261 - Past Trauma and Its Effects on Patient Perception during Breast Cancer Radiotherapy
Presenter(s)
K. Gerber1, S. Burke2, A. Ali3, J. R. Rocchetti4, M. Thapar2, C. Hum5, M. Lazar6, P. R. Anne7, L. J. Wilson2, K. Wilson2,8, and N. L. Simone8; 1Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, 2Thomas Jefferson University, Philadelphia, PA, 3Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA, 4Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ, 5Cooper Medical School of Rowan University, Camden, NJ, 6Department of Surgery, Sidney Kimmel Medical College & Cancer Center at Thomas Jefferson University, Philadelphia, PA, 7Department of Radiation Oncology, Sidney Kimmel Medical College & Cancer Center at Thomas Jefferson University, Philadelpia, PA, 8Department of Radiation Oncology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA
Purpose/Objective(s):
Most breast cancer patients undergo radiation therapy (RT), but the impact of past sexual trauma—experienced by up to 80% of the U.S. population—remains unclear. We aimed to identify RT-related factors that may negatively affect the experience of patients with a history of sexual trauma.Materials/Methods:
Between May and October 2022, IRB-approved surveys were distributed to female breast cancer patients treated with radiation at Sidney Kimmel Cancer Center. The 35-question survey assessed demographics, treatment details, body image satisfaction, comfort during various times throughout the RT process, and trauma history. Statistical analysis included chi-square and linear regression.Results:
Of the 505 surveys collected, 401 met the inclusion criteria. Most patients were over 50 (74.6%), postmenopausal (73.5%), living with others (75.1%), and had at least a college degree (63.8%). The majority (78.2%) had undergone lumpectomy followed by RT and were cancer survivors at the time of the survey. Although most patients reported general comfort during RT, notable discomfort was associated with gender dynamics. Fewer patients felt uncomfortable changing for treatment (9.8%), waiting in the general area (19.4%), or being set up for RT (21.7%), but many more expressed discomfort in waiting rooms with men (41.9%) or when treated by male radiation therapists (36.3%). A history of trauma exposure was prevalent: 39% had experienced verbal harassment, 38.9% an unwanted sexual advance, 33.6% unwanted sexual touching, and 19.5% an unwanted sexual encounter. Patients with trauma history were significantly more likely to experience discomfort due to body exposure during RT (p = 0.024) and were more uncomfortable being set up for treatment (p = 0.065). Younger patients were also more likely to report discomfort across multiple healthcare settings (p < 0.05).Conclusion:
This study highlights the profound impact of past trauma on the RT experience for breast cancer patients. While most reported comfort, those with a trauma history faced increased distress, especially with body image satisfaction and during body exposure. Implementing trauma-sensitive approaches, provider training, and patient-centered accommodations is essential to improving well-being, treatment adherence, and overall satisfaction.