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Javan Biparva A, Raoofi S, Rafiei S, Pashazadeh Kan F, Kazerooni M, Bagheribayati F, Masoumi M, Doustmehraban M, Sanaei M, Zarabi F, Raoofi N, Beiramy Chomalu Z, Ahmadi B, Seyghalani Talab F, Sadat Hoseini B, Asadollahi E, Mir M, Deylami S, Zareei M, Sanaei H, Dousti Nia Kakavand F, Koohestani H, Nasiri M, Vali N, Ghashghaee A. Global quality of life in breast cancer: systematic review and meta-analysis. BMJ Support Palliat Care 2024; 13:e528-e536. [PMID: 35710706 PMCID: PMC10850719 DOI: 10.1136/bmjspcare-2022-003642] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 05/30/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND Breast cancer (BC) is the most common cancer among women worldwide. We conducted a systematic review and meta-analysis to cover the existing research gap and contribute to existing knowledge to provide both researchers and clinicians with a better profile on the topic and consequently help improve the quality of life (QoL) of patients with BC. METHODS A comprehensive review of original articles published in English from January 2000 to October 2021 from databases including Embase, Scopus, PubMed and Web of Science was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. RESULTS Based on the meta-regression which examined a total of 9012 patients with BC, the QoL score calculated by EORTC QLQ-C30 was 64.72 (95% CI 59.24 to 70.20), while the score obtained from FACT-B was 84.39 (95% CI 64.24 to 104.54) and the scores from QLQ-BR23 and SF-36 were 66.33 (95% CI 62.76 to 69.90) and 57.23 (95% CI 47.65 to 66.82), respectively. A meta-analysis affirmed a significant direct relationship between the QoL score of patients with BC and their age (p=0.03). The results also revealed that the QoL scores of patients who had completed treatment were higher than those who were currently under treatment. CONCLUSION The present systematic review identified several factors that affect the QoL of women with BC worldwide and provided several implications for developing policy interventions to effectively improve the QoL of women with BC. In this way, clinicians can sufficiently give advice to their patients with the purpose of improving their QoL. PROSPERO registration number CRD42022309791.
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Affiliation(s)
- Akbar Javan Biparva
- Student Research Committee, School of Health Management and Medical Informatics, Iranian Center of Excellence in Health Management, Tabriz University of Medical Sciences, Tabriz, Iran (the Islamic Republic of)
| | - Samira Raoofi
- Student Research Committee, School of Health Management and Information Sciences Branch, Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Sima Rafiei
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Fatemeh Pashazadeh Kan
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Mitra Kazerooni
- Department of Obstetrics and Gynecology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Farzaneh Bagheribayati
- Cellular and Molecular Biology, University of Zanjan, Zanjan, Iran (the Islamic Republic of)
| | - Maryam Masoumi
- Clinical Research and Development Center, Qom University of Medical Sciences, Qom, Iran (the Islamic Republic of)
| | - Maryam Doustmehraban
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mohaddeseh Sanaei
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Farnaz Zarabi
- Department of Anesthesia, Faculty of Allied Medicine, Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Neda Raoofi
- Clinical Research Development Center, Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran (the Islamic Republic of)
| | - Zahra Beiramy Chomalu
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Behrooz Ahmadi
- Clinical Research Development Center, Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran (the Islamic Republic of)
| | | | - Batool Sadat Hoseini
- Department of Anesthesia, Faculty of Allied Medicine, Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Elnaz Asadollahi
- Student Research Committee, School of Health Management and Information Sciences Branch, Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Maryam Mir
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Sama Deylami
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Mahsa Zareei
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Hadis Sanaei
- School of health Managment and information sciences, University of Social welfare and Rehabilitation sciences, Tehran, Iran
| | - Fateme Dousti Nia Kakavand
- Student Research Committee, School of Health Management and Information Sciences Branch, Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Hooman Koohestani
- Department of Neurosurgery, 7Tir Hospital, Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | | | - Negin Vali
- Shahid AkbarAbadi Clinical Research Development unit (SHACRDU), Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Ghashghaee
- Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran
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da Silva Tozzo FCB, Sarri AJ, Pirola WE, da Silva UBC, de Oliveira MA, de Pádua Souza C, da Costa Vieira RA. Evaluation of upper limb lymphoedema and diagnostic accuracy of bioimpedance spectroscopy. A comprehensive validation in a Brazilian population. Ecancermedicalscience 2023; 17:1649. [PMID: 38419858 PMCID: PMC10901233 DOI: 10.3332/ecancer.2023.1649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Indexed: 03/02/2024] Open
