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Cernikova KA, Kracmarova LK, Pesoutova M, Tavel P. We will be different forever: A qualitative study of changes of body image in women with breast cancer. BMC Public Health 2024; 24:2517. [PMID: 39285297 PMCID: PMC11403935 DOI: 10.1186/s12889-024-20017-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 09/09/2024] [Indexed: 09/22/2024] Open
Abstract
OBJECTIVE This study explores the experience of body-image changes throughout the trajectory of breast cancer. METHODS We conducted qualitative in-depth interviews with 53 women (n = 53) representing diverse age groups, with a mean age of 48.61 years (SD = 13.12), from various regions across the Czech Republic. The interviews were audio/video recorded and divided into two phases. The initial phase consisted of a narrative part, followed by a semi-structured interview. Thematic analysis was employed to identify and explore the topics that held significant importance to the participants. RESULTS This research investigated how body image and emotional responses evolve in women with breast cancer during various stages of the illness. Throughout the breast cancer journey, women undergo diverse body image changes, with some of them being described as particularly traumatic, such as hair loss and preventive operations. The effects of breast cancer extend beyond physical scars, influencing femininity and womanhood in the long run. The experience of womanhood is marked by visible and non-visible effects that persist for years after treatment. CONCLUSION Study has provided valuable insights into the emotional journey that women experience during breast cancer diagnosis, treatment, and survivorship. The illness trajectory framework has proven to be a valuable tool for understanding the complexities of body image concerns and the emotional implications faced by breast cancer patients. By acknowledging the significance of body image issues and providing targeted interventions, healthcare providers can improve the psychosocial well-being and overall quality of life for breast cancer survivors. Further research in this area is needed to develop and refine supportive interventions that address the unique challenges women face during their breast cancer journey. Ultimately, by fostering a sensitive and comprehensive approach to care, we can empower women to navigate their breast cancer journey with greater resilience and confidence.
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Affiliation(s)
- Kristyna A Cernikova
- The Department of Christian Education, Palacky University, Univerzitni 22, Olomouc, 771 11, Czech Republic.
| | | | - Markéta Pesoutova
- Olomouc University Social Health Institute, Palacky University, Olomouc, Czech Republic
| | - Peter Tavel
- Olomouc University Social Health Institute, Palacky University, Olomouc, Czech Republic
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2
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Jang DK, Nam HS, Kim J, Kim YH. Health-Related Quality of Life and Associated Comorbidities in Community-Dwelling Women with Breast Cancer. J Clin Med 2024; 13:5321. [PMID: 39274534 PMCID: PMC11396280 DOI: 10.3390/jcm13175321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Revised: 08/22/2024] [Accepted: 09/05/2024] [Indexed: 09/16/2024] Open
Abstract
Objective: With advancements in treatment, the increasing number of women with breast cancer has led to a growing focus on enhancing their well-being by understanding health-related quality of life (HRQoL). This study aimed to investigate the association between comorbidities and HRQoL in middle-aged and older community-dwelling Korean women with breast cancer. Methods: Data from the Sixth, Seventh, and Eighth Korea National Health and Nutrition Examination Surveys between 2014 and 2020 were used to analyze 12,218 women aged ≥50 years (244 women with breast cancer vs. 11,974 women without breast cancer). HRQoL was assessed using the EQ-5D-3L tool and the EQ-5D index. Associations between comorbidities (arthritis, depression, hypertension, diabetes, and cardiovascular disease) and HRQoL were examined. Results: Among women with breast cancer, arthritis was associated with problems in mobility (OR, 3.24; 95% CI, 1.39-7.53) and pain/discomfort (OR, 7.30; 95% CI, 3.62-14.73). Depression was associated with problems in self-care (OR, 7.02; 95% CI, 1.97-25.01), usual activities (OR, 5.73; 95% CI, 1.52-21.59), pain/discomfort (OR, 5.58; 95% CI, 1.49-20.87), and anxiety/depression (OR, 3.81; 95% CI, 1.14-12.72). Arthritis and depression were also considerably associated with overall HRQoL, as measured by the EQ-5D index. Hypertension, diabetes, and cardiovascular disease were not independently associated with HRQoL. Conclusions: Arthritis and depression were markedly associated with HRQoL in middle-aged and older women in the community who suffer from breast cancer. Public health interventions that focus on managing these comorbidities can enhance the well-being of women with breast cancer.
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Affiliation(s)
- Dong Kee Jang
- Department of Internal Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Republic of Korea
| | - Hyung Seok Nam
- Department of Rehabilitation Medicine, Sheikh Khalifa Specialty Hospital, Ras al Khaimah 6365, United Arab Emirates
| | - Jieun Kim
- Department of Rehabilitation Medicine, Ewha Womans University College of Medicine, Seoul 07985, Republic of Korea
| | - Yeo Hyung Kim
- Department of Rehabilitation Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
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Brick RS, Gallicchio L, Mollica MA, Zaleta AK, Tonorezos ES, Jacobsen PB, Castro KM, Miller MF. Survivorship concerns among individuals diagnosed with metastatic cancer: Findings from the Cancer Experience Registry. J Cancer Surviv 2024:10.1007/s11764-024-01573-8. [PMID: 38592607 DOI: 10.1007/s11764-024-01573-8] [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: 01/05/2024] [Accepted: 03/17/2024] [Indexed: 04/10/2024]
Abstract
INTRODUCTION Individuals with metastatic cancer experience many medical, physical, and emotional challenges due to changing medical regimens, oscillating disease states, and side effects. The purpose of this study was to describe the type and prevalence of survivorship concerns reported by individuals with metastatic cancer, and their associations with cancer diagnosis, treatment, and socio-demographic variables. METHODS This study utilized data from the Cancer Support Community's Cancer Experience Registry. Individuals were included if they self-reported a solid tumor metastatic cancer and completed CancerSupportSource, which evaluates five domains of concerns (emotional well-being, symptom burden, body image/healthy lifestyle, healthcare team communication, and relationships/intimacy). Multivariable linear regression examined associations between independent predictors of each survivorship concern domain. RESULTS Of the 403 included participants, individuals reported a metastatic diagnosis of breast (43%), colorectal (20%), prostate (7%), lung (7%), gynecologic cancer (6%) and other. Nearly all (96%) reported at least one survivorship concern, with the most prevalent concern about cancer progression or recurrence. Survivorship concerns were higher across multiple domains for individuals unemployed due to disability. Individuals who were less than five years since diagnosis reported higher concerns related to emotional well-being, symptom burden, and healthcare communication compared to those more than five years since diagnosis. CONCLUSION Individuals with metastatic cancer experience a variety of moderate-to-severe survivorship concerns that warrant additional investigation. IMPLICATIONS FOR CANCER SURVIVORS As the population of individuals with metastatic cancer lives longer, future research must investigate solutions to address modifiable factors associated with survivorship concerns, such as unemployment due to disability.
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Affiliation(s)
- Rachelle S Brick
- Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA
| | - Lisa Gallicchio
- Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA
| | - Michelle A Mollica
- Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA
| | - Alexandra K Zaleta
- Department of Research, CancerCare, 275 Seventh Avenue, New York, NY, 10001, USA
| | - Emily S Tonorezos
- Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA
| | - Paul B Jacobsen
- Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA
| | - Kathleen M Castro
- Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA
| | - Melissa F Miller
- Research and Training Institute, Cancer Support Community, 5614 Connecticut Avenue NW, Suite 280, Washington, D.C, 20015, USA.
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Tollow P, Ogden J, McCabe CS, Harcourt D. Physical appearance and well-being in adults with incurable cancer: a thematic analysis. BMJ Support Palliat Care 2023; 13:e163-e169. [PMID: 33246936 DOI: 10.1136/bmjspcare-2020-002632] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 10/16/2020] [Accepted: 11/05/2020] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Existing research has established the importance of appearance concerns for individuals with cancer and identified appearance as an important factor in dying with dignity. No research, however, has explored in depth the role of appearance in the experiences of individuals who have incurable cancer. This research aims to explore patients' experiences and perspectives in relation to the role of appearance issues in adults with incurable cancer. METHODS Semi-structured interviews were conducted with 24 adults with incurable cancer (20 women, 4 men; mean age 54.5, SD 11.32). RESULTS Thematic analysis generated three themes: 'Identity: Embodying Cancer', 'Communication: Wearing your illness' and 'Support: Holistic Care'. Appearance was felt to be an important element of identity, which was often dominated by cancer, leading to feelings of separation from the participant's previous self. Appearance changes also influenced the way in which individuals communicated with their external world, forcing discussion of their diagnosis, and increasing focus on their cancer, with participants having to manage the emotional impact of this on loved ones, as well as the impact on their legacy. Finally, participants highlighted the positive impact of appearance-related support in their well-being and identified peer connections and refocusing on the self as key elements of such support. CONCLUSIONS Appearance changes play an important role in the experiences of individuals with incurable cancer with regards to both identity and communication and challenged participants' ability to maintain normalcy. Further psychosocial support relating to appearance concerns was considered necessary to promote dignity and provide truly holistic patient care.
