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Konara Mudiyanselage SP, Wu YL, Kukreti S, Chen CC, Lin CN, Tsai YT, Ku HC, Fang SY, Wang JD, Ko NY. Dynamic changes in quality of life, psychological status, and body image in women who underwent a mastectomy as compared with breast reconstruction: an 8-year follow up. Breast Cancer 2023; 30:226-240. [PMID: 36319889 DOI: 10.1007/s12282-022-01413-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 10/27/2022] [Indexed: 02/24/2023]
Abstract
BACKGROUND Surgical decisions and methods of surgery highly influence long term QoL for breast cancer (BC) survivors. This study is aimed towards an exploration of the dynamic changes in quality of life (QoL), anxiety/depression status, and body image (BI) among women with BC who received a mastectomy compared with those receiving breast reconstruction (BR) within an 8-year follow-up period. METHODS Women with major BC surgeries were invited to complete the World Health Organization Quality of Life-Brief (WHOQOL-BREF), the European quality of life five dimensions questionnaire (EQ-5D), and a body image scale within 8 years of surgery. Kernel smoothing methods were applied to describe dynamic changes in QoL, anxiety/depression, and BI at different time points. Linear mixed effects models were constructed to identify the interaction between time, different types of surgery, and the determinants of QoL in these patients. RESULTS After 1:10 propensity score matching, a total of 741 women who had undergone a BR and mastectomy were included. The BR group exhibited a high WHOQOL QoL score one to five years after surgery with some fluctuations. The mastectomy group had comparatively stable QoL scores on WHOQOL items and were less depressed/anxious. The BR group generally showed fluctuating, higher BI scores two years after surgery, but they exhibited more anxiety/depression during follow up for 8 years. Medical comorbidities, the status of anxiety/depression, and BI were the major factors influencing all domains and items of the WHOQOL BREF among women with BC. CONCLUSION The mastectomy group showed a decreased trend toward depression in patients with BC. The BR group showed a significant improvement in QoL in the first 5 years with massive fluctuations. These findings should be considered and discussed in patient participatory decision-making and promotion of QoL for breast cancer survivors.
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Affiliation(s)
- Sriyani Padmalatha Konara Mudiyanselage
- International Doctoral Program in Nursing, Department of Nursing, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC.,Operation Theatre Department, The National Hospital of Sri Lanka, Colombo, Sri Lanka
| | - Yi-Lin Wu
- International Doctoral Program in Nursing, Department of Nursing, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC.,Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC
| | - Shikha Kukreti
- Department of Public Health, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC.,Department of Public Health College of Medicine, National Cheng Kung University, No. 1, University Road, Tainan, 70101, Taiwan
| | - Chang-Chun Chen
- International Doctoral Program in Nursing, Department of Nursing, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC
| | - Chia-Ni Lin
- Department of Public Health, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC
| | - Yi-Tseng Tsai
- International Doctoral Program in Nursing, Department of Nursing, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC.,, No. 66, Sec. 2, Changhe Rd., Annan Dist., Tainan, 709, Taiwan
| | - Han-Chang Ku
- International Doctoral Program in Nursing, Department of Nursing, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC.,, No. 66, Sec. 2, Changhe Rd., Annan Dist., Tainan, 709, Taiwan
| | - Su-Ying Fang
- Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC.,Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jung-Der Wang
- Department of Public Health, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC.,Department of Public Health College of Medicine, National Cheng Kung University, No. 1, University Road, Tainan, 70101, Taiwan
| | - Nai-Ying Ko
- Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC. .,Department of Public Health, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC. .,Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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Barrett F, Sutter ME, Campo-Engelstein L, Sampson A, Caplan A, Lawrence M, Vadaparampil ST, Quinn GP. Perspectives surrounding fertility preservation and posthumous reproduction for adolescent and young adults with terminal cancer: Survey of allied health professionals. Cancer Med 2023; 12:6129-6138. [PMID: 36226382 PMCID: PMC10028037 DOI: 10.1002/cam4.5345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 09/29/2022] [Accepted: 10/02/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND While all reproductive-aged individuals with cancer should be offered fertility preservation (FP) counseling, there is little guidance over offers to adolescent and young adults (AYA) with terminal diagnoses, especially when considering posthumous assisted reproduction (PAR). The Enriching Communication skills for Health professionals in Oncofertility (ECHO/ENRICH) trains Allied Health Professionals (AHPs) to improve communication with AYAs with cancer. Little is known about AHPs' role in assisting in FP and PAR decisions. METHODS This is a cross-sectional survey of ECHO/ENRICH trainees' attitudes and experience with FP and PAR in AYA with terminal cancer. RESULTS The response rate was 61% (365/601). While 69% felt comfortable discussing FP with terminal AYA after ECHO/ENRICH training, 85% desired further education. The majority (88%) agreed FP should be an option for AYA with cancer, though some agreed offering FP provided false hope (16%) or was a waste of resources (7%). Most shared that avoidance of FP discussions was common practice, especially in the medically fragile, late-stage disease, or among minors. Many attributed lack of conversations to oncology team goals. Only 9% had prior experience with PAR. Many were conflicted about how PAR reproductive material should be gifted and who should be permitted to use PAR. Several raised moral concerns for PAR, or discomfort advising family. Many voiced desire for additional PAR-specific education. CONCLUSION ECHO/ENRICH trainees had varied levels of exposure to FP in terminal AYA and limited experiences with PAR. Many expressed uncertainties with PAR, which may be alleviated with further training and transparent institutional policies.
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Affiliation(s)
- Francesca Barrett
- Department of Obstetrics and Gynecology, New York University Grossman School of Medicine, New York, New York, USA
| | - Megan E Sutter
- Department of Obstetrics and Gynecology, New York University Grossman School of Medicine, New York, New York, USA
| | - Lisa Campo-Engelstein
- University of Texas Medical Branch, Institute for Bioethics & Health Humanities, Galveston, Texas, USA
| | - Amani Sampson
- Department of Obstetrics and Gynecology, New York University Grossman School of Medicine, New York, New York, USA
| | - Arthur Caplan
- Division of Medical Ethics, Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
| | - Morgan Lawrence
- Barnard College, Columbia University, New York, New York, USA
| | - Susan T Vadaparampil
- Division of Population Science, Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | - Gwendolyn P Quinn
- Department of Obstetrics and Gynecology, New York University Grossman School of Medicine, New York, New York, USA
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Almeida SS, Oliveira MA, Medeiros R, Guerra MP, Pariante CM, Fernandes L. Emotional, inflammatory, and genetic factors of resilience and vulnerability to depression in patients with premenopausal breast cancer: A longitudinal study protocol. PLoS One 2023; 18:e0279344. [PMID: 36787313 PMCID: PMC9928105 DOI: 10.1371/journal.pone.0279344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 12/06/2022] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Psychosocial stress and depressive disorder have been associated with cancer as putative contributors to worse prognosis. On the other hand, cancer diagnosis is a recognised life event that can contribute to distress and depressive states. Humoral and cellular inflammation can promote depressive disorder by means of decreased monoamine synthesis, glutamate neurotoxicity, neurogenesis and neuroplasticity, dysregulated hypothalamic-pituitary-adrenal axis, and glucocorticoid resistance. This protocol objectives are to observe the interactions between psychosocial variables and biochemical and immunological biomarkers in a longitudinal, prospective design; to identify inflammation-related depression endophenotypes in breast cancer patients and to understand if early diagnosed and treated depression in this population will translate in better inflammation status and better global prognosis. METHODS Prospective observational cohort, composed by 100 consecutive premenopausal patients, diagnosed with non-distant metastatic breast carcinoma and with no history of major psychopathology or other organic illness. The participants will have an in-person assessment in three different moments, along illness treatment and follow-up, with respect to cytometric, immunologic, and psychosocial parameters and will be tested for depression vulnerability and resilience inflammation-related functional genetic polymorphisms. Additionally, at years 5 and 10 post enrollment, patients`medical records will be assessed. As a control cohort, all patients excluded due to psychiatric history or past psychiatric treatments will have their clinical records assessed at years 5 and 10 after admission. All the data will be managed with the SPSS® software. DISCUSSION AND CONCLUSION This study is an original longitudinal cohort of breast cancer premenopausal patients, with a comprehensive approach to psychosocial, clinical, inflammatory, and genetic variables. It expects to provide evidence regarding the links between genetic, cytometric, immunologic, and psychosocial factors, their potential contribution to the pathophysiology of depressive disorder, breast cancer course, progression, and prognosis. It may further contribute with data to better efficacy of the psycho-oncological interventions. TRIAL REGISTRATION National Commission of Data Protection (CNPD) 13413/2017; Ethics Committee of IPOP project code CI-IPOP81/2017.
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Affiliation(s)
- Susana S. Almeida
- Psychiatry Service, Portuguese Oncology Institute of Porto (IPO Porto), Porto, Portugal
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Porto, Portugal
- Psychiatry and Psychology Service, CUF Porto Hospital, Porto, Portugal
| | - Magda A. Oliveira
- Psychiatry and Psychology Service, CUF Porto Hospital, Porto, Portugal
- Psychology Service, Portuguese Oncology Institute of Porto (IPO Porto), Porto, Portugal
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - Rui Medeiros
- Molecular Oncology and Viral Pathology Group, Research Center of IPO Porto (CI-IPOP)/RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto) /Porto Comprehensive Cancer Center (Porto.CCC), Research Center-LAB2, Porto, Portugal
- ICBAS, Abel Salazar Institute for the Biomedical Sciences, University of Porto, Porto, Portugal
- Biomedical Research Center (CEBIMED), Faculty of Health Sciences, Fernando Pessoa University (UFP), Porto, Portugal
- Research Department, LPCC- Portuguese League Against Cancer (NRNorte), Porto, Portugal
| | - Marina P. Guerra
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- Center for Psychology at University of Porto (CPUP), Porto, Portugal
| | - Carmine M. Pariante
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College of London, London, United Kingdom
| | - Lia Fernandes
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Porto, Portugal
- Psychiatry Service, Centro Hospitalar Universitário São João (CHUSJ), Porto, Portugal
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Communication between mothers with breast cancer and minor children: a qualitative systematic review and meta-synthesis. Support Care Cancer 2023; 31:169. [PMID: 36786856 DOI: 10.1007/s00520-023-07630-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 02/05/2023] [Indexed: 02/15/2023]
Abstract
PURPOSE Both women with breast cancer and their minor children were affected by a breast cancer diagnosis. The purpose of this review was to synthesize the evidence from qualitative studies on illness-related communication between mothers with breast cancer and their minor children from mothers' perspectives. METHODS A thorough systematic review and meta-synthesis of qualitative studies was conducted. English articles published prior to 6 November 2021 were searched from five databases, including PubMed/ MEDLINE, EMBASE, Web of Science, CINAHL, and PsycINFO. After screening the titles, abstracts, and full texts, seven articles were finally included in the quality appraisal and meta-aggregation. RESULTS Four synthesized findings were derived from seven articles, including disclosure dilemma, factors impacting disclosure, methods of communication, and information needs. CONCLUSIONS This systematic review offered insight into the communication between mothers with breast cancer and their minor children. Various factors influenced the decision-making process on illness-related disclosure, as well as the methods and contents of the communication. Future studies should be undertaken to explore the common model shared by mothers and children who have had comparable experiences, as well as to completely analyze the differences between different cultures in this topic.
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Kapoor E. Premature Ovarian Insufficiency. CURRENT OPINION IN ENDOCRINE AND METABOLIC RESEARCH 2023; 28:100435. [PMID: 36936056 PMCID: PMC10022589 DOI: 10.1016/j.coemr.2023.100435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Natural menopause typically occurs between the ages of 46 to 55 years. Premature ovarian insufficiency or premature menopause refers to compromised ovarian follicular activity, occurring spontaneously or because of medical interventions, prior to the age of 40 years. The premature loss of estrogen leads to bothersome menopause symptoms and predisposes the women to multiple long-term health risks including a higher mortality risk. Hormone replacement therapy used until the natural age of menopause can help manage the symptoms effectively and can mitigate the long-term risk of estrogen deprivation to some extent. However, hormone replacement therapy is underutilized in this population due to the inappropriate extrapolation of potential risks that have been demonstrated with hormone therapy use in women after natural menopause. There is a large unmet need for educating patients and providers regarding the impact of premature ovarian insufficiency and the compelling need for its appropriate management.
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Affiliation(s)
- Ekta Kapoor
- Center for Women’s Health, Mayo Clinic, Rochester, MN, USA
- Menopause and Women’s Sexual Health Clinic, Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic Rochester, MN, USA
- Women’s Health Research Center, Mayo Clinic, Rochester, MN, USA
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56
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Ee C, Cave A, Vaddiparthi V, Naidoo D, Boyages J. Factors associated with weight gain after breast cancer: Results from a community-based survey of Australian women. Breast 2023:S0960-9776(23)00012-7. [PMID: 36710237 DOI: 10.1016/j.breast.2023.01.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 01/27/2023] Open
Abstract
PURPOSE Weight gain after breast cancer is common. The aim of this study was to determine factors associated with weight gain after breast cancer in Australian women. METHODS A cross-sectional online survey was conducted between November 2017 and January 2018. Women living in Australia who self-identified as having breast cancer or ductal carcinoma in-situ were eligible. We created stepwise linear and logistic regression models to evaluate predictors for absolute and clinically significant (≥5%) weight gain respectively. RESULTS Data from 276 women were analysed. Most were Caucasian and 92% had been diagnosed with Stage 0-III breast cancer. Absolute weight gain was associated with hot flushes, being in the menopausal transition at diagnosis, being less physically active than at diagnosis, lower eating self-efficacy when watching television or using a computer, and higher self-efficacy when anxious or nervous (F-ratio = 3.26, R2-adjusted = 0.16, p < .001). Clinically significant weight gain was associated with tamoxifen use (OR 2.7), being less physically active than at diagnosis (OR 3.1), and lower eating self-efficacy when watching television or using a computer (OR 0.82) (Chi-square 64.94, df = 16, p < .001). Weight gain was not associated with chemotherapy, radiotherapy, aromatase inhibitor use, number of lymph nodes removed, or body mass index at diagnosis. CONCLUSIONS Interventions to prevent weight gain after breast cancer, particularly aiming to maintain physical activity, should be targeted at women receiving tamoxifen. The role of eating self-efficacy, especially attentive eating, in managing weight after breast cancer should be explored.
