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Rosenberg SM, Zheng Y, Ruddy K, Poorvu PD, Snow C, Kirkner GJ, Meyer ME, Tamimi RM, Schapira L, Peppercorn J, Come S, Borges VF, Warner E, Gelber S, Collins L, Winer EP, Partridge AH. Helping ourselves, helping others: the Young Women's Breast Cancer Study (YWS) - a multisite prospective cohort study to advance the understanding of breast cancer diagnosed in women aged 40 years and younger. BMJ Open 2024; 14:e081157. [PMID: 38951008 PMCID: PMC11218027 DOI: 10.1136/bmjopen-2023-081157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 05/29/2024] [Indexed: 07/03/2024] Open
Abstract
PURPOSE Compared with older women diagnosed with breast cancer, younger women are more likely to die of breast cancer and more likely to suffer psychosocially in both the short-term and long term. The Young Women's Breast Cancer Study (YWS) is a multisite prospective cohort study established to address gaps in our knowledge about this vulnerable and understudied population. PARTICIPANTS The YWS enrolled 1302 women newly diagnosed with stages 0-IV breast cancer at age 40 years or younger at 13 academic and community sites in North America between 2006 and 2016. Longitudinal patient-reported outcome data are complemented by clinical data abstraction and biospecimen collection at multiple timepoints. FINDINGS TO DATE Key findings related to fertility include that nearly 40% of participants were interested in pregnancy following diagnosis; of those who reported interest, 10% pursued fertility preservation. Overall, approximately 10% of YWS participants became pregnant in the first 5 years after diagnosis; follow-up is ongoing for pregnancies after 5 years. Studies focused on psychosocial outcomes have characterised quality of life, post-traumatic stress and fear of recurrence, with findings detailing the factors associated with the substantial psychosocial burden many young women face during and following active treatment. Multiple studies have leveraged YWS biospecimens, including whole-exome sequencing of tumour analyses that revealed that select somatic alterations occur at different frequencies in young (age≤35) versus older women with luminal A breast cancer, and a study that explored clonal hematopoiesis of indeterminate potential found it to be rare in young survivors. FUTURE PLANS With a median follow-up of approximately 10 years, the cohort is just maturing for many relevant long-term outcomes and provides outstanding opportunities to further study and build collaborations to address gaps in our knowledge, with the ultimate objective to improve care and outcomes for young women with breast cancer. TRIAL REGISTRATION NUMBER NCT01468246.
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Affiliation(s)
- Shoshana M Rosenberg
- Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Population Health Sciences, Weill Cornell Medicine, New York, New York, USA
| | - Yue Zheng
- Data Science, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Kathryn Ruddy
- Medical Oncology, Mayo Clinic, Rochester, Minnesota, USA
| | - Philip D Poorvu
- Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Craig Snow
- Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Gregory J Kirkner
- Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Meghan E Meyer
- Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Rulla M Tamimi
- Population Health Sciences, Weill Cornell Medicine, New York, New York, USA
| | - Lidia Schapira
- Department of Medicine, Division of Medical Oncology, Stanford University, Stanford, California, USA
| | - Jeffrey Peppercorn
- Department of Medicine, Division of Medical Oncology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Steven Come
- Medical Oncology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Virginia F Borges
- Medical Oncology, University of Colorado Denver, Denver, Colorado, USA
| | - Ellen Warner
- Medical Oncology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Shari Gelber
- Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Laura Collins
- Pathology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Eric P Winer
- Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Yale University Yale Cancer Center, New Haven, Connecticut, USA
| | - Ann H Partridge
- Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
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Brkic E, Prichard I, Daly A, Dudley S, Beatty L. Testing the efficacy of a brief online writing intervention on body image and distress in female cancer survivors. PATIENT EDUCATION AND COUNSELING 2024; 127:108356. [PMID: 38944983 DOI: 10.1016/j.pec.2024.108356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 05/01/2024] [Accepted: 06/15/2024] [Indexed: 07/02/2024]
Abstract
OBJECTIVE This study tested the feasibility and efficacy of two iterations of a low-intensity online writing intervention, Expand Your Horizon (EYH), in improving body image and distress in a cancer population. METHODS In study 1 (3-session version of EYH), adult female cancer survivors (N = 201) were randomised to EYH, where they described their body functionality, or a creative writing control. Outcomes assessed at baseline and one-week follow-up included body appreciation, body dissatisfaction, and distress. In study 2 (1 session version of EYH), adult female cancer survivors (N = 65) were randomised to EYH or a neutral writing control. Outcomes (assessed at baseline, immediately post-intervention and one-week follow-up) included body appreciation, body functionality appreciation, body dissatisfaction and distress. RESULTS Study 1 experienced severe attrition; only 14 participants (7 %) completed the intervention and follow-up. Study 2 had higher retention, with 74 % completing the study. In study 2, while no significant differences emerged between EYH or control, both groups significantly improved immediately post-intervention across all outcomes. No differences were found at follow-up. CONCLUSIONS A single-session online writing intervention for cancer survivors appears to be more feasible than multi-session, however the efficacy of EYH for this population remains to be established.
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Affiliation(s)
- Elizabeta Brkic
- Flinders University, College of Education, Psychology and Social Work, Flinders Institute for Mental Health & Wellbeing, South Australia, Australia
| | - Ivanka Prichard
- Flinders University, College of Nursing and Health Sciences, Caring Futures Institute, South Australia, Australia
| | | | - Sareya Dudley
- Flinders University, College of Education, Psychology and Social Work, Flinders Institute for Mental Health & Wellbeing, South Australia, Australia
| | - Lisa Beatty
- Flinders University, College of Education, Psychology and Social Work, Flinders Institute for Mental Health & Wellbeing, South Australia, Australia.
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Probst H, Reed H, Stanton A, Simpson RM, Walters SJ, Simpson H, Brown G, Hielscher S, Bryan-Jones K, Johnson J, Horsman J, Din OS. A Randomised Clinical Feasibility Trial of a Breast Immobilisation Device: The SuPPORT 4 All Bra. Clin Oncol (R Coll Radiol) 2023; 35:801-810. [PMID: 37777357 DOI: 10.1016/j.clon.2023.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 06/23/2023] [Accepted: 09/18/2023] [Indexed: 10/02/2023]
Abstract
AIMS Despite the breast being a mobile organ, there is currently no standard suitable immobilisation device to optimise radiotherapy for women with larger breasts treated after a wide local excision. The SuPPORT 4 All (S4A) bra was co-designed with patients and radiotherapy professionals. The purpose of this study was to test the feasibility of using the S4A bra in the existing breast cancer radiotherapy pathway. MATERIALS AND METHODS A randomised feasibility trial was conducted in a single institution; the primary feasibility endpoint was the recruitment of 50 participants. Efficacy endpoints were also tested, including assessment of skin reactions, dose to organs at risk and patient comfort. Fifty women were randomised to receive either standard radiotherapy with no immobilisation (control) or radiotherapy with the S4A bra (intervention). A separate planning study was undertaken on the cases randomised to receive the S4A bra. Participants in the intervention arm (S4A bra) underwent two planning computed tomography scans, one with the bra on and one without the bra; allowing direct comparison of organs at risk data for S4A bra versus no bra. RESULTS All women who started radiotherapy wearing the S4A bra completed treatment with the bra; patient comfort did not change across the 3 weeks of treatment. Positional accuracy using the bra was comparable with existing published accuracy for methods without immobilisation. The mean ipsilateral lung doses showed some improvement when positioning with the S4A bra was compared with the no bra set-up (3.72 Gy versus 4.85 Gy for right-sided cases, 3.23 Gy versus 3.62 Gy for left-sided cases). CONCLUSIONS The S4A bra is feasible to use in the radiotherapy pathway with good patient adherence. The S4A bra has potential to reduce dose to organs at risk (specifically ipsilateral lung dose) while maintaining good breast tissue coverage, and improved patient dignity, warranting further investigation on a larger scale.
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Affiliation(s)
- H Probst
- Sheffield Hallam University, Sheffield, UK.
| | - H Reed
- Sheffield Hallam University, Sheffield, UK
| | - A Stanton
- Sheffield Hallam University, Sheffield, UK
| | | | | | - H Simpson
- Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
| | - G Brown
- Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
| | - S Hielscher
- Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
| | - K Bryan-Jones
- Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
| | - J Johnson
- Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
| | | | - O S Din
- Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
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Vesentini L, Hoeylaerts L, Van Overmeire R, Vanhoeij M, Bauwens S, Bilsen J. Optimizing sexuality of young women with breast cancer: how can the breast clinic help? Support Care Cancer 2023; 31:613. [PMID: 37796309 DOI: 10.1007/s00520-023-08077-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 09/25/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND Breast cancer treatment can lead to sexual dysfunction which, in general, impacts younger women more. Being well informed and having good social support are important elements in dealing with this dysfunction. AIMS This study aims to explore how specialized breast clinics can help young women with questions or problems regarding their sexual health by fulfilling their information and social support needs. METHOD A thematic analysis was used for 16 interviews with young women (18-45 years) diagnosed with breast cancer, in Belgium. RESULTS Participants report a lack of information on sexual issues and find the information insufficiently tailored to young women. The empathy of healthcare providers and their communication skills play an important role in whether sexual issues can be discussed. Finally, they indicate that more attention should be paid to their partner (relationship). CONCLUSION The breast clinic might help young women by giving more specific advice on what is sexually allowed (or not) during treatment, by informing them about lubricants and sex toys, by adapting brochures and information sessions to young women, by investing in the partner's well-being and their relationship, and by training healthcare providers better.
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Affiliation(s)
- Lara Vesentini
- Mental Health and Wellbeing Research Group (MENT), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium.
| | - Laura Hoeylaerts
- Mental Health and Wellbeing Research Group (MENT), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
| | - Roel Van Overmeire
- Mental Health and Wellbeing Research Group (MENT), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
| | - Marian Vanhoeij
- Breast Clinic, University Hospital Brussels, Brussels, Belgium
| | | | - Johan Bilsen
- Mental Health and Wellbeing Research Group (MENT), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
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Kearse L, Goll C, Wise B, Yang S, Mohamadipanah H, Witt A, Ratliff P, Pugh C. Promoting breast health awareness: Can a sensor-enabled training system for patient education help? Am J Surg 2023; 226:497-501. [PMID: 37258320 DOI: 10.1016/j.amjsurg.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/16/2023] [Accepted: 05/02/2023] [Indexed: 06/02/2023]
Abstract
INTRODUCTION According to a 2009 study published in the Journal of Clinical Oncology, 79% of women (N = 222) diagnosed with breast cancer reported that they identified their cancers through breast self-exam (BSE). However, the U.S. Preventative Services Task Force does not require clinicians to teach women how to perform BSE. METHODS To address this grave challenge, our team at the Technology Enabled Clinical Improvement (TECI) Center has developed a mobile, sensor-enabled haptic training system to teach women proper BSE technique. To validate the efficacy of the training system, our team deployed a data collection at the 2019 Breast Cancer and African Americans (BCAA) event where survey, sensor, and anecdotal data were collected from 61 participants. The custom-built breast model used in this study had a single, hard mass embedded in it. RESULTS Participants at the BCAA event were able to successfully identify the mass 65% of the time and used an average force of 7.2 N. When looking at participants' confidence in their abilities to perform BSE, only 10% of respondents answered "very confident" pre-training whereas post-training, the reporting for "very confident" jumped to 66% (p < 0.01). CONCLUSION By comparison, our previous work revealed that practitioners who use less than 10 N of force are 70% more likely to miss a lesion. The integration of sensors into the BSE haptic training system allowed for objective, evidence-based assessment of hands-on skill. In addition to teaching women proper BSE technique, this training empowered women to be informed advocates in their breast health journey. Future community-based training/feedback sessions will allow for continuous advancement of the training system.
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Affiliation(s)
- LaDonna Kearse
- Department of Surgery, Stanford University, 300 Pasteur Drive, Stanford, CA, 94305, USA.
| | - Cassidi Goll
- Department of Surgery, Stanford University, 300 Pasteur Drive, Stanford, CA, 94305, USA.
| | - Brett Wise
- Department of Surgery, Stanford University, 300 Pasteur Drive, Stanford, CA, 94305, USA.
| | - Su Yang
- Department of Surgery, Stanford University, 300 Pasteur Drive, Stanford, CA, 94305, USA.
| | - Hossein Mohamadipanah
- Department of Surgery, Stanford University, 300 Pasteur Drive, Stanford, CA, 94305, USA.
| | - Anna Witt
- Department of Surgery, Stanford University, 300 Pasteur Drive, Stanford, CA, 94305, USA.
| | - Pamela Ratliff
- Stanford Cancer Institute, Lorry Lokey Building, SIM 1, 265 Campus Drive, Ste G2103, Stanford, CA, 94305, USA.
| | - Carla Pugh
- Department of Surgery, Stanford University, 300 Pasteur Drive, Stanford, CA, 94305, USA.
