Psychosocial aspects and life project disruption in young women diagnosed with metastatic hormone-sensitive HER2-negative breast cancer

Abstract

Metastatic breast cancer (MBC) diagnosis in young women negatively impacts on quality of life (QoL) and daily activities, disrupting their life project and forcing them to face new psychosocial challenges. The recently published results on the improvement of the overall survival of pre- or perimenopausal women with hormone-receptor-positive, HER2-negative MBC treated with CDK4/6 inhibitors plus endocrine therapy, while preserving, and in some items improving their QoL, will change the landscape of the management of this patient population. Their extended survival and potential improvement in QoL will, therefore, modify their specific needs in terms of psychosocial support. The complexity of the care of young women with MBC is described herein, based on an extensive literature review. Further research about the specific psychosocial requirements of these women and a new multidisciplinary holistic approach is paramount to properly address their concerns and preferences. The communication with and support of their partners, parents and children is an important factor affecting the QoL of these patients. Altogether, a multidisciplinary care, open communication and personalized support is required to address the psychosocial implications of the new prognostic expectations on these patients with the incorporation of new targeted therapies.

Breast cancer patient experiences through a journey map: A qualitative study

“…Emotionally, they report suffering bouts of depression and anxiety, as well as fear because of the spread of their cancer. As for their relational QoL, their children’s welfare is their number one concern, especially for mothers of young children [ 17 , 57 ]. What’s more, these women felt isolated from society in general and, more specifically, from the non-advanced breast cancer community, inasmuch as they feel that nobody understands what they are going through [ 18 ].…”

Use of sickness benefits by patients with metastatic breast cancer—A Swedish cohort study

“…Advances in the treatment of mBC have led to improved progression-free survival and life expectancy [7][8][9], with median overall survival for women in western countries ranging from two to three years [2]. About half of women with mBC are of working age [7,10], and novel treatments for mBC may enhance the possibility of these women returning to work and being productive [11,12].…”

“…Patients in Sweden with illnesses like mBC are expected to work to the extent that they are able [17,18]. As patients with mBC become more likely to enjoy good health for a period of time [11,12], the ability to return to work may contribute to their sense of well-being [19].…”

Development and validation of a rapid psychosocial well-being screening tool in patients with metastatic breast cancer

“…BT was the main moderator of all sessions. Semi-structured questions, developed based on relevant literature on the psychosocial well-being of MCB patients from both patients’ and caretakers’ perspectives [ 23 , 31 , 32 ], were used as guidelines to conduct sessions.…”

“…The understanding of attitudes and behavior toward the end of life may help MBC patients to endure negative aspects of poor health and the side effects of treatment [ 21 ]. While the existing comprehensive quality of life measures for cancer and breast cancer patients have been reportedly used in MBC patients [ 22 ], these instruments are not specifically developed for MBC patients [ 23 ], given that the goal of treatment of MBC is distinct from the treatment goals of cancer or breast cancer, in general. Particularly, the emphasis of palliative care for MBC patients should rather address psychosocial well-being [ 24 ].…”