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Affiliation(s)
- Carolyn Ee
- NICM Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, Sydney, New South Wales, Australia; Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, Sydney, New South Wales, Australia; LivingRoom, Chris O' Brien Lifehouse Cancer Centre, PO Box M33, Missenden Rd, Camperdown, Sydney, New South Wales, Australia; Caring Futures Institute, Flinders University, Bedford Park, Adelaide, South Australia, Australia.
| | - Adele Cave
- NICM Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, Sydney, New South Wales, Australia
| | - Vaishnavi Vaddiparthi
- NICM Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, Sydney, New South Wales, Australia
| | - Dhevaksha Naidoo
- NICM Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, Sydney, New South Wales, Australia
| | - John Boyages
- ICON Cancer Centre, Sydney Adventist Hospital, 185 Fox Valley Road, Wahroonga, Sydney, New South Wales, Australia; Faculty of Health and ANU College of Health & Medicine, Canberra, Australian Capital Territory, Australia
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Fresno-Alba S, Denche-Zamorano Á, Pastor-Cisneros R, Pereira-Payo D, Franco-García JM, Jiménez-Castuera R. Breast cancer and physical activity: A bibliometric analysis. Front Oncol 2023; 12:1051482. [PMID: 36713550 PMCID: PMC9879290 DOI: 10.3389/fonc.2022.1051482] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 12/07/2022] [Indexed: 01/13/2023] Open
Abstract
Breast cancer is a pathology suffered by millions of women worldwide, affecting the mental health, quality of life (QoL), physical functioning, cognitive functioning, and social and work life of surviving patients. Moreover, breast cancer is associated with weight gain, muscle atrophy, and weakness. Physical exercise appears to be an effective non-pharmacological treatment to improve short-term self-esteem, QoL, fatigue, and psychological factors such as depression, anxiety, happiness, and body image. The practice of physical activity is also associated with a reduction in the side effects of treatment. This bibliometric analysis analyzed the trend followed by publications on breast cancer and physical activity. The Web of Science database was used, and bibliometric laws were applied to identify the most prolific authors, the journals most involved in the field, and the countries, institutions, and keywords most used by the authors. Breast cancer and physical activity have an exponential trend in the number of publications, with Psycho-Oncology being the journal with the highest number of publications.
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Affiliation(s)
- S. Fresno-Alba
- Didactic and Behavioral Analysis in Sport Research Group, Faculty of Sport Sciences, University of Extremadura, Cáceres, Spain
| | - Á. Denche-Zamorano
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, Cáceres, Spain
| | - R. Pastor-Cisneros
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, Cáceres, Spain
| | - D. Pereira-Payo
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, Cáceres, Spain
| | - J. M. Franco-García
- Health Economy Motricity and Education (HEME), Faculty of Sport Sciences, University of Extremadura, Cáceres, Spain
| | - R. Jiménez-Castuera
- Didactic and Behavioral Analysis in Sport Research Group, Faculty of Sport Sciences, University of Extremadura, Cáceres, Spain,*Correspondence: R. Jiménez-Castuera,
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Bower JE, Partridge AH, Wolff AC, Cole SW, Irwin MR, Thorner ED, Joffe H, Petersen L, Crespi CM, Ganz PA. Improving biobehavioral health in younger breast cancer survivors: Pathways to Wellness trial secondary outcomes. J Natl Cancer Inst 2023; 115:83-92. [PMID: 36130057 PMCID: PMC9830488 DOI: 10.1093/jnci/djac180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 07/27/2022] [Accepted: 09/12/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The Pathways to Wellness trial tested the efficacy of 2 interventions for younger breast cancer survivors: mindful awareness practices (MAPs) and survivorship education (SE). This planned secondary analysis examines intervention effects on stress, positive psychological outcomes, and inflammation (Clincaltrials.gov NCT03025139). METHODS Women diagnosed with breast cancer at or before age 50 years who had completed treatment and had elevated depressive symptoms were randomly assigned to 6 weeks of MAPs, SE, or wait-list control (WLC). Assessments conducted at pre- and postintervention and at 3- and 6-month follow-up measured general stress perceptions, cancer-related intrusive thoughts and worry, positive affect, meaning and peace in life, altruism and empathy, and markers of inflammation. Analyses compared change in outcomes over time in each intervention group relative to WLC using linear mixed models. RESULTS A total 247 women were randomly assigned to MAPs (n = 85), SE (n = 81), or WLC (n = 81). MAPs statistically significantly decreased intrusive thoughts and worry at postintervention and 3-month follow-up relative to WLC (P < .027) and statistically significantly increased positive affect and meaning and peace at postintervention, with positive affect persisting at 3-month follow-up (P < .027). SE statistically significantly decreased intrusive thoughts at 3-month follow-up and statistically significantly increased positive affect at 6-month follow-up relative to WLC (P < .01). Proinflammatory gene expression increased in WLC relative to MAPs (P = .016) but did not differ from SE. There were no intervention effects on other outcomes. CONCLUSION MAPs had beneficial effects on psychological and immune outcomes in younger breast cancer survivors and is a promising approach for enhancing biobehavioral health.
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Affiliation(s)
- Julienne E Bower
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA, USA
| | - Ann H Partridge
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA, USA
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Antonio C Wolff
- The Johns Hopkins University School of Medicine and Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, USA
| | - Steve W Cole
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Medicine (Hematology-Oncology), David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Michael R Irwin
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA, USA
| | - Elissa D Thorner
- The Johns Hopkins University School of Medicine and Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, USA
| | - Hadine Joffe
- Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Laura Petersen
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA, USA
| | - Catherine M Crespi
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Patricia A Ganz
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Medicine (Hematology-Oncology), David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
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Brown K, Armstrong N, Potdar N. Fertility preservation decisions in young women with breast cancer: a qualitative study of health care professionals' views and experiences. HUM FERTIL 2022; 25:903-911. [PMID: 34096435 DOI: 10.1080/14647273.2021.1933219] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Fertility preservation (FP) discussions prior to breast cancer treatment are an important aspect of care and considered routine practice. However, studies show that women diagnosed with breast cancer have unmet needs about FP discussions. To better understand them, a qualitative study was conducted to explore the perceptions of healthcare professionals (HCPs) regarding FP for young women diagnosed with breast cancer. Semi-structured interviews were performed in a University teaching hospital to explore the knowledge, attitudes and reported behaviours of HCPs (oncologists, breast surgeons, breast care specialist nurses and fertility specialists) who offer FP discussions (n = 20). Data were analysed thematically. HCPs in this study were aware of the need to discuss FP with patients but were not confident in their knowledge and were unsure of their role in the discussion. Patient characteristics of younger age, nulliparity and ethnicity appeared to influence if and how HCPs discussed FP, in addition to the personal attitudes and knowledge of HCPs. Specialist nurses were identified as having an important role in FP discussions. Raising awareness of the essential components of FP discussions by a checklist or algorithm may help in addressing ambiguity and promoting consistent FP discussions by HCPs.
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Affiliation(s)
- Kathryn Brown
- Leicester Medical School, University of Leicester, Leicester, United Kingdom
| | - Natalie Armstrong
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom
| | - Neelam Potdar
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom.,Women and Children CMG, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
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Treatment discontinuation, patient-reported toxicities and quality-of-life by age following trastuzumab emtansine or paclitaxel/trastuzumab (ATEMPT). NPJ Breast Cancer 2022; 8:127. [PMID: 36450763 PMCID: PMC9712612 DOI: 10.1038/s41523-022-00495-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 11/11/2022] [Indexed: 12/05/2022] Open
Abstract
In the ATEMPT trial, adjuvant trastuzumab emtansine (T-DM1) compared to paclitaxel plus trastuzumab (TH) for stage I HER2-positive breast cancer improved patient-reported outcomes (PROs), while maintaining excellent disease outcomes. We report treatment discontinuation and use multivariable models to compare, patient-reported toxicity and quality-of-life (QOL) by age (≤50, >50) and treatment arm at 18 months post-enrollment among 366 eligible participants randomized in a 3:1 ratio to T-DM1 or TH. T-DM1 discontinuation was higher among women >50 vs. ≤50 (23% vs. 9%, p = 0.003, Fisher's Exact test) with 4%, 8%, and 17% of older patients discontinuing treatment by 3, 6, and 9 months, respectively. Superior QOL with T-DM1 vs. TH was observed among women ≤50 with estimated mean difference of 6.48 (95% confidence interval (CI) 0.51-12.46) and driven by better social/family well-being and breast cancer-specific sub-scores. Among women >50, T-DM1 was associated with superior physical well-being and less activity impairment, with no differences in global QOL. Older women had decreased neuropathy with T-DM1 vs. TH. De-escalated treatment regimens for HER2 positive breast cancer may have age-varying impact on treatment tolerance, toxicities and subsequent QOL, which should be considered when selecting therapy options.Clinical Trial Registration: ClinicalTrials.gov, NCT01853748.
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Andreu Y, Soto-Rubio A, Ramos-Campos M, Escriche-Saura A, Martínez M, Gavilá J. Impact of hormone therapy side effects on health-related quality of life, distress, and well-being of breast cancer survivors. Sci Rep 2022; 12:18673. [PMID: 36333362 PMCID: PMC9636256 DOI: 10.1038/s41598-022-22971-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022] Open
Abstract
To explore the modulatory role of Adjuvant Hormone Therapy (AHT) on health-related quality of life (QoL), subjective well-being and distress prevalence in Breast Cancer (BC) survivors, considering the survival phase. Cross-sectional study with control group. 616 BC survivors participated. Examination of interaction effect between AHT and time since end of primary treatment showed that many of the positive changes observed through the survival phases were experienced exclusively by survivors without AHT. When AHT was not prescribed, longer time elapsed was associated with a decrease in distress prevalence and an improvement in subjective well-being and QoL. It seems there is a turning point around the fifth year after finalization of primary treatment, from which the survivors without AHT significantly improve in several areas and those with AHT do so to a lesser extent. It is expected that the improvement in QoL throughout the different survival phases will have a significant impact on the adherence and maintenance of AHT and, consequently, the likelihood of survival. Thus, AHT side-effects should be routinely assessed by health care providers to gain accurate knowledge that allows improving the QoL of BC survivors.
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Affiliation(s)
- Y Andreu
- Personality, Assessment and Psychological Treatments Department, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - A Soto-Rubio
- Personality, Assessment and Psychological Treatments Department, Faculty of Psychology, University of Valencia, Valencia, Spain.
| | - M Ramos-Campos
- Asociación Española Contra el Cáncer (AECC), Valencia, Spain
| | | | - M Martínez
- Department of Medical Oncology, Hospital Clínico Universitario de Valencia-Biomedical Research Institute INCLIVA, Valencia, Spain
| | - J Gavilá
- Medical Oncology Department, Fundación Instituto Valenciano de Oncología, Valencia, Spain
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Smith T, Kingsberg SA, Faubion S. Sexual dysfunction in female cancer survivors: Addressing the problems and the remedies. Maturitas 2022; 165:52-57. [DOI: 10.1016/j.maturitas.2022.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 07/11/2022] [Accepted: 07/16/2022] [Indexed: 10/31/2022]
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Aitken LA, Hossan SZ. The Psychological Distress and Quality of Life of Breast Cancer Survivors in Sydney, Australia. Healthcare (Basel) 2022; 10:healthcare10102017. [PMID: 36292463 PMCID: PMC9601883 DOI: 10.3390/healthcare10102017] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/08/2022] [Accepted: 10/11/2022] [Indexed: 11/16/2022] Open
Abstract
In Australia, breast cancer is one of the most common cancers affecting women. Between 1987-1991 and 2012-2016, the five-year survival rate improved from 75% to 91%. The increased chance of survival due to early detection and treatment interventions has resulted in more women living with the diagnosis. This qualitative study was designed to analyse the journey of breast cancer survivors, their experience of psychological distress and changes in quality of life (QOL) due to the increased prevalence amongst Australian women. In-depth interviews were conducted; they lasted over 45 min and comprised 15 participants. The main topics discussed were knowledge of breast cancer prior to diagnosis, psychological distress, QOL and experience of use of healthcare services. The results showed that the process of diagnosis, undergoing treatment and isolation post-treatment resulted in high amounts of psychological distress. A reduction in QOL was also experienced due to treatment and medication side effects, fatigue, cognitive changes, and body-image perception. These findings can assist researchers in providing evidence-based frameworks for policy changes and for further investigation into effective healthcare interventions.