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Affiliation(s)
- Philippa Tollow
- Centre for Appearance Research, University of the West of England, Bristol, UK
| | - Jane Ogden
- School of Psychology, University of Surrey, Guildford, UK
| | - Candida S McCabe
- Dorothy House Hospice, Winsley, UK
- University of the West of England, Bristol, UK
- Florence Nightingale Foundation, London, UK
| | - Diana Harcourt
- Centre for Appearance Research, University of the West of England, Bristol, UK
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Hespe GE, Matusko N, Hamill JB, Kozlow JH, Pusic AL, Wilkins EG. Outcomes of breast reconstruction in patients with stage IV breast cancer. J Plast Reconstr Aesthet Surg 2023; 83:51-56. [PMID: 37270995 DOI: 10.1016/j.bjps.2023.04.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 03/31/2023] [Accepted: 04/11/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND Patients with Stage IV breast cancer are living longer but breast reconstruction in this setting remains controversial. There is limited research evaluating the benefits of breast reconstruction in this patient cohort. STUDY DESIGN Drawing from the Mastectomy Reconstruction Outcomes Consortium (MROC) dataset, a prospective cohort study that involved 11 leading medical centers in the US and Canada, we compared patient-reported outcomes (PROs) assessed utilizing the BREAST-Q, a condition-specific, validated patient-reported outcome measure (PROM) for mastectomy reconstruction, as well as complications between a cohort of patients with Stage IV disease undergoing reconstruction and a control group of women with Stage I-III disease also receiving reconstruction. RESULTS Among the MROC population, 26 patients with Stage IV and 2613 women with Stage I-III breast cancer underwent breast reconstruction. Preoperatively, the Stage IV cohort reported significantly lower baseline scores for satisfaction with breast (p = 0.004), psychosocial well-being (p = 0.043) and sexual well-being (p = 0.001), compared with Stage I-III women. Following breast reconstruction, Stage IV patients' mean PRO scores improved over baseline and were not significantly different from those of Stage I-III reconstruction patients. There were also no significant differences in overall/any (p = 0.782), major (p = 0.751) or minor complication (p = 0.787) rates between the two groups at two years following reconstruction. CONCLUSIONS The findings in this study suggest that breast reconstruction offers significant quality-of-life benefits for women with advanced breast cancer with no increase in postoperative complications and thus may be a reasonable option in this clinical setting.
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Affiliation(s)
- Geoffrey E Hespe
- Department of Surgery, Section of Plastic Surgery, University of Michigan, Ann Arbor, MI, United States.
| | - Niki Matusko
- Department of Surgery, Section of Plastic Surgery, University of Michigan, Ann Arbor, MI, United States
| | - Jennifer B Hamill
- Department of Surgery, Section of Plastic Surgery, University of Michigan, Ann Arbor, MI, United States
| | - Jeffrey H Kozlow
- Department of Surgery, Section of Plastic Surgery, University of Michigan, Ann Arbor, MI, United States
| | - Andrea L Pusic
- Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Edwin G Wilkins
- Department of Surgery, Section of Plastic Surgery, University of Michigan, Ann Arbor, MI, United States
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Parkinson J, Bandera A, Crichton M, Shannon C, Woodward N, Hodgkinson A, Millar L, Teleni L, van der Meij BS. Poor Muscle Status, Dietary Protein Intake, Exercise Levels, Quality of Life and Physical Function in Women with Metastatic Breast Cancer at Chemotherapy Commencement and during Follow-Up. Curr Oncol 2023; 30:688-703. [PMID: 36661703 PMCID: PMC9857792 DOI: 10.3390/curroncol30010054] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/06/2022] [Accepted: 12/29/2022] [Indexed: 01/06/2023] Open
Abstract
This study aimed to investigate nutritional status, body composition, dietary protein intake, handgrip strength, 6 min or 4 m walk tests, self-reported physical activity, physical function, and quality of life (QoL-EORTC-QLQc30) at commencement of chemotherapy; to detect changes over time (from commencement of chemotherapy, and after 3, 6, 12, 26 and 52 weeks) in women with metastatic breast cancer (MBC); and to investigate the relationship between nutritional variables. 'Sarcopenia' was defined as low muscle mass and strength, 'myosteatosis' as muscle fat-infiltration (CT scan). Continuous variables were analysed using paired t-tests between baseline and follow-ups. Fifteen women (54y, 95% CI [46.3;61.2]) were recruited. At baseline, malnutrition was present in 3 (20%) participants, sarcopenia in 3 (20%) and myosteatosis in 7 (54%). Thirteen (87%) participants had low protein intake; low handgrip strength was observed in 0, and low walk test distance and physical activity in four (27%) participants. Physical function and QoL were low in 10 (67%) and 9 (60%), respectively. QoL between baseline and 52 weeks decreased by 11.7 (95% CI [2.4;20.9], p = 0.025). Other variables did not significantly change over time. In this small study sample, myosteatosis, low dietary protein intake, low exercise levels and impaired quality of life and physical function are common.
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Affiliation(s)
- Jessica Parkinson
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD 4226, Australia
| | - Amelia Bandera
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD 4226, Australia
| | - Megan Crichton
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD 4226, Australia
| | - Catherine Shannon
- Mater Health, Brisbane, QLD 4101, Australia
- Mater Research Institute, University of Queensland, Brisbane, QLD 4072, Australia
| | - Natasha Woodward
- Mater Health, Brisbane, QLD 4101, Australia
- Mater Research Institute, University of Queensland, Brisbane, QLD 4072, Australia
| | - Adam Hodgkinson
- Mater Research Institute, University of Queensland, Brisbane, QLD 4072, Australia
| | - Luke Millar
- Mater Research Institute, University of Queensland, Brisbane, QLD 4072, Australia
| | - Laisa Teleni
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD 4226, Australia
| | - Barbara S. van der Meij
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD 4226, Australia
- Mater Health, Brisbane, QLD 4101, Australia
- Mater Research Institute, University of Queensland, Brisbane, QLD 4072, Australia
- Department of Nutrition, Dietetics and Lifestyle, HAN University of Applied Sciences, 6525 EN Nijmegen, The Netherlands
- Division of Human Nutrition and Health, Wageningen University and Research, 6708 PD Wageningen, The Netherlands
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Loibl S, Loirat D, Tolaney SM, Punie K, Oliveira M, Rugo HS, Bardia A, Hurvitz SA, Brufsky AM, Kalinsky K, Cortés J, O'Shaughnessy JA, Dieras V, Carey LA, Gianni L, Gharaibeh M, Preger L, Phan S, Chang L, Shi L, Piccart MJ. Health-related quality of life in the phase III ASCENT trial of sacituzumab govitecan versus standard chemotherapy in metastatic triple-negative breast cancer. Eur J Cancer 2023; 178:23-33. [PMID: 36379186 PMCID: PMC11195534 DOI: 10.1016/j.ejca.2022.10.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 10/10/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND The antibody-drug conjugate sacituzumab govitecan (SG) prolongs progression-free survival and overall survival in patients with refractory/relapsed metastatic triple-negative breast cancer (mTNBC). Here, we investigated its effect on health-related quality of life (HRQoL). METHODS This analysis was based on the open-label phase III ASCENT trial (NCT02574455). Adults with refractory/relapsed mTNBC who had received ≥2 prior systemic therapies (≥1 in the metastatic setting) were randomised 1:1 to SG or treatment of physician's choice (TPC; capecitabine, eribulin, vinorelbine, or gemcitabine). HRQoL was assessed on day 1 of each treatment cycle using the EORTC QLQ-C30. Score changes from baseline were analysed using linear mixed-effect models for repeated measures. Stratified Cox regressions evaluated time to first clinically meaningful change of HRQoL. RESULTS The analysis population comprised 236 patients randomised to SG and 183 to TPC. For global health status (GHS)/QoL, physical functioning, fatigue, and pain, changes from baseline were superior for SG versus TPC. Compared with TPC, SG was inferior regarding changes from baseline for nausea/vomiting and diarrhoea but non-inferior for other QLQ-C30 domains. Median time to first clinically meaningful worsening was longer for SG than for TPC for physical functioning (22.1 versus 12.1 weeks, P < 0.001), role functioning (11.4 versus 7.1 weeks, P < 0.001), fatigue (7.7 versus 6.0 weeks, P < 0.05), and pain (21.6 versus 9.9 weeks, P < 0.001). CONCLUSIONS SG was generally associated with greater improvements and delayed worsening of HRQoL scores compared with TPC. This supports the favourable profile of SG as an mTNBC treatment.