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Afshar-Bakshloo M, Albers S, Richter C, Berninger O, Blohmer JU, Roehle R, Speiser D, Karsten MM. How breast cancer therapies impact body image - real-world data from a prospective cohort study collecting patient-reported outcomes. BMC Cancer 2023; 23:705. [PMID: 37507687 PMCID: PMC10375629 DOI: 10.1186/s12885-023-11172-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND In breast cancer patients body image (BI) is a crucial aspect of quality of life (QoL). This study examined the postoperative impact of different surgical approaches on long-term BI analyzing real-world data to guide pre- and postoperative patient care and preserve QoL. METHODS EORTC QLQ-BR23 BI scores were collected electronically in 325 breast cancer patients within routine clinical care for a duration of 41.5 months (11/17/2016 - 4/30/2020) at predefined time points preoperatively and repeatedly up to two years after breast-conserving surgery (BCS) (n = 212), mastectomy alone (M) (n = 27) or mastectomy with immediate breast reconstruction (MIBR) (n = 86). Higher scores indicated better BI. A linear mixed regression model was used to analyze the impact of BCS, M and MIBR, as well as non-surgical therapies on BI at treatment initiation and over time. RESULTS BI scores deteriorated by 5 points (95%-confidence interval (CI) -8.94 to -1.57, p≈0.005) immediately after BCS, by 7 points (95%-CI -12.13 to -1.80, p≈0.008) after MIBR and by 19 points (95%-CI -27.34 to -10.34, p < 0.001) after M. The change over time after BCS (+ 0.10 points per week, 95%-CI -0.17 to 0.38), MIBR (-0.07 points per week, 95%-CI -0.35 to 0.20) and M (+ 0.14 points per week, 95%-CI -0.19 to 0.48) were not statistically significant (each p > 0.05). At treatment initiation chemotherapy was associated with a 22-point decline (95%-CI -25.39 to -17.87, p < 0.001) in BI score, while radiotherapy was associated with a 5-point increase (95%-CI 1.74 to 9.02, p≈0.004). However, over time chemotherapy was associated with a score recovery (+ 0.28 points per week, 95%-CI 0.19 to 0.37, p < 0.001), whereas for radiotherapy a trend towards BI deterioration was observed (-0.11 points per week, 95%-CI -0.23 to 0.02, p≈0.101). CONCLUSIONS Breast cancer surgery negatively affects BI. BCS and MIBR presumably harm BI less than M in the early postoperative period. Our data suggests BI to be deteriorating in the long term after MIBR while improving after BCS or M. Radiotherapy seems to have an additional negative long-term impact on BI. These findings should be confirmed in further studies to enable evidence-based patient information as part of preoperative shared decision-making and postoperative patient care.
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Affiliation(s)
- Melissa Afshar-Bakshloo
- Department of Gynecology With Breast Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Sarah Albers
- Department of Gynecology With Breast Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Chiara Richter
- Department of Gynecology With Breast Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Ottilia Berninger
- Department of Gynecology With Breast Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Jens-Uwe Blohmer
- Department of Gynecology With Breast Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Robert Roehle
- Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Dorothee Speiser
- Department of Gynecology With Breast Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Maria Margarete Karsten
- Department of Gynecology With Breast Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.
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Uhelski ACR, Blackford AL, Sheng JY, Snyder C, Lehman J, Visvanathan K, Lim D, Stearns V, Smith KL. Factors associated with weight gain in pre- and post-menopausal women receiving adjuvant endocrine therapy for breast cancer. J Cancer Surviv 2023:10.1007/s11764-023-01408-y. [PMID: 37261654 DOI: 10.1007/s11764-023-01408-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 05/22/2023] [Indexed: 06/02/2023]
Abstract
PURPOSE Weight gain after breast cancer poses health risks. We aimed to identify factors associated with weight gain during adjuvant endocrine therapy (AET). METHODS Women initiating AET enrolled in a prospective cohort. Participants completed FACT-ES plus PROMIS pain interference, depression, anxiety, fatigue, sleep disturbance and physical function measures at baseline, 3, 6, 12, 24, 36, 48 and 60 months. Treatment-emergent symptoms were defined as changes in scores in the direction indicative of worsening symptoms that exceeded the minimal important difference at 3 and/or 6 months compared to baseline. We used logistic regression to evaluate associations of clinicodemographic features and treatment-emergent symptoms with clinically significant weight gain over 60 months (defined as ≥ 5% compared to baseline) in pre- and post-menopausal participants. RESULTS Of 309 participants, 99 (32%) were pre-menopausal. The 60 months cumulative incidence of clinically significant weight gain was greater in pre- than post-menopausal participants (67% vs 43%, p < 0.001). Among pre-menopausal participants, treatment-emergent pain interference (OR 2.49), aromatase inhibitor receipt (OR 2.8), mastectomy, (OR 2.06) and White race (OR 7.13) were associated with weight gain. Among post-menopausal participants, treatment-emergent endocrine symptoms (OR 2.86), higher stage (OR 2.25) and White race (OR 2.29) were associated with weight gain while treatment-emergent physical function decline (OR 0.30) was associated with lower likelihood of weight gain. CONCLUSIONS Weight gain during AET is common, especially for pre-menopausal women. Clinicodemographic features and early treatment-emergent symptoms may identify at risk individuals. IMPLICATIONS FOR CANCER SURVIVORS Patients at risk for weight gain can be identified early during AET. CLINICAL TRIALS GOV IDENTIFIER NCT01937052, registered September 3, 2013.
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Affiliation(s)
- Anna-Carson Rimer Uhelski
- Johns Hopkins Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Hematology/Oncology Fellowship Program, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Amanda L Blackford
- Division of Biostatistics and Bioinformatics, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, USA
| | - Jennifer Y Sheng
- Johns Hopkins Women's Malignancies Disease Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Claire Snyder
- Johns Hopkins Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jennifer Lehman
- Johns Hopkins Women's Malignancies Disease Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kala Visvanathan
- Johns Hopkins Women's Malignancies Disease Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Division of Cancer Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - David Lim
- Division of Biostatistics and Bioinformatics, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, USA
- Division of Statistics, Collaborative Inc., WCG, Washington, DC, USA
| | - Vered Stearns
- Johns Hopkins Women's Malignancies Disease Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, Under Armour Breast Health Innovation Center, The Skip Viragh Outpatient Cancer, Building 201 North Broadway Viragh 10th floor, Room 10291, Baltimore, MD, 21287, USA.
| | - Karen Lisa Smith
- Johns Hopkins Women's Malignancies Disease Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- AstraZeneca, Gaithersburg, MD, USA
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Reis AD, Pereira PTVT, Filha JGLC, Rodrigues EF, Laranjeira IP, Ramallo BT, Castro MRD, Rossi FE, Júnior IFF, Garcia JBS. Effect of Combined Training on Body Image, Body Composition and Functional Capacity in Patients with Breast Cancer: Controlled Clinical Trial. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2023; 45:242-252. [PMID: 37339643 PMCID: PMC10281770 DOI: 10.1055/s-0043-1770126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2023] Open
Abstract
OBJECTIVE Evaluate the effect of combined training on body image (BI), body composition and functional capacity in patients with breast cancer. As also the relationship of BI with body composition and functional capacity. METHODS This was a Controlled Clinical Trial study, this study including 26 patients with breast cancer (30 to 59 years). The training group (n = 13) underwent 12 weeks of training, including three 60-min sessions of aerobic exercise and resistance training, and two sessions of flexibility training per week; each flexibility exercise lasted 20s. The Control Group (n = 13) received only the standard hospital treatment. Participants were evaluated at baseline and after 12 weeks. BI (primary outcomes) was assessed using the Body Image After Breast Cancer Questionnaire; Body composition was estimated with the indicators: Body mass index; Weight, Waist hip Ratio; Waist height ratio; Conicity index; Reciprocal ponderal index; Percentage of fat; Circumference of the abdomen and waist; Functional capacity by cardiorespiratory fitness (cycle ergometer) and strength (manual dynamometer). The statistic was performed in the Biostatistics and Stata 14.0 (α = 5%). RESULTS The patients in the training group showed a reduction in the limitation dimension (p = 0.036) on BI, However, an increase in waist circumference was observed in both groups. In addition an increase in VO2max (p < 0.001) and strength in the right (p = 0.005) and left arms (p = 0.033). CONCLUSION Combined training demonstrates to be an effective and non-pharmacological strategy to patients with breast cancer, with improvement on BI and functional capacity, changing related variables negatively when there is no physical training.
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9
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Dayaratna N, Nguyen CL, Spillane A, Mak C, Warrier SK, Dusseldorp JR. Trends and variations in post-mastectomy breast reconstruction rates in Australia over 10 years. ANZ J Surg 2023; 93:242-250. [PMID: 36651629 DOI: 10.1111/ans.18243] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 12/12/2022] [Accepted: 12/19/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND Offering breast reconstruction (BR) at the time of mastectomy is standard of care in Australia with proven quality-of-life benefits. Previously BR rates in Australia have been low compared to similar countries. Accurate up-to-date information is needed to promote equity in access to BR and inform future planning of services. This study analysed recent trends and variations of BR uptake in Australia. METHOD Data from the BreastSurgANZ Quality Audit (BQA) were used to identify patients who underwent mastectomy with or without reconstruction for invasive or in situ breast carcinoma from 2010 to 2019. The association between BR uptake and the variables of jurisdiction (state or territory), age, hospital type and remoteness, and remoteness of patients' home addresses were analysed. RESULTS A total 41 880 women underwent mastectomy between 2010 to 2019. The national BR rate steadily increased from 12.8% in 2010 to 29% in 2019, with a 10-year national average of 21.3%. Statistically significant differences in BR uptake (P < 0.001) were found between states with higher rates in New South Wales and Victoria, with BR more likely in private hospitals and in younger women (P < 0.001), and less likely in remote areas (P < 0.001). CONCLUSION The Australian BR rate has increased over the 10-year period, but significant variation still exists between states. BR is lower in older women and those living in regional and remote areas. While the steady increase in BR uptake is encouraging, barriers that exist to equitable provision of reconstructive surgical services for all women living with breast cancer still need to be corrected.
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Affiliation(s)
- Nirmal Dayaratna
- Department of Breast Surgery, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia.,Northern Clinical School, Royal North Shore Hospital, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Chu Luan Nguyen
- Department of Breast Surgery, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Department of Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Andrew Spillane
- Northern Clinical School, Royal North Shore Hospital, Sydney, New South Wales, Australia.,Melanoma Institute Australia, The Poche Centre, Sydney, New South Wales, Australia.,The Mater Hospital, Sydney, New South Wales, Australia
| | - Cindy Mak
- Department of Breast Surgery, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Sanjay Kumar Warrier
- Department of Breast Surgery, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Joseph R Dusseldorp
- Department of Breast Surgery, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Department of Plastic Surgery, Concord Repatriation Hospital, Sydney, New South Wales, Australia
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Thakur M, Sharma R, Mishra AK, Singh K, Kar SK. Psychological distress and body image disturbances after modified radical mastectomy among breast cancer survivors: A cross-sectional study from a tertiary care centre in North India. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2022; 7:100077. [PMID: 37383931 PMCID: PMC10305859 DOI: 10.1016/j.lansea.2022.100077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
Background Breast cancer (BC) diagnosis and treatment can affect women both physically and psychologically. Women with BC undergo various painful and debilitating therapies as well as emotional trauma. Additionally, treatment modalities can bring about multiple changes, causing distress and alteration in one's appearance. This study aimed to assess the psychological distress and body image disturbances after modified radical mastectomy (MRM) among BC survivors. Methods A descriptive, cross-sectional study was conducted at a tertiary care centre in North India on 165 female survivors of BC who underwent MRM and attended outpatient follow-up. The median (interquartile range) age was 42 (36-51) years. Patients were evaluated using MINI 6·0·0 to assess for psychiatric comorbidities. The Depression Anxiety and Stress Scale (DASS-21) was used to measure psychological distress. Additionally, the ten-item Body Image Satisfaction (BIS-10) scale was used to evaluate body image disturbances. Findings The rates of depression, anxiety, and stress were 27·8%, 31·5%, and 24·8%, respectively. Most patients (92%) experienced body image disturbances, and BC survivors who completed treatment within 12 months were more likely (p < 0·01) to have body image disturbances than women who had a long time since completion of treatment. Body image disturbances were not associated with age or psychological distress. Interpretation Depression, anxiety, stress, and body image issues are common among BC survivors. Follow-up management plans for BC survivors should also include evaluation and treatment of psychological distress and addressing body image disturbances in patients undergoing mastectomy. Funding Not applicable.
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Affiliation(s)
- Monika Thakur
- Telemedicine Centre, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Roopali Sharma
- Amity Institute of Psychology and Allied Sciences (AIPS), Amity University, India
| | - Anand Kumar Mishra
- Department of Endocrine Surgery, King George's Medical University, Lucknow, India
| | - Kulranjan Singh
- Department of Endocrine Surgery, King George's Medical University, Lucknow, India
| | - Sujita Kumar Kar
- Department of Psychiatry, King George's Medical University, Lucknow, India
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11
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Effa C, Al Onazi MM, Spencer N, Pritchard L, Fletcher I, McNeely ML. Exploring the validity of the body image scale with survivors of breast cancer: A cognitive interview approach. Eur J Cancer Care (Engl) 2022; 31:e13717. [PMID: 36168095 DOI: 10.1111/ecc.13717] [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: 07/23/2021] [Revised: 07/24/2022] [Accepted: 09/01/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The aim of this study is to explore the construct validity of the Body Image Scale for Cancer Questionnaire (BIS) using cognitive interviews. METHODS Twelve breast cancer survivors participated in a cognitive interview while completing the BIS. Each participant was asked to think-out-loud while answering items, and an interviewer asked probing questions relating to the participants' comprehension, example retrieval, certainty of answer and other decision-making factors. Interviews were audio recorded and transcribed, and the data were analysed deductively and inductively. RESULTS The participants' interpretations of the questions varied significantly. Several participants perceived the phrasing of some questions to be leading. The participants were able to provide examples of how their physical, physiological and body function affected their body image. The participants expressed positive attitudes towards, and gratitude for their body, which was not captured by the questionnaire. At times, the participants felt uncertain in how to respond appropriately to specific items, and the participants found some items challenging to answer. Finally, the BIS included sensitive questions that elicited emotional reactions and discomfort for some participants. CONCLUSION The findings of this study provide insight into, and suggestions for potential questionnaire revisions that may enhance the validity and relevance of the BIS for use with breast cancer survivors.
