Exploring the Experiences of Left-Sided Breast Cancer Patients Receiving Radiation Therapy Using the Active Breathing...

The Active Breathing Coordinator (ABC) to induce breath hold during radiation therapy is used with the intent to reduce the risk of long-term, radiation-induced cardiovascular morbidity. Many studies have explored the dosimetric and toxicity benefits of using the device, but limited research has been done on the patient's perspective. The aim of this study was to explore the patient's experience using the ABC device and to evaluate the teaching provided.

Following Research Ethics Board approval and written informed consent, paper questionnaires were used, and cross-sectional data were collected from 30 English-speaking women receiving radiation therapy for left-sided breast cancer using the ABC device. Questions were both quantitative (a 10-point Likert scale) and qualitative in nature and evaluated patient-reported anxiety levels, confidence levels, and suggestions for process improvement. Descriptive and inferential statistics were used to analyze the results, with thematic analysis of qualitative comments.

Fifty-three percent of patients reported higher than 5 on the Likert scale for anxiety related to using the ABC device. Half the sample indicated that they were equally anxious about using the ABC as they were about receiving radiation therapy, a third reported being more anxious about using ABC than they were about receiving radiation therapy. Participants under 50 years were significantly more likely to feel "highly" anxious about using ABC than those older than 50 years (37% vs. 5%; P = 0.001). Half the participants indicated that their confidence level increased as treatment progressed, and suggested that the inclusion of a training video, practice sessions and constant communication via the treatment unit intercom would be helpful in reducing their anxiety.

This hypothesis generating study suggests that moderate-to-high levels of anxiety were common for left-sided breast cancer patients using the ABC device, particularly for patients younger than 50 years. As treatment progressed, patients seemed to become less anxious and more confident using the device. These preliminary findings support the need for further research in this area, using formal validated anxiety scoring tools.