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Affiliation(s)
- Sibylle Loibl
- Hämatologisch-Onkologische Gemeinschaftspraxis Am Bethanien-Krankenhaus, Frankfurt, Germany.
| | - Delphine Loirat
- Medical Oncology Department and D3i, Institut Curie, Paris, France
| | - Sara M Tolaney
- Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Kevin Punie
- Department of General Medical Oncology and Multidisciplinary Breast Centre, Leuven Cancer Institute, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - Mafalda Oliveira
- Medical Oncology Department and Breast Cancer Group, Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Hope S Rugo
- Department of Medicine, University of California San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | - Aditya Bardia
- Department of Hematology and Oncology, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Sara A Hurvitz
- Department of Medicine, Division of Hematology/Medical Oncology, David Geffen School of Medicine, University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Adam M Brufsky
- Division of Hematology/Oncology, Magee-Womens Hospital and the Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Kevin Kalinsky
- Department of Medicine, Columbia University Irving Medical Center, New York, USA; Department of Hematology and Medical Oncology, Winship Cancer Institute at Emory University, Atlanta, GA, USA
| | - Javier Cortés
- Oncology Department, International Breast Cancer Center (BCC), Pangaea Oncology, Quirónsalud, Barcelona, Spain; Department of Medicine, Faculty of Biomedical and Health Sciences, European University of Madrid, Madrid, Spain
| | - Joyce A O'Shaughnessy
- Medical Oncology, Texas Oncology - Baylor Charles A. Sammons Cancer Center, Dallas, TX, USA
| | - Véronique Dieras
- Department of Medical Oncology, Centre Eugène Marquis, Rennes, France
| | - Lisa A Carey
- Medicine - Hematology/Oncology Division, University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
| | - Luca Gianni
- Medical Oncology, Gianni Bonadonna Foundation, Milano, Italy
| | - Mahdi Gharaibeh
- Department of Global Value and Access, Gilead Sciences, Inc., Foster City, CA, USA
| | - Luciana Preger
- Department of Medical Affairs, Gilead Sciences, Inc., Foster City, CA, USA
| | - See Phan
- Department of Clinical Development, Gilead Sciences, Inc., Foster City, CA, USA
| | - Lawrence Chang
- Department of Global Value and Access, Gilead Sciences, Inc., Foster City, CA, USA
| | - Ling Shi
- Evidence Synthesis, Modeling & Communication (EMC), Evidera PPD, Waltham, MA, USA
| | - Martine J Piccart
- Medical Oncology Department, Institut Jules Bordet and l'Université Libre de Bruxelles, Brussels, Belgium
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An J, Zhou K, Li M, Li X. Assessing the relationship between body image and quality of life among rural and urban breast cancer survivors in China. BMC Womens Health 2022; 22:61. [PMID: 35246115 PMCID: PMC8896367 DOI: 10.1186/s12905-022-01635-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 02/07/2022] [Indexed: 01/18/2023] Open
Abstract
Background Breast cancer survivors experience altered body image and quality of life (QoL) due to the disease and its treatment. The multidimensional nature of body image and QoL makes their relationships complex. This study aimed to examine the associations between the two concepts in Chinese breast cancer survivors and test whether these associations are moderated by rural–urban residence. Methods A cross-sectional design was adopted. Breast cancer survivors were recruited via a convenience sampling method. Two validated questionnaires (the Body Image Self-Rating Questionnaire for Breast Cancer and 36-item Short-Form Health Survey) and questions assessing demographic and clinical covariates were administered. Multiple linear regressions were used to assess the relationship between body image and QoL domains and to examine the moderating effect of rural–urban residence. Results In our sample of 354 breast cancer survivors, half (50.28%) lived in rural areas. After adjusting for demographic and clinical variables, better perception of body image-related sexual activity change, role change, and psychological change was significantly associated with better physical (β ranged from − 0.15 to − 0.11, p < 0.05) and mental (β ranged from − 0.46 to − 0.34, p < 0.001) well-being. Better perception of body image-related social and behavior change was significantly associated only with better mental well-being (β ranged from − 0.40 to − 0.33, p < 0.001). The association between body image and mental well-being was much stronger in urban subjects (b = − 0.38, p < 0.001) than in rural subjects (b = − 0.20, p < 0.001). Conclusions Our findings suggest that multidimensional body image is associated with physical and mental well-being in Chinese breast cancer survivors. Body image appears to play a larger role in urban breast cancer survivors’ mental well-being. Our results indicate that incorporating interventions that address body image issues would be advantageous for survivorship care to enhance QoL in breast cancer survivors. Furthermore, rural–urban differences should be considered in the strategic design of survivorship care programs in rural and urban settings.
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Affiliation(s)
- Jinghua An
- School of Nursing, Health Science Center of Xi'an Jiaotong University, Yanta West Road 76, Xi'an, 710061, Shaanxi, China
| | - Kaina Zhou
- School of Nursing, Health Science Center of Xi'an Jiaotong University, Yanta West Road 76, Xi'an, 710061, Shaanxi, China
| | - Minjie Li
- Nethersole School of Nursing, The Chinese University of Hong Kong, Central Ave, Shatin, Hong Kong, SAR
| | - Xiaomei Li
- School of Nursing, Health Science Center of Xi'an Jiaotong University, Yanta West Road 76, Xi'an, 710061, Shaanxi, China.
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9
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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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Nabulsi NA, Naing KW, Deng H, Cueto J, Asfaw AA, Hubbard CC, Zhou J, Lee I, Mitra D, Calip GS, Law EH. Health-related Quality of Life in Hormone Receptor-Positive Early Breast Cancer: Analyses From the Surveillance, Epidemiology, and End Results Medicare Health Outcomes Survey. J Patient Exp 2022; 9:23743735221113058. [PMID: 35846244 PMCID: PMC9277434 DOI: 10.1177/23743735221113058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
This study describes health-related quality of life (HRQoL) among older Medicare
beneficiaries with hormone receptor-positive (HR+) early breast cancer (eBC).
Women aged ≥65 years diagnosed with stage I-III HR+ eBC between 1997 and 2014
using the Surveillance, Epidemiology, and End Results Medicare Health Outcomes
Survey Data Resource were included. HRQoL was measured using the Short Form
Health Survey including physical/mental component summary (PCS/MCS) scores and
subscales. Patient surveys ≤ 24 months post-diagnosis were matched to
non-cancer controls. Mean differences in HRQoL were compared using analysis of
covariance. Among 1880 HR+ eBC patients versus 5640 matched non-cancer controls,
eBC patients surveyed ≤ 6 months post-diagnosis (n = 530) scored lower on
component scores (PCS mean difference = 1.6 [95%CI: 0.6-2.6]; MCS mean
difference = 2.0 [95%CI: 1.0-3.0]) and multiple subscales. Among women
surveyed 19 to 24 months post-diagnosis (n = 402), mean differences in HRQoL
were modest (PCS: 1.2 [95%CI: 0.1-2.4]; MCS: −1.5 [95%CI: −2.7 to −0.3]). Most
differences in HRQoL following diagnosis of eBC did not indicate statistical
significance or minimally important difference, emphasizing that preservation of
HRQoL is an important and realistic goal among patients with eBC.