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Affiliation(s)
- Corrie Effa
- Faculty of Rehabilitation Medicine, Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada
| | - Mona M Al Onazi
- Faculty of Rehabilitation Medicine, Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada
| | - Nancy Spencer
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Lesley Pritchard
- Faculty of Rehabilitation Medicine, Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada
| | - Ian Fletcher
- Clinical Psychology, Division of Health Research, Lancaster University, Lancaster, UK
| | - Margaret L McNeely
- Faculty of Rehabilitation Medicine, Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada.,Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
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12
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Biopsychosocial Markers of Body Image Concerns in Patients with Head and Neck Cancer: A Prospective Longitudinal Study. Curr Oncol 2022; 29:4438-4454. [PMID: 35877213 PMCID: PMC9319375 DOI: 10.3390/curroncol29070353] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/30/2022] [Accepted: 06/14/2022] [Indexed: 11/18/2022] Open
Abstract
(1) Background: Patients and survivors of head and neck cancer (HNC) are at a high risk of developing body image concerns. Despite the prevalence of body image concerns in patients with HNC, there is a lack of longitudinal research exploring the wide array of its associated determinants. The current longitudinal study examined the determinants and longitudinal course of body image dissatisfaction in patients with HNC. (2) Methods: Patients participated in Structured Clinical Interviews and self-administered questionnaires at four time-points: (T1) upon cancer diagnosis, (T2) at 3 months post-diagnosis, (T3) at 6 months post-diagnosis, and (T4) at 12 months post-diagnosis. They also underwent a disfigurement rating on an objective scale. (3) Results: Two hundred and twenty-four patients participated in our study. Fourteen percent to twenty-eight percent of patients reported at least moderate body image concerns across time points, with the lowest rates at baseline and the highest at 3 months (T1). It was found that patients more predisposed to developing higher levels of body image concerns presented physical markers (i.e., advanced cancer stage, lower physical functioning, higher disfigurement), psychosocial markers (i.e., higher depression, higher anxiety, and higher levels of coping with denial), and health disparities (i.e., younger age, female sex, French language, and marital status, with divorced and widowers most affected). (4) Conclusions: The findings of this study highlight the multifaceted nature of body image concerns in patients with HNC and its biopsychosocial determinants. Clinicians should pay specific attention to these biopsychosocial markers in their clinics to predict high levels of body image concerns and tailor communication/refer for support accordingly.
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13
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Li F, Zhou J, Wan C, Yang Z, Liang Q, Li W, Chen H. Development and Validation of the Breast Cancer Scale QLICP-BR V2.0 Based on Classical Test Theory and Generalizability Theory. Front Oncol 2022; 12:915103. [PMID: 35769719 PMCID: PMC9235398 DOI: 10.3389/fonc.2022.915103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 05/16/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveThe aim of this study was to develop and validate the breast cancer scale among the system of quality-of-life instruments for cancer patients (QLICP-BR V2.0).MethodsProgrammed decision procedures and theories on instrument development were applied to develop QLICP-BR V2.0. A total of 246 breast cancer inpatients were investigated using QLICP-BR V2.0 from hospital admission until discharge. The reliability, validity, and responsiveness of the QLICP-BR V2.0 scale were evaluated by using the classical test theory combined with the generalizability theory (GT), including correlation analysis, multi-trait scaling analysis, factor analyses, t-tests, and also multivariate generalizability theory analysis.ResultsThe test–retest reliability of the total scale is 0.79, the Cronbach coefficient is 0.85, and the intra-class correlations coefficient is 0.88. The item–domain correlation analysis showed that the correlation coefficient between items and their own domain is greater than that with other domains except of item GSO4. The exploratory factor analysis showed that three principal components are obtained in the specific module. The outcome of the factor analysis coincides substantially with our theoretical conception. The score difference of each domain of the scale and the total scale before and after treatment is statistically significant (P < 0.05), with the standardized response mean of the total scale being 0.61. According to GT, the generalization coefficient of the scores in the 5 domains is between 0.626 and 0.768, and the reliability index is between 0.557 and 0.695.ConclusionQLICP-BR V2.0 exhibited reasonable degrees of validity, reliability, and responsiveness according to classical test and the generalizability theory. The number of items in the scale is appropriate.
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Affiliation(s)
- Fei Li
- School of Humanities and Management, Research Center for Quality of Life and Applied Psychology, Key Laboratory for Quality of Life and Psychological assessment and Intervention, Guangdong Medical University, Dongguan, China
| | - Jiali Zhou
- Medical Insurance Office, Capital Medical University Electric Teaching Hospital, Beijing, China
| | - Chonghua Wan
- School of Humanities and Management, Research Center for Quality of Life and Applied Psychology, Key Laboratory for Quality of Life and Psychological assessment and Intervention, Guangdong Medical University, Dongguan, China
- *Correspondence: Chonghua Wan,
| | - Zheng Yang
- School of Public Health, Guangdong Medical University, Dongguan, China
| | - Qilian Liang
- Affiliated Hospital of Guangdong Medical University, The Three Wards of Medical Oncology, Zhanjiang, China
| | - Weiqiang Li
- School of Humanities and Management, Research Center for Quality of Life and Applied Psychology, Key Laboratory for Quality of Life and Psychological assessment and Intervention, Guangdong Medical University, Dongguan, China
| | - Huanwei Chen
- Central Hospital of Guangdong Nongken, The Six Wards of Medical Oncology, Zhanjiang, China
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14
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Chien JC, Liu WS, Huang WT, Shih LC, Liu WC, Chen YC, Chou KJ, Shiue YL, Lin PC. Local treatment options for young women with ductal carcinoma in situ: A systematic review and meta-analysis comparing breast conserving surgery with or without adjuvant radiotherapy, and mastectomy. Breast 2022; 63:29-36. [PMID: 35299032 PMCID: PMC8927828 DOI: 10.1016/j.breast.2022.03.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 02/14/2022] [Accepted: 03/11/2022] [Indexed: 10/29/2022] Open
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Tan MYL, Onggo J, Serag S, Phan K, Dusseldorp JR. Deep inferior epigastric perforator (DIEP) flap safety profile in slim versus non-slim BMI patients: A systematic review and meta-analysis. J Plast Reconstr Aesthet Surg 2022; 75:2180-2189. [PMID: 35650004 DOI: 10.1016/j.bjps.2022.04.046] [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: 04/04/2021] [Revised: 01/28/2022] [Accepted: 04/12/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND/PURPOSE The complications of breast reconstruction using deep inferior epigastric perforator (DIEP) flaps in non-slim patients are well recognized. However, the effects of this surgery performed on slim patients are yet to be consolidated. This study aims to compare the outcomes of performing DIEP flap breast reconstruction in slim and non-slim body mass index (BMI) patients. METHODS Meta-analysis was performed with a multi-database search (Cochrane, EMBASE, OVID Medline, PubMed, and Web of Sciences) according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines on 1 February 2021. Data from articles meeting inclusion criteria were extracted and analyzed with an inverse variance statistical model. RESULTS Seven studies were included, comprising 574 slim patients and 901 non-slim BMI patients who underwent autologous DIEP flap breast reconstruction. When comparing between the slim and non-slim groups, no statistically significant difference was found in terms of complete flap loss (OR=0.53, 95% CI: 0.11-2.68, p=0.44), partial flap loss (OR=0.92, 95% CI: 0.3-2.82, p=0.88), and fat necrosis (OR=0.91, 95% CI: 0.61-1.37, p=0.66). Similarly, in terms of general surgical complications, there was no statistically significant difference between groups in terms of all complications (OR=0.83, 95% CI: 0.45-1.51, p=0.54), abdominal wound healing complications (OR=1.01, 95% CI: 0.59-1.73, p=0.97), infections (OR=0.74, 95% CI: 0.41-1.37, p=0.34), and seroma (OR=0.89, 95% CI: 0.35-227, p=0.81). CONCLUSION There is no increased risk of postoperative complications in either group. DIEP flaps can be safely performed in slim patients, though higher quality research may be required to further confirm this.
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Affiliation(s)
- Michelle Y L Tan
- University of Adelaide Medical School, Adelaide, South Australia, Australia.
| | - James Onggo
- Department of Surgery, Box Hill Hospital, Melbourne, Victoria, Australia; Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Saleh Serag
- University of New South Wales, Sydney, New South Wales, Australia
| | - Kevin Phan
- Department of Plastic and Reconstructive Surgery, Concord Hospital, Sydney, New South Wales, Australia
| | - Joseph R Dusseldorp
- Department of Plastic and Reconstructive Surgery, Concord Hospital, Sydney, New South Wales, Australia
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16
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Saita E, Ferraris G, Acquati C, Molgora S, Sorge A, Valenti F, Grassi MM, Vagnini D. Dyadic Profiles of Couples Coping With Body Image Concerns After Breast Cancer: Preliminary Results of a Cluster Analysis. Front Psychol 2022; 13:869905. [PMID: 35401315 PMCID: PMC8983958 DOI: 10.3389/fpsyg.2022.869905] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 02/28/2022] [Indexed: 11/16/2022] Open
Abstract
Breast cancer treatments have multiple adverse effects, including concerns about body appearance and function that are experienced by most patients. Altered body image negatively affects mental health, social, and relationship functioning. While the relationship with a partner is critical for patients’ psychological wellbeing and partners can promote positive body image, limited research has investigated individual and relational factors affecting the experience of both. This cross-sectional study aimed at (1) exploring rates of body image concerns among breast cancer patients, and (2) identifying dyadic profiles among participating dyads. Couples composed by patients who had undergone surgery and their romantic partners (n = 32) were recruited from the Breast Unit of a hospital in northern Italy. Both partners completed measures of personality characteristics (BFQ-2), psychological distress (HADS), coping flexibility (PACT), dyadic coping (DCQ), and closeness (IOS). Body image (BIS) and adjustment to cancer (Mini-MAC) measures were completed by patients only. K-mean cluster analyses identified 2-cluster solution among patients and partners, respectively. “Active patients” (cluster-1) reported low rates of body image concerns (p < 0.001), anxious preoccupation, negative dyadic coping, and self-oriented stress communication (p < 0.05), compared to “worried patients” (cluster-2). “Comfortable partners” (cluster-1) reported lower anxiety and depression (p < 0.001), self-oriented negative dyadic coping and closeness (p < 0.05) than “uncomfortable partners” (cluster-2). Three different dyadic profiles emerged: functional, dysfunctional, and ambivalent. Significant variations (p < 0.05) by anxiety, depression, and delegating dyadic coping existed. Results indicate there are groups of couples at greater risk for impaired psychological distress and body image concerns, which should be addressed in the context of dyadic psychosocial interventions.
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Affiliation(s)
- Emanuela Saita
- Department of Psychology, Catholic University of Sacred Heart, Milan, Italy
| | - Giulia Ferraris
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Chiara Acquati
- Graduate College of Social Work, University of Houston, Houston, TX, United States.,Department of Clinical Sciences, College of Medicine, University of Houston, Houston, TX, United States.,Department of Health Disparities Research, The UT MD Anderson Cancer Center, Houston, TX, United States
| | - Sara Molgora
- Department of Psychology, Catholic University of Sacred Heart, Milan, Italy
| | - Antonia Sorge
- Department of Psychology, Catholic University of Sacred Heart, Milan, Italy
| | | | | | - Denise Vagnini
- Department of Psychology, Catholic University of Sacred Heart, Milan, Italy
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17
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Henry M, Albert JG, Frenkiel S, Hier M, Zeitouni A, Kost K, Mlynarek A, Black M, MacDonald C, Richardson K, Mascarella M, Morand GB, Chartier G, Sadeghi N, Lo C, Rosberger Z. Body Image Concerns in Patients With Head and Neck Cancer: A Longitudinal Study. Front Psychol 2022; 13:816587. [PMID: 35401366 PMCID: PMC8988682 DOI: 10.3389/fpsyg.2022.816587] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 02/08/2022] [Indexed: 12/12/2022] Open
Abstract
Objective Head and neck cancer (HNC) treatments are known to significantly affect functionality and appearance, leading to an increased risk for body image disturbances. Yet, few longitudinal studies exist to examine body image in these patients. Based on a conceptual model, the current study aimed to determine, in patients newly diagnosed with HNC: (1) the prevalence, level, and course of body image concerns; (2) correlates of upon cancer diagnosis (pre-treatment) body image concerns; (3) predictors of immediate post-treatment body image concerns; and (4) association between body image concerns and levels of anxiety, depression, suicidal ideation, support (i.e., satisfaction with support from physician, social/family wellbeing, and unmet support needs), and alcohol and drug misuse. Methods Two hundred and twenty-three (participation rate = 72%), newly diagnosed with a primary HNC were assessed using structured clinical interviews and psychometric measures at three, and 6 months after diagnosis. Primary outcome was 3-month, as it was most salient to body image disturbance. Multiple linear regression analyses were conducted on the potential body image predictors, based on the model. Results Sixty-eight percent of patients with HNC (n = 148 of 218) presented some level of body image concerns. Body image concerns at baseline (i.e., upon cancer diagnosis, pre-treatment) and post-treatment were significantly related and significantly increased from pre- to post-treatment. Immediately post-treatment (i.e., at 3 month follow-up), 89% (n = 132 of 148) presented some level of body image concerns. Correlates of body image concerns in patients with HNC at baseline included: physical symptom burden, difficulties with communication and eating, coping with the cancer diagnosis using denial, suicidal ideation, and having had a past anxiety diagnosis. When controlling for sociodemographic and medical variables, body image concerns in patients with HNC in the immediate post-treatment were predicted by: baseline body image, physical symptom burden, and neuroticism. Conclusion This longitudinal study helps identify patients more susceptible to experience body image disturbance following head and neck cancer. Clinicians ought to pay special attention to body image concerns upon cancer diagnosis, physical symptom burden, and neuroticism, and may want to target these factors in future preventive interventions.
