Patient-reported Outcomes After Routine Treatment of In Situ/Atypical Lesions: The PORTAL Study.

Area of Science:

• Oncology
• Breast Cancer Research
• Patient-Reported Outcomes

Background:

• Guideline-concordant care (GCC) for ductal carcinoma in situ (DCIS) involves surgery, radiation, and/or endocrine treatment.
• Active monitoring (AM) is used for high-risk breast lesions and proposed for low-risk DCIS.
• This study compares patient-reported outcomes for DCIS treated with GCC versus an active monitoring-proxy (AM-P) group.

Purpose of the Study:

• To compare patient-reported outcomes between women with DCIS receiving GCC and those in an AM-P group.
• To assess differences in surgical-area pain, generalized pain, anxiety, depression, and quality of life (QOL).

Main Methods:

• Survey of 912 women diagnosed with DCIS (GCC) or high-risk lesions (AM-P) between 2012-2017.
• Assessment of surgical-area pain, severity, burden, generalized pain, anxiety, depression, and QOL.
• Multivariable logistic and negative binomial regression models were used for analysis.

Main Results:

• The AM-P group had significantly lower odds of experiencing pain (odds ratio 0.35) and clinically significant pain (odds ratio 0.43).
• Lower adjusted mean pain severity, sensory disturbance, and pain-related emotional impact were observed in the AM-P group.
• Generalized pain, QOL, anxiety, and depressive symptoms did not differ significantly between the groups.

Conclusions:

• Women with DCIS undergoing GCC experienced more breast/chest wall pain compared to the AM-P group.
• Quality of life was comparable between the groups, indicating similar overall well-being.
• Findings support considering surgical de-escalation for high-risk lesions, including low-risk DCIS.