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. Author manuscript; available in PMC: 2020 Aug 22.
Published in final edited form as: Breast. 2013 Aug 31;22(5):593–605. doi: 10.1016/j.breast.2013.07.050

Table 5.

Resource allocations for treatment-related toxicity (B): hematologic complications, symptom management, women’s health concerns, and monitoring during treatment

Basic Limited Enhanced Maximal
Hematologic Toxicity and Infection Antibiotics: broad spectrum Antifungals
Red blood cell transfusion
Infectious disease consultation for febrile neutropenia		 Growth factors; granulocyte growth factors
Platelet transfusion
Iron therapy
Fatigue, Insomnia and Non-specific Pain Pain management, including morphinea
Patient and family educationb
Women’s Health Issues Patient and partner education: early menopause, body image, reproductive health / fertilityc Management of menopausal symptomsd
Patient and partner education: sexual healthc 		Fertility clinic (ie, assisted reproduction)
Egg/embryo freezing
Monitoring Physical exam, CBC, potassium and sodium, urea, bilirubin and transaminase, and when needed CXR, UA, microbiology
Check for early lymphedema, nausea and vomiting, constipation and diarrhea, fatigue and insomnia, and pain		 Other blood chemistry and liver function tests
Renal function assessment
Non-imaging cardiovascular assessment		 Extensive lab support, bone density tests

Note: The table stratification scheme implies incrementally increasing resource allocation at the basic, limited, and enhanced levels. Maximal-level resources should not be targeted for implementation in LMICs, even though they may be used in some higher-income settings.

Abbreviations: CBC, complete blood count; CXR, chest x-ray; UA, urinalysis.

a

Pain management should follow the World Health Organization pain ladder recommendations. Morphine should be available and easily accessible at a basic level of resources.

b

Patient, family and/or partner education may be the primary intervention for some supportive care services.

c

Women’s health issues for breast cancer patients include menopause, body image, reproductive health, including fertility, and sexual health; educational efforts should include partners. See the companion BHGI consensus statement Supportive Care after Curative Treatment for recommendations for menopausal symptom management.