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Affiliation(s)
- Melissa Henry
- Department of Oncology, McGill University, Montreal, QC, Canada
- Department of Otolaryngology – Head and Neck Surgery, McGill University, Montreal, QC, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Department of Oncology, Jewish General Hospital, Montreal, QC, Canada
- Department of Otolaryngology – Head and Neck Surgery, Jewish General Hospital, Montreal, QC, Canada
| | - Justine G. Albert
- Department of Oncology, McGill University, Montreal, QC, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
| | - Saul Frenkiel
- Department of Otolaryngology – Head and Neck Surgery, McGill University, Montreal, QC, Canada
- Department of Otolaryngology – Head and Neck Surgery, Jewish General Hospital, Montreal, QC, Canada
| | - Michael Hier
- Department of Oncology, McGill University, Montreal, QC, Canada
- Department of Otolaryngology – Head and Neck Surgery, McGill University, Montreal, QC, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Department of Otolaryngology – Head and Neck Surgery, Jewish General Hospital, Montreal, QC, Canada
| | - Anthony Zeitouni
- Department of Otolaryngology – Head and Neck Surgery, McGill University, Montreal, QC, Canada
- Department of Otolaryngology – Head and Neck Surgery, McGill University Health Centre, Montreal, QC, Canada
| | - Karen Kost
- Department of Otolaryngology – Head and Neck Surgery, McGill University, Montreal, QC, Canada
- Department of Otolaryngology – Head and Neck Surgery, McGill University Health Centre, Montreal, QC, Canada
| | - Alex Mlynarek
- Department of Otolaryngology – Head and Neck Surgery, McGill University, Montreal, QC, Canada
- Department of Otolaryngology – Head and Neck Surgery, Jewish General Hospital, Montreal, QC, Canada
- Department of Otolaryngology – Head and Neck Surgery, McGill University Health Centre, Montreal, QC, Canada
| | - Martin Black
- Department of Otolaryngology – Head and Neck Surgery, McGill University, Montreal, QC, Canada
- Department of Otolaryngology – Head and Neck Surgery, Jewish General Hospital, Montreal, QC, Canada
| | - Christina MacDonald
- Department of Otolaryngology – Head and Neck Surgery, Jewish General Hospital, Montreal, QC, Canada
- Department of Nursing, Jewish General Hospital, Montreal, QC, Canada
| | - Keith Richardson
- Department of Otolaryngology – Head and Neck Surgery, McGill University, Montreal, QC, Canada
- Department of Otolaryngology – Head and Neck Surgery, McGill University Health Centre, Montreal, QC, Canada
| | - Marco Mascarella
- Department of Otolaryngology – Head and Neck Surgery, McGill University, Montreal, QC, Canada
- Department of Otolaryngology – Head and Neck Surgery, Jewish General Hospital, Montreal, QC, Canada
| | - Gregoire B. Morand
- Department of Otolaryngology – Head and Neck Surgery, McGill University, Montreal, QC, Canada
| | - Gabrielle Chartier
- Department of Otolaryngology – Head and Neck Surgery, Jewish General Hospital, Montreal, QC, Canada
- Department of Nursing, Jewish General Hospital, Montreal, QC, Canada
| | - Nader Sadeghi
- Department of Otolaryngology – Head and Neck Surgery, McGill University, Montreal, QC, Canada
- Department of Otolaryngology – Head and Neck Surgery, McGill University Health Centre, Montreal, QC, Canada
| | - Christopher Lo
- Department of Psychology, College of Healthcare Sciences, James Cook University, Singapore, Singapore
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Department of Social and Behavioural Health Sciences, Dalla Lana School of Public Health, Toronto, ON, Canada
| | - Zeev Rosberger
- Department of Oncology, McGill University, Montreal, QC, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Department of Psychology, McGill University, Montreal, QC, Canada
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Ettridge K, Scharling-Gamba K, Miller C, Roder D, Prichard I. Body image and quality of life in women with breast cancer: Appreciating the body and its functionality. Body Image 2022; 40:92-102. [PMID: 34902783 DOI: 10.1016/j.bodyim.2021.11.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 11/08/2021] [Accepted: 11/17/2021] [Indexed: 01/25/2023]
Abstract
Women with breast cancer often experience major physical changes, which can impact their body image and Quality of Life (QoL). Traditional assessments of body image implemented within breast cancer research focus solely on body dissatisfaction. This study explored the association between both positive and negative body image and QoL. Australian women (N = 123) within 5-years of a breast cancer diagnosis were invited to complete a web-based questionnaire including measures of body appreciation and functionality appreciation, cancer-specific measures of body dissatisfaction and QoL, and demographic, health and treatment/illness questions. All body image measures were significantly associated with QoL (p < .01). However, when body image variables were entered simultaneously as predictors of QoL (adjusting for comorbidity, treatment and employment), only body dissatisfaction was significantly associated with QoL (p < .001). Further analyses indicated this was due to shared variance in QoL between body and functionality appreciation, suggesting they assess highly related constructs within this population. Results indicate positive and negative components of body image are relevant to QoL within breast cancer populations; though, body dissatisfaction remained the strongest predictor of QoL indicating its pervasiveness. Future research should explore the development and use of breast cancer-specific measures of positive body image.
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Affiliation(s)
- Kerry Ettridge
- Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, SA, Australia; The University of Adelaide's School of Psychology, Adelaide, SA, Australia.
| | - Katrine Scharling-Gamba
- Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, SA, Australia; School of Psychology, Flinders University, Adelaide, SA, Australia
| | - Caroline Miller
- Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, SA, Australia; The University of Adelaide's School of Public Health, Adelaide, SA, Australia
| | - David Roder
- Cancer Epidemiology and Population Health, University of South Australia, Adelaide, SA, Australia
| | - Ivanka Prichard
- Caring Futures Institute, Flinders University, Adelaide, SA, Australia
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Mohammadi F, Oshvandi K, Kamallan SR, Khazaei S, Ranjbar H, Ahmadi‐Motamayel F, Gillespie M, Jenabi E, Vafaei SY. Effectiveness of sodium bicarbonate and zinc chloride mouthwashes in the treatment of oral mucositis and quality of life in patients with cancer under chemotherapy. Nurs Open 2022; 9:1602-1611. [PMID: 35170247 PMCID: PMC8994952 DOI: 10.1002/nop2.1168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 11/09/2021] [Accepted: 12/15/2021] [Indexed: 11/29/2022] Open
Abstract
Aim The purpose of the study is to evaluate the effectiveness of sodium bicarbonate and zinc chloride mouthwashes on oral mucositis and quality of life in patients undergoing chemotherapy. Design The present study was a randomized controlled trial study. Methods One hundred forty‐four patients with a cancer diagnosis were randomly assigned into three groups: sodium bicarbonate mouthwash (n = 48), zinc chloride mouthwash (n = 48) and placebo group (n = 48). The severity of mucositis and quality of life were examined blindly at the baseline and 3‐week follow‐up. Results The grade of oral mucositis decreased at the end of the third weeks in the sodium bicarbonate and zinc chloride groups rather than the placebo group (p < .001). The severity of oral mucositis in the sodium bicarbonate and zinc chloride groups decreased from end of the first week until third week (p < .001). In addition, there was significant difference in the severity of oral mucositis among the groups at the end of the second (p = .014) and the third weeks (p < .001). Also, there was a statistically significant difference in quality of life scores between the sodium bicarbonate and zinc chloride mouthwash with the placebo group (p < .001). Conclusion Zinc chloride and sodium bicarbonate mouthwashes were effective in treating and reducing the severity of oral mucositis, and subsequently improving quality of life in patients with cancer under chemotherapy. Therefore, we can recommend zinc chloride and sodium bicarbonate at the beginning of chemotherapy to improve oral health and promoting quality of life in these patients.
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Affiliation(s)
- Fateme Mohammadi
- Department of Pediatric Nursing, Chronic Diseases (Home Care) Research Center and Autism Spectrum Disorders Research CenterDepartment of NursingHamadan University of Medical SciencesHamadanIran
| | - Khodayar Oshvandi
- Department of Medical Surgical NursingSchool of Nursing and Midwifery, Mother and Child Care Research CenterHamadan University of Medical SciencesHamadanIran
| | - Seyed Ramesh Kamallan
- Department of Medical‐Surgical NursingStudent Research CenterHamadan University of Medical SciencesHamadanIran
| | - Salman Khazaei
- Department of EpidemiologyHealth Sciences Research CenterHealth Sciences & Technology Research InstituteHamadan University of Medical SciencesHamadanIran
| | - Hossein Ranjbar
- Department of Hematology and OncologyDepartment of Internal MedicineSchool of MedicineHamadan University of Medical SciencesHamadanIran
| | - Fatemeh Ahmadi‐Motamayel
- Department of Oral and Maxillofacial MedicineSchool of DentistryDental Research CenterHamadan University of Medical SciencesHamadanIran
| | - Mark Gillespie
- School of Health Nursing and MidwiferyUniversity of the West of ScotlandPaisleyScotland
| | - Ensiyeh Jenabi
- Research Assistant Professor of Reproductive Health (By Research)Autism Spectrum disorders Research CenterHamadan University of Medical SciencesHamadanIran
| | - Seyed Yaser Vafaei
- Department of PharmaceuticsDepartment of Pharmaceutics and Pharmaceutical BiotechnologySchool of PharmacyHamadan University of Medical SciencesHamadanIran
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Pitch N, Stefaniuk S, MacMillan M, Catsburg J, Gupta AA, Vora T. Looking Back to Move Forward: Lessons Learned from a Successful, Sustainable, Replicable Model of Adolescent and Young Adult Program of a Tertiary Cancer Care Center. J Adolesc Young Adult Oncol 2022; 11:181-188. [PMID: 35007440 PMCID: PMC9057888 DOI: 10.1089/jayao.2021.0156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background: The Princess Margaret Cancer Centre (PM) established the adolescent and young adult (AYA) oncology program in 2014 to address the unique needs of AYA by delivering targeted, evidence-based care through a multidisciplinary team. Methods: We performed a retrospective analysis of patients who underwent a consultation with the PM AYA program from 2014 to 2020. The association between the health domain concerns reported and age at consultation, cancer diagnoses, and time since diagnosis was analyzed using chi-square test of independence in SPSS. Results: In our cohort of 1128 AYA, the median age at assessment was 28.2 years. The most common diagnoses were lymphoma (n = 251, 22.2%), leukemia (n = 207, 18.4%), and breast cancer (n = 162, 14.4%). The most common concerns reported were related to fertility (n = 882, 78.2%) and work/school (n = 472, 41.8%). Fertility concerns were most common in 25–34 age group (443/540, 82.0%) and work-/school-related concerns were highest in 18–24 age group (191/355, 53.8%). Diagnoses significantly affect majority of concerns reported. Fertility concerns were most common in AYA consulted near diagnosis, while body image-, exercise-, and diet-related concerns were more frequently reported, while on active treatments. Conclusions: Supporting fertility concerns remains the cornerstone of any successful AYA program. Work-/school-related concerns deserve more elucidation and attention. We identified important patterns in the health-related concerns of AYA, especially as they relate to age, diagnoses, and time since diagnosis. This insight will guide us for improving patient-centered care delivery to AYA.
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Affiliation(s)
- Natalie Pitch
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.,Adolescent and Young Adult Program, Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Canada
| | - Stephanie Stefaniuk
- Adolescent and Young Adult Program, Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Canada
| | - Meghan MacMillan
- Adolescent and Young Adult Program, Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Canada.,Alberta Health Services, Edmonton, Canada
| | - Jennifer Catsburg
- Adolescent and Young Adult Program, Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Canada
| | - Abha A Gupta
- Adolescent and Young Adult Program, Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Canada.,Division of Hematology/Oncology, Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Tushar Vora
- Adolescent and Young Adult Program, Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Canada.,Division of Hematology/Oncology, Hospital for Sick Children, University of Toronto, Toronto, Canada
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21
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Huang H, Bast JH, Otterburn DM. Delineating the Risk Factors of Venous Congestion: An Analysis of 455 Deep Inferior Epigastric Perforator Flaps with Radiographic Correlation. J Plast Reconstr Aesthet Surg 2022; 75:1886-1892. [DOI: 10.1016/j.bjps.2022.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 01/08/2022] [Indexed: 10/19/2022]
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22
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Thakur M, Sharma R, Mishra A, Gupta B. Body image disturbances among breast cancer survivors: A narrative review of prevalence and correlates. CANCER RESEARCH, STATISTICS, AND TREATMENT 2022. [DOI: 10.4103/crst.crst_170_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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23
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Fergus K, Ahmad S, Gardner S, Ianakieva I, McLeod D, Stephen J, Carter W, Periera A, Warner E, Panchaud J. Couplelinks online intervention for young couples facing breast cancer: A randomised controlled trial. Psychooncology 2021; 31:512-520. [PMID: 34669239 DOI: 10.1002/pon.5836] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 08/29/2021] [Accepted: 10/01/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Young women with breast cancer and their partners are more distressed than couples who are affected later in life. While dyadic interventions in the context of cancer are promising, there are access barriers, particularly for younger couples. This study evaluated Couplelinks, a professionally facilitated, web-based program designed to help couples improve their conjoint coping. METHOD This randomised controlled trial employed a waitlist control evaluation of the program. Outcomes included dyadic coping, relationship adjustment, depression, and anxiety. RESULTS Seventy-five couples consented to participate and were randomised. The final analysis included 31 couples in the treatment group and 36 couples in the waitlist group. Modest improvements were found in positive dyadic coping but effects were not maintained at 3-month follow-up. No effect was seen on overall relationship adjustment. CONCLUSIONS Our findings inform the rapidly expanding field of online programming for couples in general, and those affected by BC in particular. Intervention timing, 'dose', low overall relational distress, and the mainly enrichment rather than problem-focus of Couplelinks may help explain the lack of change on relationship adjustment.