Abstract
Lymphoedema is a complication of breast cancer treatment. Its early diagnosis is related to a good prognosis for lymphoedema treatment. The bioimpedance spectroscopy (BIS) evaluates changes in extracellular fluid. The objective of our study was to evaluate the validity, agreement and accuracy of BIS in the diagnosis of breast cancer-related lymphoedema in a Brazilian population. Methods This is a prospective, cross-sectional study of a convenience sample of 462 women who underwent surgical treatment for breast cancer (mastectomy or breast-conserving treatment). The validity, agreement and accuracy were performed comparing BIS (lymphoedema index (L-DEX) ≥ 6.5 or 10) with volumetry by water displacement, which is the gold standard for evaluating lymphoedema. Receiver operating characteristic curve was performed. Additionally, other methods like perimetry and indirect volumetry of the upper limbs were compared with water displacement volumetry (direct volumetry), and the BIS were compared with subjective evaluation. Results Considering L-DEX ≥ 10 the sensitivity of the BIS was 44.1%, specificity 95.4%, positive predictive value (PPV) was 70.7%, negative predictive value (NPV) was 87% and kappa was 0.459. The BIS with L-DEX ≥ 6.5, the sensitivity, specificity, PPV, NPV and kappa were 57%, 88.5%, 55.8%, 89% and 0.452, respectively. Area under curve was 0.724 and a possible cut-off point of L-DEX ≥ 7.35 with sensitivity of 57%, specificity of 90.7% and kappa value = 0.489. Conclusion Although BIS was significantly associated with the subjective evaluation of lymphoedema, it showed low sensitivity and agreement and moderate correlation when used as a method for diagnosing the condition. Thus, it is not the most valid method for evaluating lymphoedema. In addition, it was not the most accurate method when compared with other objective evaluation tools. Public health resources are scarce and must be used consciously. The knowledge that BIS is not a more accurate method than other, lower-cost instruments allows for better targeting of these resources.
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Affiliation(s)
| | - Almir José Sarri
- Department of Physical Therapy, Barretos Cancer Hospital, São Paulo 14784-390, Brazil
- https://orcid.org/0000-0001-9184-584X
| | - Willian Eduardo Pirola
- Post-Graduate Program, Barretos Cancer Hospital, São Paulo 14784-400, Brazil
- https://orcid.org/0000-0003-3372-2504
| | | | - Marco Antonio de Oliveira
- Center of Epidemiology and Biostatistics, Barretos Cancer Hospital, São Paulo 14784-400, Brazil
- https://orcid.org/0000-0001-6879-2778
| | - Cristiano de Pádua Souza
- Post-Graduate Program, Barretos Cancer Hospital, São Paulo 14784-400, Brazil
- https://orcid.org/0000-0002-6412-8041
| | - René Aloisio da Costa Vieira
- Post-Graduate Program, Barretos Cancer Hospital, São Paulo 14784-400, Brazil
- Department of Breast Cancer, Barretos Cancer Hospital, São Paulo 14784-400, Brazil
- https://orcid.org/0000-0003-2014-9016
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Fearn N, Llanos C, Dylke E, Stuart K, Kilbreath S. Quantification of breast lymphoedema following conservative breast cancer treatment: a systematic review. J Cancer Surviv 2023; 17:1669-1687. [PMID: 36301407 PMCID: PMC10539190 DOI: 10.1007/s11764-022-01278-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 10/15/2022] [Indexed: 10/31/2022]
Abstract
PURPOSE Breast lymphoedema is a possible side effect of breast conserving surgery, but it is poorly understood. This is due, in part, to difficulty assessing the breast. This systematic review described outcome measures that quantify breast lymphoedema signs and symptoms and evaluated the measurement properties for these outcome measures. METHOD Seven databases were searched using terms in four categories: breast cancer, lymphoedema and oedema, clinician reported (ClinROM) and patient reported outcome measures (PROM) and psychometric and measurement properties. Two reviewers independently reviewed studies and completed quality assessments. The Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) methodology was used for studies including measurement property evidence. RESULTS Fifty-six papers were included with thirteen questionnaires, eight patient-reported rating scales, seven physical measures, seven clinician-rating scales and four imaging techniques used to quantify breast lymphoedema. Based on COSMIN methodology, one ClinROM had sufficient reliability, ultrasound measuring dermal thickness. Tissue dielectric constant (TDC) measuring local tissue water had promising reliability. Four questionnaires had sufficient content validity (BLYSS, BLSQ, BrEQ and LYMQOL-Breast). CONCLUSIONS Ultrasound is recommended to reliably assess breast lymphoedema signs. No PROM can be recommended with confidence, but BLYSS, BLSQ, BrEQ and LYMQOL-Breast are promising. Further research is recommended to improve evidence of measurement properties for outcome measures. IMPLICATIONS FOR CANCER SURVIVORS There are many approaches to assess breast lymphoedema, but currently, only ultrasound can be recommended for use, with others, such as TDC and questionnaires, showing promise. Further research is required for all approaches to improve evidence of measurement properties.
