Background: Cleveland Clinic breast cancer patients have routinely been offered survivorship visits since 2009. In addition to receiving treatment summaries and follow-up care plans, survivors complete a questionnaire about present concerns and symptoms. It is hypothesized that patient-reported concerns will differ based on treatment received, age, exercise, body mass index (BMI) and timing of survivorship visit. Methods: We conducted a retrospective and prospective IRB-approved cohort study evaluating patient-reported symptoms, comorbidities and associated risk factors at the initial survivorship visit. Patients included had stage 0-III breast cancer, had completed questionnaires and known staging and treatment information. Thirty-four symptoms and comorbidities were analyzed; risk factors were determined using univariable and multivariable logistic regression analyses. Results: Between April 2009 and November 2015, 1126 eligible survivors were seen. Median age was 59 (range 21-93) years. Median time from treatment to survivorship visit was 18 (range 0-300) months. Sixty-six percent of patients were overweight or obese; 52% reported exercising at least 30 minutes most days. All patients had surgery and 64%, 66% and 78% had chemotherapy (CTX), radiotherapy and hormonal therapy respectively. The table demonstrates the most common reported symptoms and significant associations with CTX, BMI and exercise habits using multivariable analyses. Age and time since treatment had variable impact on patient reported concerns. Minimal impact was observed with receipt of radiotherapy or endocrine therapy. Conclusions: In breast cancer survivors, use of chemotherapy and obesity, but not radiation and endocrine therapy, were significantly associated with patient-reported symptoms and comorbidities. Exercise appeared to attenuate the adverse effects.

I: increased symptom prevalence, D: decreased symptom prevalence.