Time toxicity in breast cancer care: a nationwide cross-sectional survey of multidimensional time burden in Japan.

Abstract

Background: Time toxicity has increasingly been recognized as an important dimension of cancer care alongside traditional clinical outcomes such as survival and toxicity. Although breast cancer therapy has become increasingly individualized, limited evidence exists regarding time toxicity beyond hospital-based care. This study aimed to quantify and characterize time toxicity in patients with breast cancer in Japan.

Methods: A nationwide cross-sectional web-based survey of female patients was conducted in Japan. Among 866 respondents, the analysis focused on 598 patients with breast cancer. The survey assessed care-related time, non-care time, family caregiving time, information-seeking time, subjective distress associated with time burden, and activity restrictions.

Results: The median waiting time for outpatient consultations was 60 min. The median hospital stay per visit was 240 min for chemotherapy and 40 min for radiotherapy. Overall, 69.1% of patients perceived hospital stay as "long" and 67.8% as "distressing." Patients required a median of 10 days of rest during peak treatment-related symptom burden and an additional 15 min per outing for appearance-related care. Participants reported that family members spent a median of 25.5 h per month providing caregiving support. Patients also reported substantial time spent seeking information after diagnosis and forgoing work, travel, and exercise.

Conclusions: Time toxicity in breast cancer care extends beyond hospital visits to include substantial non-care time and family caregiving time. Recognizing time toxicity as a potentially modifiable dimension of treatment burden may help inform treatment planning, supportive care, and shared decision-making in breast cancer care.