Breast Cancer Survivors' Perceptions of Their Cardiovascular Care During Treatment With Anthracyclines or Trastuzumab: A Qualitative Analysis

Abstract

Background: Cardiovascular disease (CVD) is a leading cause of mortality among breast cancer survivors, and racial disparities exist between Black and White women. Therefore, the purpose of this study was to assess breast cancer survivors' perceptions of heart health resources and communication received during active treatment with potentially cardiotoxic therapies and to evaluate whether differences in perceptions are associated with race.

Methods: This qualitative analysis included semi-structured interviews with breast cancer survivors who received potentially cardiotoxic treatment(s). Survivors were asked to recall conversations with their healthcare providers regarding cancer treatment, the risk of CVD during and following treatment, and discussions of heart healthy behaviors that could be employed during treatment. Audio recorded interviews were transcribed, and codes were developed using Dedoose Qualitative Software.

Results: Of the 17 participants, 9 women were White and 8 were Black. A majority of participants were married (58.8%), reported an annual household income of at least $60,000, had a Bachelor's degree or higher (70.6%), and had a mastectomy (70.6%). Participants had an average age of 50.9 years (SD = 11.85). Approximately 88% (100% White women, 75% Black women) recalled receiving heart health information either prior to or during treatment. The majority also received trastuzumab (88.2%). Four themes were identified from the interviews. Key results showed that Black survivors were more likely to share positive experiences when their family members were a part of their treatment conversations and that White women were more likely to have positive experiences throughout their treatment.

Conclusions: This qualitative analysis did not show striking differences in perceived care experiences between Black and White survivors. However, there were notable differences in community support, such as the inclusion of family members in treatment conversations and the receipt and timing of heart health information. Enhancing healthcare communication with a particular focus on culturally diverse populations is needed.

Keywords: breast cancer; cardiovascular disease; cardio‐oncology and cancer care delivery; provider communication.