Underrecognition of Symptoms Caused by Breast Radiation Therapy

Clinicians will readily acknowledge that limited time with patients in a busy clinic often does not allow for a complete survey of all symptoms that may be affecting a given patient. This is true in all subspecialties caring for patients with breast cancer. The current analysis comparing patient-reported outcomes (PROs) with radiation oncologists' assessments of common symptoms of breast radiotherapy (pain, pruritis, edema, and fatigue) brings this issue to the fore.

Nearly 10,000 patients from across radiation oncology 29 practices were included, of whom 17% were Black and 80% were white. More than 50% of patients experienced acute toxicity related to radiation therapy that went underrecognized by physicians. Factors independently associated with underreporting included younger patient age (< 50 years vs. 60–69 years: odds ratio, 1.35; 50–59 years vs. 60–69 years: OR, 1.19), patient race (Black vs. white: OR, 1.56; “Other” race and ethnicity vs. white: OR, 1.52), conventional radiation fractionation (OR, 1.26), male physician (OR, 1.54), and receipt of 2-field radiotherapy without supraclavicular field (OR, 0.80).