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Affiliation(s)
- Nicola Fearn
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Susan Wakil Health Sciences Building, Western Avenue, Camperdown, NSW, Australia
| | - Catalina Llanos
- Westmead Breast Cancer Institute, Westmead Hospital, Sydney, NSW, Australia
| | - Elizabeth Dylke
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Susan Wakil Health Sciences Building, Western Avenue, Camperdown, NSW, Australia
| | - Kirsty Stuart
- Westmead Breast Cancer Institute, Westmead Hospital, Sydney, NSW, Australia
- Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
- Department of Radiation Oncology, Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, NSW, Australia
| | - Sharon Kilbreath
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Susan Wakil Health Sciences Building, Western Avenue, Camperdown, NSW, Australia.
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de Oliveira-Junior I, da Costa Vieira RA, Biller G, Sarri AJ, da Silva FCB, Nahás EAP. Factors associated with unsatisfactory cosmetic results in oncoplastic surgery. Front Oncol 2023; 13:1071127. [PMID: 37554162 PMCID: PMC10405917 DOI: 10.3389/fonc.2023.1071127] [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: 10/15/2022] [Accepted: 07/10/2023] [Indexed: 08/10/2023] Open
Abstract
INTRODUCTION Oncoplastic surgery (OS) has expanded the indications for breast-conserving surgery associated with an adequate aesthetic result. However, few studies have described the factors associated with unsatisfactory cosmetic outcomes from this surgical modality. MATERIALS AND METHODS This is a cross-sectional prospective study that included patients undergoing breast-conserving surgery (BCS) with or without OS. The patients self-evaluated the cosmetic results of the breasts posttreatment and had them photographed. The photos were analyzed by BCCT.core. Individual and treatment factors (local and systemic) for all patients were evaluated. These factors were dichotomized according to the use of OS and to the cosmetic result (satisfactory and unsatisfactory). Categorical variables were tested for association with surgical outcome using the chi-square test while numerical variables using the Mann-Whitney U test. Variables with p <0,2 were selected for multivariate analysis. RESULTS Of the 300 patients evaluated, 72 (24,0%) underwent OS. According to the patient self-evaluations, an unsatisfactory cosmetic result from OS was significantly associated with younger age at diagnosis, higher body mass index (BMI) at the time of evaluation, larger tumor size and greater weight of the surgical specimen. According to the BCCT.core, only the laterality of the tumor (left) was significantly associated with an unsatisfactory cosmetic result. In logistic regression, considering OS as a control variable, the risk of an unsatisfactory outcome according to patient self-evaluation was related to the tumor ≥ T2 odds ratio (OR) 1,85 (1,027-3,34) and age at diagnosis < 40 [OR 5,0 (1,84-13,95)]. However, according to the software, the variables were associated with an increased risk of an unsatisfactory outcome were the time interval between surgery and evaluation [OR 1,27 (1,16-1,39)], the presence of lymphedema [OR 2,97 (1,36-6,46)], surgical wound infection [OR 3,6 (1,22-11,16)], tumor location on the left side [OR 3,06 (1,69-5,53)], overweight [OR 2,93 (1,48-5,8)] and obesity [OR 2,52 (1,2-5,31)]. CONCLUSION There is no standard methodology for breast cosmesis evaluation, which influences the factors associated with unsatisfactory results. Younger patients and those with increased BMI, left breast cancer and extensive resections tend to present with unsatisfactory cosmetic results when OS is performed.