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64
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Strehle LD, Russart KLG, Burch VA, Grant CV, Pyter LM. Ovarian status modulates endocrine and neuroinflammatory responses to a murine mammary tumor. Am J Physiol Regul Integr Comp Physiol 2022; 323:R432-R444. [PMID: 35993563 PMCID: PMC9512114 DOI: 10.1152/ajpregu.00124.2022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 08/01/2022] [Accepted: 08/05/2022] [Indexed: 11/22/2022]
Abstract
Patients with breast cancer have increased circulating inflammatory markers and mammary tumors increase neuroinflammation in rodent models. Menopausal status is not only important in the context of breast cancer as circulating estrogen influences tumor progression, but also because estrogen is anti-inflammatory and an essential modulator of endocrine function in the brain and body. Here, we manipulated "menopause" status (ovary-intact and ovariectomized) in an estrogen receptor (ER)+ mouse mammary tumor model to determine the extent to which ovarian status modulates: 1) tumor effects on estrogen concentrations and signaling in the brain, 2) tumor effects on estrogen-associated neurobiology and inflammation, and 3) the ability for tumor resection to resolve the effects of a tumor. We hypothesized that reduced circulating estradiol (E2) after an ovariectomy exacerbates tumor-induced peripheral and central inflammation. Notably, we observed ovarian-dependent modulation on tumor-induced peripheral outcomes, including E2-dependent processes and, to a lesser degree, circulating inflammatory markers. In the brain, ovariectomy exacerbated neuroinflammatory markers in select brain regions and modulated E2-related neurobiology due to a tumor and/or resection. Overall, our data suggest that ovarian status has moderate implications for tumor-induced alterations in neuroendocrinology and neuroinflammation and mild effects on peripheral inflammatory outcomes in this murine mammary tumor model.
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Affiliation(s)
- Lindsay D Strehle
- Institute for Behavioral Medicine Research, The Ohio State University, Columbus, Ohio
| | - Kathryn L G Russart
- Institute for Behavioral Medicine Research, The Ohio State University, Columbus, Ohio
- Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio
| | - Valerie A Burch
- Institute for Behavioral Medicine Research, The Ohio State University, Columbus, Ohio
| | - Corena V Grant
- Institute for Behavioral Medicine Research, The Ohio State University, Columbus, Ohio
| | - Leah M Pyter
- Institute for Behavioral Medicine Research, The Ohio State University, Columbus, Ohio
- Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio
- Department of Neuroscience, The Ohio State University, Columbus, Ohio
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Wan X, Huang H, Peng Q, Zhang Y, Hao J, Lu G, Chen C. The relation between coping style and posttraumatic growth among patients with breast cancer: A meta-analysis. Front Psychol 2022; 13:926383. [PMID: 36248465 PMCID: PMC9556874 DOI: 10.3389/fpsyg.2022.926383] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 09/12/2022] [Indexed: 12/05/2022] Open
Abstract
Posttraumatic growth (PTG) has been correlated with coping style among patients with breast cancer. However, to date, there is no consensus on the extent to which coping style is associated with PTG in patients with breast cancer. Therefore, we performed a meta-analysis to quantitatively synthesize previous findings. Based on the PRISMA method, this study employed a random effects model using the Stata software (version 16.0) to calculate the pooled correlation coefficient and examined a range of moderators: cancer stage, publication type, participants’ age, and coping style measurement tools. Relevant studies, published from inception to 9 March 2022, were identified through a systematic search in PubMed, Embase, Web of Science, PsycINFO, WANFANG DATA, Chinese National Knowledge Infrastructure (CNKI), and China Science and Technology Journal Database (VIP) databases. Finally, 20 studies involving 3,571 breast cancer patients were included in this investigation. The results showed a high positive relation between confrontation coping and PTG and a moderate positive relation between avoidance coping and PTG (confrontation: r = 0.456; avoidance: r = 0.291). Additionally, a moderate negative relation was identified between acceptance–resignation coping and PTG (r = –0.289). Publication type and coping style measurement tools moderated the relation between coping style and PTG among breast cancer patients. The findings indicated that breast cancer patients should either confront the disease or avoid coping with it according to their disease state, which would facilitate better growth. More studies, especially, large prospective studies, are warranted to verify our findings.
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Affiliation(s)
- Xiao Wan
- College of Nursing and Health, Institute of Nursing and Health, Henan University, Kaifeng, Henan, China
| | - Haitao Huang
- College of Nursing and Health, Institute of Nursing and Health, Henan University, Kaifeng, Henan, China
| | - Qianwen Peng
- College of Nursing and Health, Institute of Nursing and Health, Henan University, Kaifeng, Henan, China
| | - Yiming Zhang
- College of Nursing and Health, Institute of Nursing and Health, Henan University, Kaifeng, Henan, China
| | - Jiwei Hao
- College of Nursing and Health, Institute of Nursing and Health, Henan University, Kaifeng, Henan, China
- *Correspondence: Jiwei Hao,
| | - Guangli Lu
- School of Business, Institute of Business Administration, Henan University, Kaifeng, China
- Guangli Lu,
| | - Chaoran Chen
- College of Nursing and Health, Institute of Nursing and Health, Henan University, Kaifeng, Henan, China
- Chaoran Chen,
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Wilson JM, Colebaugh CA, Flowers KM, Edwards RR, Partridge AH, Dominici LS, Schreiber KL. Early postoperative psychological distress as a mediator of subsequent persistent postsurgical pain outcomes among younger breast cancer patients. Breast Cancer Res Treat 2022; 196:363-370. [DOI: 10.1007/s10549-022-06720-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/19/2022] [Indexed: 12/01/2022]
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Miller KD, Nogueira L, Devasia T, Mariotto AB, Yabroff KR, Jemal A, Kramer J, Siegel RL. Cancer treatment and survivorship statistics, 2022. CA Cancer J Clin 2022; 72:409-436. [PMID: 35736631 DOI: 10.3322/caac.21731] [Citation(s) in RCA: 969] [Impact Index Per Article: 484.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 04/18/2022] [Indexed: 12/12/2022] Open
Abstract
The number of cancer survivors continues to increase in the United States due to the growth and aging of the population as well as advances in early detection and treatment. To assist the public health community in better serving these individuals, the American Cancer Society and the National Cancer Institute collaborate triennially to estimate cancer prevalence in the United States using incidence and survival data from the Surveillance, Epidemiology, and End Results cancer registries, vital statistics from the Centers for Disease Control and Prevention's National Center for Health Statistics, and population projections from the US Census Bureau. Current treatment patterns based on information in the National Cancer Database are presented for the most prevalent cancer types by race, and cancer-related and treatment-related side-effects are also briefly described. More than 18 million Americans (8.3 million males and 9.7 million females) with a history of cancer were alive on January 1, 2022. The 3 most prevalent cancers are prostate (3,523,230), melanoma of the skin (760,640), and colon and rectum (726,450) among males and breast (4,055,770), uterine corpus (891,560), and thyroid (823,800) among females. More than one-half (53%) of survivors were diagnosed within the past 10 years, and two-thirds (67%) were aged 65 years or older. One of the largest racial disparities in treatment is for rectal cancer, for which 41% of Black patients with stage I disease receive proctectomy or proctocolectomy compared to 66% of White patients. Surgical receipt is also substantially lower among Black patients with non-small cell lung cancer, 49% for stages I-II and 16% for stage III versus 55% and 22% for White patients, respectively. These treatment disparities are exacerbated by the fact that Black patients continue to be less likely to be diagnosed with stage I disease than White patients for most cancers, with some of the largest disparities for female breast (53% vs 68%) and endometrial (59% vs 73%). Although there are a growing number of tools that can assist patients, caregivers, and clinicians in navigating the various phases of cancer survivorship, further evidence-based strategies and equitable access to available resources are needed to mitigate disparities for communities of color and optimize care for people with a history of cancer. CA Cancer J Clin. 2022;72:409-436.
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Affiliation(s)
| | - Leticia Nogueira
- Health Services Research, American Cancer Society, Atlanta, Georgia
| | - Theresa Devasia
- Data Analytics Branch, Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | - Angela B Mariotto
- Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | - K Robin Yabroff
- Health Services Research, American Cancer Society, Atlanta, Georgia
| | - Ahmedin Jemal
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Joan Kramer
- Department of Hematology and Medical Oncology, Emory University, Atlanta, Georgia
| | - Rebecca L Siegel
- Surveillance Research, American Cancer Society, Atlanta, Georgia
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Crown A, Muhsen S, Sevilimedu V, Kelvin J, Goldfarb SB, Gemignani ML. Fertility Preservation in Young Women with Breast Cancer: Impact on Treatment and Outcomes. Ann Surg Oncol 2022; 29:5786-5796. [PMID: 35672625 PMCID: PMC10118746 DOI: 10.1245/s10434-022-11910-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 05/03/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND The impact of chemotherapy timing on the fertility preservation (FP) decision is poorly understood. Here we evaluate factors associated with FP completion among women age ≤ 45 years with breast cancer who received chemotherapy and consulted with a reproductive endocrinology and infertility (REI) specialist, and report pregnancy and oncologic outcomes. PATIENTS AND METHODS This retrospective review included all women age ≤ 45 years diagnosed with stage I-III unilateral breast cancer at Memorial Sloan Kettering Cancer Center between 2009 and 2015 who received chemotherapy and consulted with an REI specialist. Clinicopathologic features and factors associated with the decision to undergo FP were analyzed, and comparisons were made with the Wilcoxon rank-sum test, Chi-square test, or Fisher's exact test. Survival curves were constructed using the Kaplan-Meier method. RESULTS Among the 172 women identified, median age was 34 years (interquartile range 31-37 years). The majority of women were single (n = 99, 57.6%) and nulliparous (n = 134, 77.9%). Most women underwent FP (n = 121, 70.3%). Factors associated with the decision to undergo FP included younger median age (33 vs. 37 years, p < 0.001), having private insurance (p < 0.001), nulliparity (p < 0.001), and referral from Breast Surgery (p = 0.004). Tumor characteristics and treatments were similar between women who underwent FP and those who declined. Overall survival and recurrence-free survival were also similar between groups. Women who underwent FP were more likely to have a biological child after breast cancer treatment. CONCLUSIONS Women underwent FP at high rates independent of timing of chemotherapy and oncologic factors. FP is associated with having a biological child and does not compromise oncologic outcomes.
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Affiliation(s)
- Angelena Crown
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Breast Surgery, True Family Women's Cancer Center, Swedish Cancer Institute, Seattle, WA, USA
| | - Shirin Muhsen
- Clemenceau Medical Center/Johns Hopkins International, Beirut, Lebanon
| | - Varadan Sevilimedu
- Biostatistics Service, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Joanne Kelvin
- Survivorship Center, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Shari B Goldfarb
- Breast Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Mary L Gemignani
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
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69
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Yu K, Wang Y, Wang XQ, Ma R, Li YL, Zhou YQ. Experience of reproductive concerns in women with schizophrenia: A descriptive phenomenological study. Int J Nurs Stud 2022; 135:104343. [PMID: 36029550 DOI: 10.1016/j.ijnurstu.2022.104343] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 07/01/2022] [Accepted: 08/02/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Reproductive concerns significantly affect the mental health of people, causing more serious psychological stress than disease. The reproductive concerns faced by women with schizophrenia are issues that have been neglected in the areas of psychiatry and women's health. OBJECTIVES To explore the experience of reproductive concerns through the perspective of women with schizophrenia. DESIGN Descriptive phenomenology interview study. SETTING Data collection was carried out in a psychiatric hospital in China. PARTICIPANTS 15 women with schizophrenia were recruited with a prospective sampling. All participants were 26-40 years old. METHODS The interview recordings were transcribed by the research team, and transcripts were analyzed by two independent coders with Colaizzi's descriptive analysis framework. The process employed NVivo 12 software. RESULTS Data analysis identified 9 subthemes falling into the 4 macrothemes: (a) Potential risks of reproduction; (b) The difficulties in raising children; (c) Significance of reproduction; (d) Multiparty cooperation is needed to relieve reproductive concerns. CONCLUSION Women with schizophrenia have reproductive concerns under the conflict between the significance of reproduction and obstacles. Interventions to address the reproductive problems of women with schizophrenia should be developed in three areas: the women themselves, the women's spouses and the medical staff.
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Affiliation(s)
- Kai Yu
- Department of Nursing, Harbin Medical University, Harbin, Heilongjiang 150081, China
| | - Yu Wang
- Department of Nursing, Harbin Medical University, Harbin, Heilongjiang 150081, China
| | - Xiao-Qing Wang
- Department of Nursing, Harbin Medical University, Harbin, Heilongjiang 150081, China
| | - Rui Ma
- Department of Nursing, Harbin Medical University, Harbin, Heilongjiang 150081, China
| | - Ying-Li Li
- Medicine College Jiaxing University, Jiaxing, Zhejiang, 314001, China
| | - Yu-Qiu Zhou
- Department of Nursing, Harbin Medical University, Harbin, Heilongjiang 150081, China.