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Affiliation(s)
- Nadia A Nabulsi
- Department of Pharmacy Systems, Outcomes and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Khatija W Naing
- Division of Health Policy and Administration, University of Illinois at Chicago, Chicago, IL, USA
| | - Huiwen Deng
- Department of Pharmacy Systems, Outcomes and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Jenilee Cueto
- Formerly Patient & Health Impact, Pfizer, Inc., New York, NY, USA
| | - Alemseged A Asfaw
- Department of Pharmacy Systems, Outcomes and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Colin C Hubbard
- Department of Pharmacy Systems, Outcomes and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Jifang Zhou
- Department of Pharmacy Systems, Outcomes and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Inyoung Lee
- Department of Pharmacy Systems, Outcomes and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | | | - Gregory S Calip
- Department of Pharmacy Systems, Outcomes and Policy, University of Illinois at Chicago, Chicago, IL, USA
- Flatiron Health, New York, NY, USA
| | - Ernest H Law
- Patient & Health Impact, Pfizer, Inc., New York, NY, USA
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11
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Hsu HT, Juan CH, Chen JL, Hsieh HF. Mediator Roles of Social Support and Hope in the Relationship Between Body Image Distress and Resilience in Breast Cancer Patients Undergoing Treatment: A Modeling Analysis. Front Psychol 2021; 12:695682. [PMID: 34630208 PMCID: PMC8498031 DOI: 10.3389/fpsyg.2021.695682] [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: 04/15/2021] [Accepted: 08/30/2021] [Indexed: 12/27/2022] Open
Abstract
Breast cancer and its treatment are particularly distressing for patients because of their potential impacts on body image. The most difficult phase of cancer treatment is usually the first year after a diagnosis. Cancer patients with strong resilience have the positive attitude, internal strength and external resources needed to cope with the disease and its treatment. This cross-sectional study investigated the mediator roles of hope and social support in the association between body image distress and resilience. A structured questionnaire was used to collect data for a convenience sample of 141 breast cancer patients undergoing treatment in southern Taiwan. Structural equation modeling was used for data analysis. The results showed that the final model had a good fit to the data and accounted for 51% of the total variance in resilience. The model of multiple parallel mediators of resilience revealed that hope and social support had mediator roles in the effect of body image distress on resilience. Hope had an important partial mediating role in the association between body image distress and resilience. Social support also had a partial mediating role in the relationship between body image distress and resilience. Social support did not directly affect resilience and indirectly affected resilience through hope. Psychosocial interventions aimed at reducing the impact of body image distress and increasing resilience in breast cancer patients should focus on cultivating hope and increasing social support, particularly support from family members and health professionals.
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Affiliation(s)
- Hsin-Tien Hsu
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chiung-Hui Juan
- Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jyu-Lin Chen
- Department of Family Health Care Nursing, University of California, San Francisco, San Francisco, CA, United States
| | - Hsiu-Fen Hsieh
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
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12
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Saab M, Hartmann M, Han X. Defense Mechanism Functioning in Patients With Breast Cancer: Using the Defense Mechanism Rating Scale. Front Psychol 2021; 12:666373. [PMID: 34456786 PMCID: PMC8385787 DOI: 10.3389/fpsyg.2021.666373] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 07/05/2021] [Indexed: 02/04/2023] Open
Abstract
Background: Breast cancer (BC) is one of the highest incidence rates in Lebanon. Previous studies had focused scarcely on the unconscious protective shield of patients with BC or BC survivors against cancer, while only some studies had focused on the relationship between defense mechanisms (DMs) and high adaptation with the disease process and progress. Therefore, this study aimed to investigate the reaction of inpatients with BC toward the disease by measuring DMs in the Lebanon context. Methods: Seventy inpatients with BC were recruited randomly from six hospitals. Their DMs were measured using the Defense Mechanism Rating Scale. Moreover, the Relationship Anecdotes Paradigm (RAP) was used with three recent life vignettes of initial diagnosis, family, and daily life. The data were analyzed using repeated measure ANOVA, Wilcoxon rank-sum test, and Spearman's rank. Results: Patients with stage 2 BC used more high-adaptive defense levels than patients with stage 4 BC who used more minor image distorting defense levels. Moreover, patients with stage 2 BC used more self-observation and undoing, while patients with stage 4 BC used more devaluation. Conclusion: The severity of BC, the age of carriers, and the social status may lead to higher use of DMs, at the level of the individual defense and the hierarchal or the tripartite levels.
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Affiliation(s)
- Marwa Saab
- School of Psychology, Northeast Normal University, Changchun, China
| | - Matias Hartmann
- School of Psychology, Northeast Normal University, Changchun, China
| | - Xue Han
- School of Psychology, Northeast Normal University, Changchun, China
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13
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Claessens AKM, Ramaekers BLT, Lobbezoo DJA, van Kampen RJW, de Boer M, van de Wouw AJ, Dercksen MW, Geurts SME, Joore MA, Tjan-Heijnen VCG. Quality of life in a real-world cohort of advanced breast cancer patients: a study of the SONABRE Registry. Qual Life Res 2020; 29:3363-3374. [PMID: 32816222 PMCID: PMC7686224 DOI: 10.1007/s11136-020-02604-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2020] [Indexed: 01/19/2023]
Abstract
PURPOSE We aimed to evaluate quality of life (QoL) using the European Quality of Life Five-Dimensions questionnaire (EQ-5D-3L) in a real-world cohort of Dutch advanced breast cancer (ABC) patients. Secondary, we reported differences in QoL between subgroups of patients based on age, comorbidity, tumor-, and treatment characteristics, and assessed the association of duration of metastatic disease and time to death with QoL. METHODS ABC patients who attended the outpatient clinic between October 2010 and May 2011 were asked to fill out the EQ-5D-3L questionnaire. Patient-, disease-, and treatment characteristics were obtained from the medical files. Health-utility scores were calculated. Subgroups were described and compared for utility scores by parametric and non-parametric methods. RESULTS A total of 92 patients were included with a median utility score of 0.691 (Interquartile range [IQR] 0.244). Patients ≥ 65 years had significantly worse median utility scores than younger patients; 0.638 versus 0.743, respectively (p = 0.017). Moreover, scores were significantly worse for patients with versus those without comorbidity (medians 0.620 versus 0.725, p = 0.005). Utility scores did not significantly differ between subgroups of tumor type, type of systemic treatment, number of previous palliative treatment(s), or number or location of metastatic site(s). The remaining survival was correlated with utility scores (correlation coefficient (r) = 0.260, p = 0.0252), especially in the subgroup < 65 years (r = 0.340, p = 0.0169), whereas there was no significant correlation with time since metastatic diagnosis (r = - 0.106, p = 0.3136). CONCLUSION Within this real-world cross-sectional study, QoL was significantly associated with age, comorbidity, and remaining survival duration. The observation of a lower QoL in ABC patients, possibly indicating the last period of life, may assist clinical decision-making on timing of cessation of systemic antitumor therapy.
