Abstract B020: Does surgical procedure influence psychosocial outcomes after treatment in women with ductal carcinoma in situ?
Bibliographic record
Abstract
Abstract Objective: Rates of bilateral mastectomy are increasing in women with ductal carcinoma in situ (DCIS). We aim to characterize the trajectory of psychosocial outcomes after surgery in women with DCIS. Methods: We have been prospectively collecting psychosocial data on women receiving surgery for stage 0-III breast cancer at University Health Network in Toronto, Ontario, Canada since 2009. We queried our prospective database to identify all women receiving surgery for DCIS between May 2009 and January 2020. Women completed validated psychosocial questionnaires (e.g. BREAST-Q, Impact of Event Scale, Hospital Anxiety & Depression Scale) pre-operatively, and at 6 and 12 months following surgery. We analyzed the change in psychosocial scores between three surgical procedures (breast-conserving therapy, unilateral mastectomy and bilateral mastectomy) using linear mixed models, controlling for age and sociodemographic factors (e.g. ethnicity, education level, income and marital status). P values < .05 were significant. Results: 89 women with DCIS were identified, with a mean age of 52.4 ± 10.3 years. By surgical procedure, 7 women underwent breast-conserving therapy (8%), 46 underwent unilateral mastectomy (52%) and 36 underwent bilateral mastectomy (40%). Breast satisfaction (-8, P = .03) and sexual well-being (-10, P = .02) scores decreased over time but was not influenced by surgical procedure. Younger women had worse psychosocial well-being scores (-0.5/year, P = .02), with no impact of surgical procedure. There was a significant interaction between surgical procedure and time for chest physical well-being scores (P = .04); women having breast-conserving therapy had better chest physical well-being scores compared with both unilateral and bilateral mastectomy (with no difference between mastectomy groups). Unemployed women had worse chest physical well-being scores (-9, P = .04). There was a significant interaction between procedure and time for distress scores (P = .02); women having unilateral or bilateral mastectomy had higher distress scores before surgery but at 12 months, there was no difference between surgical procedures. Women with a higher annual income (≥80,000$) had higher breast satisfaction (+10, P = .03), psychosocial well-being (+14, P = .004), and sexual well-being (+12, P = .02), and lower distress (-12, P = .004 ) scores than women earning less than 80,000$ per year. There was a significant interaction (P = .01) between procedure and time for anxiety scores; while all surgical groups had mild anxiety scores at baseline, the anxiety scores for both unilateral and bilateral mastectomy groups improved to normal range over time while scores for women having breast-conserving therapy remained mild. Conclusions: Surgical procedure influences chest physical well-being, distress and anxiety scores in women with DCIS. Our data may help inform surgical decision-making for women with DCIS, and highlight a need for identifying women with high distress at diagnosis who may benefit from targeted psychosocial support. Citation Format: David W. Lim, Helene Retrouvey, Isabel Kerrebijn, Benita Hosseini, Anne C. O'Neill, Tulin D. Cil, Toni Zhong, Stefan O.P. Hofer, David R. McCready, Kelly A. Metcalfe. Does surgical procedure influence psychosocial outcomes after treatment in women with ductal carcinoma in situ? [abstract]. In: Proceedings of the AACR Special Conference on Rethinking DCIS: An Opportunity for Prevention?; 2022 Sep 8-11; Philadelphia, PA. Philadelphia (PA): AACR; Can Prev Res 2022;15(12 Suppl_1): Abstract nr B020.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".