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Affiliation(s)
- Idam de Oliveira-Junior
- Postgraduate Program of Tocogynecology, Botucatu Medical School, Sao Paulo State University, UNESP, Sao Paulo, Brazil
- Postgraduate Program of Oncology, Barretos Cancer Hospital, Sao Paulo, Brazil
- Nucleous of Mastology, Barretos Cancer Hospital, Sao Paulo, Brazil
| | - René Aloísio da Costa Vieira
- Postgraduate Program of Tocogynecology, Botucatu Medical School, Sao Paulo State University, UNESP, Sao Paulo, Brazil
- Postgraduate Program of Oncology, Barretos Cancer Hospital, Sao Paulo, Brazil
| | - Gabriele Biller
- Postgraduate Program of Oncology, Barretos Cancer Hospital, Sao Paulo, Brazil
- Faculty of Health Sciences of Barretos Dr. Paulo Prata (FACISB) School of Medicine, Sao Paulo, Brazil
| | - Almir José Sarri
- Nucleous of Mastology, Barretos Cancer Hospital, Sao Paulo, Brazil
| | - Fabíola Cristina Brandini da Silva
- Postgraduate Program of Oncology, Barretos Cancer Hospital, Sao Paulo, Brazil
- Nucleous of Mastology, Barretos Cancer Hospital, Sao Paulo, Brazil
| | - Eliana Aguiar Petri Nahás
- Postgraduate Program of Tocogynecology, Botucatu Medical School, Sao Paulo State University, UNESP, Sao Paulo, Brazil
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Vieira RADC, Bailão-Junior A, de Oliveira-Junior I. Does breast oncoplastic surgery improve quality of life? Front Oncol 2023; 12:1099125. [PMID: 36713564 PMCID: PMC9877289 DOI: 10.3389/fonc.2022.1099125] [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: 11/15/2022] [Accepted: 12/28/2022] [Indexed: 01/15/2023] Open
Abstract
Breast Oncoplastic Surgery (OS) has established itself as a safe procedure associated with the treatment of breast cancer, but the term is broad, encompassing procedures associated with breast-conserving surgeries (BCS), conservative mastectomies and fat grafting. Surgeons believe that OS is associated with an increase in quality of life (QOL), but the diversity of QOL questionnaires and therapeutic modalities makes it difficult to assess from the patient's perspective. To answer this question, we performed a search for systematic reviews on QOL associated with different COM procedures, and in their absence, we selected case-control studies, discussing the main results. We observed that: (1) Patients undergoing BCS or breast reconstruction have improved QoL compared to those undergoing mastectomy; (2) In patients undergoing BCS, OS has not yet shown an improvement in QOL, a fact possibly influenced by patient selection bias; (3) In patients undergoing mastectomy with reconstruction, the QoL results are superior when the reconstruction is performed with autologous flaps and when the areola is preserved; (4) Prepectoral implants improves QOL in relation to subpectoral implant-based breast reconstruction; (5) ADM do not improves QOL; (6) In patients undergoing prophylactic mastectomy, satisfaction is high with the indication, but the patient must be informed about the potential complications associated with the procedure; (7) Satisfaction is high after performing fat grafting. It is observed that, in general, OS increases QOL, and when evaluating the procedures, any preservation or repair, or the use of autologous tissues, increases QOL, justifying OS.
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Affiliation(s)
- René Aloisio da Costa Vieira
- Programa de Pós-Graduação em Tocoginecologia, Faculdade de Medicina de Botucatu, Botucatu/SP, Brazil,Programa de Pós-Graduação em Oncologia, Hospital de Câncer de Barretos, Barretos/SP, Brazil,Departamento de Cirurgia Oncológica, Divisão de Mastologia, Hospital de Câncer de Muriaé, Muriaé/MG, Brazil,Active Member of European Organisation for Research and Treatment (EORTC) Quality of life Group, Brussels, Belgium,*Correspondence: René Aloisio da Costa Vieira,
| | - Antônio Bailão-Junior
- Programa de Pós-Graduação em Tocoginecologia, Faculdade de Medicina de Botucatu, Botucatu/SP, Brazil,Departamento de Mastologia e Reconstrução Mamária, Hospital de Câncer de Barretos, Barretos/SP, Brazil
| | - Idam de Oliveira-Junior
- Programa de Pós-Graduação em Tocoginecologia, Faculdade de Medicina de Botucatu, Botucatu/SP, Brazil,Programa de Pós-Graduação em Oncologia, Hospital de Câncer de Barretos, Barretos/SP, Brazil,Departamento de Mastologia e Reconstrução Mamária, Hospital de Câncer de Barretos, Barretos/SP, Brazil
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Li Y, Guo J, Sui Y, Chen B, Li D, Jiang J. Quality of Life in Patients with Breast Cancer following Breast Conservation Surgery: A Systematic Review and Meta-Analysis. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:3877984. [PMID: 35140901 PMCID: PMC8820849 DOI: 10.1155/2022/3877984] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 12/17/2021] [Accepted: 12/29/2021] [Indexed: 01/29/2023]
Abstract
To evaluate the health-related quality-of-life (QOL) outcomes in surgical breast cancer survivors who received breast conservation therapy (BCT) compared to mastectomy, we utilized a systematic review to conduct observational studies of QOL in patients with breast cancer following breast conservation therapy from their inception until October 2021. The PubMed, the Cochrane Library, and the Web of Science databases were systematically searched to retrieve the observational studies. The pooled odds ratios (ORs) with 95% confidence intervals (CIs) were applied as an effect estimate and calculated using Stata 15 software. Nine studies comprising 2301 patients were included. The results showed that no significant differences compared to mastectomy were detected for global health status (P=0.971 and P=0.613), physical function (P=0.099), emotional function (P=0.096), cognitive function (P=0.377), social function (P=0.602), sexual functioning (P=0.072), and sexual enjoyment (P=0.142), while role function (P=0.036), body image (P=0.000), and future perspective (P=0.012) showed a significant difference for BCT when compared to mastectomy. When compared to breast reconstruction (BR), the BCT group was inferior at physical function (P=0.002) and cognitive function (P=0.040) but superior at body image (P=0.001). When used the Functional Assessment of Cancer Therapy (FACT) tool, BCT has better results in physical function (P=0.000), emotional function (P=0.000), and social function (P=0.000) than mastectomy. QOL outcomes after BCT were better than mastectomy in body image, future perspective, and role function. BCT may be an acceptable option in the study setting for breast cancer patients who pursue high QOL.