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Affiliation(s)
- Anouk K. M. Claessens
- Department of Medical Oncology, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, PO BOX 5800, 6202 AZ Maastricht, The Netherlands
- Department of Medical Oncology, Zuyderland Medical Center, PO BOX 5500, 6130 MB Sittard-Geleen, The Netherlands
| | - Bram L. T. Ramaekers
- Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Centre, PO BOX 5800, 6202 AZ Maastricht, The Netherlands
| | - Dorien J. A. Lobbezoo
- Department of Medical Oncology, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, PO BOX 5800, 6202 AZ Maastricht, The Netherlands
| | - Roel J. W. van Kampen
- Department of Medical Oncology, Zuyderland Medical Center, PO BOX 5500, 6130 MB Sittard-Geleen, The Netherlands
| | - Maaike de Boer
- Department of Medical Oncology, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, PO BOX 5800, 6202 AZ Maastricht, The Netherlands
| | - Agnes J. van de Wouw
- Department of Internal Medicine, VieCuri Medical Center, PO BOX 1926, 5900 BX Venlo, The Netherlands
| | - M. Wouter Dercksen
- Department of Internal Medicine, Máxima Medical Center, PO BOX 90052, 5600 PD Eindhoven, The Netherlands
| | - Sandra M. E. Geurts
- Department of Medical Oncology, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, PO BOX 5800, 6202 AZ Maastricht, The Netherlands
| | - Manuela A. Joore
- Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Centre, PO BOX 5800, 6202 AZ Maastricht, The Netherlands
| | - Vivianne C. G. Tjan-Heijnen
- Department of Medical Oncology, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, PO BOX 5800, 6202 AZ Maastricht, The Netherlands
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14
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Vila MM, Barco Berron SD, Gil-Gil M, Ochoa-Arnedo C, Vázquez RV. Psychosocial aspects and life project disruption in young women diagnosed with metastatic hormone-sensitive HER2-negative breast cancer. Breast 2020; 53:44-50. [PMID: 32623094 PMCID: PMC7375669 DOI: 10.1016/j.breast.2020.06.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 05/18/2020] [Accepted: 06/25/2020] [Indexed: 01/17/2023] Open
Abstract
Metastatic breast cancer (MBC) diagnosis in young women negatively impacts on quality of life (QoL) and daily activities, disrupting their life project and forcing them to face new psychosocial challenges. The recently published results on the improvement of the overall survival of pre- or perimenopausal women with hormone-receptor-positive, HER2-negative MBC treated with CDK4/6 inhibitors plus endocrine therapy, while preserving, and in some items improving their QoL, will change the landscape of the management of this patient population. Their extended survival and potential improvement in QoL will, therefore, modify their specific needs in terms of psychosocial support. The complexity of the care of young women with MBC is described herein, based on an extensive literature review. Further research about the specific psychosocial requirements of these women and a new multidisciplinary holistic approach is paramount to properly address their concerns and preferences. The communication with and support of their partners, parents and children is an important factor affecting the QoL of these patients. Altogether, a multidisciplinary care, open communication and personalized support is required to address the psychosocial implications of the new prognostic expectations on these patients with the incorporation of new targeted therapies. Life project disruption in young women with metastatic breast cancer. Scarce research and lack of specific QoL questionnaires. Multidisciplinary holistic approach key to address concerns of young MBC patients. New therapies extend survival and improve quality of life of MBC patients. Psychosocial support needs to be adapted to these new prognostic expectations.
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Affiliation(s)
- Mireia Margelí Vila
- B-ARGO Group, Institut Català D'Oncologia, Medical Oncology Service, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Sonia Del Barco Berron
- Breast Cancer Unit. Institut Català D'Oncologia, Hospital Universitari Josep Trueta, Girona, Spain
| | - Miguel Gil-Gil
- Medical Oncology Unit. Institut Català D'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain; Institut D'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Cristian Ochoa-Arnedo
- Psycho-Oncology Unit. Institut Català D'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain; Clinical Psychology and Psychobiology Department, Universitat de Barcelona, Spain; Institut D'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Rafael Villanueva Vázquez
- Medical Oncology Unit. Institut Català D'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain; Breast Cancer Unit. Institut Català D'Oncologia, Hospital Moisès Broggi. Sant Joan Despí, Barcelona, Spain.
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15
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Zhou K, Wang W, Li M, An J, Huo L, He X, Li J, Li X. Body image mediates the relationship between post-surgery needs and health-related quality of life among women with breast cancer: a cross-sectional study. Health Qual Life Outcomes 2020; 18:163. [PMID: 32487117 PMCID: PMC7268611 DOI: 10.1186/s12955-020-01400-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 05/07/2020] [Indexed: 11/16/2022] Open
Abstract
Background Although body image (BI) disturbance is a common problem that often contributes to poor health-related quality of life (HRQoL) among women with breast cancer following surgery, the mediating role of BI (as a self-perceptive factor) in the relationship between needs and HRQoL after controlling for socio-demographic factors remains unclear. The purpose of this study was to identify the mediating role of BI between post-surgery needs and HRQoL after controlling for socio-demographic factors among women with breast cancer. Methods In this cross-sectional study, the primary outcome was HRQoL (as measured with the 36-item Short-Form Health Survey version 2 [SF-36v2] and Functional Assessment of Cancer Therapy-Breast version 4.0 [FACT-Bv4.0]). The secondary outcomes included needs (measured in terms of needs importance [NI] and needs satisfaction [NS]) and BI. Structural equation modeling was used to identify the mediating role of BI between needs and HRQoL while considering socio-demographics. Results The 406 eligible patients reported poor HRQoL, and approximately half reported important unmet needs and poor BI. NI, NS, and socio-demographics had differing direct effects on BI and HRQoL, and contrasting indirect effects on HRQoL via BI. NI, NS, surgery type, presence of chronic disease, and BI explained 4% of the variance in the SF-36v2 physical component summary score; NI, NS, surgery type, residence, and BI explained 20% of the variance in the mental component summary score; and NI, NS, marital status, employment status, radiotherapy, and BI explained 33% of the variance in the FACT-Bv4.0 total score. Conclusions After surgery, women with breast cancer have poor HRQoL and BI, and important unmet needs. BI mediates the relationship between needs and HRQoL after controlling for socio-demographics. The present findings provide information for developing comprehensive BI-based needs interventions and preparing targeted health-management programs for patients with breast cancer.
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Affiliation(s)
- Kaina Zhou
- School of Nursing, Xi'an Jiaotong University Health Science Centre, No. 76 Yanta West Road, Xi'an, 710061, Shaanxi, China
| | - Wen Wang
- School of Nursing, Xi'an Jiaotong University Health Science Centre, No. 76 Yanta West Road, Xi'an, 710061, Shaanxi, China
| | - Minjie Li
- School of Nursing, Xi'an Jiaotong University Health Science Centre, No. 76 Yanta West Road, Xi'an, 710061, Shaanxi, China
| | - Jinghua An
- School of Nursing, Xi'an Jiaotong University Health Science Centre, No. 76 Yanta West Road, Xi'an, 710061, Shaanxi, China
| | - Lanting Huo
- School of Nursing, Xi'an Jiaotong University Health Science Centre, No. 76 Yanta West Road, Xi'an, 710061, Shaanxi, China
| | - Xiaole He
- School of Nursing, Xi'an Jiaotong University Health Science Centre, No. 76 Yanta West Road, Xi'an, 710061, Shaanxi, China
| | - Jin Li
- School of Nursing, Xi'an Jiaotong University Health Science Centre, No. 76 Yanta West Road, Xi'an, 710061, Shaanxi, China
| | - Xiaomei Li
- School of Nursing, Xi'an Jiaotong University Health Science Centre, No. 76 Yanta West Road, Xi'an, 710061, Shaanxi, China.
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16
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Rowe L, Vera E, Acquaye A, Crandon S, Shah V, Bryla C, Wu J, Wall K, Siegel C, Reyes J, Penas-Prado M, Leggiero N, Cordova C, Burton E, Antony R, Boris L, Aboud O, Vyas Y, Mathen P, Gilbert M, Camphausen K, Mendoza T, Armstrong T. The prevalence of altered body image in patients with primary brain tumors: an understudied population. J Neurooncol 2020; 147:397-404. [PMID: 32096067 PMCID: PMC7136178 DOI: 10.1007/s11060-020-03433-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 02/12/2020] [Indexed: 11/28/2022]
Abstract
Purpose Body image (BI) is an important issue for cancer patients, as patients with BI concerns are susceptible to depression, anxiety, difficulty coping, and poor quality of life (QoL). While this concern has been documented in patients with other malignancies, no data exists of this QoL issue in patients with primary brain tumors (PBT). Methods A cross-sectional survey of 100 PBT patients was conducted on an IRB approved prospective protocol using structured questionnaires. Participants completed the body image scale (BIS), Appearance Scheme Inventory Revised (ASI-R), MD Anderson Symptom Inventory Brain Tumor (MDASI-BT), and Patient-Reported Outcomes Measurement Information System (PROMIS) Depression, Anxiety, and Psychosocial Impact Positive measures. Results The prevalence of clinically significant body image dissatisfaction (BIS ≥ 10) was 28% (95% CI 19–37%), median BIS score was 5 (range 0–27). The median ASI-R composite score was 2.9 (range 1.5–4.7). BIS was significantly correlated with the ASI-R (r = 0.53, 95% CI 0.37 to 0.65). The mean PROMIS Depression score was 48.4 (SD = 8.9), PROMIS Anxiety score was 49.4 (SD = 9.9), and PROMIS Psychosocial Illness Impact Positive score was 48.9 (SD = 9.7). BIS was significantly correlated with age, and trended with BMI and sex. The PROMIS Psychosocial Illness Impact Positive and PROMIS Anxiety scores were the most strongly related to BIS. Conclusions This study, the first to explore altered body image in PBT patients, revealed clinically significant body image dissatisfaction in nearly 1/3 of patients, similar to other malignancies. These findings underscore the potential contribution of disease and treatment-related body image concerns on psychosocial wellbeing in patients with PBT. Electronic supplementary material The online version of this article (10.1007/s11060-020-03433-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lindsay Rowe
- Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
| | - Elizabeth Vera
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Alvina Acquaye
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Sonja Crandon
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Veeraj Shah
- University of Maryland, College Park, MD, USA
| | - Christine Bryla
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Jing Wu
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Kathleen Wall
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Christine Siegel
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Jennifer Reyes
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Marta Penas-Prado
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Nicole Leggiero
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Christine Cordova
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Eric Burton
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Ramya Antony
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Lisa Boris
- Leidos Biomedical Research, Frederick National Laboratory for Cancer Research Sponsored By the National Cancer Institute, Frederick, MD, USA
| | - Orwa Aboud
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Yamini Vyas
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Peter Mathen
- Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Mark Gilbert
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Kevin Camphausen
- Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Tito Mendoza
- Department of Symptom Research, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Terri Armstrong
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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17
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Ginter AC. "The day you lose your hope is the day you start to die": Quality of life measured by young women with metastatic breast cancer. J Psychosoc Oncol 2020; 38:418-434. [PMID: 32067600 DOI: 10.1080/07347332.2020.1715523] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Purpose/Objectives: The number of young women with metastatic breast cancer (MBC) is growing in the United States. The intersection of age and cancer stage presents unique challenges for this population. However, there is little extant research on the concerns and perspectives of young women with MBC. The purpose of this study is to understand how young women describe their lived experiences following their diagnoses of MBC.Design: A cross-sectional qualitative study with a life course theoretical framework was employed.Sample/Participants: Purposive sampling yielded nine participants who took part in semi-structured interviews. Phenomenology informed understanding of the lived experience of young women with MBC.Findings: The findings describe how young women with MBC measure quality of life, via themes of facing off-time diagnoses, strategizing disclosure, relying on mindfulness and spirituality, contemplating the future, and differentiating surviving from truly living.Conclusion: The notion of short-term or long-term decision-making is clouded by a metastatic prognosis.Implications for Psychosocial Providers: These findings present new information about the needs of young women with MBC, with potentially transferable implications for young adults with other forms of metastatic cancer.
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Affiliation(s)
- Amanda C Ginter
- Department of Family Studies and Community Development, Towson University, Towson, MD, USA
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18
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Burbage D, Duffy N, Johnson EJ, Schneider SM. Cancer Survivorship Program: Implementation for Individuals With Recurrent Breast Cancer. Clin J Oncol Nurs 2020; 24:89-94. [PMID: 31961834 DOI: 10.1188/20.cjon.89-94] [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: 11/17/2022]
Abstract
BACKGROUND Patients are living longer with recurrent breast cancer, but survivorship programs for these individuals are lacking. OBJECTIVES The aims were to implement a survivorship program for individuals with recurrent breast cancer, increase their quality of life (QOL), and evaluate patient satisfaction with the program. METHODS Survivors were referred for a one-hour coaching intervention tailored to their needs based on results of the Functional Assessment of Cancer Therapy-Breast (FACT-B) survey. Satisfaction was assessed immediately and two weeks postintervention. A paired t test was used to evaluate QOL scores before and two weeks following participation. FINDINGS Statistically significant (p = 0.000) improvements were observed overall and in each subscale of the FACT-B survey. Patient satisfaction was high immediately postintervention and remained high at the two-week assessment.
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Affiliation(s)
- Darcy Burbage
- Helen F. Graham Cancer Center and Research Institute
| | - Nicole Duffy
- Helen F. Graham Cancer Center and Research Institute
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19
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Kaur M, Pusic AL, Cano SJ, Xie F, Bordeleau L, Zhong T, Klassen A. International phase 1 study protocol to develop a health state classification system for a preference-based measure for women with breast cancer: the BREAST-Q Utility module. BMJ Open 2020; 10:e034451. [PMID: 31915176 PMCID: PMC6955575 DOI: 10.1136/bmjopen-2019-034451] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 12/04/2019] [Accepted: 12/12/2019] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Concerns unique to women with breast cancer can include impact of cancer on body image, sexual well-being and changes in breast appearance and sensation. These important issues are not captured by the existing generic preference-based measures (PBMs) and no breast cancer-specific PBM currently exists. This Phase 1 protocol describes a mixed-methods study to develop and validate the descriptive health state classification system for a breast cancer-specific PBM, called the BREAST-Q Utility module. METHODS AND ANALYSIS A heterogeneous sample of women aged 18 years and older diagnosed with breast cancer who are undergoing or have had treatment for breast cancer will be invited to participate in qualitative interviews. Participants will be asked to describe impact of their diagnosis and treatment(s) on their health-related quality of life (HRQOL). Interviews will be audio recorded, transcribed verbatim and coded using a line-by-line approach. At the end of each interview, based on each participant's cancer treatment history, patients will complete the mastectomy, breast-conserving therapy or reconstruction module of BREAST-Q, with modified 5-point Likert scale to measure importance of the BREAST-Q concepts. Both sources of data will be analysed to identify the most important HRQOL concerns.A conceptual framework and item pool will be developed from the qualitative dataset. Preliminary version of the BREAST-Q Utility module will be created and refined at an in-person meeting of multidisciplinary experts. Content validity of the Utility module will be examined (cognitive debriefing, expert feedback). Psychometric properties of Utility module will be evaluated in a large sample of women with breast cancer. ETHICS AND DISSEMINATION The study has been approved by Hamilton Integrated Research Ethics Board, Canada. Results of this study will be presented at international conferences and published in peer-reviewed journals.
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Affiliation(s)
- Manraj Kaur
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Andrea L Pusic
- Plastic Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | | | - Feng Xie
- Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | - Louise Bordeleau
- Medical Oncology, Juravinski Cancer Centre, Hamilton, Ontario, Canada
| | - Toni Zhong
- Plastic Surgery, Toronto General Hospital, Toronto, Ontario, Canada
| | - Anne Klassen
- Pediatrics, McMaster University, Hamilton, Ontario, Canada
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Ward M, Harnett J, Bell TJ, Mardekian J. Risk Factors of QTc Prolongation in Women With Hormone Receptor‒positive/Human Epidermal Growth Factor Receptor 2‒negative Metastatic Breast Cancer: A Retrospective Analysis of Health Care Claims Data. Clin Ther 2019; 41:494-504.e1. [PMID: 30792074 DOI: 10.1016/j.clinthera.2019.01.012] [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: 10/22/2018] [Revised: 01/16/2019] [Accepted: 01/21/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE In addition to biomarker status, treatment selection for metastatic breast cancer (mBC) includes individual patient and clinical characteristics such as tumor burden, timing of disease recurrence, and comorbidities. Women with mBC may take medications that can increase the risk of drug-induced toxicities, including prolongation of cardiac repolarization (prolongation of QT interval). Corrected QT (QTc) prolongation, a toxicity associated with many cancer treatments, can lead to potentially life-threatening ventricular arrhythmias. As such, it is important to identify patients at risk for QTc prolongation due to comorbid conditions, concomitant medications, or electrolyte abnormalities. This real-world study estimated the proportion of women with hormone receptor‒positive (HR+)/human epidermal growth factor receptor 2‒negative (HER2‒) mBC who may be at risk of developing QTc prolongation. Results in the elderly are also included. METHODS This retrospective, cross-sectional cohort study used the Truven Health MarketScan and Optum Clinformatics administrative claims databases. Patients' medical and pharmacy data were evaluated to assess the risk of QTc prolongation. Prescription and medication administration claims were evaluated during the 7-day period before the index date (ie, first secondary neoplasm diagnosis). In addition, International Classification of Diseases, Ninth/Tenth Revision, Clinical Modification, codes were evaluated 12 months before the index date to describe congenital long QT syndrome, cardiac disease, and electrolyte abnormalities. FINDINGS A cohort of 24,340 women with HR+/HER2‒ mBC were identified, including 5059 women aged 65-74 years and 4851 aged ≥75 years. Based on an overall analysis of risk factors (congenital long QT syndrome, cardiovascular disease, electrolyte abnormalities, or concomitant medications), 29.5% of all patients, 33.2% of patients aged 65-74 years, and 40.5% of patients aged ≥75 years had risk factors for QTc prolongation. IMPLICATIONS This analysis of real-world data indicates that almost 1 in 3 women with HR+/HER2‒ mBC had congenital long QT syndrome, cardiovascular disease, and/or electrolyte abnormalities or received a concomitant medication that could increase the risk of developing QTc prolongation. The risk factors for congenital long QT syndrome, cardiovascular disease, or electrolyte abnormalities were more common in older patients. This analysis emphasizes the importance of individualized benefit/risk assessment during treatment decisions, especially when considering drugs with known or possible QTc prolongation risk.
