments. We assessed the presence of racial and age disparities in relation to these outcomes. Results: Aim 1 included 1,688 survivors. The prevalences of persistent lymphedema, PN, and co-occurrence were 18.7%, 27.7%, and 8.8%, respectively. Lymphedema was higher among those receiving mastectomy and >5 lymph nodes removed and PN was higher among women treated with taxane-based chemotherapy. Co-occurrence was higher among women with >5 lymph nodes removed (vs. <5, PD: 5.1; CI 1.0, 9.2) and received taxane-based chemotherapy (vs. no chemotherapy, PD: 7.9; CI 3.8, 12.1). Racial and age disparities were observed in the burden of PN and co-occurrence with respect to patient characteristics and treatments received. Aim two included 1,445 women. Overall, 27.1% of participants reported having ≥5 unmet needs. We observed a higher burden of ≥5 unmet needs among Black women (vs. White PD: 14.2; CI 9.6, 18.7) and among women <50 years of age (vs. ≥50 PD: 9.5; CI 5.0, 13.9). Notably, women reporting more barriers to care had the highest prevalence of ≥5 unmet needs with a 28.6 percentage points higher prevalence (vs. “fewer barriers to care” PD: 28.6; CI 18.7, 38.5).Conclusions: We identified a high burden of persistent treatment-related sequelae and unmet needs among breast cancer survivors more than 10-year post diagnosis. Black and younger women experience a higher burden of these outcomes. Targeted interventions are needed to improve wellbeing and quality of life for long-term survivors.
DOI: 10.17615/70se-vr50
Author: Yarosh, Rina Alyse
Institution: University of North Carolina at Chapel Hill
Language: English
Topic: Cancer survivorship and care
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7162017117
Cites:
Cited by:
Related to: