Patient-reported outcome based symptom management is a better option for early postoperative recovery after breast...

We aimed to assess the efficacy and feasibility of applying patient-reported outcome (PRO) based symptom management in the early postoperative period after breast cancer surgery.

Before surgery, patients diagnosed with breast cancer who met the inclusion criteria were randomly assigned in a 1:1 ratio to receive either postoperative PRO-based symptom management or usual care. All patients completed the MD Anderson Symptom Inventory-Chinese version (MDASI-C) via the electronic PRO system preoperatively, on a daily basis postoperatively, and twice weekly after discharge, for a duration up to 2 weeks. In the PRO-based care group, in addition to receiving usual care, patients whose symptoms reported by completing MDASI-C with a score of ≥4 will be managed symptomatically by the attending surgeon. Patients in the usual care group received routine care and their MDASI-C scores were unknown to their attending surgeon. The primary outcome was the MDASI-C score of patients at the time of discharge. Analyses were conducted in accordance with the established protocol.

Of the 134 participants, 67 were randomly assigned to each group. At discharge, the total score of MDASI-C scale was significantly higher in the usual care group comapred to the PRO-based care group (median [interquartile range], 22 [19] vs. 35 [36]; P = 0.002). The score of FACT-B scale (adjusted mean difference, 0.39; 95% confidence interval, 0.11-1.06; P = 0.009) was significantly lower in the usual care group than in the PRO-based care group during the 14 days after surgery. In the PRO-based care group, 87.2% of patients found the PRO-based symptom management approach helpful in their early postoperative recovery.

The implementation of a PRO-based symptom management system within 2 weeks after breast cancer surgery effectively alleviates symptom burden and improves quality of life compared to usual care.