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70
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Breast Cancer Disparities Related to Young Age at Diagnosis. CURRENT BREAST CANCER REPORTS 2022. [DOI: 10.1007/s12609-022-00459-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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71
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Sparidaens EM, Beerendonk CCM, Fleischer K, Nelen WLDM, Braat DDM, Hermens RPMG. Exploration of fertility and early menopause related information needs and development of online information for young breast cancer survivors. BMC Womens Health 2022; 22:329. [PMID: 35922784 PMCID: PMC9351061 DOI: 10.1186/s12905-022-01901-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 07/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Approximately half of premenopausal women diagnosed with breast cancer desire to conceive after they finish treatment. Counseling about the risk of infertility prior to cancer treatment has been proven to improve quality of life after cancer treatment. As a result of this, guidelines focus on informing women on this topic prior to treatment. However, it is equally important to provide fertility related information after primary treatment has been completed, when the wish to conceive might become actual. Therefore, the aim of this study was to identify the fertility and early menopause related information needs of young breast cancer survivors and to design, develop and implement online information material with input of stakeholders. METHODS A phenomenological qualitative study consisting of four phases was performed: identification of information needs through semi-structured interviews from a professional perspective (1) and a patient perspective (2). Exploration of stakeholders perspective regarding development and implementation of online information material (3) and development and implementation of the information material (4). RESULTS Professionals indicated that there are no guidelines regarding the provision of fertility related information during cancer survivorship. Survivors reported unmet information needs. Women identified the following as most important information needs (a) fertility preservation options, (b) the risk of menopause or infertility, and (c) long term consequences of early menopause. A wide range of stakeholders involved in breast cancer care were interviewed. Based on their proposed design the information material was implemented on a nationwide website aiming at informing and supporting breast cancer patients. CONCLUSIONS Fertility and early menopause related information needs of young breast cancer survivors and their professionals were identified. Information material has been designed, developed and nationally implemented. This way, professionals in breast cancer care are provided with an information tool that helps them meet the information needs and preferences of their patients.
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Affiliation(s)
- Ellen Marie Sparidaens
- Department of Obstetrics and Gynaecology, Radboud University Medical Center, P.O. Box 9101, 6500HB, Nijmegen, The Netherlands.
| | - Catharina C M Beerendonk
- Department of Obstetrics and Gynaecology, Radboud University Medical Center, P.O. Box 9101, 6500HB, Nijmegen, The Netherlands
| | - Kathrin Fleischer
- Department of Obstetrics and Gynaecology, Radboud University Medical Center, P.O. Box 9101, 6500HB, Nijmegen, The Netherlands
| | - Willianne L D M Nelen
- Department of Obstetrics and Gynaecology, Radboud University Medical Center, P.O. Box 9101, 6500HB, Nijmegen, The Netherlands
| | - Didi D M Braat
- Department of Obstetrics and Gynaecology, Radboud University Medical Center, P.O. Box 9101, 6500HB, Nijmegen, The Netherlands
| | - Rosella P M G Hermens
- Scientific Institute for Quality of Healthcare (IQ Healthcare), Radboud University Medical Center, P.O. Box 9101, 6500HB, Nijmegen, The Netherlands
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Wang Y, Tesch ME, Lim C, Xu YH, Lee S, Perdizet K, Yokom D, Warner E, Roberts J, Lohrisch CA. Risk of recurrence and pregnancy outcomes in young women with breast cancer who do and do not undergo fertility preservation. Breast Cancer Res Treat 2022; 195:201-208. [PMID: 35908122 DOI: 10.1007/s10549-022-06650-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 06/01/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE To assess the impact of fertility preservation (FP) requiring ovarian stimulation on breast cancer outcomes and pregnancy after breast cancer. METHODS Women aged ≤ 40 years diagnosed with stage I-III breast cancer between 2007 and 2018 and referred for FP consultation prior to systemic therapy were identified from a British Columbia fertility center database. The primary endpoint was invasive breast cancer-free survival (iBCFS) and secondary endpoints were overall survival (OS) and achievement of pregnancy. Survival and pregnancy endpoints were compared using Cox and logistic regression analyses, respectively, for patients who did and did not undergo FP. RESULTS The study included 153 patients, with 71 (46%) in the FP group and 82 (54%) in the non-FP group. Patients who underwent FP were more likely to be ECOG 0 (99% vs. 88%, p = 0.011) and receive chemotherapy (93% vs. 67%, p < 0.001), but had similar ER positivity status to non-FP patients (70% vs. 79%, p = 0.21). Over a median follow-up of 4.1 years, there were no differences in iBCFS (HR 1.006, 95% CI 0.416-2.438, p = 0.988) or OS (HR 0.789, 95% CI 0.210-2.956, p = 0.725) between FP and non-FP groups. Patients who underwent FP had higher odds of conceiving at least once (OR 3.024, 95% CI 1.312-6.970, p = 0.008). CONCLUSION At a median follow-up of 4.1 years, FP did not impact iBCFS or OS, supporting its safety in young women with breast cancer. In addition, patients who underwent FP were more likely to become pregnant after breast cancer, highlighting the value of pre-oncologic treatment FP in survivorship family planning.
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Affiliation(s)
- Ying Wang
- Department of Medical Oncology, British Columbia Cancer, 600 West 10th Avenue, Vancouver, BC, V5Z 4E6, Canada
| | - Megan E Tesch
- Department of Medical Oncology, British Columbia Cancer, 600 West 10th Avenue, Vancouver, BC, V5Z 4E6, Canada
| | - Chloe Lim
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Ying Hui Xu
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Shaina Lee
- Division of Oncology and Department of Gynecology, Allan Blair Cancer Centre, Regina, SK, Canada
| | | | - Dan Yokom
- Trillium Health Partners, Credit Valley Hospital, Mississauga, ON, Canada
| | - Ellen Warner
- Division of Medical Oncology, Sunnybrook Odette Cancer Centre, Toronto, ON, Canada
| | - Jeffery Roberts
- Pacific Centre for Reproductive Medicine, Vancouver, BC, Canada
| | - Caroline A Lohrisch
- Department of Medical Oncology, British Columbia Cancer, 600 West 10th Avenue, Vancouver, BC, V5Z 4E6, Canada.
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Akin Telli T, Ozturk MA, Alan O, Hasanov R, Kostek O, Arikan R, Basoglu T, Kaya S, Ercelep O, Akgul Babacan N, Dane F, Yumuk PF. Real-world assessment of quality-of-life in patients with breast cancer treated with adjuvant endocrine therapy. Future Oncol 2022; 18:2425-2439. [PMID: 35695547 DOI: 10.2217/fon-2021-1322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Objective: The aim of this study was to investigate quality-of-life (QoL) in breast cancer (BC) patients treated with adjuvant endocrine therapy (AET). Methods: We designed a cross-sectional study of 233 BC patients treated with AET and used the Functional Assessment of Cancer Therapy - Breast questionnaire. Results: No significant difference was observed between endocrine agents. Duration of AET did not affect QoL. In the entire cohort, multivariate analysis determined age (p = 0.034) and switching treatment from tamoxifen to aromatase inhibitors (p = 0.049) as significant positive coefficients of QoL, while comorbidity (p = 0.072) tended to be associated with lower scores. Education level (p = 0.001) and chemotherapy (p = 0.04) were significant predictors of QoL in the tamoxifen group, while comorbidity (p = 0.04), surgery type (p = 0.02), radiotherapy (p = 0.006) and stage (p = 0.009) had a significant impact on QoL in aromatase inhibitors group. Conclusion: Evaluating the well-being of BC patients by QoL questionnaires is of great importance to identify particular subgroups that may require supportive care.
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Affiliation(s)
- Tugba Akin Telli
- Department of Medical Oncology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Mehmet Akif Ozturk
- Department of Medical Oncology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Ozkan Alan
- Department of Medical Oncology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Rahib Hasanov
- Department of Medical Oncology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Osman Kostek
- Department of Medical Oncology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Rukiye Arikan
- Department of Medical Oncology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Tugba Basoglu
- Department of Medical Oncology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Serap Kaya
- Department of Medical Oncology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Ozlem Ercelep
- Department of Medical Oncology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Nalan Akgul Babacan
- Department of Medical Oncology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Faysal Dane
- Department of Medical Oncology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Perran Fulden Yumuk
- Department of Medical Oncology, Faculty of Medicine, Marmara University, Istanbul, Turkey
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74
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Bártolo A, Santos IM, Guimarães R, Reis S, Monteiro S. Attentional Bias Toward Reproduction-Related Stimuli and Fertility Concerns Among Breast Cancer Survivors. Behav Med 2022; 48:273-283. [PMID: 33872117 DOI: 10.1080/08964289.2021.1879725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The current study examined whether an attentional bias exists for reproduction-related visual cues among breast cancer survivors and its relationship with fertility concerns and emotional distress. Breast cancer survivors (n = 38) aged 18-40 were compared to 37 healthy women recruited from the general population. Attentional bias was investigated using a visual dot-probe task and response times (RT) were measured. Participants also completed several questionnaires, including the Reproductive Concerns After Cancer Scale (RCACS) and the Hospital Anxiety and Depression Scale (HADS). Biased cognitive processing toward reproduction-related stimuli was observed for all young women. However, attentional bias was a significant predictor of concerns about partner disclosure of fertility status, with higher bias scores associated with higher levels of concern only for breast cancer survivors. The desire to have a (or another) biological child was also a significant predictor of higher concerns related with fertility potential for all young women. Higher vigilance regarding reproduction-related cues seems to lead to higher concerns among women with breast cancer history whose fertility is threatened. This result may have important research and clinical implications. Interventions focused on goal-oriented attention self-regulation and problem-solving can help to manage fertility concerns and distress in the course of the disease.
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Affiliation(s)
- Ana Bártolo
- Center for Health Technology and Services Research (CINTESIS), Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Isabel M Santos
- William James Center for Research, Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Raquel Guimarães
- Breast Center, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Salomé Reis
- Department of Gynecology and Obstetrics, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Sara Monteiro
- Center for Health Technology and Services Research (CINTESIS), Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
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75
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Al-Kaylani HM, Loeffler BT, Mott SL, Curry M, Phadke S, van der Plas E. Characterizing Early Changes in Quality of Life in Young Women With Breast Cancer. Front Psychol 2022; 13:871194. [PMID: 35645920 PMCID: PMC9132041 DOI: 10.3389/fpsyg.2022.871194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 03/22/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Younger age at diagnosis is a risk factor for poor health-related quality of life (HRQOL) in long-term breast cancer survivors. However, few studies have specifically addressed HRQOL in young adults with breast cancer (i.e., diagnosed prior to age 40), nor have early changes in HRQOL been fully characterized. Methods Eligible female patients with breast cancer were identified through our local cancer center. To establish HRQOL, patients completed the Functional Assessment of Cancer Therapy-Breast (FACT-B) around diagnosis and 12 months later. Sociodemographic factors, genetic susceptibility to cancer, tumor- and treatment-related factors, and comorbidities (e.g., depression/anxiety) were abstracted from medical records and the local oncology registry. Mixed-effects models were used to identify changes in FACT-B scores during the first year of treatment and to determine whether any demographic/treatment-related factors modulated changes in scores. Results Health-related quality of life in young patients with breast cancer was within normal limits at baseline, with a FACT-B overall well-being score of 108.5 (95% confidence limits [CI] = 103.7, 113.3). Participants reported slight improvements over a 12-month period: FACT-B overall well-being scores increased 6.6 points (95% CI = 2.1, 11.1, p < 0.01), functional well-being improved 3.0 points (95% CI = 2.0, 4.1, p < 0.01), emotional well-being improved 1.9 points (95% CI = 0.9, 2.8, p < 0.01), and physical well-being improved 1.5 points (95% CI = 0.2, 2.8, p = 0.03), on average. Participants with anxiety/depression at baseline reported greater improvements in FACT-B overall well-being (change: 12.9, 95% CI = 6.4, 9.5) and functional well-being (change: 5.2, 95% CI = 3.5, 6.9) than participants who did not have anxiety/depression at baseline (change in FACT-B overall well-being: 4.9, 95% CI = 0.2, 9.7; change in functional well-being: 2.3, 95% CI = 1.1, 3.4). Marital status, reconstructive surgery, and baseline clinical staging were also significantly associated with changes in aspects of HRQOL, although their impact on change was relatively minimal. Conclusion Young women with breast cancer do not report HRQOL concerns during the first year of treatment. Improvements in HRQOL during the first year of treatment may be attributable to a sense of relief that the cancer is being treated, which, in the short run, may outweigh the negative late effects of treatment.
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Affiliation(s)
- Hend M Al-Kaylani
- Department of Psychiatry, University of Iowa Hospital and Clinics, Iowa City, IA, United States
| | - Bradley T Loeffler
- Holden Comprehensive Cancer Center, University of Iowa Hospital and Clinics, Iowa City, IA, United States
| | - Sarah L Mott
- Holden Comprehensive Cancer Center, University of Iowa Hospital and Clinics, Iowa City, IA, United States
| | - Melissa Curry
- Holden Comprehensive Cancer Center, University of Iowa Hospital and Clinics, Iowa City, IA, United States
| | - Sneha Phadke
- Division of Hematology, Oncology, and Blood and Marrow Transplantation, Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA, United States
| | - Ellen van der Plas
- Department of Psychiatry, University of Iowa Hospital and Clinics, Iowa City, IA, United States
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76
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Gradishar WJ, Moran MS, Abraham J, Aft R, Agnese D, Allison KH, Anderson B, Burstein HJ, Chew H, Dang C, Elias AD, Giordano SH, Goetz MP, Goldstein LJ, Hurvitz SA, Isakoff SJ, Jankowitz RC, Javid SH, Krishnamurthy J, Leitch M, Lyons J, Mortimer J, Patel SA, Pierce LJ, Rosenberger LH, Rugo HS, Sitapati A, Smith KL, Smith ML, Soliman H, Stringer-Reasor EM, Telli ML, Ward JH, Wisinski KB, Young JS, Burns J, Kumar R. Breast Cancer, Version 3.2022, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2022; 20:691-722. [PMID: 35714673 DOI: 10.6004/jnccn.2022.0030] [Citation(s) in RCA: 375] [Impact Index Per Article: 187.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The therapeutic options for patients with noninvasive or invasive breast cancer are complex and varied. These NCCN Clinical Practice Guidelines for Breast Cancer include recommendations for clinical management of patients with carcinoma in situ, invasive breast cancer, Paget disease, phyllodes tumor, inflammatory breast cancer, and management of breast cancer during pregnancy. The content featured in this issue focuses on the recommendations for overall management of ductal carcinoma in situ and the workup and locoregional management of early stage invasive breast cancer. For the full version of the NCCN Guidelines for Breast Cancer, visit NCCN.org.