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Affiliation(s)
- Karen Fergus
- Department of Psychology, York University, Toronto, Ontario, Canada.,Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Saunia Ahmad
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Toronto Psychology Clinic, Toronto, Ontario, Canada
| | - Sandra Gardner
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada.,Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Iana Ianakieva
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Deborah McLeod
- School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Joanne Stephen
- Clinical Neurosciences, Alberta Health Services, Calgary, Alberta, Canada
| | - Wendy Carter
- Toronto Academic Pain Institute, Women's College Hospital, Toronto, Ontario, Canada
| | - Amanda Periera
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Ellen Warner
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Jim Panchaud
- Campus Ministry, King's University College, London, Ontario, Canada
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24
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Kang D, Lee JK, Kim N, Kim S, Lee SK, Lee JE, Nam SJ, Cho J. Effect of mind and body education on quality of life among young breast cancer patients: a randomized controlled trial. Support Care Cancer 2021; 30:721-729. [PMID: 34368886 DOI: 10.1007/s00520-021-06459-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 07/21/2021] [Indexed: 02/08/2023]
Abstract
PURPOSE This study aim was to evaluate efficacy of the combination with cosmetic and psychosocial education program on body image, sexual function, and emotional function among young-onset breast cancer (YBC). METHODS An unblended, randomized, controlled trial design was conducted in patients newly diagnosed with stage I-III breast cancer from 2014 to 2015. The intervention group received a structured education program including appearance management and mind control for 4 weeks. The outcome of this study shows effect on body image and sexual functioning and a distress due to altered appearance and anxiety after the intervention and 6 months after intervention. RESULTS Among 228 eligible patients, 109 (47.8%) agreed to participate in the present study and were randomized to intervention (n = 54) or control (n = 55) groups. After intervention, the intervention group reported significantly better body image compared to the control group (mean score of 75.0 vs. 59.3, respectively; P < 0.01). The intervention group also reported significantly lower levels of distress due to altered appearance and higher levels of sexual functioning compared to the control group after the intervention. The effects were maintained even 6 months after intervention. CONCLUSION(S) Body image intervention for YBC had effect on improving body image and sexual functioning and a reduction in distress due to altered appearance and anxiety. Trial registration number and date of registration: The study was registered at the Clinical Research Information Service (no. KCT0001191, https://cris.nih.go.kr/cris ) on 23 July 2014.
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Affiliation(s)
- Danbee Kang
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea.,Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Cancer Education Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jae Kyung Lee
- Patient-Centered Outcomes Research Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Nayeon Kim
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea.,Cancer Education Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sooyeon Kim
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea.,Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Se Kyung Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jeong Eon Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Seok Jin Nam
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Juhee Cho
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea. .,Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. .,Cancer Education Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
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25
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The effect of mobile health educational intervention on body image and fatigue in breast cancer survivors: a randomized controlled trial. Ir J Med Sci 2021; 191:1599-1605. [PMID: 34370166 DOI: 10.1007/s11845-021-02738-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 07/31/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Cancer-related fatigue, physical changes, and pain are among the most troublesome symptoms caused by breast cancer treatment and influence the patients' quality of life. The aim of the present study was to examine the effect of mobile health educational intervention on body image and fatigue in breast cancer survivors. METHODS The present clinical trial study conducted on 38 women with breast cancer referred to Golestan and Shahid Baghaei 2 hospitals, Ahvaz, south west Iran in 2018-2019. Patients were randomly assigned into two intervention group, and control groups on 1:1 basis. Data collection tool included three parts: cancer fatigue scale, body image concern inventory, and demographic information. Text messages sent to intervention group via WhatsApp messenger for 7 weeks on a daily schedule. The control group did not receive any messages. Data were analyzed using SPSS Version 23.0. RESULTS The mean age of participants was 46.34 ± 9.96. The mean score of cancer fatigue scale after the intervention in the intervention group was decreased significantly (p = 0.005), but no statistically significant difference was observed in the control group. There was a significant difference in the mean score of body image concern inventory in the intervention group (p = 0.002) after the intervention compared with the control group. CONCLUSION Mobile health educational intervention improved cancer-related fatigue and body image among women breast cancer survivors. The integration of education for the management of fatigue and body image disturbance as part of routine care among breast cancer survivors is recommended.
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26
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Martino ML, Lemmo D, Gargiulo A. A review of psychological impact of breast cancer in women below 50 years old. Health Care Women Int 2021; 42:1066-1085. [PMID: 34357855 DOI: 10.1080/07399332.2021.1901901] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
A breast cancer diagnosis is a critical event with a potentially traumatic nature. In recent years there has been an increase of this illness in women aged under-fifty, a group of particular scientific interest. In this article the authors review the recent scientific literature on psychological impact of breast cancer experiences in under-50 women. Our results highlight three trajectories: clinical psychological risks; feminine-specific concerns; resources between individual and relational aspects. This overview illustrates the complexity of the effects of breast cancer in under-50women allowing to think about theoretical and psychosocial models to provide support for under-50 women during the illness experience.
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Affiliation(s)
- Maria Luisa Martino
- Department of Humanistic Studies, University of Naples Federico II, Naples, Italy
| | - Daniela Lemmo
- Department of Humanistic Studies, University of Naples Federico II, Naples, Italy
| | - Anna Gargiulo
- Department of Humanistic Studies, University of Naples Federico II, Naples, Italy
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Oshvandi K, Vafaei SY, Kamallan SR, Khazaei S, Ranjbar H, Mohammadi F. Effectiveness of zinc chloride mouthwashes on oral mucositis and weight of patients with cancer undergoing chemotherapy. BMC Oral Health 2021; 21:364. [PMID: 34294072 PMCID: PMC8296564 DOI: 10.1186/s12903-021-01706-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 07/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Oral mucositis is one of the most emerging and debilitating complications of chemotherapy during the treatment period, which strongly affects the nutritional status and physical and mental condition of these patients. Zinc increased protein synthesis and improved cell membrane stability so passible effective in prevent and treat oral mucositis and promote oral health. Therefore, this study aimed to evaluate the effect of zinc chloride mouthwash on the prevention, incidence, and severity of oral mucositis in cancer patients undergoing chemotherapy. METHODS The present study was a randomized control trial study. 96 patients with a cancer diagnosis selected from one oncology clinic in the west of Iran. Then they assigned randomly to the zinc chloride group and placebo group. The patients in each group should rinse their mouths every 8 h two times and each time 2 min with 7.5 ml from mouthwash. The severity of mucositis and weight loss examined blindly at the baseline and 3-week follow-up. RESULTS The incidence and severity of oral mucositis between groups were significant higher at the end of the second (p < 0.002) and third (p < 0.001) week. The mucositis severity decreased well during the third weeks in the zinc chloride group. The difference in the weight loss was significant higher between the zinc chloride and the placebo group (p < 0.01). CONCLUSION Zinc chloride mouthwash was effective in preventing and reducing the severity of oral mucositis and improving weight in patients undergoing chemotherapy. Trial registration We can therefore recommend more studies examine the effects zinc chloride as preventive care at the beginning of chemotherapy to improve oral health and subsequently preventing weight loss in these patients.
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Affiliation(s)
- Khodayar Oshvandi
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Mother and Child Care Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Seyed Yaser Vafaei
- Department of Pharmaceutics & Pharmaceutical Biotechnology, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Seyed Ramesh Kamallan
- Department of Medical Surgical Nursing, Student Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Salman Khazaei
- Department of Epidemiology, Health Sciences Research Center, Health Sciences and Technology Research Institute, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Hossein Ranjbar
- Department of Hematology Oncology, Department of Internal Medicine, School of Medicine, Shahid Beheshti Medical Educational Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Fateme Mohammadi
- Department of Pediatric Nursing, Chronic Diseases (Home Care) Research Center and Autism Spectrum Disorders Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.
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28
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Miseré RM, van Kuijk SM, Claassens EL, Heuts EM, Piatkowski AA, van der Hulst RR. Breast-related and body-related quality of life following autologous breast reconstruction is superior to implant-based breast reconstruction - A long-term follow-up study. Breast 2021; 59:176-182. [PMID: 34271290 PMCID: PMC8287213 DOI: 10.1016/j.breast.2021.07.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 06/09/2021] [Accepted: 07/05/2021] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION The better survival rates after breast cancer allow for setting of long-term goals, such as Quality of Life (QoL) and aesthetic outcomes following breast reconstruction. Studies find a higher breast-related QoL and greater satisfaction with breasts following autologous breast reconstruction (ABR) compared to implant-based breast reconstruction (IBR). However, aesthetic results from donor sites can influence body image. This concern is little addressed in the literature. Therefore, the aim of this study was to compare the long-term breast-related and body-related QoL of women who underwent ABR to women who underwent IBR. MATERIAL AND METHODS A multicenter, cross-sectional survey was conducted between November and December 2020 among women who underwent postmastectomy breast reconstruction between January 2015 and December 2018. A general questionnaire, the BREAST-Q, and the BODY-Q were used to collect data. Multivariable linear regression was performed to adjust differences in Q-scores for potential confounders. RESULTS In total, 336 patients were included (112 IBR, 224 ABR). Autologous reconstruction resulted in significantly higher mean scores in all subdomains of the BREAST-Q. On the BODY-Q, IBR scored significantly higher on scars, while ABR scored moderately to significantly higher on all other scales. Despite a lower mean score on Hips & outer thighs in women with Lateral Thigh Perforator (LTP) flap reconstruction, no negative influence on body image was found in these women. CONCLUSIONS Long-term breast-related and body-related outcomes of ABR are superior to IBR. Donor site aesthetic does not adversely affect body image in women who underwent free flap breast reconstruction.
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Affiliation(s)
- Renée Ml Miseré
- Department of Plastic, Reconstructive and Hand Surgery, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX, Maastricht, the Netherlands; NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands.
| | - Sander Mj van Kuijk
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX, Maastricht, the Netherlands.
| | - Eva L Claassens
- Faculty of Health Medicine and Life Sciences, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, the Netherlands.
| | - Esther M Heuts
- Department of General Surgery, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX, Maastricht, the Netherlands.
| | - Andrzej A Piatkowski
- Department of Plastic, Reconstructive and Hand Surgery, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX, Maastricht, the Netherlands.
| | - René Rwj van der Hulst
- Department of Plastic, Reconstructive and Hand Surgery, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX, Maastricht, the Netherlands; NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands.
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29
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Gorven A, du Plessis L. Corporeal Posttraumatic Growth As a Result of Breast Cancer: An Interpretative Phenomenological Analysis. JOURNAL OF HUMANISTIC PSYCHOLOGY 2021. [DOI: 10.1177/0022167818761997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Women’s traumatic experience of breast cancer (BC) can result in posttraumatic growth (PTG). Women’s embodied experiences of BC seem particularly pertinent to their experiences of both difficulty and growth. While PTG is usually conceptualized as having five domains, it seems that BC survivors experience a sixth domain—corporeal PTG (CPTG). CPTG was recently defined as a “reclaiming” and renewed connection to the body through increased appreciation of the physical self, a new sense of bodily responsibility, positive health changes, and a new sense of positive identification with the body. This study’s aim was to explore how women experience CPTG due to BC. In-depth interviews were conducted with female BC survivors. Interpretative phenomenological analysis extracted three themes: losing, regaining, and relinquishing ultimate control over the body, reconstructing embodied identity, and a newfound appreciation for the body. Participants spoke of a complicated journey from distress, loss, and fragmentation to a reshaping of their assumptions about their bodies. The findings suggest that the body plays a vital role in women’s traumatic and growth-related experiences of BC. Future research on the embodied experience of BC is recommended as it forms a crucial part of BC recovery.
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Affiliation(s)
- Amy Gorven
- University of Johannesburg, Johannesburg, Gauteng, South Africa
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30
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Setiawan AR, Tunjungsari F, Sander MA. The relationship of self-acceptance with decision making duration in cancer patient to perform mastectomy. Breast Dis 2021; 40:S109-S113. [PMID: 34057125 DOI: 10.3233/bd-219016] [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: 11/15/2022]
Abstract
BACKGROUND Cancer is a disease caused by abnormal growth of body cells that turn malignant and continue to grow uncontrollably. One of the treatments for breast cancer is mastectomy. The quickness of decision-making determines the survival rate of prognosis patients. OBJECTIVE This study aimed to determine the relationship of self-acceptance with decision-making duration in cancer patients to perform a mastectomy. METHODS An analytic observation method with cross-sectional design. The samples were taken by purposive sampling method with 50 samples of breast cancer patients. Data collected include age, last level of education, marital status, profession, stage of cancer during mastectomy, self-acceptance score, and decision-making duration to perform a mastectomy. RESULTS The data analyzed with the Kruskal-Wallis test. The test showed the relationship of self-acceptance (p = 0.027) with decision-making duration in breast cancer patients to perform a mastectomy. CONCLUSION In conclusion, there is a relationship of self-acceptance with decision-making duration in breast cancer patients to perform a mastectomy.
