B43
The psychological impact of the diagnosis and treatment of DCIS; (BASO-DCISII Trial (CRUK05/005)
Judith Mills1, Roger A'Hern1, Judith Bliss1, Nigel Bundred2, Penelope Hopwood1, on behalf of the BASO-DCISII Trial Management Group1
1The Institute of Cancer Research, Sutton, UK, 2University Hospital of South Manchester, UK
Background
The diagnosis of DCIS has increased with mammographic screening but psychological studies focused on DCIS in this area are lacking. It is unclear whether or not the psychological impact of DCIS is equivalent to that of invasive breast cancer. A randomised controlled trial was opened in 2004 to investigate if post-operative RT is necessary for all women.
Method
Patients completed QOL questionnaires including the HADS (Hospital Anxiety and Depression Scale), IES (Impact of Events) and BIS (Body Image Scale) before randomisation to post operative RT or no RT, and then at 6, 12 and 24 months follow up. Changes between baseline scores and each follow-up were tested using the Wilcoxon signed rank test. Scores were also compared with those from other sources.
Results
54 patients were recruited to the QOL study with compliance of >98% at 6 & 12m, 90% at 24m. Early closure of the trial prevented further accrual. There was an improvement in IES morbidity from a baseline rate of 28% (CI 16 -40%) to 24m rate of 12% (CI 0 - 25%) A transient increase in body image concerns occurred at 6m relative to baseline. No significant changes in HADS scores were observed over time. There was no difference in any QOL domains between the RT and the no RT group at any time point in this small sample but comparisons with data from other larger studies are underway.
Conclusion
Findings are tentative with this limited sample but data from other non randomised studies of DCIS suggest similar outcomes using comparable measures. If confirmed, women could be reassured that post-op RT did not impair QOL.