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Affiliation(s)
- Yue Li
- Harbin Medical University Cancer Hospital, No. 150 Haping Road, Nangang District, Harbin City, Heilongjiang Province, China
| | - Jianming Guo
- Harbin Medical University Cancer Hospital, No. 150 Haping Road, Nangang District, Harbin City, Heilongjiang Province, China
| | - Yuan Sui
- Harbin Medical University Cancer Hospital, No. 150 Haping Road, Nangang District, Harbin City, Heilongjiang Province, China
| | - Baihui Chen
- Harbin Medical University Cancer Hospital, No. 150 Haping Road, Nangang District, Harbin City, Heilongjiang Province, China
| | - Dalin Li
- Harbin Medical University Cancer Hospital, No. 150 Haping Road, Nangang District, Harbin City, Heilongjiang Province, China
| | - Jiakang Jiang
- Heilongjiang University of Chinese Medicine, No. 26 Heping Road, Xiangfang District, Harbin City, Heilongjiang Province, China
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Vieira RADAC, Biller G, Silva FCBDA, Silva JJDA, Oliveira MADE, Bailão-Junior A. New criteria for breast symmetry evaluation after breast conserving surgery for cancer. Rev Col Bras Cir 2021; 48:e20202698. [PMID: 34133654 PMCID: PMC10683423 DOI: 10.1590/0100-6991e-20202698] [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: 06/27/2020] [Accepted: 11/05/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE to evaluate symmetry after breast-conserving surgery (BCS) for cancer. METHODS a prospective study of patients undergoing BCS. These patients were photographed using the same criteria of evaluation. The references points used were the nipple height difference (NH), the nipple-manubrium distances (NM), nipple-sternum distances (NS) and the angle between the intramammary fold and the nipple (nipple angle; NA). ImageJ software was used. Three breast symmetry models were evaluated: excellent/others (model 1), excellent-good/others (model 2) and others/poor (model 3). The ROC curve was used to select acceptable criteria for the evaluation of symmetry. Decision tree model analysis was performed. RESULTS a total of 274 women were evaluated. The BCCT.core result was excellent in 5.8% (16), good in 24.1% (66), fair in 46.4% (127) and poor in 23.7% (65). The difference in NH was associated with good breast area (0.837-0.846); acceptable differences were below 3.1 cm, while unacceptable values were greater than 6.4 cm. Differences in the NM were associated with average breast area (0.709-0.789); a difference in value of less than 4.5 cm was acceptable, while values greater than 6.3 cm were unacceptable. In the decision tree combined model, a good-excellent outcome for patients with differential (d) dNH = 1 (0 to 5.30 cm) and dNM ≠ 3 (<6.28 cm); and for a poor/poor result, values dNM = 3 (> 6.35). CONCLUSIONS the results presented here are simple tools that can assist the surgeon for breast symmetry evaluation.
