Retrospective analysis of the prevalence of specialised palliative care services for patients with metastatic breast cancer

BackgroundPatients with metastatic breast cancer (MBC) have a considerable symptom burden and may require extensive care for a long period of time. Palliative care (PC) has the potential to improve their quality of care and reduce their use of medical services. However, the role of specialised PC (S...

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Published inESMO open Vol. 5; no. 5; p. e000905
Main Authors Jäger, Eva Maria, Filipits, Martin, Glechner, Anna, Zwickl-Traxler, Elisabeth, Schmoranzer, Gabriele, Pecherstorfer, Martin, Kreye, Gudrun
Format Journal Article
LanguageEnglish
Published England Elsevier Ltd 18.09.2020
BMJ Publishing Group
Elsevier
Subjects
metastatic breast cancer
Original Research
palliative care
specialized palliative care
specialized palliative care
palliative care
metastatic breast cancer
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Abstract BackgroundPatients with metastatic breast cancer (MBC) have a considerable symptom burden and may require extensive care for a long period of time. Palliative care (PC) has the potential to improve their quality of care and reduce their use of medical services. However, the role of specialised PC (SPC) in patients with MBC remains unclear.Patients and methodsWe performed a retrospective analysis of the medical records of patients diagnosed with breast cancer (BC) from 2008 to 2018 at an university-based referral centre to examine the extent of early and late integration of SPC services for patients with MBC. A descriptive analysis of the patients was also established.ResultsIn all, 932 patients were diagnosed with BC from 2008 to 2018; 225 of these patients had or developed metastases related to their BC. In addition, 132 patients received SPC (58.7%) and 93 patients did not receive SPC (41.3%). The median probability of overall survival (OS) for patients who did not receive SPC services was 3.6 years (95% CI 2.0 to 5.1) and 1.8 years (95% CI 1.3 to 2.3) (p<0.0001) for patients who did receive SPC. In multivariate analysis, referral to SPC services was independently associated with OS (HR 1.60, 95% CI 1.16 to 2.22, p=0.004).ConclusionPatients who received SPC lived significantly shorter amounts of time than patients not referred for SPC services at our hospital. We concluded that the referral to SPC services was often too late and should be implemented earlier in the course of the disease. We suggest that patients with MBC should participate in a consultation by a SPC team ≤60 days after the start of systemic palliative anticancer therapy in addition to endocrine treatment. Larger prospective studies are needed to evaluate the benefit of the early integration of SPC services for patients with MBC.
AbstractList BACKGROUNDPatients with metastatic breast cancer (MBC) have a considerable symptom burden and may require extensive care for a long period of time. Palliative care (PC) has the potential to improve their quality of care and reduce their use of medical services. However, the role of specialised PC (SPC) in patients with MBC remains unclear. PATIENTS AND METHODSWe performed a retrospective analysis of the medical records of patients diagnosed with breast cancer (BC) from 2008 to 2018 at an university-based referral centre to examine the extent of early and late integration of SPC services for patients with MBC. A descriptive analysis of the patients was also established. RESULTSIn all, 932 patients were diagnosed with BC from 2008 to 2018; 225 of these patients had or developed metastases related to their BC. In addition, 132 patients received SPC (58.7%) and 93 patients did not receive SPC (41.3%). The median probability of overall survival (OS) for patients who did not receive SPC services was 3.6 years (95% CI 2.0 to 5.1) and 1.8 years (95% CI 1.3 to 2.3) (p<0.0001) for patients who did receive SPC. In multivariate analysis, referral to SPC services was independently associated with OS (HR 1.60, 95% CI 1.16 to 2.22, p=0.004). CONCLUSIONPatients who received SPC lived significantly shorter amounts of time than patients not referred for SPC services at our hospital. We concluded that the referral to SPC services was often too late and should be implemented earlier in the course of the disease. We suggest that patients with MBC should participate in a consultation by a SPC team ≤60 days after the start of systemic palliative anticancer therapy in addition to endocrine treatment. Larger prospective studies are needed to evaluate the benefit of the early integration of SPC services for patients with MBC.
