The following article features coverage from ONS Bridge 2020. Click here to read more of Oncology Nurse Advisor‘s conference coverage.

Significant improvements in the quality of life (QOL) of patients with recurrent breast cancer were demonstrated for participants in a quality improvement (QI) project focused on a survivorship program designed to address the unique needs of these patients, according to a poster presentation on the Oncology Nursing Society (ONS) Bridge, a virtual conference. 

Survivorship programs tailored to the specific circumstances of patients with recurrent breast cancer represent an unmet need.

The aims of this QI project were to develop a survivorship program for patients with recurrent breast cancer, increase the QOL of these patients, and also evaluate the level of patient satisfaction with the survivorship program.

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Called the Healthy Outcomes for Positivity and Encouragement (HOPE) program, the survivorship program was originally developed at Duke University in Durham, North Carolina, and subsequently implemented at the Helen F. Graham Cancer Center & Research Institute at ChristianaCare in Newark, Delaware.

At baseline, participants in this study provided demographic information and completed the Functional Assessment of Cancer Therapy – Breast (FACT-B) questionnaire, a validated tool for the assessment of 5 domains related to QOL: physical, emotional, social, functional, and breast.

Based on initial results of the FACT-B assessment, the top 3 concerns of the survivor were identified and coaching was tailored to address their specific needs.

“Overall, the most common concerns were related to body image, social isolation, and financial issues,” stated Darcy Burbage, DNP, of the Helen F. Graham Cancer Center & Research Institute, who presented the results of this study.

Patients completed a survey designed to assess satisfaction with the program immediately following the intervention and then 2 weeks later by mail. In addition, the FACT-B measure was also re-administered at the 2-week follow-up. The baseline and follow-up assessments were de-identified.

Of the 71 survivors referred to the program, a convenience sample of 40 contacted the project coordinator and participated in the initial intervention between October 2018 and February 2019, with 34 participants completing all surveys for inclusion in the analysis.

“The high participation rate supports that the program was feasible to implement in this setting,” Dr Burbage commented.

The mean age of study participants was 55.4 years and the mean length of time living with recurrent breast cancer was 1.8 years. All study participants were female, 65% were White, more than two-thirds were college graduates, and most were undergoing active treatment for breast cancer.

A comparison of pre- and post-intervention FACT-B scores revealed significant improvements (P =.000) in all QOL domains, with the emotional well-being subscale showing the greatest increase.

In addition, participants reported a high level of patient satisfaction, both immediately following the intervention and at the 2-week follow-up.

Limitations of this study included the small convenience sample, as well as a study group represented by predominantly well-educated, White women from a single cancer center.

“Additional research is necessary in larger groups of patients and in individuals of diverse racial and ethnic backgrounds to ensure culturally appropriate care is provided,” Dr Burbage noted.

In summarizing the overall results of this study, the study authors stated that “the survivorship program was successfully implemented and valued by participants.”


Burbage D, Duffy N, Johnson EJ, Schneider S. Implementing a cancer survivorship program for individuals with recurrent breast cancer. Presented at: ONS Bridge; September 8-17, 2020. Accessed September 11, 2020.