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Affiliation(s)
- René Aloisio DA Costa Vieira
- - Hospital de Câncer de Barretos, Programa de Pós-graduação em Oncologia - Barretos - SP - Brasil
- - Universidade Estadual Paulista (UNESP), Faculdade de Medicina de Botucatu, Programa de Pós-graduação em Tocoginecologia - Botucatu - SP - Brasil
- - Hospital de Câncer de Muriaé, Departamento de Cirurgia. Divisão de Mastologia - Muriaé - MG - Brasil
| | - Gabriele Biller
- - Hospital de Câncer de Barretos, Programa de Pós-graduação em Oncologia - Barretos - SP - Brasil
| | | | - Jonathas José DA Silva
- - Hospital de Câncer de Barretos, Programa de Pós-graduação em Oncologia - Barretos - SP - Brasil
| | | | - Antônio Bailão-Junior
- - Hospital de Câncer de Barretos, Departamento de Mastologia e Reconstrução Mamária - Barretos - SP - Brasil
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Oncoplastic Surgery: Does Patient and Medical Specialty Influences the Evaluation of Cosmetic Results? Clin Breast Cancer 2021; 21:247-255.e3. [DOI: 10.1016/j.clbc.2020.09.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/21/2020] [Accepted: 09/26/2020] [Indexed: 12/17/2022]
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de Oliveira-Junior I, da Silva IDA, da Silva FCB, da Silva JJ, Sarri AJ, Paiva CE, Vieira RADC. Oncoplastic Surgery in Breast-Conserving Treatment: Patient Profile and Impact on Quality of Life. Breast Care (Basel) 2021; 16:243-253. [PMID: 34248465 PMCID: PMC8248771 DOI: 10.1159/000507240] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 03/16/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Breast-conserving treatment (BCT) provides better quality of life (QL) than mastectomy without reconstruction. Oncoplastic surgery (OS) encompasses a series of surgical techniques, increasing the indications for BCT, but few studies have evaluated the impact on QL in patients who undergo BCT with OS. MATERIALS AND METHODS A prospective, cross-sectional study was conducted in women who underwent BCT. We evaluated the characteristics of patients who underwent BCT with and without OS and the associated QL. QL was assessed through the EORTC QLQ-30, EORTC QLQ-BR23, and Breast Cancer Treatment Outcome Scale (BCTOS) questionnaires. RESULTS A total of 300 patients underwent BCT, 72 underwent breast OS, and 37 underwent bilateral surgery. Patients who underwent OS were younger (p = 0.004), had a higher level of education (p = 0.01), had a smaller time interval since the end of treatment (p = 0.02), had tumours with greater dimensions (p = 0.003), and were more likely to receive neoadjuvant chemotherapy (p = 0.05). Based on the QL questionnaires, no difference was observed between the groups. Breast symmetry was not associated with high patient satisfaction (p = 0.55). CONCLUSION Despite the fact that OS was performed in patients with worse tumour conditions and in more demanding patients, OS allowed similar cosmetic results to classical BCT.
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Affiliation(s)
- Idam de Oliveira-Junior
- Department of Mastology and Breast Reconstruction, Barretos Cancer Hospital, Sao Paulo, Brazil
- Postgraduate Program of Gynecology, Obstetrics and Mastology, Botucatu Medical School, Sao Paulo State University − UNESP, Sao Paulo, Brazil
| | - Igor de Araujo da Silva
- Department of Mastology and Breast Reconstruction, Barretos Cancer Hospital, Sao Paulo, Brazil
- Postgraduate Program of Oncology, Barretos Cancer Hospital, Sao Paulo, Brazil
| | - Fabíola Cristina Brandini da Silva
- Postgraduate Program of Oncology, Barretos Cancer Hospital, Sao Paulo, Brazil
- Department of Physiotherapy, Barretos Cancer Hospital, Sao Paulo, Brazil
| | - Jonathas José da Silva
- Postgraduate Program of Oncology, Barretos Cancer Hospital, Sao Paulo, Brazil
- Department of Physiotherapy, Barretos Cancer Hospital, Sao Paulo, Brazil
| | - Almir José Sarri
- Department of Physiotherapy, Barretos Cancer Hospital, Sao Paulo, Brazil
| | - Carlos Eduardo Paiva
- Postgraduate Program of Oncology, Barretos Cancer Hospital, Sao Paulo, Brazil
- Department of Clinical Oncology, Barretos Cancer Hospital, Sao Paulo, Brazil
| | - René Aloisio da Costa Vieira
- Department of Mastology and Breast Reconstruction, Barretos Cancer Hospital, Sao Paulo, Brazil
- Postgraduate Program of Gynecology, Obstetrics and Mastology, Botucatu Medical School, Sao Paulo State University − UNESP, Sao Paulo, Brazil
- Postgraduate Program of Oncology, Barretos Cancer Hospital, Sao Paulo, Brazil
