Abstract P4-05-03: Acceptability and feasibility of early cancer physiatry consultation in management of aromatase inhibitor-induced musculoskeletal symptoms (AIMSS) in early-stage hormone receptor positive breast cancer

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Abstract Aromatase inhibitors (AIs) are the mainstay of adjuvant therapy for postmenopausal hormone receptor (HR)-positive breast cancer (BC). AI-induced musculoskeletal symptoms (AIMSS) are a common side effect seen in up to 50% of patients, leading to discontinuation in 20-30%. This non-adherence is an independent predictor of mortality. While guidelines for AIMSS management are lacking, exercise, physical therapy, and acupuncture offer benefit, and pharmacologic options exist. However, preventative measures remain unexplored. Physiatrists, physicians who specialize in physical medicine and rehabilitation, can employ conservative measures that may help to treat and/or prevent AIMSS. This study evaluated the feasibility and acceptability of early physiatry consultation for AIMSS. Methods: Patients with early-stage HR-positive BC starting AI therapy were enrolled in this prospective study. Patients underwent baseline physiatry consultation before AI initiation, followed by visits at 6 weeks, 3 months, and 6 months. Primary objectives were feasibility (determined by appointment attendance) and acceptability (measured by the validated Treatment Acceptability and Preference (TAP) score at 6 months), a mean TAP score above mid-point scale of 2, deems the intervention acceptable. Results: 25 patients enrolled in this prospective study. 76% were African American, and 24% were Caucasian. The mean age was 66.2 years. The mean BMI was 28.2. 100% of patients attended all physiatry clinic visits, demonstrating the intervention is feasible. The average TAP score of the cohort was 2.7 (SD +/- 0.9) indicating that early physiatry consultation is acceptable. During physiatry visits, diagnostic imaging was performed in 24% of patients and 40% were offered referral to physical therapy. 2 patients were offered bracing, 2 patients received injections, 3 patients were given prescription medications, and 6 patients were offered over the counter (pain) medications. More than 50% were prescribed topical NSAIDS. Conclusion: Early cancer physiatry consultations are feasible and acceptable for BC patients on AI therapy. A larger prospective study with a control group is needed to evaluate if this multidisciplinary approach can reduce AIMSS, thus promoting adherence and potentially improving survival outcomes. Physiatry consultation can offer counseling and diverse pharmacological/non-pharmacological interventions for AIMSS management. Citation Format: Oday Elmanaseer, Arun Kumar, Ami Chitalia, Eric Wisotzky. Acceptability and feasibility of early cancer physiatry consultation in management of aromatase inhibitor-induced musculoskeletal symptoms (AIMSS) in early-stage hormone receptor positive breast cancer [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2024; 2024 Dec 10-13; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(12 Suppl):Abstract nr P4-05-03.

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