title: Retrospective study of the effect of disease progression on patient reported outcomes in HER-2 negative metastatic breast cancer patients.
abstract: BACKGROUND
  This retrospective study evaluated the impact of disease progression and of specific sites of metastasis on patient reported outcomes (PROs) that assess symptom burden and health related quality of life (HRQoL) in women with metastatic breast cancer (mBC).
  
  
  METHODS
  HER-2 negative mBC patients (n = 102) were enrolled from 7 U.S. community oncology practices. Demographic, disease and treatment characteristics were abstracted from electronic medical records and linked to archived Patient Care Monitor (PCM) assessments. The PCM is a self-report measure of symptom burden and HRQoL administered as part of routine care in participating practices. Linear mixed models were used to examine change in PCM scores over time.
  
  
  RESULTS
  Mean age was 57 years, with 72% of patients Caucasian, and 25% African American. Median time from mBC diagnosis to first disease progression was 8.8 months. Metastasis to bone (60%), lung (28%) and liver (26%) predominated at initial metastatic diagnosis. Results showed that PCM items assessing fatigue, physical pain and trouble sleeping were sensitive to either general effects of disease progression or to effects associated with specific sites of metastasis. Progression of disease was also associated with modest but significant worsening of General Physical Symptoms, Treatment Side Effects, Acute Distress and Impaired Performance index scores. In addition, there were marked detrimental effects of liver metastasis on Treatment Side Effects, and of brain metastasis on Acute Distress.
  
  
  CONCLUSIONS
  Disease progression has a detrimental impact on cancer-related symptoms. Delaying disease progression may have a positive impact on patients' HRQoL.
authors.affiliation: ACORN Research, LLC, 6555 Quince, Suite 400, Memphis, TN 38119, USA. mwalker@acorncro.com
authors.forename: Mark S
authors.initials: MS
authors.lastname: Walker
authors.forename: Murad
authors.initials: M
authors.lastname: Hasan
authors.forename: Yeun Mi
authors.initials: YM
authors.lastname: Yim
authors.forename: Elaine
authors.initials: E
authors.lastname: Yu
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Stepanski
authors.forename: Lee S
authors.initials: LS
authors.lastname: Schwartzberg
mesh_terms: D001859:Bone Neoplasms / Q000556:secondary; D001943:Breast Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000523:psychology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D016014:Linear Models; D008113:Liver Neoplasms / Q000556:secondary; D008175:Lung Neoplasms / Q000556:secondary; D008499:Medical Records; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011788:Quality of Life; D018719:Erb-b2 Receptor Tyrosine Kinases; D012189:Retrospective Studies; D057566:Self Report; D018434:Sickness Impact Profile; D014481:United States
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; C508053:ERBB2 protein, human