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10
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Lang AE, Kim SY, Dickerson CR, Milosavljevic S. Measurement of objective shoulder function following breast cancer surgery: a scoping review. PHYSICAL THERAPY REVIEWS 2020. [DOI: 10.1080/10833196.2020.1851439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Angelica E. Lang
- School of Rehabilitation Sciences, University of Saskatchewan, Saskatoon, Canada
| | - Soo Y. Kim
- School of Rehabilitation Sciences, University of Saskatchewan, Saskatoon, Canada
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11
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Siqueira TC, Frágoas SP, Pelegrini A, de Oliveira AR, da Luz CM. Factors associated with upper limb dysfunction in breast cancer survivors. Support Care Cancer 2020; 29:1933-1940. [PMID: 32808138 DOI: 10.1007/s00520-020-05668-7] [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: 12/23/2019] [Accepted: 08/03/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To analyze factors associated with upper limb dysfunction in women after breast cancer treatment. METHODOLOGY A cross-sectional study with 233 women over 18 years of age diagnosed with breast cancer and undergoing at least one cancer treatment (surgery and/or adjuvant treatment). Sociodemographic, anthropometric, and cancer treatment data were collected, as well as current physical and functional complications. Changes in breast tenderness and intercostobrachial nerve pathway, winged scapula, pain, cicatricial adherence, and lymphedema were evaluated by physical examination (inspection and palpation). Upper limb dysfunction was assessed using the DASH questionnaire. Chi-square test and logistic regression were used to verify possible associations between upper limb dysfunction and other variables. RESULTS The results showed that 55.4% of women had some level of upper limb dysfunction. Evaluating treatment conditions, lymphadenectomy, lymphedema, presence of pain, and intercostobrachial nerve injury were associated with some level of upper limb dysfunction in the crude analysis. The adjusted analysis showed that only upper limb dysfunction remained associated with intercostobrachial nerve injury, regardless of age and body mass index. CONCLUSION Upper limb dysfunction is frequent after breast cancer treatment and may be associated with neuropathies due to changes in the intercostobrachial nerve pathway.
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Affiliation(s)
- Thais Cristina Siqueira
- Physiotherapy Postgraduate Program, Health and Sports Science Center, Santa Catarina State University (UDESC), Pascoal Simone, 358, Coqueiros, Florianópolis, SC, 88080-350, Brazil
| | - Simone Pedrozo Frágoas
- Physiotherapy Postgraduate Program, Health and Sports Science Center, Santa Catarina State University (UDESC), Pascoal Simone, 358, Coqueiros, Florianópolis, SC, 88080-350, Brazil
| | - Andreia Pelegrini
- Human Movement Sciences Postgraduate Program, Health and Sports Science Center, Santa Catarina State University (UDESC), Florianópolis, Brazil
| | - Ana Rosa de Oliveira
- Mastology Service, Carmela Dutra Maternity, Santa Catarina State Department of Health, Florianópolis, Brazil
| | - Clarissa Medeiros da Luz
- Physiotherapy Postgraduate Program, Health and Sports Science Center, Santa Catarina State University (UDESC), Pascoal Simone, 358, Coqueiros, Florianópolis, SC, 88080-350, Brazil.
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12
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Kanda MH, da Costa Vieira RA, Lima JPSN, Paiva CE, de Araujo RLC. Late locoregional complications associated with adjuvant radiotherapy in the treatment of breast cancer: Systematic review and meta-analysis. J Surg Oncol 2019; 121:766-776. [PMID: 31879978 DOI: 10.1002/jso.25820] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 12/14/2019] [Indexed: 02/06/2023]
Abstract
This systematic review with meta-analysis addressed late locoregional complications associated with adjuvant radiotherapy (RT) in breast cancer. Among 2120 titles, ten comparative studies in patients undergoing surgery vs surgery and radiotherapy reporting complications were evaluated. RT was associated with an increased risk of capsular contracture and decreased the mobility of the upper limb. A borderline association of lymphedema risk using RT was noted in the random-effects model but was significant in the fixed-effects model.