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Beese SE, Harris IM, Moore D, Dretzke J. Body image dissatisfaction in patients with inflammatory bowel disease: a systematic review protocol. Syst Rev 2018; 7:184. [PMID: 30424797 PMCID: PMC6234647 DOI: 10.1186/s13643-018-0844-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 10/17/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Inflammatory bowel disease (IBD) is a debilitating chronic disease characterised by inflammation and ulceration of the gastrointestinal tract. It is associated with a range of debilitating symptoms and reduced quality of life. People living with IBD may also be at risk of body image dissatisfaction (BID). BID is a distorted and negative view of the physical self, which in turn can adversely affect mental health and quality of life. To date, there have been no systematic reviews of the evidence on BID in IBD patients. Therefore, the aim of this systematic review is to clarify the evidence base on BID in *IBD patients including (i) the tools used to measure BID, (ii) the prevalence and severity of BID, (iii) the risk factors associated with BID and (iv) the relationship between BID and quality of life. METHODS Bibliographic databases (EMBASE, MEDLINE, PsycINFO, Cochrane CENTRAL) will be searched using a sensitive search strategy aiming to identify any quantitative study reporting on body image in the context of IBD. This will be supplemented by searches of ongoing trials registers and checking of reference lists. Studies will be assessed for eligibility using predetermined selection criteria for each question. Data will be extracted using a predefined data extraction form, and risk of bias (quality) of included studies will be assessed based on checklists appropriate to the study designs identified. Key methodological steps will be undertaken in duplicate to minimise bias and error. Synthesis will be undertaken separately for the different systematic review sub-questions. Given the anticipated heterogeneity of evidence on each question, it is likely that synthesis will be mostly narrative. DISCUSSION To the best of our knowledge, this will be the first systematic review to collate the existing evidence on BID in IBD patients. Understanding the impact of BID, its relationship with quality of life, and which patients may be at greater risk, may ultimately lead to the development of interventions to prevent or treat BID and to better patient care. Any gaps in the identified evidence will help to inform the research agenda in this area. SYSTEMATIC REVIEW REGISTRATION PROSPERO: (CRD42018060999).
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Affiliation(s)
- Sophie Elizabeth Beese
- Institute of Applied Health Research, Public Health Building, University of Birmingham, Birmingham, B15 2TT UK
| | - Isobel Marion Harris
- Institute of Applied Health Research, Public Health Building, University of Birmingham, Birmingham, B15 2TT UK
| | - David Moore
- Institute of Applied Health Research, Public Health Building, University of Birmingham, Birmingham, B15 2TT UK
| | - Janine Dretzke
- Institute of Applied Health Research, Public Health Building, University of Birmingham, Birmingham, B15 2TT UK
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Abstract
The diagnosis of breast cancer elicits diverse emotional responses in patients and partners. Surviving cancer has raised new needs and caretakers must understand the medical and psychological latent effects of oncology therapy. Improving patients' well-being is crucial as 19 million survivors are expected in the next decade in the United States alone. In general, sexuality contributes to one's well-being but when it is disrupted by the occurrence of cancer, women withdraw emotionally, no longer feel desirable due to esthetic damage, and become overwhelmed by the thought of sex. Alopecia and mastectomy elicit feelings of unattractiveness affecting even some women with nipple sparing mastectomy. Couples who share the psychological distress of experiencing cancer should be logically included in survivorship interventions. Hence, any support offered to the couple improves their ability to cope significantly. Treatments causing premature ovarian failure as well as adjuvant endocrine treatments deepen the effects of hypo-estrogenism on the genital modifications of arousal. Sexual rehabilitation with vaginal dilators and sensate focus exercises help to lessen pain, and reduce the couple's anxiety toward sex. In conclusion, caregivers must realize that surviving women are often reluctant to voice their needs, thus, efficient interventions must be available to everyone.
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Affiliation(s)
- Anna Ghizzani
- a Division of Obstetrics and Gynecology, Department of Molecular and Developmental Medicine , University of Siena , Siena , Italy
| | - Simone Bruni
- a Division of Obstetrics and Gynecology, Department of Molecular and Developmental Medicine , University of Siena , Siena , Italy
| | - Stefano Luisi
- a Division of Obstetrics and Gynecology, Department of Molecular and Developmental Medicine , University of Siena , Siena , Italy
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Manier KK, Rowe LS, Welsh J, Armstrong TS. The impact and incidence of altered body image in patients with head and neck tumors: a systematic review. Neurooncol Pract 2018; 5:204-213. [PMID: 31386002 DOI: 10.1093/nop/npy018] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Body image dissatisfaction is a common issue among patients with cancer and is associated with difficulty coping, anxiety, and depression. Patients with tumors involving the head and neck are at increased risk of body image dissatisfaction due to the visible disfigurement that can occur from their illness and its treatment. Patients with primary central nervous system (CNS) malignancies often face similar tumor-related and treatment-related effects, yet there is limited research conducted in this population. Our aim was to perform a systematic review of the literature on body image in patients with tumors of the head and neck, and identify factors associated with body image alterations during treatment, with the intention of applying these approaches to those with CNS disease. A systematic search of PubMed and EMBASE was performed using predefined criteria. Nine studies met the inclusion criteria and were selected for review. The literature collected showed a relationship between body image and age, depressive symptoms, and tumor grade or stage. In addition, body image disturbance had an impact on patients' daily functioning and psychosocial indices including anxiety, coping, and body reintegration. Evaluation of the impact of body image alterations in patients with CNS tumors is needed to direct clinical care, explore research opportunities, and improve patient quality of life.
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Affiliation(s)
- Karra K Manier
- Neuro-Oncology Branch, National Cancer Institute Building, Room, Bethesda, MD
| | - Lindsay S Rowe
- Center for Cancer Research National Cancer Institute Building CRC, Room Bethesda, MD
| | - Judith Welsh
- NIH Library, National Institutes of Health, Building, Room, Bethesda, MD
| | - Terri S Armstrong
- Neuro-Oncology Branch, National Cancer Institute Building, Room, Bethesda, MD
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Determinants of satisfaction with cosmetic outcome in breast cancer survivors: A cross-sectional study. PLoS One 2018; 13:e0193099. [PMID: 29466412 PMCID: PMC5821366 DOI: 10.1371/journal.pone.0193099] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 02/05/2018] [Indexed: 11/19/2022] Open
Abstract
Little research has been done into cosmetic outcomes in non-Western breast cancer populations. We aimed to study the prevalence and determinants of dissatisfaction with cosmetic outcome after breast cancer surgery of Asian breast cancer survivors, and its association with patient-reported anxiety, depression, and quality of life. In a hospital-based cross-sectional study, 384 breast cancer survivors of at least 12 months after diagnosis completed questionnaires on satisfaction with cosmetic appearance, quality of life (EORTC-QLQ-C30) and anxiety and depression (HADS). Cumulative logit models were used to examine the adjusted association between dissatisfaction with cosmetic appearance and demographic and clinical characteristics. Kruskal-Wallis test was used to test for associations between dissatisfaction with cosmetic appearance and patient-reported outcomes. Overall, 20% of women reported to be (very) dissatisfied with cosmetic appearance. Survivors of Chinese ethnicity were more likely dissatisfied with cosmetic appearance compared to Malay survivors (22% and 14% respectively, adjusted OR = 2.4, 95%CI: 1.4-3.9). Women with DCIS (adjusted OR = 2.2, 95%CI: 1.3-3.7) or advanced stage disease (adjusted OR = 2.2, 95%CI: 1.2-3.9) had a higher risk of being dissatisfied with their cosmetic appearance. Women treated with mastectomy were at a higher risk of dissatisfaction with cosmetic appearance (adjusted OR = 1.7, 95%CI: 1.1-2.5). Dissatisfaction with cosmetic appearance was associated with increased depression scores. In this South-East Asian population, one in five breast cancer patients were (very) dissatisfied with the cosmetic outcome of treatment. Chinese women, women with larger tumors and women treated with mastectomy were most likely to report dissatisfaction with cosmetic appearance.
