Personalized Follow-up After Breast Cancer Surgery Via Electronic Patient Reported Outcomes

Description

This study aims to build a new multidisciplinary care pathway (BEAUTIFY = BrEast cAncer qUaliTy of lIfe aFter surgerY) with post-operative follow-up via electronic patient-reported outcomes of breast cancer surgery complications in order to optimise the quality of life of patients.

The study will use focus groups of caregivers and patients treated by surgery for breast cancer to identify the specific needs of this population and then develop the BEAUTIFY care pathway.

In oncology, the monitoring of symptoms and treatment toxicities by caregivers is most often done through hetero-assessments. However, caregivers tend to underestimate them in relation to what the patient is experiencing. The discrepancy between the measures of side-effects recorded by the doctor's and patient's measures of side effects has indeed been demonstrated many times. For the patient's own view of his or her symptoms, health symptoms, health status, or quality of life (QoL), the (QoL), Patient Reported Outcomes (PRO) are increasingly used in oncology. They are defined as "any measure of the patient's health status reported directly by the patient, without interpretation by the physician or a third person". Several clinical trials have been conducted in recent years to assess the feasibility and value of collecting PROs in clinical routine in oncology, particularly through the use of electronic objects (ePROS). Improvements have been shown in the overall survival and QoL of patients followed by ePROS compared to conventionally followed patients, in patients on chemotherapy for metastatic cancer and in lung cancer surveillance.

Breast cancer surgery is responsible for specific acute (infection, haematoma, pain) and chronic (breast pain, axillary pain, arm pain, allodynia, paresthesia, retractile capsulitis of the shoulder post-mastectomy syndrome). Acute infections Post-operative infections may occur in 3 to 19% of 2020 RUBAN ROSE patients, especially after mastectomy. Chronic pain is reported in up to 70% of patients depending on the series. Post-mastectomy syndrome affects 20 to 50% of patients. These complications may be increased by radiotherapy. Many studies have shown that all of these chronic complications have a negative impact on the quality of life of patients and are responsible for depression and/or anxiety, sleep disorders and difficulties in returning to work.

Nevertheless, there are specific treatments (PEC) that can reduce these symptoms: physiotherapy, analgesic medication, analgesic patches, botulinum toxin injections, psychotherapy, etc. Several studies have shown that the earlier this treatment is undertaken, the lower the risk of complications.

It is therefore necessary to detect these complications as early as possible in order to manage them as quickly as possible. A close follow-up of specific symptoms of breast cancer surgery complications by ePRO could lead to earlier detection and management of these complications and thus improve patients' pain and quality of life (QoL).

We propose to develop an original care pathway focused on the collection of post-surgery complications in breast cancer via ePROs. The BEAUTIFY programme will be built by a committee of experts on the basis of reflections carried out within 2 focus groups: a group of 10 patients treated at Nmes University Hospital for breast cancer; a group of caregivers from the University Hospitals of Nmes, Montpellier and the ICM.

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