Financial toxicity linked to quality of life after breast cancer surgery

Financial toxicity (FT) is associated with worse quality of life (QOL) for breast cancer patients after mastectomy or lumpectomy, according to a study published online Dec. 11 in the Journal of the American College of Surgeons.

Christopher J. Coroneos, M.D., from McMaster University in Hamilton, Ontario, Canada, and colleagues conducted a single-institution cross-sectional survey of female breast cancer patients who underwent lumpectomy or mastectomy between January 2018 and June 2019 to examine the correlation between FT and QOL and patient satisfaction. The 11-item Comprehensive Score for financial Toxicity (COST) instrument was used to measure FT. Condition-specific and global QOL were assessed using the BREAST-Q and 12-Item Short Form Health Survey (SF-12).

Data were included from 532 patients, with 64.3 percent undergoing reconstruction. The researchers found that the mean COST score was 28.0, and median household income was $80,000 to $120,000 per year. A positive relationship was seen for all outcomes after multivariable adjustment: Lower COST (greater cost-associated distress) scores correlated with lower scores on BREAST-Q and SF-12. The strongest correlation was seen for BREAST-Q psychosocial well-being, with a 0.89 change per unit change in COST score.

"What clinicians have to do with these study results is to consider the financial reserve patients have when discussing breast cancer management," Coroneos said in a statement. "From a research perspective, integrating the financial risk and patient reported outcomes can inform decision-making models, and is especially important in vulnerable populations."

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