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Development of the body image self-rating questionnaire for breast cancer (BISQ-BC) for Chinese mainland patients. BMC Cancer 2018; 18:19. [PMID: 29301503 PMCID: PMC5753569 DOI: 10.1186/s12885-017-3865-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 11/30/2017] [Indexed: 11/23/2022] Open
Abstract
Background Body image is a complex post-treatment concern among female patients with breast cancer, and various tools have been developed and applied to measure this multifaceted issue. However, these available tools were developed in other countries and only a few have been modified into Chinese versions. Furthermore, body-image evaluation instruments that are specific to Chinese mainland female patients with breast cancer have not been devised yet. Therefore, we developed the Body Image Self-rating Questionnaire for Breast Cancer for Chinese mainland female patients with breast cancer. Methods We performed two rounds of the Delphi technique and a cross-sectional pilot survey. Items were selected using a Likert scale (1–5) to determine ratings of importance (i.e., the significance of the item from experts’ perspective; coefficients of variation ≤0.25), internal consistency reliability (Cronbach’s α ≥ 0.70), convergent validity (hypothesized item-subscale correlations ≥0.40), and discriminant validity (stronger correlations of the item with the hypothesized subscale than for other subscales). All decisions on items were made based on statistical analysis results, experts’ recommendations, and in-depth discussion among researchers. Results Twenty-five eligible experts completed the two Delphi rounds (mean age: 42.20 ± 8.90 years). Over half the experts were professors (56%, n = 14) or worked as clinical staff (68%, n = 17). Twenty (mean age = 49.55 ± 10.01 years) and 50 patients (mean age = 48.44 ± 9.98 years) completed the first- and second-round survey, respectively. Over half the patients had a tertiary education level, were married, and were employed. Regarding the revised questionnaire (comprising 33 items across seven subscales), the expert panelists’ ratings of each item met the criteria (Kendall’s W = 0.238, p < .001). Five subscales had a Cronbach’s α value over 0.60 (range: 0.62–0.69) and two subscales were over 0.80 (range: 0.84–0.88). All items satisfied the criteria for convergent and discriminant validity. Conclusions The findings of this study provide evidence of a suitable tool for body image evaluation among Chinese mainland female patients with breast cancer. Studies with larger sample sizes should be conducted to validate this questionnaire in this patient population. Electronic supplementary material The online version of this article (10.1186/s12885-017-3865-5) contains supplementary material, which is available to authorized users.
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Object-Based and Egocentric Mental Rotation Performance in Women With Breast Cancer. WOMEN’S HEALTH BULLETIN 2017. [DOI: 10.5812/whb.58268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Chronic Effects of Resistance Training in Breast Cancer Survivors. BIOMED RESEARCH INTERNATIONAL 2017; 2017:8367803. [PMID: 28835898 PMCID: PMC5557266 DOI: 10.1155/2017/8367803] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 06/15/2017] [Accepted: 06/28/2017] [Indexed: 01/05/2023]
Abstract
Objective. To analyse effects of resistance training (RT) in breast cancer survivors (BCS) and how protocols and acute variables were manipulated. Methods. Search was made at PubMed, Science Direct, and LILACS. All articles published between 2000 and 2016 were considered. Studies that met the following criteria were included: written in English, Spanish, or Portuguese; BCS who have undergone surgery, chemotherapy, and/or radiotherapy; additional RT only; analysis of muscle performance, body mass composition (BMC), psychosocial parameters, or blood biomarkers. Results. Ten studies were included. PEDro score ranged from 5 to 9. Rest interval and cadence were not reported. Two studies reported continuous training supervision. All reported improvements in muscle strength, most with low or moderate effect size (ES), but studies performed with high loads presented large ES. Five described no increased risk or exacerbation of lymphedema. Most studies that analysed BMC showed no relevant changes. Conclusions. RT has been shown to be safe for BCS, with no increased risk of lymphedema. The findings indicated that RT is efficient in increasing muscle strength; however, only one study observed significant changes in BMC. An exercise program should therefore consider the manipulation of acute and chronic variables of RT to obtain optimal results.
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McClelland SI. Gender and Sexual Labor Near the End of Life: Advanced Breast Cancer and Femininity Norms. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/23293691.2017.1276367] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Rezaei M, Elyasi F, Janbabai G, Moosazadeh M, Hamzehgardeshi Z. Factors Influencing Body Image in Women with Breast Cancer: A Comprehensive Literature Review. IRANIAN RED CRESCENT MEDICAL JOURNAL 2016; 18:e39465. [PMID: 28184329 PMCID: PMC5291938 DOI: 10.5812/ircmj.39465] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 06/14/2016] [Accepted: 07/17/2016] [Indexed: 11/25/2022]
Abstract
Context Many psycho-socioeconomic and other types factors associated with cancer, the treatment process, and changes in patients’ physical appearance and sexual function influence the body image of women with breast cancer. The purpose of this study was to determine which factors influence the body image of women with breast cancer. Data Collection A narrative literature review was conducted. Electronic databases, including Google Scholar, SID, Magiran, IranDoc, Barekat, Web of Science, Science Direct, Cochrane Library, ProQuest, Scopus, and PubMed, including Medline, were searched to retrieve articles published from 1993 to 2016 using the keywords breast cancer, treatment, body image, and related factors. The quality of selected studies was appraised using a checklist adapted from Samadaee-Gelehkolaee (2016). Results Of 690 articles retrieved in the search, 190 articles were selected for full text appraisal. Finally, 44 articles were selected for data analysis. The results were classified under three headings: bio-psycho-socioeconomic factors, factors associated with the disease and treatment processes, and physical appearance and sexual function. Conclusions The findings of this review showed that many factors can influence the body image of women suffering from breast cancer. These factors were predictors of patients’ inter-personal and intra-personal relationships with their partners and others who influenced various other aspects of their lives, possibly leading to many life’s issues. These factors must be identified and considered to make the most appropriate decisions for patients. The strength of this study lies in the exploration of factors influencing the body image of women with breast cancer which earlier studies did not consider. Moreover, the authors believe that this research has addressed nearly all the factors that are real concerns in the body image of women with breast cancer.
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Affiliation(s)
- Maedeh Rezaei
- Student Research Committee, Nasibeh Nursing and Midwifery Faculty, Mazandaran University of Medical Sciences, Sari, IR Iran
- Department of Reproductive Health and Midwifery, Mazandaran University of Medical Sciences, Sari, IR Iran
| | - Forouzan Elyasi
- Psychiatry and Behavioral Research Center, Department of Psychiatry, School of Medicine, Mazandaran University of Medical Sciences, Sari, IR Iran
| | - Ghasem Janbabai
- Department of Hematology-Oncology, Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, IR Iran
| | - Mahmood Moosazadeh
- Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, IR Iran
| | - Zeinab Hamzehgardeshi
- Sexual and Reproductive Health Research Center, Mazandaran University of Medical Sciences, Sari, IR Iran
- Department of Reproductive Health and Midwifery, Mazandaran University of Medical Sciences, Sari, IR Iran
- Traditional and Complementary Medicine Research Center, Mazandaran University of Medical Sciences, Sari, IR Iran
- Corresponding Author: Zeinab Hamzehgardeshi, Sexual and Reproductive Health Research Center, Mazandaran University of Medical Sciences, Vesal St., Amir Mazandarani Blvd., P. O. Box: 4816715793, Sari, Mazandaran, IR Iran. Tel: +98-1133367342-5, Fax: +98-1133368915, E-mail:
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Shah C, Vicini FA. Regional Nodal Irradiation: Moving Beyond Overall Survival. Int J Radiat Oncol Biol Phys 2016; 94:208-209. [PMID: 26700715 DOI: 10.1016/j.ijrobp.2015.09.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 09/18/2015] [Indexed: 10/23/2022]
Affiliation(s)
- Chirag Shah
- Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio.
| | - Frank A Vicini
- 21st Century Oncology/Michigan Healthcare Professionals, Farmington Hills, Michigan
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