Financial distress following a mastectomy or lumpectomy operation is associated with worse psychological wellbeing in patients with breast cancer, according to a study published in the Journal of American College of Surgeons.

Women who undergo surgery for breast cancer often face financial stress due to the expensive and extended nature of the treatments. Out-of-pocket costs can often lead to financial toxicity, which is the harm or stress patients experience due to the unaffordability of their medical care. 

Investigators looked at the results of 3 self-reported surveys and medical data of 532 women who underwent lumpectomy or mastectomy at the University of Texas MD Anderson Cancer Center in Houston, according to the study. Patients were 18 years of age and older and completed the surveys within 18 months of their operation. More than half of the patients, 64%, underwent breast reconstruction. The median household income reported was between $80,000 and $120,000 a year, which is above the national average.

The study found that a 1 unit increase in a patient’s Comprehensive Score for financial Toxicity (COST) was associated with a 0.89 united increase in psychological wellbeing. According to the study, a lower COST score was associated with lower BREAST-Q and SF-12 scores, indicating worse breast cancer outcomes. 

“In this world of patient-centered outcomes and value-based care, there are two takeaway points from our study. First, for populations at high risk for financial toxicity, deliberations around treatment costs are incredibly important. Second, early intervention in instances of self-reported financial toxicity will be a key element of maximizing patient-reported outcomes in breast cancer surgery. This is because financial toxicity really does dampen the high-quality, patient-centered outcomes we are capable of delivering," said study senior author Anaeze C. Offodile II, MD, MPH, an assistant professor of plastic surgery at The University of Texas MD Anderson Cancer Center, Houston, in a press release.

This study builds on prior research that examined a link between quality of life and financial toxicity. A prospective multi-center study to replicate results in a variety of settings is underway. The study authors hope to gain a more in-depth understanding of how economic wellbeing affects quality of life outcomes in breast cancer surgery and how those outcomes can be produced.  

REFERENCE:
Financial distress negatively impacts well-being, satisfaction of breast cancer patients [News Release] December 11, 2020; Huston, TX. Accessed December 14, 2020. https://www.eurekalert.org/pub_releases/2020-12/acos-fdn121120.php.