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Affiliation(s)
| | | | - Jame Abraham
- Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
| | - Rebecca Aft
- Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
| | - Doreen Agnese
- The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
| | | | | | | | | | - Chau Dang
- Memorial Sloan Kettering Cancer Center
| | | | | | | | | | | | | | | | - Sara H Javid
- Fred Hutchinson Cancer Research Center/University of Washington
| | | | | | - Janice Lyons
- Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
| | | | | | | | | | - Hope S Rugo
- UCSF Helen Diller Family Comprehensive Cancer Center
| | | | | | | | | | | | | | - John H Ward
- Huntsman Cancer Institute at the University of Utah
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77
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The mediating effect of pleasure and menopausal symptoms on sexual activity among young breast cancer survivors. Support Care Cancer 2022; 30:5085-5092. [PMID: 35218415 DOI: 10.1007/s00520-022-06923-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 02/15/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE Young breast cancer survivors often go through a rapid change in menopause status due to cancer treatment and suffer from abrupt symptoms. This transition compels them to deal with unique medical and psychological side effects on their quality of life. One of the most affected quality of life domains is sexual functioning. This study explored the differences in frequency of sexual activity between young breast cancer survivors and young healthy women. It also examined whether this difference in sexual activity frequency was mediated by discomfort and/or pleasure during intercourse, both of which are affected by symptoms of premature menopause. METHODS A total of 97 young breast cancer survivors and 75 young healthy women completed a sociodemographic questionnaire: the Fallowfield's Sexual Activity Questionnaire (FSAQ) and the Menopausal Rating Scale (MRS). Additionally, the breast cancer participants completed a medical data questionnaire. RESULTS Findings revealed a significant direct effect between group and menopausal symptoms, menopausal symptoms and pleasure, and pleasure and frequency of sexual activity. Structural equation modeling explained the differences between the groups in frequency of sexual activity as mediated by menopausal symptoms and both pleasure and discomfort. CONCLUSIONS AND IMPLICATIONS These results highlight the impact of pleasure on the frequency of young breast cancer survivors' sexual activity, and its relation to menopausal symptoms. These young women should be provided with appropriate information and interventions that will help them experience increased pleasure during sexual activity despite their early and induced menopausal symptoms.
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78
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Tesch ME, Partridge AH. Treatment of Breast Cancer in Young Adults. Am Soc Clin Oncol Educ Book 2022; 42:1-12. [PMID: 35580291 DOI: 10.1200/edbk_360970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Although breast cancer is rare and understudied in adults age 40 and younger, recent epidemiologic data show an increasing incidence of breast cancer among young women in the United States and ongoing inferior long-term outcomes. Given breast cancers arising at a young age are more likely to present at advanced stages and to have aggressive biology, multimodal treatments are often indicated. Elevated local recurrence risks and greater propensity for germline cancer predisposition mutations can impact local therapy choices. Recently, escalated systemic therapy regimens for triple-negative breast cancer incorporating immunotherapy, de-escalated anti-HER2 therapy, and emerging targeted agents, including CDK4/6 inhibitors and PARP inhibitors, for early-stage disease may be employed in younger and older patients alike, with some special considerations. Prognostic genomic signatures can spare low-risk young women with hormone receptor-positive breast cancer adjuvant chemotherapy, but management of intermediate-risk patients remains controversial. Ovarian function suppression and extended endocrine therapy are improving outcomes in hormone receptor-positive breast cancer, but treatment adherence is a particular problem for young patients. Young women may also face greater challenges in long-term survivorship, including impaired fertility, difficulties in psychosocial adjustment, and other treatment-related comorbidities. Consideration of these age-specific issues through dedicated multidisciplinary strategies is necessary for optimal care of young women with breast cancer.
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79
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Rock CL, Thomson CA, Sullivan KR, Howe CL, Kushi LH, Caan BJ, Neuhouser ML, Bandera EV, Wang Y, Robien K, Basen-Engquist KM, Brown JC, Courneya KS, Crane TE, Garcia DO, Grant BL, Hamilton KK, Hartman SJ, Kenfield SA, Martinez ME, Meyerhardt JA, Nekhlyudov L, Overholser L, Patel AV, Pinto BM, Platek ME, Rees-Punia E, Spees CK, Gapstur SM, McCullough ML. American Cancer Society nutrition and physical activity guideline for cancer survivors. CA Cancer J Clin 2022; 72:230-262. [PMID: 35294043 DOI: 10.3322/caac.21719] [Citation(s) in RCA: 248] [Impact Index Per Article: 124.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/22/2021] [Accepted: 12/15/2021] [Indexed: 12/13/2022] Open
Abstract
The overall 5-year relative survival rate for all cancers combined is now 68%, and there are over 16.9 million survivors in the United States. Evidence from laboratory and observational studies suggests that factors such as diet, physical activity, and obesity may affect risk for recurrence and overall survival after a cancer diagnosis. The purpose of this American Cancer Society guideline is to provide evidence-based, cancer-specific recommendations for anthropometric parameters, physical activity, diet, and alcohol intake for reducing recurrence and cancer-specific and overall mortality. The audiences for this guideline are health care providers caring for cancer survivors as well as cancer survivors and their families. The guideline is intended to serve as a resource for informing American Cancer Society programs, health policy, and the media. Sources of evidence that form the basis of this guideline are systematic literature reviews, meta-analyses, pooled analyses of cohort studies, and large randomized clinical trials published since 2012. Recommendations for nutrition and physical activity during cancer treatment, informed by current practice, large cancer care organizations, and reviews of other expert bodies, are also presented. To provide additional context for the guidelines, the authors also include information on the relationship between health-related behaviors and comorbidities, long-term sequelae and patient-reported outcomes, and health disparities, with attention to enabling survivors' ability to adhere to recommendations. Approaches to meet survivors' needs are addressed as well as clinical care coordination and resources for nutrition and physical activity counseling after a cancer diagnosis.
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Affiliation(s)
- Cheryl L Rock
- Department of Family Medicine, School of Medicine, University of California at San Diego, La Jolla, California
| | - Cynthia A Thomson
- Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | - Kristen R Sullivan
- Department of Population Sciences, American Cancer Society, Atlanta, Georgia
| | - Carol L Howe
- Department of Medicine, University of Arizona Health Sciences Library, Tucson, Arizona
- Department of Family and Community Medicine, University of Arizona Health Sciences Library, Tucson, Arizona
| | - Lawrence H Kushi
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Bette J Caan
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Marian L Neuhouser
- Cancer Prevention Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Elisa V Bandera
- Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Ying Wang
- Department of Population Sciences, American Cancer Society, Atlanta, Georgia
| | - Kimberly Robien
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia
| | - Karen M Basen-Engquist
- Division of Cancer Prevention and Population Sciences, Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Justin C Brown
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana
| | - Kerry S Courneya
- Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Tracy E Crane
- Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
- Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Coral Gables, Florida
| | - David O Garcia
- Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | - Barbara L Grant
- Cancer Care Center, St Alphonsus Regional Medical Center, Boise, Idaho
| | - Kathryn K Hamilton
- Carol G. Simon Cancer Center, Morristown Medical Center, Morristown, New Jersey
| | - Sheri J Hartman
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California at San Diego, La Jolla, California
| | - Stacey A Kenfield
- Department of Urology, University of California at San Francisco, San Francisco, California
| | - Maria Elena Martinez
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California at San Diego, La Jolla, California
- Moores Cancer Center, University of California at San Diego, La Jolla, California
| | | | - Larissa Nekhlyudov
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - Alpa V Patel
- Department of Population Sciences, American Cancer Society, Atlanta, Georgia
| | - Bernardine M Pinto
- College of Nursing, University of South Carolina, Columbia, South Carolina
| | - Mary E Platek
- School of Health Professions, D'Youville College, Buffalo, New York
- Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Erika Rees-Punia
- Department of Population Sciences, American Cancer Society, Atlanta, Georgia
| | - Colleen K Spees
- College of Medicine, The Ohio State University, Columbus, Ohio
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80
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Update on Pregnancy Following Breast Cancer Diagnosis and Treatment. Cancer J 2022; 28:176-182. [PMID: 35594464 DOI: 10.1097/ppo.0000000000000599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Survivorship has become a crucial component in breast cancer care. For women who have not completed their family planning, conceiving at the end of anticancer treatments should not be discouraged but might be challenging. Oncofertility counseling should be offered at the time of diagnosis to all patients, in order to inform them about the potential treatment-induced gonadotoxicity as well as the available strategies for fertility preservation, thus allowing to increase the chances of a future pregnancy. This article reports an updated overview on the current state of the art on pregnancy in women with prior breast cancer diagnosis and treatment, with a main focus on the issues faced by patients with history of hormone receptor-positive disease and BRCA carriers.
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81
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Aupomerol M, Chaltiel D, Pautier P, Wehrer D, Véron L, Degousée L, Fasse L, Guéroult-Accolas L, Di Meglio A, Scotté F, De-Jesus A, Vaz-Luis I, Delaloge S, Lambertini M, Pistilli B. Breast cancer patients' experience and wishes regarding communication on sexual health: the BEROSE study. Cancer Invest 2022; 40:483-493. [PMID: 35468006 DOI: 10.1080/07357907.2022.2066112] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
BEROSE is a single-center observational study, which aimed to determine the proportion of women with breast cancer who received information on sexual health from health professionals throughout their whole care pathway. A total of 318 women with all stages of breast cancer (30% metastatic) and at different time interval from diagnosis (up to 7 years) participated to the survey. Sixty-five percent of women reported that they had not received any information about sexual health over the whole care. Increased awareness among the healthcare professionals and particularly the oncology community is needed to discuss sexual health in women with breast cancer.
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Affiliation(s)
- M Aupomerol
- Department of Medical oncology, Gustave Roussy Cancer Center, Villejuif, France
| | - D Chaltiel
- Department of Biostatistics and Epidemiology, Gustave Roussy Cancer Center, University Paris-Saclay, Villejuif, France.,Oncostat U1018, Inserm, University Paris-Saclay, labeled Ligue Contre le Cancer, Villejuif, France
| | - P Pautier
- Department of Medical oncology, Gustave Roussy Cancer Center, Villejuif, France
| | - D Wehrer
- Department of Medical oncology, Gustave Roussy Cancer Center, Villejuif, France
| | - L Véron
- Department of Medical oncology, Gustave Roussy Cancer Center, Villejuif, France
| | - L Degousée
- Department of Medical oncology, Gustave Roussy Cancer Center, Villejuif, France
| | - L Fasse
- Department of Interdisciplinary Cancer Course and supportive care (DIOPP), psychology Unit, Gustave Roussy Cancer Center, Villejuif, France
| | | | - A Di Meglio
- Department of Medical oncology, Gustave Roussy Cancer Center, Villejuif, France.,INSERM unit 981, Gustave Roussy Cancer Center, Villejuif, France
| | - F Scotté
- Department of Interdisciplinary Cancer Course and Supportive care (DIOPP), Gustave Roussy Cancer Center, Villejuif, France
| | - A De-Jesus
- Coordinator of Patient Group, Gustave Roussy Cancer Center, Villejuif, France
| | - I Vaz-Luis
- Department of Medical oncology, Gustave Roussy Cancer Center, Villejuif, France.,INSERM unit 981, Gustave Roussy Cancer Center, Villejuif, France
| | - S Delaloge
- Department of Medical oncology, Gustave Roussy Cancer Center, Villejuif, France
| | - M Lambertini
- Department of Medical Oncology, Breast Unit, IRCCS Ospedale Policlinico San Martino, Genova,Italy.,Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - B Pistilli
- Department of Medical oncology, Gustave Roussy Cancer Center, Villejuif, France
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82
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Risk factors for psychological morbidity and the protective role of coping self-efficacy in young women with breast cancer early in diagnosis: a national multicentre cohort study. Breast Cancer Res Treat 2022; 194:91-102. [DOI: 10.1007/s10549-022-06576-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 03/17/2022] [Indexed: 11/02/2022]
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83
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Di Meglio A, Havas J, Gbenou AS, Martin E, El-Mouhebb M, Pistilli B, Menvielle G, Dumas A, Everhard S, Martin AL, Cottu PH, Lerebours F, Coutant C, Lesur A, Tredan O, Soulie P, Vanlemmens L, Joly F, Delaloge S, Ganz PA, André F, Partridge AH, Jones LW, Michiels S, Vaz-Luis I. Dynamics of Long-Term Patient-Reported Quality of Life and Health Behaviors After Adjuvant Breast Cancer Chemotherapy. J Clin Oncol 2022; 40:3190-3204. [PMID: 35446677 PMCID: PMC9509127 DOI: 10.1200/jco.21.00277] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We aimed to characterize long-term quality of life (QOL) trajectories among patients with breast cancer treated with adjuvant chemotherapy and to identify related patterns of health behaviors.
