A pilot survey of breast cancer survivors' reporting of palpitations to healthcare providers

Abstract

Background: Breast cancer survivors (BCS) may experience cardiotoxicities from chemotherapy and oral endocrine therapy. Although a few studies have documented that palpitations are prevalent and associated with poorer outcomes, there is limited to no information on BCS' reporting of palpitations to healthcare providers. Objectives: To compare BCS who did and did not report their palpitations to a healthcare provider and describe how those who did report palpitations recalled their provider responding. Design: This was a cross-sectional, national, electronic, pilot survey of BCS enrolled in the Love Army of Women registry. Methods: Participants (n = 52 with palpitations) completed standardized and investigator-designed questionnaires. Data were analyzed using frequency and descriptive statistics, chi-square tests, and Mann-Whitney tests. Responses to one open-ended question were analyzed using frequency counts and standard content analysis. Results: Compared to BCS who reported palpitations to a provider (n = 34), BCS who did not report their palpitations (n = 18) were significantly more anxious (p = 0.002) and more likely to feel palpitations as an irregular heartbeat (70.6% versus 38.9%, p = 0.027). Among the 34 BCS who reported palpitations to a provider, 32 completed the open-ended question. Of these 32 BCS, a majority (n = 27, 84%) indicated their provider recommended cardiac testing and/or referral to a cardiologist. Most (n = 24) reported completing testing. Test results included diagnosis of a new arrhythmia or other cardiac abnormality (n = 11, 46%), receipt of a new prescription (n = 5, 21%), or normal results (n = 5, 21%). Five (16%) of the 32 BCS did not receive recommendations for testing or referral and felt their provider normalized or dismissed their symptoms. Conclusion: Palpitations are a salient topic for further research and clinical practice recommendations to address cardiac health in BCS.