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Affiliation(s)
| | - Feny Tunjungsari
- Departement of Industry & Family Medicine, University of Muhammadiyah Malang, Malang, Indonesia
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31
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Corey B, Smania MA, Spotts H, Andersen M. Young Women With Breast Cancer: Treatment, Care, and Nursing Implications. Clin J Oncol Nurs 2021; 24:139-147. [PMID: 32196004 DOI: 10.1188/20.cjon.139-147] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Young women with breast cancer (YWBC) are more likely to have aggressive disease, carry mutations for hereditary cancer genes, and experience higher mortality. They also may face reduced fertility because of the toxicity of chemotherapy. OBJECTIVES This article aims to present a review of YWBC treatments, sequelae of treatment, and psychosocial challenges. METHODS The authors performed a review of guideline-supported treatment options, patient resources, and nursing implications. FINDINGS Because of high-risk cancers and a lack of specific treatment guidelines, healthcare providers may consider aggressive treatments for younger patients. However, studies indicate that the foundation for treatment decisions for YWBC are best based on disease stage and National Comprehensive Cancer Network guidelines.
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32
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Mifsud A, Pehlivan MJ, Fam P, O’Grady M, van Steensel A, Elder E, Gilchrist J, Sherman KA. Feasibility and pilot study of a brief self-compassion intervention addressing body image distress in breast cancer survivors. Health Psychol Behav Med 2021; 9:498-526. [PMID: 34104572 PMCID: PMC8158280 DOI: 10.1080/21642850.2021.1929236] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 05/09/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The majority of breast cancer survivors (BCSs) experience body image concerns following treatment. Body Image distress (BID) is associated with psychological distress and diminished quality of life. A web-based self-compassion focused writing activity (My Changed Body - MyCB) reduces BID in BCSs, yet limited research exists on participant characteristics associated with such intervention adherence. Self-compassion-based meditations are also efficacious in reducing BID in non-BCS populations. This parallel, double-blind pilot randomised controlled trial aimed to assess the feasibility and acceptability of MyCB, with and without an additional meditation component, on BID and related psychological outcomes in BCSs. The trial was registered with the Australian and New Zealand Clinical Trials Registry (#ACTRN12619001693112). METHODS BCSs were randomly allocated to MyCB (n = 39), MyCB + Meditation (MyCB + M) (n = 17) or an expressive writing (EW) active control arm (n = 23). The primary outcome was BID. Secondary outcomes were body appreciation, affect (positive and negative), psychological distress (depression, anxiety and stress) and self-compassion (state and trait). Assessments were completed online at baseline, post-intervention and 1-month. RESULTS Adherence to the MyCB writing (45%) and meditation (50%) was modest, and acceptability was high for both MyCB and MyCB + M. Intent to treat linear mixed model analyses indicated: Post-intervention - state self-compassion and positive affect increased for MyCB compared to EW; 1-month: BID scores decreased across all conditions; trait self-compassion increased and anxiety decreased for MyCB + M compared to MyCB and EW. CONCLUSION These findings provide preliminary evidence for the efficacy and potential clinical use of the MyCB brief web-based self-compassion intervention alone and with the addition of meditation, to increase self-compassion and psychological wellbeing in BCSs.
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Affiliation(s)
- Angela Mifsud
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Melissa J. Pehlivan
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Paul Fam
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Maddison O’Grady
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Annamiek van Steensel
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Elisabeth Elder
- Westmead Breast Cancer Institute, Westmead Hospital, Sydney, Australia
| | | | - Kerry A. Sherman
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
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33
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Vani MF, Lucibello KM, Trinh L, Santa Mina D, Sabiston CM. Body image among adolescents and young adults diagnosed with cancer: A scoping review. Psychooncology 2021; 30:1278-1293. [PMID: 33882162 DOI: 10.1002/pon.5698] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 04/02/2021] [Accepted: 04/06/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Cancer and treatment can produce temporary or permanent body changes, which may affect the body image (BI) of adolescents and young adults diagnosed with cancer (AYAs). This evidence has not been comprehensively summarized. A scoping review was conducted to explore the available evidence on BI among AYAs and identify the definitions, theories, models, frameworks, measures, and methods used to assess BI. METHODS Databases MEDLINE, EMBASE, PsycINFO (via Ovid) and CINAHL and Gender Studies (via EBSCO) were searched to identify published studies from 1 January 2000 to 25 November 2019. Inclusion criteria were: qualitative, quantitative, or mixed methodology; at least one BI-related measure or theme; published in English; and majority of the sample between 13 and 39 years at diagnosis and a mean age at diagnosis between 13 and 39 years. Two authors screened the titles, abstracts, and full-text articles and data were extracted and summarized. RESULTS The search yielded 11,347 articles and 82 met inclusion criteria. Articles included 45 quantitative, 33 qualitative, and four mixed-methods studies. The majority of studies used cross-sectional designs, while BI definitions, theories, models, frameworks, and measures were varied. Studies explored descriptive, psychological, physical, coping, and social factors, with BI being described most often as an outcome rather than a predictor. CONCLUSIONS Theory-based research that employs a holistic BI definition and uses longitudinal or intervention study designs or a qualitative methodology is needed to better understand the BI experience of AYAs and inform the development of strategies and programs to reduce BI concerns and increase positive body experiences.
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Affiliation(s)
- Madison F Vani
- Department of Kinesiology, Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Kristen M Lucibello
- Department of Kinesiology, Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Linda Trinh
- Department of Kinesiology, Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Daniel Santa Mina
- Department of Kinesiology, Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Catherine M Sabiston
- Department of Kinesiology, Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, Ontario, Canada
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Fidan E, Çelik S. Factors affecting medical healthcare-seeking behaviours of female patients according to their stage of being diagnosed with breast cancer. Eur J Cancer Care (Engl) 2021; 30:e13436. [PMID: 33694269 DOI: 10.1111/ecc.13436] [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: 04/09/2020] [Revised: 01/18/2021] [Accepted: 02/25/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of study was to determine factors affecting the medical healthcare-seeking behaviours of female patients according to their stage of being diagnosed with breast cancer. METHODS This descriptive and correlational study was carried out with 150 women. The data were collected by a survey form, the Body Perception Scale, the Rosenberg Self-Esteem Scale and the Social Appearance Anxiety Scale. RESULTS About 54% of the women were diagnosed with early-stage breast cancer, 68.7% had high self-esteem, and 80% had positive body perceptions, while their social appearance anxiety levels were moderate. The patients with breast cancer at the 4th stage had a high body perception score of 174.00 ± 23.34. Self-esteem was the highest in the patients with stage 2B breast cancer with a value of 0.61 ± 0.91. The highest social anxiety mean score was found in the patients with stage 2A breast cancer as 31.65 ± 12.50. There was no statistically significant difference in the women's sociodemographic characteristics, health and breast cancer history, self-esteem, body perception and social appearance anxiety based on their stages of cancer (p > 0.05). CONCLUSION Nurses' identification of risky individuals in early diagnosis, information for the individual / family and society by planning trainings and raising awareness will contribute positively to the patients' medical health-seeking behaviours.
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Affiliation(s)
- Emine Fidan
- Faculty of Pharmacy, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
| | - Sevim Çelik
- Nursing Department, Bartın University Health Science Faculty, Bartın, Turkey
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Surgical Treatment after Neoadjuvant Systemic Therapy in Young Women with Breast Cancer: Results from a Prospective Cohort Study. Ann Surg 2020; 276:173-179. [PMID: 33378304 DOI: 10.1097/sla.0000000000004296] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE We aimed to investigate eligibility for breast-conserving surgery (BCS) pre- and post-neoadjuvant systemic therapy (NST), and trends in the surgical treatment of young breast cancer patients. BACKGROUND Young women with breast cancer are more likely to present with larger tumors and aggressive phenotypes, and may benefit from NST. Little is known about how response to NAC influences surgical decisions in young women. METHODS The Young Women's Breast Cancer Study (YWS), a multicenter prospective cohort of women diagnosed with breast cancer at age ≤40, enrolled 1302 patients from 2006 to 2016. Disease characteristics, surgical recommendations, and reasons for choosing mastectomy among BCS-eligible patients were obtained through the medical record. Trends in use of NST, rate of clinical and pathologic complete response (cCR and pCR), and surgery were also assessed. RESULTS Of 1117 women with unilateral stage I-III breast cancer, 315 (28%) received NST. Pre-NST, 26% were BCS eligible, 17% were borderline eligible, and 55% were ineligible. After NST, BCS eligibility increased from 26% to 42% (p < 0.0001). Among BCS-eligible patients after NST (n = 133), 41% chose mastectomy with reasons being patient preference (53%), BRCA or TP53 mutation (35%) and family history (5%). From 2006 to 2016, the rates of NST (p = 0.0012), cCR (p < 0.0001) and bilateral mastectomy (p < 0.0001) increased, but the rate of BCS did not increase (p = 0.34). CONCLUSION While the proportion of young women eligible for BCS increased after NST, many patients choose mastectomy, suggesting that surgical decisions are often driven by factors beyond extent of disease and treatment response.
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Kang D, Kim IR, Choi HJ, Jung CW, Yoon SS, Kim JS, Lee CH, Jang JH, Cho J. Association between body image dissatisfaction and poor quality of life and depression among patients with hematopoietic stem cell transplantation. Support Care Cancer 2020; 29:3815-3822. [PMID: 33241506 DOI: 10.1007/s00520-020-05884-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 11/05/2020] [Indexed: 12/31/2022]
Abstract
PURPOSE This study aims to evaluate the association between body image dissatisfaction and quality of life and depression among patients after hematopoietic stem cell transplantation (HSCT). METHODS We conducted a cross-sectional survey at three university-based HSCT outpatient clinics and the Korea Blood Cancer Association. We assessed the body image using the body image scale; quality of life and depression were measured using the World Health Organization Quality of Life-BREF and the Patient Health Questionnaire 9, respectively. Univariate and multivariate linear regression models were used to find an association between body image, quality of life, and depression. RESULTS Among 163 study participants, 71.8% were male, and the mean age of the participants was 48.3 (SD = 11.2). Over 70% of the participants reported that they felt less physically and sexually attractive due to HSCT, and 39.3% of the patients were dissatisfied with their body image. In fully adjusted models, patients with dissatisfied body image had significantly poorer quality of life (- 13.68, 95% confidence interval [CI] = - 18.16, - 9.21). Moreover, patients with body image dissatisfaction were 8.59 times (95% CI = 3.79, 19.48) more likely to have depressive symptoms than patients without it. CONCLUSION The majority of HSCT patients experienced body image dissatisfaction, which was significantly associated with poor quality of life and depression. It would be essential to evaluate body image after HSCT and provide appropriate interventions for preventing further psychological consequences.
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Affiliation(s)
- Danbee Kang
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea.,Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Im-Ryung Kim
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea.,Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hye Jin Choi
- Department of Nursing (Cancer center), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Chul Won Jung
- Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Sung-Soo Yoon
- Division of Hematology/Oncology, Department of Internal Medicine, Seoul National University School of Medicine, Seoul, South Korea
| | - Jin Seok Kim
- Division of Hematology, Department of Internal Medicine, Yonsei University College of Medicine, Severance Hospital, Seoul, South Korea
| | | | - Jun Ho Jang
- Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
| | - Juhee Cho
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea. .,Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. .,Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. .,Departments of Epidemiology and Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Ghaffari F, Ghahramanian A, Zamanzadeh V, Onyeka TC, Davoodi A, Mazaheri E, Asghari-Jafarabadi M. Patient-centred communication for women with breast cancer: Relation to body image perception. J Clin Nurs 2020; 29:4674-4684. [PMID: 32956571 DOI: 10.1111/jocn.15508] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 08/26/2020] [Accepted: 09/06/2020] [Indexed: 12/27/2022]
Abstract
AIMS AND OBJECTIVES This study aimed to determine the predictive values of patient-centred communication (PCC) and patient's characteristics on the body image (BI) perception in postmastectomy patients. BACKGROUND Patient-centred communication has been touted as a means of addressing BI issues, especially for postmastectomy patients. DESIGN AND METHODS This predictive correlational study was conducted on 275 surgically treated breast cancer patients admitted to the Oncology Departments of two hospitals in Tabriz, Iran. These patients were selected using a convenience sampling method. The Body Image after Breast Cancer Questionnaire (BIBCQ) and patient-centred communication questionnaire (PCCQ) were used for collecting the data. Descriptive and inferential statistics were applied to the data. Reporting was in accordance with the STROBE guideline. RESULTS A multivariable model significantly predicted BI perception in participants using surgery type and time elapsed following surgery. Participants' limitations were significantly affected by surgery type and participants' perception of the nurses' PCC skills. Arm concern was significantly affected by surgery type and nurses' PCC skills. CONCLUSION Patient-centred skills in nurse-patient communication are critical for resolving BI difficulties such as arm concerns and limitations regarding the disease and its treatment. RELEVANCE TO CLINICAL PRACTICE Patient-centred communication skills can be taught nurses in the clinical setting to help alleviate patients' BI problems.
