Mobile health tool may improve quality of life for adolescent and young adult breast cancer survivors

(Press-News.org) SAN ANTONIO – A mobile health (mHealth) intervention for adolescent and young adult breast cancer survivors that offered tailored support by monitoring electronic patient-reported outcomes (ePROs) significantly improved quality of life and symptoms related to vaginal and arm problems, according to results from a randomized clinical trial presented at the San Antonio Breast Cancer Symposium (SABCS), held December 9-12, 2025.

Incidence of breast cancer in women between the ages of 15 and 39 has risen on average 0.6% each year between 1975 and 2022. “Young adults with breast cancer are more likely to suffer both emotionally and medically after a breast cancer diagnosis than older women,” said study presenter Ann H. Partridge, MD, MPH, vice chair of medical oncology and chief clinical strategy officer at Dana-Farber Cancer Institute, where she founded and directs the Program for Young Adults with Breast Cancer.

Our health care system is not equipped to meet the intensive needs of these patients after they are no longer receiving active cancer treatment but may still be struggling with the aftermath, explained Partridge, who is also professor of medicine at Harvard Medical School. “While many acute physical complaints resolve following initial treatment, the long-term physical, emotional, and psychosocial impact on a young woman’s life trajectory may worsen or only become evident in survivorship, when much less attention is paid to them from the health care system,” she said.

Recognizing a need for accessible, scalable, and self-managed interventions to support adolescent and young adult breast cancer survivors, Partridge and her colleagues piloted a study for the Young, Empowered & Strong (YES) mHealth tool to see if it would improve outcomes. YES is a web- and app-based tool that delivers information and support based on ePRO responses. For example, when a woman mentions particular symptoms (e.g., anxiety, pain, menopausal symptoms) or concerns (e.g., fertility, financial, body image concerns), she receives tailored information and links to resources to address those issues in the YES portal. Additionally, YES incorporates other complementary supportive care strategies, including an expressive writing platform and a monitored chat room with other young survivors for peer support.

In a multicenter randomized controlled trial of YES, Partridge and colleagues enrolled 360 women between the ages of 15 and 39 who were diagnosed with stage 0-3 breast cancer within the last three years. After completing the Quality of Life in Adult Cancer Survivors (QLACS) questionnaire to evaluate their general (evaluating aspects such as emotional well-being, fatigue, pain, social relationships, and sense of purpose) and cancer-specific (evaluating aspects such as worry about the cancer coming back, changes in appearance, sexual problems, and the impact of cancer on health and outlook on life) quality of life at baseline, the patients were randomly assigned to the YES intervention (179) or to receive usual care (181).

At baseline, the mean QLACS scores were 86.3 for general and 52.5 for cancer-specific quality of life in the YES arm and 79.7 and 48.9 in the usual care arm. Higher QLACS scores indicate poorer quality of life.

After six months, mean QLACS scores for general quality of life decreased by 8.7 points in the YES arm and 1.6 points in the usual care arm, indicative of greater improvement of quality of life in the group randomized to YES. Further, mean cancer-specific quality of life scores decreased by 7.8 points in the YES arm and 3 points in the usual care arm. Overall, adjusted differences in the change from baseline to six months between the two arms were statistically significant favoring the YES arm for both general quality of life (4.8-point greater decrease with YES) and cancer-specific quality of life (3.2-point greater decrease with YES).

“The fact that a remote, scalable mHealth intervention that does not directly link into the patient’s care team but supports patients to self-manage their symptoms and concerns led to significant improvements is paradigm changing,” Partridge explained. “Most interventions using ePROs that have shown benefit have been with patients undergoing active therapy with high clinician effort, and now we have shown that a low-touch intervention with limited clinician input can improve outcomes important to patients.”

Additionally, the trial looked at changes in certain symptoms from baseline evaluated by the PROMIS Fatigue scale, Center for Epidemiologic Studies Depression Scale (CES-D), and Breast Cancer Prevention Trial (BCPT) scale. After six months, arm and vaginal symptoms, common concerns in young breast cancer survivors, also improved significantly in the YES arm, with a difference in mean change between the two arms of -0.57 for vaginal problems and -0.39 for arm problems. There was also a modest, but not statistically significant, improvement in fatigue. However, no differences were found between arms for CES-D-measured depressive symptoms or other BCPT symptoms, including hot flashes, nausea, bladder control, musculoskeletal pain, cognitive problems, and weight problems.

“The intervention did not appear to improve certain menopausal, anxiety, or depressive symptoms and we need to do more work to improve the tool,” Partridge said. “But this type of intervention has the potential to improve the health and well-being of several other hard-to-reach populations, such as busy young adults and rural Americans who are less able to engage in person with cancer center resources and support.”

Limitations of this study include participation and engagement bias. The findings may also have been affected by a change to a new vendor with a new platform halfway through the study, and the fact that the first part of accrual occurred closer to the COVID-19 shutdown, which may have impacted how participants engaged with the portal. Women were also enrolled from three academic sites (Dana-Farber Cancer Institute, The Ohio State University, and Columbia University Irving Medical Center) where they may receive more support and resources compared with other clinics.

This study was funded by the National Institutes of Health through the National Cancer Institute. The funding for the pilot work was provided from the Breast Cancer Research Foundation with additional support from Susan G. Komen. Partridge receives royalties from Wolters Kluwer for authorship of UpToDate and is an American Cancer Society Research Professor.

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