Breast Cancer Survivorship – Optimizing Follow-up Care: Patients’ Perspectives of their Practical Needs

Purpose: Purpose of this study was to explore experiences and concerns of breast cancer survivors in order to identify the impact of curative treatment 3-48 months post-treatment and to determine preferred content and format of survivorship care plan. Background: Although, Institute of Medicine’s report on cancer survivorship recommends that cancer patients completing treatment should be provided with a comprehensive care summary/followup plan that is clearly and effectively explained, it is not always practiced in most oncology settings. Design: This descriptive study utilised a qualitative approach to provide meaning to breast cancer survivors’ post-treatment experiences of cancer. Methods: Focus group and face-to-face semi-structured interviews were audio-recorded and transcribed verbatim. Participants were 18-75 years old of age; 3-48 months post-treatment; and had nonmetastatic breast cancer. Thematic/ content analysis were both utilized to provide a rich meaning. Results: Impacts of breast cancer were broad and varied by age group for the sixteen participants. Physical, emotional and social effects were more intense in younger patients with women in middle age groups experiencing more concerns centering on social support issues with fatigue and fear of recurrence being the most universal. Most women raised financial concerns relating to medical insurance coverage. Preferred format for care-plan was similar for all. Women preferred oncology nurses provide survivorship care plans either at the beginning/end of treatment; preferred written materials in lay language, and requested telephone follow-up resource person and electronic bulletins for communicating updates related to cancer treatment. Conclusions: Breast cancer survivors are diversely impacted by breast cancer treatment. Effects vary by life stage, which impacts preferred content of survivorship care plans, but not delivery format. Qualitative information on impact of breast cancer at different life stages can be used to help customize content of survivorship care plans, ensuring quality of life for survivors and adherence to recommended surveillance.