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Affiliation(s)
- Antonio Di Meglio
- Medical Oncology, Gustave Roussy, Villejuif, France.,INSERM Unit 981, Molecular Predictors and New Targets in Oncology, Gustave Roussy, University Paris-Saclay, Villejuif, France
| | - Julie Havas
- INSERM Unit 981, Molecular Predictors and New Targets in Oncology, Gustave Roussy, University Paris-Saclay, Villejuif, France
| | - Arnauld S Gbenou
- INSERM Unit 981, Molecular Predictors and New Targets in Oncology, Gustave Roussy, University Paris-Saclay, Villejuif, France
| | - Elise Martin
- INSERM Unit 981, Molecular Predictors and New Targets in Oncology, Gustave Roussy, University Paris-Saclay, Villejuif, France
| | - Mayssam El-Mouhebb
- INSERM Unit 981, Molecular Predictors and New Targets in Oncology, Gustave Roussy, University Paris-Saclay, Villejuif, France
| | - Barbara Pistilli
- INSERM Unit 981, Molecular Predictors and New Targets in Oncology, Gustave Roussy, University Paris-Saclay, Villejuif, France
| | | | - Agnes Dumas
- Université de Paris, ECEVE UMR 1123, INSERM, Paris, France
| | | | | | | | | | | | - Anne Lesur
- Institut de Cancérologie de Lorraine, Nancy, France
| | | | | | | | | | | | | | - Fabrice André
- Medical Oncology, Gustave Roussy, Villejuif, France.,INSERM Unit 981, Molecular Predictors and New Targets in Oncology, Gustave Roussy, University Paris-Saclay, Villejuif, France
| | | | - Lee W Jones
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - Stefan Michiels
- Service de Biostatistique et d'Epidémiologie, Oncostat Inserm U1018, Université Paris- Saclay, Equipe labellisée Ligue Contre le Cancer, Gustave Roussy, Villejuif, France
| | - Ines Vaz-Luis
- Medical Oncology, Gustave Roussy, Villejuif, France.,INSERM Unit 981, Molecular Predictors and New Targets in Oncology, Gustave Roussy, University Paris-Saclay, Villejuif, France
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84
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Karzai S, Port E, Siderides C, Valente C, Ahn S, Moshier E, Ru M, Pisapati K, Couri R, Margolies L, Schmidt H, Cate S. Impact of Screening Mammography on Treatment in Young Women Diagnosed with Breast Cancer. Ann Surg Oncol 2022; 29:10.1245/s10434-022-11581-6. [PMID: 35364765 DOI: 10.1245/s10434-022-11581-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 02/21/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND There is little data exploring the impact of screening mammography on subsequent treatment in the 40-49-year age group with breast cancer. We sought to assess the association between frequency of mammography in young women and extent of surgery and chemotherapy required. METHODS An IRB-approved retrospective review was performed of patients diagnosed with breast cancer between ages 40 and 49 years from 1 January 2010 to 19 November 2018 within a single health system. Patients were grouped based on last screening 1-24 months prior to diagnosis (1-24 group), > 25 months prior to diagnosis (> 25 group), never screened, and > 25+ never screened (combination group). Multivariate logistic regression models were used to assess for associations between screening intervals and tumor and nodal stage, chemotherapy use, and extent of surgery. RESULTS Of 869 patients included for analysis, 20% were never screened, 60% screened 1-24 months, and 19% screened > 25 months prior to diagnosis. Compared with the 1-24 months group, the never-screened group, > 25 months group, and combined group were more likely to receive chemotherapy. The never-screened and combined groups were more likely to undergo mastectomy and/or axillary lymph node dissection. Of patients undergoing upfront surgery, the > 25 months and combined groups were more likely to receive adjuvant chemotherapy, while the never-screened and combined groups were more likely to have nodal disease. CONCLUSION Our findings support the initiation of screening mammography at age 40 years to reduce the risk of aggressive treatments for newly diagnosed breast cancers in this group.
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Affiliation(s)
- Shkala Karzai
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Elisa Port
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Cleo Siderides
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Christopher Valente
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Soojin Ahn
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Erin Moshier
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Meng Ru
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kereeti Pisapati
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ronald Couri
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Laurie Margolies
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Hank Schmidt
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sarah Cate
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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85
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Bobrie A, Jarlier M, Moussion A, Jacot W, D'Hondt V. Sexual quality of life assessment in young women with breast cancer during adjuvant endocrine therapy and patient-reported supportive measures. Support Care Cancer 2022; 30:3633-3641. [PMID: 35028721 PMCID: PMC8857103 DOI: 10.1007/s00520-022-06810-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 01/03/2022] [Indexed: 11/12/2022]
Abstract
PURPOSE Sexual quality of life (QoL) is affected during and after breast cancer (BC) treatment. The purpose was to investigate sexual and global QoL and patient-reported measures to address this issue in young women (< 51 years) with BC after the acute treatment phase, during adjuvant endocrine therapy. METHODS Three EORTC questionnaires and an additional specific questionnaire, developed for the study, were used to assess sexual and global QoL and patient-reported supportive measures in BC patients who had received their endocrine therapy for at least 24 months. Among the 54 eligible patients, 45 (83%) agreed to participate in the study. RESULTS We showed a deterioration in sexual QoL and poor communication with healthcare professionals. Most patients (88.9%) declared that it was important that sexuality should be discussed with caregivers and that the partner should also be involved. Most patients (60%) had taken at least one action to overcome their sexual problems. Most of these interventions (63%) originated from the patient herself. CONCLUSIONS Sexual QoL is a major issue in young BC patients and is poorly addressed by healthcare professionals. Most of the supportive methods used by the patients to overcome these side effects were on their own initiative. Communication and counseling on sexuality by healthcare professionals need to be improved during BC treatment. Patients suggested supportive measures they would find useful and appropriate to develop in the clinic. The final goal is to improve the sexual QoL of BC patients with the appropriate intervention and support.
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Affiliation(s)
- Angelique Bobrie
- Medical Oncology Department, Institut du Cancer de Montpellier (ICM), 208 Avenue des Apothicaires, 34298, Montpellier Cedex5, France
- Institut de Recherche en Cancerologie de Montpellier (IRCM), INSERM, University of Montpellier, Montpellier, France
| | - Marta Jarlier
- Biometrics Unit, Institut du Cancer de Montpellier, Montpellier, France
| | - Aurore Moussion
- Medical Research Unit, Institut du Cancer de Montpellier, Montpellier, France
| | - William Jacot
- Medical Oncology Department, Institut du Cancer de Montpellier (ICM), 208 Avenue des Apothicaires, 34298, Montpellier Cedex5, France
- Institut de Recherche en Cancerologie de Montpellier (IRCM), INSERM, University of Montpellier, Montpellier, France
| | - Veronique D'Hondt
- Medical Oncology Department, Institut du Cancer de Montpellier (ICM), 208 Avenue des Apothicaires, 34298, Montpellier Cedex5, France.
- Institut de Recherche en Cancerologie de Montpellier (IRCM), INSERM, University of Montpellier, Montpellier, France.
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86
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Sleep health in young women with breast cancer: a narrative review. Support Care Cancer 2022; 30:6419-6428. [PMID: 35288784 DOI: 10.1007/s00520-022-06953-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 03/03/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE The purpose of this narrative review was to synthesize the evidence on sleep health in young women with breast cancer and provide recommendations for clinical practice and research. METHODS Multiple databases were searched (OVID Medline, OVID PsycINFO, OVID Embase, and Scopus) using the search terms "breast neoplasm", "young women", "sleep", "sleep disturbance", "sleep problems", "sleep deficiency", and "insomnia". There were 467 titles and abstracts screened, and 82 full-text papers were reviewed, yielding 11 research publications for inclusion. RESULTS Sleep problems are prevalent among young women with breast cancer and are associated with vasomotor symptoms of menopause and psychological symptom distress. The evidence, however, is weak due to methodological and design aspects of the studies. CONCLUSIONS Poor sleep health in women with breast cancer is a clinically relevant problem that persists after treatment. As sleep is multidimensional and multifactorial, future research should evaluate sleep with objective sleep measures as well as self-reports; consider longitudinal designs; include factors that potentially contribute to poor sleep quality, such as physical and psychological symptom distress, family stressors, and competing life demands for this age group; and explore the perspective of this younger population of survivors on sleep. For clinical practice, survivorship visits should incorporate sleep assessment for all breast cancer survivors, especially younger women.
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87
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Development and Validity Testing of an Assessment Tool for Oncofertility Barriers in Multidisciplinary Healthcare Providers on the Breast Cancer Team. THE JOURNAL OF NURSING RESEARCH : JNR 2022; 30:e195. [PMID: 35234209 DOI: 10.1097/jnr.0000000000000479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Multidisciplinary healthcare providers, especially clinical nurses, lack a valid tool to assess the comprehensive barriers affecting oncofertility care in breast cancer treatment. PURPOSE The aims of the research were to develop a self-assessment scale on oncofertility barriers and test its validity and reliability. METHODS This was a methodological study. The initial 36 items of the developed Oncofertility Barrier Scale (OBS) were generated through qualitative study and a review of the literature. This scale was further refined using expert validity (n = 10), face validity (n = 10), and item analysis (n = 184). Exploratory factor analysis with principal axis factoring and direct oblimin rotation was used to determine the construct validity. The reliability of the OBS was evaluated using internal consistency and test-retest analyses. RESULTS The mean item-level and scale-level content validity indices of the initial OBS were higher than .96. The data were shown to be feasible for the factor analysis, and a six-factor solution was chosen that accounted for approximately 57.6% of the total variance. These factors included (a) lack of information and education, (b) rigid thinking toward oncofertility care, (c) cancer patient stereotypes, (d) fertility risk, (e) insufficient support, and (f) interrupted oncofertility care. The Cronbach's alpha of the 27-item OBS was .91, and the test-retest reliability coefficient was .55. CONCLUSIONS/IMPLICATIONS FOR PRACTICE The final version of the developed OBS has acceptable reliability, content validity, and construct validity. This scale is appropriate for use in research and clinical practice settings to identify the barriers to fertility cancer care that should be resolved by the breast cancer care team.
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88
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Cancer-related accelerated ageing and biobehavioural modifiers: a framework for research and clinical care. Nat Rev Clin Oncol 2022; 19:173-187. [PMID: 34873313 PMCID: PMC9974153 DOI: 10.1038/s41571-021-00580-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2021] [Indexed: 12/15/2022]
Abstract
A growing body of evidence indicates that patients with cancer who receive cytotoxic treatments (such as chemotherapy or radiotherapy) have an increased risk of accelerated physical and cognitive ageing. Furthermore, accelerated biological ageing is a suspected driving force behind many of these observed effects. In this Review, we describe the mechanisms of biological ageing and how they apply to patients with cancer. We highlight the important role of specific behavioural factors, namely stress, sleep and lifestyle-related factors such as physical activity, weight management, diet and substance use, in the accelerated ageing of patients with cancer and cancer survivors. We also present a framework of how modifiable behaviours could operate to either increase the risk of accelerated ageing, provide protection, or promote resilience at both the biological level and in terms of patient-reported outcomes.
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89
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Gong FX, Zhou X, Niu ZH, Mao Y, Wang YM, Lv M, Gao XQ, Liu WJ, Wang HB. Effects of Breast-Conserving Surgery Combined with Immediate Autologous Fat Grafting on Oncologic Safety, Satisfaction and Psychology in Patients with Breast Cancer: A Retrospective Cohort Study. Cancer Manag Res 2022; 14:1113-1124. [PMID: 35300064 PMCID: PMC8921672 DOI: 10.2147/cmar.s353370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 02/23/2022] [Indexed: 12/12/2022] Open
Abstract
Purpose Autologous fat grafting (AFG) is a technique that can improve the appearance of breasts in surgical patients. There are currently few studies on breast-conserving surgery (BCS) combined with immediate AFG, although we believe that it could achieve satisfactory effects. Therefore, the purpose of this study is to observe the effects of BCS combined with immediate AFG on oncologic safety, satisfaction and psychology of breast cancer patients. Patients and Methods We retrospectively collected the data of 85 breast cancer patients from February 2018 to October 2018. After screening, 40 patients in AFG group (AG, BCS combined with immediate AFG) and 40 patients in control group (CG, BCS alone) were finally included in the study. The primary outcomes were the survival, tumor recurrence and metastasis, and BREAST-Q score of patients. The secondary outcomes were short and long-term complications, degree of depression and anxiety of patients. Results A total of 80 patients were included in the analysis. There was no significant difference in the clinicopathological data between the two groups (P>0.05). The average follow-up time of the two groups was 40.58±2.630 and 40.28±2.679 months. In the analysis of oncologic safety, no patients died in AG and 1 patient died in CG. In addition, there was no significant difference between the two groups in terms of the overall recurrence rate and the distribution of recurrence types (P>0.05). As for satisfaction, the BREAST-Q score of AG was significantly higher than that of CG (57.85±4.833 vs 51.93±5.045, P<0.001). In the secondary outcomes, there was no short-term complication specified in the study; in the long-term complications, the incidence of calcification in AG was not significantly higher than that in CG (P=0.065). In the analysis of depression and anxiety, there was no significant difference between the two groups (P>0.05). Conclusion BCS combined with immediate AFG can significantly improve patients’ satisfaction without increasing the risk of death and tumor recurrence. However, it does not seem to play a role in improving the conditions of depression and anxiety.
