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This highlights the need for gynecology and oncology specialists to also address patients\u2019 socio-medical needs. Electronic patient-reported outcomes (ePRO) must be used to identify such areas of concern.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Abstract<\/jats:title>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The aim was to investigate whether and to what extent female patients with advanced or metastatic breast cancer who are undergoing chemotherapy report financial difficulties due to their physical condition and\/or the effects of medical treatment in relation to the German reference cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A secondary data analysis was performed using data collected prospectively as part of the ePROCOM study. A total of\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009168 female patients who had answered questions regarding financial implications of the EORTC QLQ-C30 questionnaire were included in the analysis. Unpaired t tests (Welch) and Chi-square tests as well as multiple regressions were conducted. A bilateral\n                      <jats:italic>p<\/jats:italic>\n                      value of\u2009&lt;\u20090.05 was considered statistically significant in all analyses (alpha\u2009=\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The prevalence of financial distress was 50.0% (95%-CI 42.4%; 57.6%), defined as a response of at least 2 (\u201ca little\u201d) on a 4-point Likert scale. Between the reference cohort scored 4.8 and the breast cancer cohort scored 28.8, there was a significant difference of 24\u2009\u00b1\u20095.19 score points (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001; 95%-CI 18.81, 29.19) in financial burden. Overall, the regression model explained 27.7% of the total variance in financial burden through HRQoL, age, and civil status (\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.277).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Women with advanced or metastatic breast cancer reported substantially higher financial burden than the female German reference population. Lower HRQoL, younger age, and living alone were associated with greater financial impact. These findings support routine assessment of financial distress in those patients and suggest that ePRO-based screening may help identify patients in need of early social-medical support.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00404-026-08523-y","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T10:53:27Z","timestamp":1784112807000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Financial distress among women with advanced or metastatic breast cancer in Germany: secondary analysis of prospective ePROCOM data of a two-center cohort"],"prefix":"10.1007","volume":"313","author":[{"given":"Joachim","family":"Graf","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harald","family":"Abele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Wallwiener","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva J.","family":"Kantelhardt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara Y.","family":"Brucker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"Simoes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"issue":"4","key":"8523_CR1","doi-asserted-by":"publisher","first-page":"649","DOI":"10.32604\/oncologie.2022.027640","volume":"24","author":"C Shang","year":"2022","unstructured":"Shang C, Xu D (2022) Epidemiology of breast cancer. 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