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Affiliation(s)
- Fariba Ghaffari
- Department of Medical Surgical Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Akram Ghahramanian
- Medical Surgical Department, Nursing and Midwifery Faculty, Hematology & Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vahid Zamanzadeh
- Medical Surgical Department, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Tonia C Onyeka
- Department of Anaesthesia/Pain and Palliative Care Unit, Multidisciplinary Oncology Centre, College of Medicine, University of Nigeria, Enugu, Nigeria
| | - Arefeh Davoodi
- Department of Medical Surgical, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Effat Mazaheri
- Department of Medical Surgical, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Asghari-Jafarabadi
- Department of Statistics and Epidemiology, Faculty of Health, Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Probst H, Rosbottom K, Crank H, Stanton A, Reed H. The patient experience of radiotherapy for breast cancer: A qualitative investigation as part of the SuPPORT 4 All study. Radiography (Lond) 2020; 27:352-359. [PMID: 33036914 PMCID: PMC8063584 DOI: 10.1016/j.radi.2020.09.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 08/28/2020] [Accepted: 09/13/2020] [Indexed: 11/25/2022]
Abstract
Introduction Breast cancer is a global health problem with 2.09 million cases of breast cancer diagnosed worldwide in 2018. With an increase in breast cancer survival attention has now focussed on the impact treatment side effects can have on the quality of life for women during survivorship. The aim of the SuPPORT 4 All project is to develop a support bra for use during radiotherapy, that can reduce normal tissue toxicity (for women with larger breasts) and provide accuracy, dignity and modesty for all women. The first stage of the project involved a co-design process to understand the current patient experience where no support bra or modesty device is used. Method A participatory co-design methodology was adopted. Workshops were held with patient representatives (n = 9) to seek understanding of experience during radiotherapy; a total of three workshops over 4 h. The workshops were audio recorded and framework analysis was adopted to identify key patient experiences. Results Twelve categories and twenty-six sub categories were identified specific to patient experience. Patient concerns focussed on information provision, Healthcare Practitioner (HCP) knowledge of breast lymphoedema, lack of choice, experiences of being naked, and feelings of disempowerment. Conclusions A number of areas were identified that had negative effects on overall patient experience. Implications for practice Practitioners should consider patient dignity when configuring services to support patient needs regarding undressing, outside or inside the linear accelerator room. Additionally, practitioners should have an understanding of the impact permanent tattoos may have on some patients’ wellbeing and the impact that breast lymphoedema has on patient quality of life. Practitioners should also consider methods to encourage patient empowerment during radiotherapy; supporting patient self-monitoring of side-effects may be one way to facilitate this.
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Affiliation(s)
- H. Probst
- Corresponding author. Collegiate Crescent Campus, Sheffield Hallam University, Room F428, 11-15 Broomhall Road, S10 2BP, UK. Twitter icon
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Marsh S, Borges VF, Coons HL, Afghahi A. Sexual health after a breast cancer diagnosis in young women: clinical implications for patients and providers. Breast Cancer Res Treat 2020; 184:655-663. [PMID: 32968951 DOI: 10.1007/s10549-020-05880-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 08/13/2020] [Indexed: 12/26/2022]
Abstract
PURPOSE Sexual dissatisfaction after breast cancer treatment is a common phenomenon that, unfortunately, places a significant strain on young women and is becoming more common as treatment regimens rely more and more on anti-endocrine therapies. METHODS A PubMed review of peer reviewed manuscripts between the years 1998-2020 evaluating sexual health and wellbeing in cancer patients, primarily young women with breast cancer, was conducted. RESULTS There are several categories of sexual dissatisfaction women may experience as a result of her breast cancer diagnosis, including menopausal symptoms and dyspareunia, negative body image, reduced sexual desire, strained relationships and partner communication, and anxiety about cancer disclosure in dating relationships. Several methods of addressing each domain have been studied. While hormonal replacement therapy remains controversial, other medication regimens have been shown to be effective in treating menopausal symptoms and dyspareunia. Cognitive behavioral therapy, sex therapy, and couples' therapy are all effective in addressing a variety of symptoms across multiple domains. CONCLUSIONS Oncologists are often not prepared to discuss sexual health concerns as frequently as women need. Further work is needed to bring easily digestible and meaningful educational opportunities into clinical practice so young breast cancer survivors can receive comprehensive post-cancer survivorship care.
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Affiliation(s)
- Sydney Marsh
- University of Colorado Cancer Center, Aurora, CO, USA
| | | | - Helen L Coons
- University of Colorado Cancer Center, Aurora, CO, USA
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Vani MF, Sabiston CM, Petrella A, Adams SC, Eaton G, Chalifour K, Garland SN. Body image concerns of young adult cancer survivors: A brief report. J Psychosoc Oncol 2020; 39:673-679. [PMID: 32902366 DOI: 10.1080/07347332.2020.1815926] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND The purpose of this study was to describe body image among young adult (YA) cancer survivors and examine relationships between body image and personal, medical, and psychosocial variables. Methods: YAs (n = 522; Mage = 34 ± 6 years) completed an online survey and data were analyzed using descriptive statistics, bivariate correlations, and appropriate tests of mean differences. Results: Higher body image concerns were related to less time since diagnosis, lower post-traumatic growth and social support, greater distress, and a higher number of treatments received (rs = .09 to .42; ps < .05). Body image concerns were higher for those currently on treatment (p < .05). Conclusions: Findings suggest greater attention to YAs' body image is necessary. Specifically, longitudinal research and the development of strategies dedicated to reducing body image concerns among YAs are needed.
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Affiliation(s)
- Madison F Vani
- Department of Exercise Sciences, Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Catherine M Sabiston
- Department of Exercise Sciences, Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Anika Petrella
- Department of Exercise Sciences, Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Scott C Adams
- Department of Exercise Sciences, Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Geoff Eaton
- Young Adult Cancer Canada, St. John's, Newfoundland and Labrador, Canada
| | - Karine Chalifour
- Young Adult Cancer Canada, St. John's, Newfoundland and Labrador, Canada
| | - Sheila N Garland
- Department of Psychology, Faculty of Science, Memorial University, St. John's, Newfoundland and Labrador, Canada.,Discipline of Oncology, Faculty of Medicine, Memorial University, St. John's, Newfoundland and Labrador, Canada
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Weiner LS, Nagel S, Su HI, Hurst S, Hartman SJ. A Remotely Delivered, Peer-Led Physical Activity Intervention for Younger Breast Cancer Survivors (Pink Body Spirit): Protocol for a Feasibility Study and Mixed Methods Process Evaluation. JMIR Res Protoc 2020; 9:e18420. [PMID: 32673270 PMCID: PMC7381067 DOI: 10.2196/18420] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 05/03/2020] [Accepted: 05/12/2020] [Indexed: 12/13/2022] Open
Abstract
Background Younger breast cancer survivors consistently report a greater impact of their cancer experience on quality of life compared with older survivors, including higher rates of body image disturbances, sexual dysfunction, and fatigue. One potential strategy to improve quality of life is through physical activity, but this has been understudied in younger breast cancer survivors, who often decrease their activity during and after cancer treatment. Objective The aim of this study is to explore the feasibility and acceptability of a technology-based, remotely delivered, peer-led physical activity intervention for younger breast cancer survivors. We will also assess the preliminary impact of the intervention on changes in physical activity and multiple aspects of quality of life. Methods This study is a community-academic partnership between University of California, San Diego and Haus of Volta, a nonprofit organization that promotes positive self-image in younger breast cancer survivors. This ongoing pilot study aims to recruit 30 younger breast cancer survivors across the United States (<55 years old, >6 months post primary cancer treatment, self-report <60 min of moderate-to-vigorous-intensity physical activity [MVPA]) into a 3-month peer-delivered, fully remote exercise program. Participants will complete 6 biweekly video chat sessions with a trained peer mentor, a fellow younger breast cancer survivor. Participants will receive a Fitbit Charge 3; weekly feedback on Fitbit data from their peer mentor; and access to a private, in-app Fitbit Community to provide and receive support from other participants and all peer mentors. At baseline, 3 months, and 6 months, participants will complete quality of life questionnaires, and MVPA will be measured using the ActiGraph accelerometer. Feasibility and acceptability will be explored through a mixed methods approach (ie, quantitative questionnaires and qualitative interviews). Intervention delivery and adaptations by peer mentors will be tracked through peer mentor self-evaluations and reflections, review of video-recorded mentoring sessions, and monthly templated reflections by the research team. Results Recruitment began in September 2019. As of February 2020, the physical activity intervention is ongoing. Final measures are expected to occur in summer 2020. Conclusions This study explores the potential for physical activity to improve sexual function, body image, and fatigue, key quality of life issues in younger breast cancer survivors. Using peer mentors extends our reach into the young survivor community. The detailed process evaluation of intervention delivery and adaptations by mentors could inform a future hybrid-effectiveness implementation trial. Finally, remote delivery with commercially available technology could promote broader dissemination. Trial Registration ClinicalTrials.gov NCT04064892; https://clinicaltrials.gov/ct2/show/NCT04064892 International Registered Report Identifier (IRRID) DERR1-10.2196/18420
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Affiliation(s)
- Lauren S Weiner
- Department of Family Medicine & Public Health, University of California, San Diego, La Jolla, CA, United States.,Moores Cancer Center, University of California, San Diego, La Jolla, CA, United States
| | | | - H Irene Su
- Moores Cancer Center, University of California, San Diego, La Jolla, CA, United States.,Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, La Jolla, CA, United States
| | - Samantha Hurst
- Department of Family Medicine & Public Health, University of California, San Diego, La Jolla, CA, United States
| | - Sheri J Hartman
- Department of Family Medicine & Public Health, University of California, San Diego, La Jolla, CA, United States.,Moores Cancer Center, University of California, San Diego, La Jolla, CA, United States
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Nissim RS, Roth A, Gupta AA, Elliott M. Mindfulness-Based Cognitive Therapy Intervention for Young Adults with Cancer: A Pilot Mixed-Method Study. J Adolesc Young Adult Oncol 2020; 9:256-261. [DOI: 10.1089/jayao.2019.0086] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Rinat S. Nissim
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Amanda Roth
- Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Abha A. Gupta
- Department of Haematology/Oncology, The Hospital for Sick Children, Toronto, Canada
- Department of Medical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
- Department of Paediatrics, University of Toronto, Toronto, Canada
| | - Mary Elliott
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
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Oliveri S, Ongaro G, Durosini I, Curigliano G, Pravettoni G. Breast implant-associated anaplastic large cell lymphoma: emotional impact and guidelines for psychological support. Breast Cancer Res Treat 2020; 181:221-224. [PMID: 32232699 DOI: 10.1007/s10549-020-05601-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 03/18/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE During the last two decades, the number of breast implants used in aesthetic, oncologic, and risk-reducing surgery has increased substantially mainly due to the improvement and confirmed safety of these devices. Since the identification of the first case of anaplastic large cell lymphoma associated with a breast implant (BIA-ALCL) 20 years ago, there has been an increase in the number of reports of this very rare disease, demonstrating a clear association with breast implants. While the majority of cases are localized and cured by implant removal and full capsulectomy, a small percentage require chemotherapy and the mortality rate is very low. Nevertheless, the evidence linking BIA-ALCL to implant surface texturing has raised concerns about the long-term safety of these devices resulting in patient and regulatory authority concerns globally. METHODS AND RESULTS In this commentary, we report the current debate on BIA-ALCL and the main European government's actions, with a special focus on the emotional impact that media coverage has on cancer patients. We comment the emotional impact of such risk for patients with breast implant, the hard process of patient's acceptance for mastectomy and reconstructive surgery, and how this is an essential part of recovery and return to the normal living for many women. CONCLUSION We conclude by providing guidelines for patient-physician communication and patients' psychological support on this topic of delicate actuality. Our contribution aims at guiding the medical community in managing risk communication about BIA-ALCL with a multidisciplinary approach, according to the most recently available published evidence.
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Affiliation(s)
- Serena Oliveri
- Department of Oncology and Hematoncology (DIPO), University of Milan, Via Festa del Perdono 7, 20122, Milan, Italy. .,Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology (IEO), IRCCS, Milan, Italy.
| | - Giulia Ongaro
- Department of Oncology and Hematoncology (DIPO), University of Milan, Via Festa del Perdono 7, 20122, Milan, Italy.,Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology (IEO), IRCCS, Milan, Italy
| | - Ilaria Durosini
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology (IEO), IRCCS, Milan, Italy
| | - Giuseppe Curigliano
- Department of Oncology and Hematoncology (DIPO), University of Milan, Via Festa del Perdono 7, 20122, Milan, Italy.,Division of Early Drug Development for Innovative Therapy, European Institute of Oncology (IEO), IRCCS, Milan, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hematoncology (DIPO), University of Milan, Via Festa del Perdono 7, 20122, Milan, Italy.,Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology (IEO), IRCCS, Milan, Italy
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Deep Inferior Epigastric Artery Perforator Flap Breast Reconstruction in Women With Previous Abdominal Incisions: A Comparison of Complication Rates. Ann Plast Surg 2019; 81:560-564. [PMID: 30059382 DOI: 10.1097/sap.0000000000001567] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The deep inferior epigastric artery perforator (DIEP) flap is currently the most widely used method for autologous microsurgical breast reconstruction. There are mixed data in the literature regarding the impact of previous abdominal surgery on DIEP flap success in breast reconstruction. With this study, we take a closer look at the effect of prior abdominal surgery on DIEP flap and donor-site complications, with a particular focus on the different types of incisions and their influence on surgical outcomes. METHODS A retrospective cohort study was conducted over a 6-year period. Five hundred forty-four consecutive DIEP flaps were divided into a control group (321 flaps) without previous abdominal surgery and an incision group (223 flaps) with previous abdominal surgery. A comparison between both groups was made in terms of flap and donor-site complications followed by a subgroup analysis based on single types of abdominal incisions. RESULTS There were no significant differences between both groups in terms of age, body mass index, flap weight, smoking history, prior radiotherapy, diabetes, and coagulopathy (P > 0.05). The most common incision was low transverse incision (n = 116) followed by laparoscopy port (n = 103) and midline (n = 46) incisions. We found no significant differences between the control group and incision group in terms of flap complications. Subgroup analysis revealed that none of the 3 types of incision increase the flap or donor-site complications. Smoking and flap weight were the only 2 independent predictors for donor-site complications. CONCLUSIONS The results from this large series of consecutive DIEP flaps from our institution confirm that autologous breast reconstruction with DIEP flap can be safely performed in patients who have had previous abdominal surgeries; however, counseling patients about smoking is critical to avoid potential donor-site complications.