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Affiliation(s)
- Fang-xue Gong
- Department of Breast Disease Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, People’s Republic of China
| | - Xin Zhou
- Qingdao Medical College of Qingdao University, Qingdao, Shandong Province, People’s Republic of China
| | - Zhao-he Niu
- Department of Breast Disease Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, People’s Republic of China
| | - Yan Mao
- Department of Breast Disease Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, People’s Republic of China
| | - Yong-mei Wang
- Department of Breast Disease Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, People’s Republic of China
| | - Meng Lv
- Department of Breast Disease Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, People’s Republic of China
| | - Xue-qiang Gao
- Department of Breast Disease Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, People’s Republic of China
| | - Wen-jing Liu
- Department of Breast Disease Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, People’s Republic of China
| | - Hai-bo Wang
- Department of Breast Disease Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, People’s Republic of China
- Correspondence: Hai-bo Wang, Department of Breast Disease Center, The Affiliated Hospital of Qingdao University, No. 59 Haier Road, Laoshan District, Qingdao City, Shandong Province, People’s Republic of China, Tel +86 18661805787, Email
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Umashankar S, Mamounas ME, Matthys M, Hadeler EK, Wong EC, Hicks G, Hwang J, Chien AJ, Rugo HS, Hamolsky D, Esserman L, Melisko M. Evaluation of the Pathways for Survivors Program to Address Breast Cancer Survivorship-Associated Distress: Survey Study. JMIR Cancer 2022; 8:e31756. [PMID: 35212641 PMCID: PMC8917438 DOI: 10.2196/31756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 11/04/2021] [Accepted: 12/09/2021] [Indexed: 11/17/2022] Open
Abstract
Background Patients with breast cancer frequently experience escalation of anxiety after completing curative treatment. Objective This study evaluated the acceptability and psychological impact of a 1-day workshop to emphasize behavioral strategies involving intention and self-efficacy. Methods Breast cancer survivors who attended a 1-day Pathways for Survivors workshop provided feedback and completed electronic quality of life (QOL) questionnaires at baseline, 1 and 6 weeks, and 6 months after the workshop. Attendees’ baseline QOL scores were compared to follow-up (FUP) scores. Scores from patients receiving routine FUP care were also compiled as a reference population. Results In total, 77 patients attended 1 of 9 workshops. The mean satisfaction score was 9.7 out of 10 for the workshop and 9.96 out of 10 for the moderator. Participants’ baseline mean Patient-Reported Outcomes Measurement Information System (PROMIS) anxiety and depression scores were 57.8 (SD 6.9) and 55.3 (SD 7.5), respectively, which were significantly higher than those of patients receiving routine FUP care (49.1, SD 8.3 and 47.3 SD 8.0, respectively). PROMIS anxiety and depression scores decreased, and the Happiness Index Profile (HIP-10) score—measuring intention and resiliency—increased significantly at 1- and 6-week FUPs. Conclusions The Pathways for Survivors program was favorably received. Anxiety and depression decreased significantly at 1- and 6-weeks after the workshop and remained below baseline at 6 months. Increased HIP-10 scores suggest that patients acquired and implemented skills from the workshop. A 1-day workshop led by a lay moderator significantly improved several psychological measures, suggesting that it may be a useful and time-efficient strategy to improve QOL in breast cancer survivors. We are investigating whether an abbreviated “booster” of the intervention at a later date could further improve and maintain QOL gains.
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Affiliation(s)
- Saumya Umashankar
- Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Matina Elise Mamounas
- Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Madeline Matthys
- Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Edward Kenji Hadeler
- Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Emily Claire Wong
- Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Greg Hicks
- Foster, Hicks & Associates, San Francisco, CA, United States
| | - Jimmy Hwang
- Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Amy Jo Chien
- Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Hope S Rugo
- Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Deborah Hamolsky
- Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Laura Esserman
- Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Michelle Melisko
- Department of Medicine, University of California San Francisco, San Francisco, CA, United States
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91
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Robson D, de Vries B, Pather S, Marren A. Fertility preservation in gynaecology oncology patients: Experience from an Australian tertiary oncology centre. Aust N Z J Obstet Gynaecol 2022; 62:542-547. [PMID: 35166382 DOI: 10.1111/ajo.13498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Management for gynaecological cancers often includes removal of the reproductive organs and/or the use of gonadotoxic therapies resulting in sub-fertility. Oncofertility and discussion of fertility preservation in these patients is critical. AIM To determine the rate of fertility preservation discussion among a cohort of patients with a gynaecological cancer and what determinants impact likelihood of a discussion. MATERIALS AND METHODS A seven-year quantitative retrospective study was conducted at a single oncology centre, including 15-45 year old patients with a gynaecological cancer. The primary outcome was if a fertility preservation discussion occurred during a consultation. Secondary outcomes included if a referral was made and what fertility preservation services were undertaken. Determinants that impacted the likelihood of a fertility preservation discussion were analysed. RESULTS One hundred and twenty-one patients were analysed. There were 84 (69%) patients who had a documented fertility preservation discussion, and 46% were referred to a fertility specialist for consultation. Age was a significant determinant, with patients aged 30-39 years of age more commonly having a fertility preservation discussion. Patients with a high-grade cancer compared to patients with a lower-grade cancer (grade one or two) were only a third as likely to have a discussion surrounding their fertility (odds ratio: 0.33, 95% CI: 0.13-0.86; P = 0.02). CONCLUSION We conclude that rates of discussion around fertility options for patients with cancer are lower than the recommended guidelines. Oncofertility is an important discipline which we believe needs to be emphasised within the gynaecology oncology community and management of patients should include a multi-disciplinary team.
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Affiliation(s)
- Danielle Robson
- Royal Prince Alfred Hospital for Women and Babies, Sydney, New South Wales, Australia
| | - Bradley de Vries
- Sydney Institute for Women, Children and their Families, Sydney Local Health District, Sydney, New South Wales, Australia.,School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Selvan Pather
- Chris O'Brien Lifehouse, Sydney, New South Wales, Australia
| | - Anthony Marren
- Royal Prince Alfred Hospital for Women and Babies, Sydney, New South Wales, Australia.,Genea LTD, Level 2, Sydney, New South Wales, Australia.,The Institute of Academic Surgery, Royal Prince Alfred Hospital & the University of Sydney, Sydney, New South Wales, Australia
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92
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Seib C, McCarthy A, McGuire A, Porter-Steele J, Balaam S, McDonald N, Bailey T, Anderson D. Determining the psychometric properties of the Greene Climacteric Scale (GCS) in women previously treated for breast cancer: A pooled analysis of data from the Women's Wellness after Cancer Programs. Maturitas 2022; 161:65-71. [DOI: 10.1016/j.maturitas.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 02/06/2022] [Accepted: 02/11/2022] [Indexed: 11/17/2022]
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Farland LV, Stern JE, Hwang SS, Liu CL, Cabral H, Knowlton R, Gershman ST, Coddington CC, Missmer SA. History of cancer and fertility treatment outcomes: a registry linkage study in Massachusetts. J Assist Reprod Genet 2022; 39:517-526. [PMID: 35037166 PMCID: PMC8956755 DOI: 10.1007/s10815-021-02376-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 12/06/2021] [Indexed: 02/03/2023] Open
Abstract
PURPOSE To investigate assisted reproductive technology (ART) outcomes among adolescent and young-adult female cancer survivors. METHODS The Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS) data were linked to the Massachusetts Cancer Registry for 90,928 ART cycles in Massachusetts to women ≥ 18 years old from 2004 to 2013. To estimate relative risks (RR) and 95% confidence intervals (CI), we used generalized estimating equations with a log link that accounted for multiple cycles per woman and a priori adjusted for maternal age and cycle year. The main outcomes of interest were ART treatment patterns; number of autologous oocytes retrieved, fertilized, and transferred; and rates of implantation, clinical intrauterine gestation (CIG), live birth, and pregnancy loss. RESULTS We saw no difference in number of oocytes retrieved (aRR: 0.95 (0.89-1.02)) or proportion of autologous oocytes fertilized (aRR: 0.99 (0.95-1.03)) between autologous cycles with and without a history of cancer; however, cancer survivors required a higher total FSH administered (aRR: 1.12 (1.06-1.19)). Among autologous cycle starts, cycles in women with a history of cancer were less likely to result in CIG compared to no history of cancer (aRR: 0.73 (0.65-0.83)); this relationship was absent from donor cycles (aRR: 1.01 (0.85-1.20)). Once achieving CIG, donor cycles for women with a history of cancer were two times more likely to result in pregnancy loss (aRR: 1.99 (1.26-3.16)). CONCLUSIONS Our analysis suggests that cancer may influence ovarian stimulation response, requiring more FSH and resulting in lower CIG among cycle starts.
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Affiliation(s)
- Leslie V Farland
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA.
| | - Judy E Stern
- Department of Obstetrics and Gynecology, Dartmouth-Hitchcock, Lebanon, NH, USA
| | - Sunah S Hwang
- Department of Pediatrics, Section of Neonatology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Chia-Ling Liu
- Massachusetts Department of Public Health, Bureau of Family Health and Nutrition, Boston, MA, USA
| | - Howard Cabral
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Richard Knowlton
- Massachusetts Cancer Registry, Office of Data Management and Outcomes Assessment, Office of Population Health, Massachusetts Department of Public Health, Boston, MA, USA
| | - Susan T Gershman
- Massachusetts Cancer Registry, Office of Data Management and Outcomes Assessment, Office of Population Health, Massachusetts Department of Public Health, Boston, MA, USA
| | | | - Stacey A Missmer
- Department of Obstetrics and Gynecology, Carolinas Medical Center/Atrium Health, Charlotte, NC, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Obstetrics, Gynecology, and Reproductive Biology, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
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Anderson RA, Kelsey TW, Morrison DS, Wallace WHB. Family size and duration of fertility in female cancer survivors: a population-based analysis. Fertil Steril 2022; 117:387-395. [PMID: 34933761 PMCID: PMC8865032 DOI: 10.1016/j.fertnstert.2021.11.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 11/01/2021] [Accepted: 11/04/2021] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To assess family size and timescale for achieving pregnancy in women who remain fertile after cancer. DESIGN Population-based analysis. SETTING National databases. PATIENT(S) All women diagnosed with cancer before the age of 40 years in Scotland, 1981-2012 (n = 10,267) with no previous pregnancy; each was matched with 3 population controls. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) The number and timing of pregnancy and live birth after cancer diagnosis, to 2018. RESULT(S) In 10,267 cancer survivors, the hazard ratio for a subsequent live birth was 0.56 (95% confidence interval, 0.53-0.58) overall. In women who achieved a subsequent pregnancy, age at live birth increased (mean ± SD, 31.2 ± 5.5 vs. 29.7 ± 6.1 in controls), and the family size was lower (2.0 ± 0.8 vs. 2.3 ± 1.1 live births). These findings were consistent across several diagnoses. The interval from diagnosis to last pregnancy was similar to that of controls (10.7 ± 6.4 vs. 10.9 ± 7.3 years) or significantly increased, for example, after breast cancer (6.2 ± 2.8 vs. 5.3 ± 3.3 years) and Hodgkin lymphoma (11.1 ± 5.1 vs. 10.1 ± 5.8 years). CONCLUSION(S) These data quantify the reduced chance of live birth after cancer. Women who subsequently conceived achieved a smaller family size than matched controls, but the period of time after cancer diagnosis across which pregnancies occurred was similar or, indeed, increased. Thus, we did not find evidence that women who were able to achieve a pregnancy after cancer had a shorter timescale over which they have pregnancies.
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Affiliation(s)
- Richard A Anderson
- MRC Centre for Reproductive Health, Queens Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom.
| | - Tom W Kelsey
- School of Computer Science, University of St Andrews, St Andrews, United Kingdom
| | | | - W Hamish B Wallace
- Department of Hematology and Oncology, Royal Hospital for Children and Young People, Edinburgh, United Kingdom
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95
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Linnane S, Quinn A, Riordan A, Dowling M. Women's fertility decision-making with a diagnosis of breast cancer: A qualitative evidence synthesis. Int J Nurs Pract 2022; 28:e13036. [PMID: 35088478 DOI: 10.1111/ijn.13036] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 04/18/2021] [Accepted: 12/19/2021] [Indexed: 11/30/2022]
Abstract
AIM To synthesize qualitative evidence of premenopausal women's experiences of fertility decision-making with a diagnosis of breast cancer. BACKGROUND Breast cancer is increasingly more common in premenopausal women who may have not yet considered starting a family or have completed their families. DESIGN Qualitative evidence synthesis guided by Thomas and Harden's three-stage approach to thematic analysis. DATA SOURCES Twelve electronic databases were searched: CINAHL, Embase, Pubmed, Proquest, PsychINFO, Lenus, Scopus, Web of Science, Rian.ie, Medline, EThOS e-theses online and DART Europe. No year limit was set. REVIEW METHODS The 'Enhancing transparency in reporting the synthesis of qualitative research guidelines' (ENTREQ) statement was followed. RESULTS Fifteen qualitative studies were included in the synthesis. Seven review findings under four major themes were identified: (1) first comes survival, (2) making decisions 'under the gun', (3) health-care professionals should not make assumptions and (4) we want accurate, detailed information and we want it early. High confidence in six of the review findings was agreed. CONCLUSION Most women experienced rushed fertility preservation decision-making at a time when they also faced cancer treatment decisions. Women want detailed, clear information on fertility preservation early after their diagnosis.
