Poster Spotlight Session 4: Gaps in the Timing, Treatment Selection, and Supportive Services for Cancer Care
Wednesday, December 6 • 7:00 a.m. – 8:00 a.m. • Stars at Night Ballroom 3-4
Presentation: Telemedicine use and psychological and mental health symptoms in breast cancer survivors
Jincong (Jason) Freeman, MPH, MS
University of Chicago,
Chicago, Illinois
What is your presentation about?
Breast cancer patients and survivors often experience psychological and mental health symptoms and face many barriers to accessing mental health care and services. Telemedicine can help facilitate access to these care and services virtually, and breast cancer survivors may benefit uniquely from telehealth visits. However, little is known about the relationships between virtual care access and experience of psychological distress, anxiety disorder, or depression among breast cancer survivors in the United States. In this presentation, I will discuss our study findings of 1) estimated prevalences of virtual care access by these three psychological and mental health symptoms and 2) associations between having psychological distress and telemedicine use, between having depression and use of telemedicine use, and between having an anxiety disorder and telemedicine use in breast cancer survivors from the 2021 National Health Interview Survey.
What makes this topic important in 2023?
During the COVID-19 pandemic, cancer programs shifted their provision of certain care and services from in-person to virtual. Since then, we have observed rapid and unprecedented growth in both demand for and utilization of telemedicine in oncology. I think telemedicine could have the potential to address 1) barriers to accessing a variety of care and services, including psychological and mental health, and 2) care disparities and inequities among breast cancer patients and survivors. This topic is particularly important in 2023 as we, cancer centers, institutions, and researchers, further embrace telemedicine and other digital platforms. Exploring and discussing this and relevant topics will help us better understand 1) the need for telehealth care and services in breast cancer patients and survivors with psychological and mental health symptoms and 2) how we can improve virtual care and the quality of life of these patients and survivors.
How did you get involved in this particular area of breast cancer research, care, or advocacy?
Since 2022 I have been leading two studies on telemedicine use disparities among breast cancer patients and realized critical gaps in the literature on telehealth and breast oncology. Then I became interested in telemedicine as it could be a potential tool for addressing cancer care disparities and inequities among breast cancer patients and survivors. Our work has resulted in 1) two ASCO presentations, 2) a recent publication, and 3) a manuscript currently under review. I plan to continue this important work and hope our research will facilitate the transformation of breast oncology practices, particularly care and service delivery, and ultimately achieve equity in telehealth for our breast cancer patients and survivors.
Presentation: Survival benefit of regional nodal irradiation in clinically node-positive breast cancer following neoadjuvant chemotherapy and breast-conserving surgery
Mahtab Vasigh, MD
Department of Surgical Oncology, Fox Chase Cancer Center,
Philadelphia, Pennsylvania
What is your presentation about?
The role of regional nodal irradiation in clinically node-positive breast cancer patients who undergo neoadjuvant chemotherapy and breast-conserving surgery.
What makes this topic important in 2023?
With increasing neoadjuvant chemotherapy (NAC) use in cN+ patients, pathologic complete response (pCR) rates range from 40% to 70% for some breast cancer subtypes. Some clinicians use NAC to downstage the axilla and avoid a complete axillary lymph node dissection (ALND) in cN+ patients. Today the standard treatment in the setting of NAC in cN+ patients who undergo BCS is adjuvant radiotherapy (RT) to the whole breast and RNI to any portion of the undissected axilla at risk. RNI is also strongly recommended in patients who become pathologic node negative after NAC.
The utilization of NAC introduces uncertainties in axillary management, given that most data concerning decision-making had traditionally been based on clinical and pathologic factors after upfront surgery, and the benefit of RNI in the NAC setting remains unclear. This study is designed to determine the survival impact of RNI in cN+ breast cancer patients following NAC and BCS while determining predictive factors such as the number of nodes removed and the number of post-NAC positive nodes.
How did you get involved in this particular area of breast cancer research, care, or advocacy?
As a breast surgeon, I have observed the growing prominence of neoadjuvant chemotherapy (NAC) in breast cancer treatment. However, the current adjuvant radiotherapy still relies on the clinical stage assessed before chemotherapy and surgery. We have encountered patients who achieve a pathologic complete response (PCR) after NAC yet are recommended for adjuvant radiotherapy. Additionally, when residual nodal disease is present, complete axillary dissection and regional nodal irradiation are performed. This combined approach raises concerns due to increased complications. Consequently, we have initiated a critical study of the existing standard of care with the intention of fostering prospective studies that may lead to transformative changes in breast cancer treatment practices.