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Assessing the Relationship between Anxiety and Revision Surgery following Autologous Breast Reconstruction. Plast Reconstr Surg 2019; 144:24-33. [PMID: 31246794 DOI: 10.1097/prs.0000000000005696] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Revision procedures address contour irregularities and aesthetic concerns following autologous breast reconstruction. Mental health diagnoses are known to influence patient satisfaction with reconstruction. The authors aimed to identify oncologic, reconstructive, and demographic factors, including mental health diagnoses, associated with the number of revisions after autologous breast reconstruction. METHODS The medical records of all adult women undergoing abdominal free flap-based breast reconstruction at a major academic institution between 2011 and 2016 were reviewed. Multivariate logistic regression was used to identify factors associated with receipt of revisions. Negative binomial regression was used to identify characteristics associated with number of revisions received. RESULTS Of 272 patients identified, 55.2 percent received one revision, 23.2 percent received two revisions, and 10.3 percent received three or more revisions after autologous breast reconstruction (median, one; range, zero to five). After adjustment on multivariate analysis, anxiety (OR, 4.34; p = 0.016) and bilateral reconstruction (OR, 3.10; p = 0.017) were associated with receipt of any revisions; other oncologic and reconstructive factors including breast cancer stage, receipt of radiation therapy, and type or timing of free flap reconstruction were not associated with revisions. Using univariate negative binomial regression, anxiety (incidence rate ratio, 1.34; p = 0.006), Caucasian race (incidence rate ratio, 1.24; p = 0.02), and bilateral reconstruction (incidence rate ratio, 1.39; p = 0.04) were predictive of increased numbers of revisions received. After stepwise selection on multivariate analysis, anxiety remained the only significant predictor of increased numbers of revisions. CONCLUSIONS Preoperative anxiety significantly influences the number of revisions after autologous breast reconstruction. Further research is necessary to better understand the interplay among mental health, patient preference, and outcomes in breast reconstruction. CLINICAL QUESTION/LEVEL OF EVIDENCE Risk, III.
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Nyhof BB, Wright FC, Look Hong NJ, Groot G, Helyer L, Meiers P, Quan ML, Baxter NN, Urquhart R, Warburton R, Gagliardi AR. Recommendations to improve patient-centred care for ductal carcinoma in situ: Qualitative focus groups with women. Health Expect 2019; 23:106-114. [PMID: 31532871 PMCID: PMC6978860 DOI: 10.1111/hex.12973] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 08/28/2019] [Accepted: 09/03/2019] [Indexed: 11/29/2022] Open
Abstract
Background Patient‐centred care (PCC) improves health‐care experiences and outcomes. Women with ductal carcinoma in situ (DCIS) and clinicians have reported communication difficulties. Little prior research has studied how to improve communication and PCC for DCIS. Objective This study explored how to achieve PCC for DCIS. Design Canadian women treated for DCIS from five provinces participated in semi‐structured focus groups based on a 6‐domain cancer‐specific PCC framework to discuss communication about DCIS. Data were analysed using constant comparative technique. Setting and Participants Thirty‐five women aged 30 to 86 participated in five focus groups at five hospitals. Results Women said their clinicians used multiple approaches for fostering a healing relationship; however, most described an absence of desired information or behaviour to exchange information, respond to emotions, manage uncertainty, make decisions and enable self‐management. Most women were confused by terminology, offered little information about the risks of progression/recurrence, uninformed about treatment benefits and risks, frustrated with lack of engagement in decision making, given little information about follow‐up plans or self‐care advice, and received no acknowledgement or offer of emotional support. Discussion and Conclusions By comparing the accounts of women with DCIS to a PCC framework, we identified limitations and inconsistencies in women's lived experience of communication about DCIS, and approaches by which clinicians can more consistently achieve PCC for DCIS. Future research should develop and evaluate informational tools to support PCC for DCIS.
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Affiliation(s)
- Bryanna B Nyhof
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada
| | | | | | - Gary Groot
- University of Saskatchewan, Saskatoon, SK, Canada
| | | | | | | | | | | | | | - Anna R Gagliardi
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada
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47
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Edward KL, Chipman M, Stephenson J, Robinson K, Giandinoto JA, Trisno R. Recovery in early stage breast cancer-An Australian longitudinal study. Int J Nurs Pract 2019; 25:e12747. [PMID: 31168880 DOI: 10.1111/ijn.12747] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 04/16/2019] [Accepted: 04/20/2019] [Indexed: 01/07/2023]
Abstract
BACKGROUND The majority of breast cancer patients will experience some level of emotional distress, with some patients having long-term psychological maladjustment. Personal and social resources play a role in recovery yet the interplay between these factors warrants further examination. This study aimed to investigate the interaction of psychosocial factors impacting women in their breast cancer trajectory, at 2 years or less following diagnosis (stages I-III). DESIGN A longitudinal cohort study approach was used in this study. METHODS The sample consisted of n = 49 participants. Data were collected between June 2013 and October 2013 and followed for 12 months across the trajectory of the disease. RESULTS The mean age was 56.6 years (SD 11.6 years). Most participants had stage I or stage II breast cancer. Time (over three time points-4 weeks, 6 months, and 12 months) after diagnosis was significantly associated with the body image (P = .003) and age (P = .004). CONCLUSION Older women with breast cancer reported less concern regarding body image than their younger peers. These findings suggest that posttreatment younger women may require access to psychological support posttreatment.
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Affiliation(s)
- Karen-Leigh Edward
- Nursing and Practice-based Research, Swinburne University of Technology, Melbourne, Australia.,St Vincent's Private Hospital Melbourne, Melbourne, Australia.,School of Human and Health Science, University of Huddersfield, Huddersfield, UK
| | - Mitchell Chipman
- Victorian Breast and Oncology Care, East Melbourne, Victoria, Australia
| | - John Stephenson
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - Kayte Robinson
- Victorian Breast and Oncology Care, East Melbourne, Victoria, Australia
| | - Jo-Ann Giandinoto
- Australian Catholic University, Faculty of Health Sciences, School of Nursing, Midwifery and Paramedicine (Melbourne), Fitzroy, Victoria, Australia
| | - Roth Trisno
- Albury Wodonga Health, Wodonga, Victoria, Australia.,Albury Wodonga Health, Albury, New South Wales, Australia
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48
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Martino ML, Lemmo D, Gargiulo A, Barberio D, Abate V, Avino F, Tortoriello R. Underfifty Women and Breast Cancer: Narrative Markers of Meaning-Making in Traumatic Experience. Front Psychol 2019; 10:618. [PMID: 30984067 PMCID: PMC6448035 DOI: 10.3389/fpsyg.2019.00618] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Accepted: 03/06/2019] [Indexed: 02/05/2023] Open
Abstract
A diagnosis of breast cancer is considered a potential traumatic event associated with physical and psychological effects. In literature, an exploration of breast cancer experience in young women is lacking, able to shed light on the narrative processes of meaning-making of the experience in specific phases of treatment, as may be the initial impact with the onset of the cancer. Meaning-making processes are determinant aspects when dealing with traumatic events. The research took place at National Cancer Institute Pascale of Naples. We collected 50 ad hoc narrative interviews to explore the different domains of the experience with under-fifty women at the first phase of the hospitalization. The Narrative Interviews were analyzed through a qualitative methodology constructed ad hoc. Starting from the functions of meaning-making that the narrative mediate we have highlight the different modes to articulate the narrative functions: The Organization of Temporality: chronicled (38%), actualized (26%), suspended (18%), interrupted (16%), and confused (2%). The Search for Meaning: internalized (42%); generalized (24%); externalized (18%); suspended (16%). The Emotional Regulation: disconnected (44%), splitted (28%), pervasive (26%), and connected (2%). The Organization of self-other Relationship: supportive (46%), avoidant (22%), overturned (16%), and sacrificial (16%). The Finding Benefit: revaluating (38%), flattened (34%), and postponed (28%). The Orientation to Action: combative (38%), blocked (36%), and suspended (26%). Findings capture the impact with the onset of the cancer, identifying both risk and resource aspects. The study allows to identify a specific use of narrative device by under-fifty women who impacted with the experience of breast cancer. The ways in which meaning-making functions are articulated highlight the specificity of the first phase of the treatment of the cancer. From a clinical psychology point of view, our findings can be used as clinical narrative markers to grasp, in a diachronic way, the process of meaning-making, integration, and coping during the first phase of breast cancer experience in young women. We consider it valuable to increase longitudinal studies with young women to highlight trajectories of meaning-making during the different phases of the treatment to think about personalized intervention practices diachronically to the experience.
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Affiliation(s)
- Maria Luisa Martino
- Department of Humanistic Studies, University of Naples Federico II, Naples, Italy
| | - Daniela Lemmo
- Department of Humanistic Studies, University of Naples Federico II, Naples, Italy
| | - Anna Gargiulo
- Department of Humanistic Studies, University of Naples Federico II, Naples, Italy
| | - Daniela Barberio
- Clinical Psychology Unit, National Cancer Institute G. Pascale Foundation (IRCCS), Naples, Italy
| | - Valentina Abate
- Clinical Psychology Unit, National Cancer Institute G. Pascale Foundation (IRCCS), Naples, Italy
| | - Franca Avino
- Breast Surgery, National Cancer Institute G. Pascale Foundation (IRCCS), Naples, Italy
| | - Raffaele Tortoriello
- Breast Surgery, National Cancer Institute G. Pascale Foundation (IRCCS), Naples, Italy
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49
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Alhusban RY. Changed Body Image as Perceived by Jordanian Women Undergoing Breast Cancer Treatment. Asian Pac J Cancer Prev 2019; 20:767-773. [PMID: 30909683 PMCID: PMC6825753 DOI: 10.31557/apjcp.2019.20.3.767] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background: Breast cancer is the most common cancer affecting women worldwide. The purpose of this study was to generate an understanding of women’s perceptions of changes to their body image due to breast cancer treatment. Method: A phenomenological qualitative approach was taken and semi-structured interviews conducted with 20 women who underwent breast cancer treatment at a public hospital in Jordan. Results: Data were analyzed following Colaizzi’s methodology, yielding a core theme (“Broken things cannot be repaired”) and four subthemes: changes in physical wellbeing (“my body fall apart”), changes in emotional wellbeing (“broken heart”), changes in social wellbeing (“broken future”), and coping strategies (“repairing what has been broken”). Religion and family support were major factors helping the women cope with their condition. Conclusion: Nurses and other healthcare providers need to be aware of body image changes of women with breast cancer to initiate timely, and culturally sensitive nursing intervention and support. Therefore, nurses should support patients in finding their own sources of strength to facilitate their healing process.
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50
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Melissant HC, van Uden-Kraan CF, Lissenberg-Witte BI, Verdonck-de Leeuw IM. Body changes after cancer: female cancer patients' perceived social support and their perspective on care. Support Care Cancer 2019; 27:4299-4306. [PMID: 30877595 PMCID: PMC6803574 DOI: 10.1007/s00520-019-04729-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 03/05/2019] [Indexed: 12/15/2022]
Abstract
Purpose The aim of this study was to investigate among female cancer patients their perceived social support from health care professionals (HCPs), family and friends, and public media, and their perspective on care concerning body changes. Methods A study-specific questionnaire was completed by 235 female cancer patients. Descriptive statistics were used to describe social support and perspective on care. Logistic regression analyses were used to investigate the associations between social support and sociodemographic and clinical factors, psychosocial impact, and importance of appearance. Results More than half of the patients received sufficient support from HCPs (54%) and family and friends (55%), and a third from the media (32%). Higher educated patients and those who found appearance not important during illness perceived lower support from HCPs. Patients without a partner, and those with a surgical treatment only, perceived lower support from family and friends. Patients who were older, higher educated, without a partner, and those who found appearance not important during illness perceived lower support from the media. In total, 15–50% of the patients received sufficient care for different domains of body changes. Patients expressed the highest need for psychological support (28%) and nutrition (28%). Conclusions Half of the female cancer patients reported to receive sufficient social support concerning body changes after cancer. Perceived support depended on age, education, relationship status, and treatment modality. The need for more care was moderate. Electronic supplementary material The online version of this article (10.1007/s00520-019-04729-w) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Heleen C Melissant
- Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, van der Boechorststraat 7, Amsterdam, Netherlands.,Cancer Center Amsterdam (CCA), Amsterdam UMC, Vrije Universiteit Amsterdam, de Boelelaan 1118, Amsterdam, Netherlands
| | - Cornelia F van Uden-Kraan
- Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, van der Boechorststraat 7, Amsterdam, Netherlands.,Cancer Center Amsterdam (CCA), Amsterdam UMC, Vrije Universiteit Amsterdam, de Boelelaan 1118, Amsterdam, Netherlands
| | - Birgit I Lissenberg-Witte
- Amsterdam UMC, Department of Epidemiology and Biostatistics, Vrije Universiteit Amsterdam, de Boelelaan 1089a, Amsterdam, Netherlands
| | - Irma M Verdonck-de Leeuw
- Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, van der Boechorststraat 7, Amsterdam, Netherlands. .,Cancer Center Amsterdam (CCA), Amsterdam UMC, Vrije Universiteit Amsterdam, de Boelelaan 1118, Amsterdam, Netherlands. .,Amsterdam UMC, Department of Otolaryngology-Head and Neck Surgery, Amsterdam Public Health Research Institute, Cancer Center Amsterdam, Vrije Universiteit Amsterdam, P.O. Box 7057, de Boelelaan 1117, Amsterdam, 1007 MB, Netherlands.
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