Résumé
To assess the feasibility of a remission consultation with on-going personalized care for patients treated for localized breast cancer entering a monitoring phase, while collecting quality of life data for one year. The primary objective was to evaluate the rate of acceptance of the remission consultation and, in the group who accepted, evaluate the change in quality of life using the EORTC QLQ-C30 over time. The secondary objectives were to evaluate change over time of the patient's perception of body image via the BIS score, change over time in psychological distress score on a visual analog scale, time until return to work, and to describe the characteristics of patients according to the management methods chosen.
Patients in remission from non-metastatic breast cancer were invited to a one-hour consultation interview to assess psychological condition and identify personalized supportive care needs. Various psychological follow-up options were offered depending on patient needs (e.g., anxiety or depression; fear of recurrence; or difficulty reconnecting with family, friends or at work). Patients were followed up at 3, 6 and 12 months after the remission consultation.
Of the 69 patients included, 50 (72% [95%CI 60-83]) accepted the remission consultation with a psychotherapist, with 27 opting for further follow-up. There was a significant improvement in patients' overall quality of life (p = 0.01), physical functioning (p = 0.002) and body image perception (p = 0.007) over the study. Symptoms (pain, fatigue and dyspnea) significantly decreased over time. The psychological distress score halved, but was not statistically significantly different. The proportion of women returning to work increased over time.
This study evaluated acceptance rate of remission consultations and the change in patients' quality of life, well-being and reintegration over one year following the consultation. These results suggest that a remission consultation is feasible and would be well-received by a considerable number of patients. Offering a consultation at this stage represents a first step towards a better psychological management following cancer. These preliminary results require confirmation in a multicenter study with a randomized design.
NCT02740491, registered 14 April 2016.