Background Patients with metastatic breast cancer (MBC) have a considerable symptom burden and may require extensive care for a long period of time. Palliative care (PC) has the potential to improve their quality of care and reduce their use of medical services. However, the role of specialised PC (SPC) in patients with MBC remains unclear.Patients and methods We performed a retrospective analysis of the medical records of patients diagnosed with breast cancer (BC) from 2008 to 2018 at an university-based referral centre to examine the extent of early and late integration of SPC services for patients with MBC. A descriptive analysis of the patients was also established.Results In all, 932 patients were diagnosed with BC from 2008 to 2018; 225 of these patients had or developed metastases related to their BC. In addition, 132 patients received SPC (58.7%) and 93 patients did not receive SPC (41.3%). The median probability of overall survival (OS) for patients who did not receive SPC services was 3.6 years (95% CI 2.0 to 5.1) and 1.8 years (95% CI 1.3 to 2.3) (p<0.0001) for patients who did receive SPC. In multivariate analysis, referral to SPC services was independently associated with OS (HR 1.60, 95% CI 1.16 to 2.22, p=0.004).Conclusion Patients who received SPC lived significantly shorter amounts of time than patients not referred for SPC services at our hospital. We concluded that the referral to SPC services was often too late and should be implemented earlier in the course of the disease. We suggest that patients with MBC should participate in a consultation by a SPC team ≤60 days after the start of systemic palliative anticancer therapy in addition to endocrine treatment. Larger prospective studies are needed to evaluate the benefit of the early integration of SPC services for patients with MBC.
Patients with metastatic breast cancer (MBC) have a considerable symptom burden and may require extensive care for a long period of time. Palliative care (PC) has the potential to improve their quality of care and reduce their use of medical services. However, the role of specialised PC (SPC) in patients with MBC remains unclear. We performed a retrospective analysis of the medical records of patients diagnosed with breast cancer (BC) from 2008 to 2018 at an university-based referral centre to examine the extent of early and late integration of SPC services for patients with MBC. A descriptive analysis of the patients was also established. In all, 932 patients were diagnosed with BC from 2008 to 2018; 225 of these patients had or developed metastases related to their BC. In addition, 132 patients received SPC (58.7%) and 93 patients did not receive SPC (41.3%). The median probability of overall survival (OS) for patients who did not receive SPC services was 3.6 years (95% CI 2.0 to 5.1) and 1.8 years (95% CI 1.3 to 2.3) (p<0.0001) for patients who did receive SPC. In multivariate analysis, referral to SPC services was independently associated with OS (HR 1.60, 95% CI 1.16 to 2.22, p=0.004). Patients who received SPC lived significantly shorter amounts of time than patients not referred for SPC services at our hospital. We concluded that the referral to SPC services was often too late and should be implemented earlier in the course of the disease. We suggest that patients with MBC should participate in a consultation by a SPC team ≤60 days after the start of systemic palliative anticancer therapy in addition to endocrine treatment. Larger prospective studies are needed to evaluate the benefit of the early integration of SPC services for patients with MBC.
ArticleNumber e000905
Author Filipits, Martin
Jäger, Eva Maria
Kreye, Gudrun
Pecherstorfer, Martin
Schmoranzer, Gabriele
Glechner, Anna
Zwickl-Traxler, Elisabeth
AuthorAffiliation 1 Karl Landsteiner Privatuniversitat fur Gesundheitswissenschaften , Krems , Austria
2 Department of Medicine I , Medical University of Vienna , Wien , Austria
3 Department for Evidence-based Medicine and Evaluation , Danube University Krems , Krems , Austria
4 Department of Internal Medicine 2 , UH Krems , Krems , Austria
AuthorAffiliation_xml – name: 2 Department of Medicine I , Medical University of Vienna , Wien , Austria
– name: 3 Department for Evidence-based Medicine and Evaluation , Danube University Krems , Krems , Austria
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/32948629$$D View this record in MEDLINE/PubMed
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Issue 5
Keywords specialized palliative care
palliative care
metastatic breast cancer
Language English
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– ident: 10.1136/esmoopen-2020-000905_bb0070
  contributor:
    fullname: Quill
– ident: 10.1136/esmoopen-2020-000905_bb0055
  contributor:
    fullname: Gaertner
– year: 2006
  ident: 10.1136/esmoopen-2020-000905_bb0040
  publication-title: Textbook of palliative medicine
  contributor:
    fullname: Bruera
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Snippet BackgroundPatients with metastatic breast cancer (MBC) have a considerable symptom burden and may require extensive care for a long period of time. Palliative...
Patients with metastatic breast cancer (MBC) have a considerable symptom burden and may require extensive care for a long period of time. Palliative care (PC)...
BACKGROUNDPatients with metastatic breast cancer (MBC) have a considerable symptom burden and may require extensive care for a long period of time. Palliative...
Background Patients with metastatic breast cancer (MBC) have a considerable symptom burden and may require extensive care for a long period of time. Palliative...
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StartPage e000905
SubjectTerms metastatic breast cancer
Original Research
palliative care
specialized palliative care
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Title Retrospective analysis of the prevalence of specialised palliative care services for patients with metastatic breast cancer
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