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Affiliation(s)
- Márcia Helena Kanda
- Programa de Pós-Graduação em Oncologia, Hospital de Câncer de Barretos, Barretos, São Paulo, Brasil.,Departamento de Oncologia Clínica do Hospital de Câncer de Barretos, São Paulo, Brasil
| | - René Aloisio da Costa Vieira
- Programa de Pós-Graduação em Oncologia, Hospital de Câncer de Barretos, Barretos, São Paulo, Brasil.,Programa de Pós-Graduação em Ginecologia, Obstetricia e Mastologia, Faculdade de Medicina de Botucatu. UNESP, Botucatu, São Paulo, Brasil
| | - João Paulo S N Lima
- Departamento de Oncologia Clínica e Laboratório de Bioinformática, A.C. Camargo Cancer Center, São Paulo, São Paulo, Brazil
| | - Carlos Eduardo Paiva
- Programa de Pós-Graduação em Oncologia, Hospital de Câncer de Barretos, Barretos, São Paulo, Brasil.,Departamento de Oncologia Clínica do Hospital de Câncer de Barretos, São Paulo, Brasil
| | - Raphael Leonardo Cunha de Araujo
- Programa de Pós-Graduação em Oncologia, Hospital de Câncer de Barretos, Barretos, São Paulo, Brasil.,Departamento de Cirurgia do Aparelho Digestivo, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil.,Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil
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13
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Giusti R, Scarpi E, Cannita K, Silva RR, Filetti M, Mazzotta M, Ficorella C, Botticelli A, Maltoni M, Marchetti P, Porzio G, Verna L. Clinical and psychometric validation of the BreSAS questionnaire module for symptom assessment among breast cancer survivors. Support Care Cancer 2019; 28:1051-1058. [PMID: 31177390 DOI: 10.1007/s00520-019-04905-y] [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: 04/10/2019] [Accepted: 05/31/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND The large number of women surviving many years post breast cancer (BC) diagnosis has heightened interest in studying long-term effects of cancer on quality of life (QoL). Several cancer-specific health-related measures have been developed, but these may not be appropriate for long survivors. This study evaluates the reliability and clinical and psychometric validity of the BreSAS questionnaire (BQ) among BC survivors. METHODS The BQ is a quick, simple ten-item module for the assessment of long-term physical, psychological, sexual, and cognitive effects that may influence QoL. The total BreSAS score ranks from 0 to 100, with a low score indicating a better QoL. Patients complete the BQ, the FACT-ES questionnaire, and case report forms for clinical and socio-demographic data during follow-up visits. Reliability and clinical and psychometric validity of the questionnaires are assessed by correlation analyses and exploration of known group comparisons. RESULTS From September 2015 to February 2016, 149 patients from three Italian oncology units were enrolled. Baseline questionnaires were returned from all, and 134 patients (89%) completed the BQ and FACT-ES in less than 15 min. For reliability, Cronbach's alpha coefficients for each scale were greater than 0.70 in all analyzed symptoms. Convergent validity of BQ showed by Pearson's r demonstrated a high correlation between intensity of symptoms and QoL, especially for pain and depression. No data were provided about reproducibility with test-retest study. CONCLUSION The BQ demonstrates sufficient validity and reliability to support its use to assess patient-reported symptoms during planned follow-up clinical visits among BC survivors. Further full validation studies are needed.
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Affiliation(s)
- Raffaele Giusti
- Medical Oncology Unit, Azienda Ospedaliero Universitaria Sant'Andrea, Via di Grottarossa 1035-1037, 00189, Rome, Italy
| | - Emanuela Scarpi
- Biostatistics and Clinical Trials Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola (FC), Meldola, FC, Italy
| | - Katia Cannita
- Medical Oncology Unit, S. Salvatore Hospital, University of L'Aquila, L'Aquila, AQ, Italy
| | | | - Marco Filetti
- Medical Oncology Unit, Azienda Ospedaliero Universitaria Sant'Andrea, Via di Grottarossa 1035-1037, 00189, Rome, Italy
| | - Marco Mazzotta
- Medical Oncology Unit, Azienda Ospedaliero Universitaria Sant'Andrea, Via di Grottarossa 1035-1037, 00189, Rome, Italy.
| | - Corrado Ficorella
- Medical Oncology Unit, S. Salvatore Hospital, University of L'Aquila, L'Aquila, AQ, Italy
| | - Andrea Botticelli
- Medical Oncology Unit, Azienda Ospedaliero Universitaria Sant'Andrea, Via di Grottarossa 1035-1037, 00189, Rome, Italy
| | - Marco Maltoni
- Palliative Care Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola (FC), Meldola, FC, Italy
| | - Paolo Marchetti
- Medical Oncology Unit, Azienda Ospedaliero Universitaria Sant'Andrea, Via di Grottarossa 1035-1037, 00189, Rome, Italy
| | - Giampiero Porzio
- Medical Oncology Unit, S. Salvatore Hospital, University of L'Aquila, L'Aquila, AQ, Italy
| | - Lucilla Verna
- Medical Oncology Unit, S. Salvatore Hospital, University of L'Aquila, L'Aquila, AQ, Italy
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