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Affiliation(s)
- Sharon Linnane
- Public Health Nurse, Mervue Health Centre, Galway, Ireland
| | - Aoife Quinn
- Clinical Nurse Specialist (Oncology), Galway University Hospitals, Galway, Ireland
| | - Anne Riordan
- National Health Library and Knowledge Service, Merlin Park University Hospital, Galway, Ireland
| | - Maura Dowling
- School of Nursing and Midwifery, National University of Ireland, Galway, Ireland
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96
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Griffiths P, Peipert JD, Leith A, Rider A, Morgan L, Cella D, Cocks K. Validity of a single-item indicator of treatment side effect bother in a diverse sample of cancer patients. Support Care Cancer 2022; 30:3613-3623. [PMID: 35031830 PMCID: PMC8857159 DOI: 10.1007/s00520-022-06802-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 12/31/2021] [Indexed: 12/19/2022]
Abstract
Purpose With higher efficacy of cancer therapies, the numbers and types of side effects experienced by patients have also increased, evidencing a need for brief assessments of side effect bother. The Functional Assessment of Cancer Therapy-General (FACT-G) includes the item “I am bothered by side effects of treatment” (GP5). This study aimed to confirm GP5’s validity in a large, diverse, real-world patient sample. Methods Real-world data were drawn from 10 Adelphi Disease Specific Programmes (DSP™) conducted between 2015 and 2019 in France, Germany, Italy, Spain, the UK and the USA, covering 10 cancer sites. We examined correlations between GP5 responses and varied measures of patient-reported global health and the number of side effects experienced. We explored whether more advanced patients and those with worse Eastern Cooperative Oncology Group Performance Status Rating (ECOG PSR) reported greater side effect bother. Finally, we conducted differential item functioning (DIF) assessment using the Mantel–Haenszel approach. Results The sample included 6755 advanced cancer patients. GP5 responses were distributed similarly across most cancer sites. A moderate, negative correlation (rpolyserial = − 0.43) between GP5 responses and global health evidenced convergent validity. Known groups validity was evidenced by dichotomised distributions of GP5, showing expected results between cancer stage 2 vs. 3 and 4 and with ECOG PSR (p < 0.001). Little evidence of DIF was found. Conclusion GP5 exhibited evidence of validity across cancer sites and countries and appeared to measure the same construct across these countries. GP5 has significant promise as a summary indicator of side effect bother.
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Affiliation(s)
| | - John Devin Peipert
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | | | | | - David Cella
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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97
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Baudry AS, Yakimova S, Congard A, Untas A, Guiu S, Lefeuvre-Plesse C, Loustalot C, Guillemet C, Segura-Djezzar C, Savoye AM, Coussy F, Frenel JS, Vanlemmens L, Christophe V. Adjustment of young women with breast cancer after chemotherapy: A mediation model of emotional competence via emotional distress. Psychooncology 2022; 31:848-855. [PMID: 34989072 DOI: 10.1002/pon.5876] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 12/15/2021] [Accepted: 12/27/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Emotional competence (EC) is considered a substantial resource in the adjustment of cancer patients, especially via its effect on anxiety and depression symptoms. This research aimed at assessing the impact of intrapersonal EC in young women (≤45 years) with breast cancer (YWBC) on their specific quality of life (i.e. subjective experience related to daily difficulties and perceived repercussions of the disease and treatments) related to chemotherapy, via anxiety and depression symptoms. METHODS Two hundred fifty YWBC from 24 French centers completed a self-reported questionnaire after diagnosis (T1) and after the chemotherapy phase (T2), comprising the Young Women Breast Cancer Inventory, the Profile of EC and the Hospital Anxiety and Depression Scale. The indirect effect of EC (T1) on subjective experience (T2) via anxiety and depression symptoms (T2) was tested using regressions and the Macro PROCESS. RESULTS Emotional competence predicted fewer anxiety and depression symptoms at T1 and T2, and a better subjective experience at T2 via fewer anxiety and depression symptoms. Depression symptoms appeared to be a stronger mediator than anxiety symptoms on four dimensions (Support from close relatives, feeling of couple cohesion, body image and sexuality, management of children and everyday life), whereas anxiety symptoms appeared to be a stronger mediator on two dimensions (negative affectivity and apprehension about the future, deterioration of relationships). CONCLUSIONS These results support the importance of developing psycho-affective interventions to reinforce the EC of YWBC during chemotherapy in order to facilitate the cognitive and emotional processes necessary for a better adjustment and subjective experience.
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Affiliation(s)
- Anne-Sophie Baudry
- Pôle Cancérologie et Spécialités Médicales - Centre Hospitalier de Valenciennes, Valenciennes, France.,Univ. Lille, CNRS, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, Lille, France.,Human and Social Sciences Department - Centre Léon Bérard, Lyon, France
| | - Sonya Yakimova
- Aix-Marseille Université, Centre de Recherche PsyCLÉ, EA 3273, Marseille, France
| | - Anne Congard
- Nantes Université, Laboratoire de Psychologie des Pays de la Loire, LPPL, EA 4638, Nantes, France
| | - Aurélie Untas
- Université de Paris, Laboratoire de Psychopathologie et Processus de Santé, Boulogne-Billancourt, France
| | - Séverine Guiu
- Department of Medical Oncology, ICM, Montpellier, France.,IRCM, INSERM, Université Montpellier, ICM, Montpellier, France
| | | | | | | | | | | | - Florence Coussy
- Département d'oncologie Médicale, Institut Curie Hôpital René Huguenin, Saint-Cloud, France
| | | | | | - Véronique Christophe
- Univ. Lille, CNRS, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, Lille, France.,Human and Social Sciences Department - Centre Léon Bérard, Lyon, France
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98
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Abstract
The incidence of breast cancer in younger women is rising. Although early-onset breast cancer is highly associated with biologically aggressive tumors such as triple-negative and human epidermal growth factor 2 (HER2)-positive cancers, the more recent increase is disproportionately driven by an increase in the incidence of luminal cancer. In particular, the increase in de novo stage IV disease and the inherent age-based poorer survival rate among younger women with even early-stage luminal cancers suggest underlying distinct biologic characteristics that are not well understood. Further contributing to the higher number of early-onset breast cancers is pregnancy-associated breast cancer (PABC), which is attributed to persistent increases in maternal age over time. Although guidelines for screening of patients who carry a BRCA1 or BRCA2 gene mutation are well established, this population comprises only a fraction of those with early-onset breast cancer. A lack of screening in most young patients precludes timely diagnosis, underscoring the importance of early education and awareness. The disproportionate disease burden in young women of certain racial and ethnic groups, which is further exacerbated by socioeconomic disparity in health care, results in worse outcomes. An invited commentary by Monticciolo is available online. ©RSNA, 2022.
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Affiliation(s)
- Yiming Gao
- From the Department of Radiology, New York University School of Medicine, 160 E 34th St, New York, NY 10016
| | - Naziya Samreen
- From the Department of Radiology, New York University School of Medicine, 160 E 34th St, New York, NY 10016
| | - Samantha L Heller
- From the Department of Radiology, New York University School of Medicine, 160 E 34th St, New York, NY 10016
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99
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Garg D, Meeks HD, Johnstone E, Berga SL, Smith KR, Hotaling J, Letourneau JM. Cancer treatment is associated with a measurable decrease in live births in a large, population-based study. F S Rep 2021; 2:462-467. [PMID: 34934988 PMCID: PMC8655402 DOI: 10.1016/j.xfre.2021.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 08/25/2021] [Accepted: 08/25/2021] [Indexed: 11/30/2022] Open
Abstract
Objective To define the live birth rates in a large, population-based study of the most common reproductive-age cancers in women. Design Retrospective cohort study. Setting Population-based study. Patients Female cancer patients diagnosed with cancer at age 18 years old or older between 1952–2014 (n = 17,952) were compared to fertility of non-cancer controls (n = 89,436). Interventions Live births in cancer survivors were compared with those in healthy, age-matched controls. Cases and controls were matched in the ratio of 5:1 for birth year, birthplace (Utah, yes/no), and follow-up time in Utah. Main Outcome Measure Rate of at least one live birth, reported as an incidence rate ratio (IRR). Results Of all cancer survivors, 3,127 (17.4%) had at least 1 live birth after treatment in comparison to 19,405 healthy, age-matched controls (21.7%) with the same amount of time exposure for attempting pregnancy. Breast cancer was the most common cancer type (23.1% of patients in cohort). Compared with age-matched, healthy controls, IRR of live birth was 0.69 (95% confidence interval [CI], 0.67–0.70) for all cancer types, 0.25 (95% CI, 0.20–0.33) for leukemia, 0.40 (95% CI, 0.28–0.59) for gastrointestinal cancers, 0.44 (95% CI, 0.41–0.48) for breast cancer, 0.53 (95% CI, 0.47–0.59) for central nervous system cancers, and 0.57 (95% CI, 0.44–0.73) for soft tissue cancers. With all cancer types stratified by age at diagnosis, IRR for live births in cancer survivors aged >41 years at diagnosis was 0.48 (95% CI, 0.44–0.52); IRR was 0.64 (95% CI, 0.61–0.67) in the group aged 31–40 years and 0.71 (95% CI, 0.69–0.74) in the group aged 18–30 years after their cancer treatment. Conclusions Cancer and its treatment were associated with lower live birth rates when comparing women with cancer vs. age-matched, healthy controls.
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Affiliation(s)
- Deepika Garg
- University of Utah School of Medicine, Salt Lake City, Utah
| | | | | | - Sarah L Berga
- Department of Obstetrics and Gynecology, University at Buffalo, Buffalo, New York
| | - Ken R Smith
- University of Utah School of Medicine, Salt Lake City, Utah
| | - Jim Hotaling
- University of Utah School of Medicine, Salt Lake City, Utah
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100
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Azam M, Aslam M, Basharat J, Mughal MA, Nadeem MS, Anwar F. An empirical study on quality of life and related factors of Pakistani breast cancer survivors. Sci Rep 2021; 11:24391. [PMID: 34937873 PMCID: PMC8695584 DOI: 10.1038/s41598-021-03696-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 12/08/2021] [Indexed: 12/01/2022] Open
Abstract
A comprehensive understanding of the quality of life (QoL) is essential to establish long-term survivor care plans. The present study was aimed at the assessment of QoL of BC survivors with special emphasis on post-treatment physical, emotional, social, and spiritual challenges. We have assessed the QoL of 250 female BC survivors of all age groups through demographic factors. Volunteer BC survivors were registered in the present study who had got treatment from the Institute of Nuclear Medicine and Oncology (INMOL) hospital and Mayo hospital Lahore. An informed consent form was signed by each participant. The physical, psychological, and spiritual well-being was evaluated by a questionnaire filled with the help of respondents. The average age of BC survivors was 52 ± 7.8 years. Most of them (83%) complained of fatigue during daily life activities, 75.1% body pain or headache, 77.1% had problems with appetite, 63.2% reported weight loss, 77.1% had sleep problems, and 90.5% were feeling general weakness. Only 16.2% were satisfied with their physical health and 2% were not satisfied with their medication. Psychologically, 74.4% were feeling different levels of anxiety, only 10% of them were hoping to achieve a desired life. Age group 21 to 40 years reported better physical health, those with 40-50 years of age and family history of BC have shown better mental strength. The physical and psychological health of survivors from rural areas was comparatively better than those from urban areas. The BC survivor women have to face several physical, psychological and social challenges. The majorities of them complain of anxiety, body pain, fatigue, sleep problems, general weakness, and fear about the future. Our findings suggest the need for psychological support, physical activity a comprehensive post-diagnosis and post-treatment physical and mental health assistance plan for all BC survivors. Implications for Cancer Survivors. Survivors of breast cancer experience various challenges including anxiety, sleep problems, body pain, fatigue, and fear about the future. The psychological, physical and social factors make a great difference in their quality of life.
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Affiliation(s)
- Muhammad Azam
- grid.412967.f0000 0004 0609 0799Department of Statistics and Computer Science, University of Veterinary and Animal Sciences, Lahore, 54000 Pakistan
| | - Muhammad Aslam
- Department of Statistics, Faculty of Science, King Abdulaziz University, Jeddah, 21589, Saudi Arabia.
| | - Javeria Basharat
- grid.444922.d0000 0000 9205 361XDepartment of Statistics, Kinnaird College for Women, 93-Jail Road, Lahore, 54000 Pakistan
| | - Muhammad Anwar Mughal
- grid.444905.80000 0004 0608 7004Department of Statistics, Forman Christian College (A Chartered University), Ferozepur Road, Lahore, 54600 Pakistan
| | - Muhammad Shahid Nadeem
- grid.412125.10000 0001 0619 1117Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah, 21589 Saudi Arabia
| | - Firoz Anwar
- grid.412125.10000 0001 0619 1117Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah, 21589 Saudi Arabia
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