Financial Toxicity Following Surgical Treatment for Breast Cancer: A Cross-sectional Pilot Study

Area of Science:

• Oncology
• Health Economics
• Patient Advocacy

Background:

• Financial toxicity, or treatment cost-associated distress, is a growing concern for breast cancer patients.
• Limited understanding exists regarding patient and treatment characteristics influencing financial toxicity in this population.

Purpose of the Study:

• To identify patient- and treatment-level risk factors for financial toxicity in breast cancer patients undergoing surgery.
• To explore coping strategies employed by patients facing high treatment costs.

Main Methods:

• Cross-sectional survey of 571 adult female breast cancer patients who underwent surgery (lumpectomy or mastectomy) between January 2018 and June 2019.
• Utilized the 11-item Comprehensive Score for Financial Toxicity (COST) instrument to measure financial toxicity.
• Employed multivariate regression to identify factors associated with financial toxicity, linking survey data with medical records.

Main Results:

• Lower financial distress correlated with supplemental insurance, higher annual household income, and higher credit scores (≥740).
• Increased financial distress was associated with work reduction/cessation, higher out-of-pocket expenses, advanced tumor stage, and employment at diagnosis.
• Patients with greater financial distress reported reducing spending on essential and discretionary items like food, clothing, and leisure.

Conclusions:

• Financial toxicity in insured breast cancer patients is associated with demographic, disease, and treatment characteristics.
• Identified characteristics present opportunities for targeted financial navigation interventions throughout the cancer treatment continuum.