Authors (including presenting author) :
Wong SL(1), Wong KY(2), Lee MY(1), Lee WM(1), Wong KY(3), Chan WW(3)
Affiliation :
1. Kowloon East Cluster Breast Centre, United Christian Hospital 2. Nursing Services Division, United Christian Hospital 3. Department of Surgery, United Christian Hospital
Introduction :
Breast cancer is the most prevalent cancer among women in Hong Kong, with surgery being the main treatment for over 80% of patients. Postoperative symptoms often negatively affect patient’s quality of life, potentially impeding long-term outcomes. Notably, increasing numbers of postoperative breast cancer patients sought symptom management at the KEC Breast Centre. A study addressed this issue, focusing on symptom evaluation and timely intervention was implemented.
Objectives :
1. To identify the range and severity of symptoms experienced by women with breast cancer post-surgery using the Memorial Symptom Assessment Scale-Short Form (MSAS-SF) 2. To evaluate the improvement of symptoms after providing intervention
Methodology :
Patients at KEC Breast Centre who met eligibility criteria after breast cancer surgery between September 2023 and March 2024 were enrolled in the study. The Chinese version of the MSAS-SF was utilised to assess symptoms, with patients self-completed questionnaires at post-op weeks 2, 4, and 6 on follow-ups. Breast Care Nurses provided timely interventions based on reported symptoms, addressing physical and psychological concerns.
Result & Outcome :
A total of 95 patients participated in the study, with 66% underwent mastectomy and 34% had a lumpectomy. Among these, 32% had axillary dissection, 64% received sentinel lymph node biopsy, and 4% did not have any node operation. Symptom prevalence reported by patients improved over time after nurse intervention. The top five symptoms and means symptom distress score at three follow-up intervals as below: Wound pain: 90.5% (86/95) → 83.2% (79/95) → 63.2% (60/95) Worrying (worried pathology report, disease condition, possible adjuvant therapy): 57.9% (55/95) → 66.3% (63/95) → 47.4% (45/95) Numbness (operation side, upper limb, axilla region): 56.8% (54/95) → 48.4% (46/95) → 44.2% (42/95). Difficulty sleeping (wound and drain site pain, position, worrying): 37.9% (36/95)→ 49.5% (47/95) → 31.6% (30/95). Skin itching (dressing product allergy, no bathing): 33.7% (32/95) → 41% (39/95) → 9% (9/95). Total Symptom Distress: 0.2307 → 0.2119 → 0.1470 Global Distress Index: 0.4713 → 0.3638 → 0.2500 Physical Symptom Distress: 0.2482 → 0.1986 → 0.1268 Psychologic Symptom Distress: 0.3918 → 0.3803 → 0.2695 Walk-in cases related to postoperative symptoms decreased by 13.1% (16.2% → 3.1%) and no unplanned readmissions during the study period. The patient was satisfied with the comprehensive assessment. The Staff Satisfaction Survey using MSAS-SF as a postoperative symptom assessment scale scored 100% (5/5). Conclusion: This study demonstrated the improvement in reducing post-operative discomfort, improving symptom management and enhancing patient outcomes. Recommend MSAS-SF as a systematic symptoms assessment scale at Breast Nurse Clinic.
