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Alem T, Nigatu D, Birara A, Fetene T, Giza M. Quality of life of breast cancer patients in Amhara region, Ethiopia: A cross-sectional study. PLoS One 2024; 19:e0305263. [PMID: 38935776 PMCID: PMC11210875 DOI: 10.1371/journal.pone.0305263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 05/28/2024] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND Although breast cancer has a markedly higher incidence in developed countries, seven out of ten deaths occur in developing countries, including Ethiopia. However, there is a limited information on the quality of life (QoL) among breast cancer patients in Ethiopia, notably in the Amhara region. Therefore, this study aimed to assess the QoL and its associated factors among patients with breast cancer in the Amhara Region, Ethiopia. METHODS An institutional based cross-sectional study was conducted from 25th March 2019 to 7th July 2019. A systematically selected sample of 256 breast cancer patients were participated in the study. A standardized interviewer-administered Amharic version questionnaire was used to collect the data. We used the European Organization for Research and Treatment of Cancer quality of life questionnaire core 30 (EORTC QLQ C30) and breast cancer supplementary measure (QLQ-BR23) to measure QoL. The data were analyzed by SPSS version 23. A binary logistic regression model was fitted to identify the predictors of QoL. The adjusted odds ratio (AOR) with a 95% confidence interval (CI) was reported to show the strength of the association. RESULTS Sixty-eight percent of breast cancer patients had poor QoL (68.4%; 95% CI: 62.5-73.8). The mean score of QoL was 70.6 (standard deviation (SD) ±13.9; 95% CI: 69.0-72.4). All functional component scores were less than 75 on the symptom scale. Diarrhea (11.6), constipation (17.5), and dyspnea (24.7) were less noticeable symptoms. Being out of marriage (AOR = 2.59, 95% CI: 1.32-5.07), being poor (AOR = 2.39, 95%CI: 1.32-5.03), being non-housewife (AOR = 3.25, 95% CI: 1.16-7.22), and being complaints of dyspnea (AOR = 3.48, 95% CI: 1.79-6.79), and insomnia (AOR = 2.03, 95% CI: 1.05-3.91) were significantly associated with QoL. CONCLUSIONS The proportion of poor QoL among breast cancer patients was high. Health care professionals should give attention to breast cancer patients who are out of marriage, poor and non-housewife while offering the recommended treatment courses.
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Affiliation(s)
- Tamrat Alem
- Felege Hiwot Regional Referral Hospital, Bahir Dar, Ethiopia
| | - Dabere Nigatu
- Department of Reproductive Health and Population Studies, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Amsalu Birara
- Department of Environment Health Sciences, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Tamene Fetene
- Department of Pediatrics Nursing, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Mastewal Giza
- Department of Nutrition, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
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Nsaful J, Nartey ET, Dedey F, Bediako-Bowan A, Appiah-Danquah R, Darko K, Ankrah LNA, Akli-Nartey C, Annan JY, Dei-Asamoa J, Ahene-Amanquanor GA, Clegg-Lamptey JN. Quality of Life after Mastectomy with or without Breast Reconstruction and Breast-Conserving Surgery in Breast Cancer Survivors: A Cross-Sectional Study at a Tertiary Hospital in Ghana. Curr Oncol 2024; 31:2952-2962. [PMID: 38920708 PMCID: PMC11203203 DOI: 10.3390/curroncol31060224] [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: 03/31/2024] [Revised: 05/18/2024] [Accepted: 05/20/2024] [Indexed: 06/27/2024] Open
Abstract
(1) Background: Breast cancer is the leading malignancy worldwide, and in Ghana, it has a poor overall survival rate. However, approximately 50% of cases are cases of early-stage disease, and with advances in breast cancer treatment and improvements in survival, quality of life (QOL) is becoming as important as the treatment of the disease. (2) Methodology: This was a cross-sectional study of survivors who had breast-conserving surgery (BCS), mastectomy only (M) and mastectomy with breast reconstruction (BRS) from 2016 to 2020 at a tertiary hospital in Ghana, comparatively assessing their QOL using EORTC QLQ C-30 and EORTC QLQ BR-23. (3) Results: The study participants had an overall global health status (GHS) median score of 83.3 [IQR: 66.7-91.7] with no significant differences between the surgery types. The BRS group had statistically significant lower median scores for the functional scale (82.8 and 51.0) and the highest scores for the symptomatic scale (15.7 and 16.5). Body image was significantly lowest for the BRS group (83.3) [68.8-91.7] and highest (100) [91.7-100] for the BCS group (p < 0.001). (4) Conclusion: There is a need to develop support systems tailored at improving the QOL of breast cancer survivors taking into consideration the type of surgery performed.
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Affiliation(s)
- Josephine Nsaful
- Department of Surgery, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra GA-221-1570, Ghana; (F.D.); (A.B.-B.); (J.-N.C.-L.)
- Department of Surgery, Korle Bu Teaching Hospital, Accra GA-221-1570, Ghana; (R.A.-D.); (C.A.-N.); (J.Y.A.); (J.D.-A.); (G.A.A.-A.)
| | - Edmund Tetteh Nartey
- Centre for Tropical Clinical Pharmacology & Therapeutics, University of Ghana Medical School, Accra GA-221-1570, Ghana;
| | - Florence Dedey
- Department of Surgery, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra GA-221-1570, Ghana; (F.D.); (A.B.-B.); (J.-N.C.-L.)
- Department of Surgery, Korle Bu Teaching Hospital, Accra GA-221-1570, Ghana; (R.A.-D.); (C.A.-N.); (J.Y.A.); (J.D.-A.); (G.A.A.-A.)
| | - Antoinette Bediako-Bowan
- Department of Surgery, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra GA-221-1570, Ghana; (F.D.); (A.B.-B.); (J.-N.C.-L.)
- Department of Surgery, Korle Bu Teaching Hospital, Accra GA-221-1570, Ghana; (R.A.-D.); (C.A.-N.); (J.Y.A.); (J.D.-A.); (G.A.A.-A.)
| | - Rita Appiah-Danquah
- Department of Surgery, Korle Bu Teaching Hospital, Accra GA-221-1570, Ghana; (R.A.-D.); (C.A.-N.); (J.Y.A.); (J.D.-A.); (G.A.A.-A.)
| | - Kwame Darko
- National Reconstructive Plastic Surgery and Burns Centre, Korle Bu Teaching Hospital, Accra GA-221-1570, Ghana; (K.D.); (L.N.A.A.)
| | - Levi Nii Ayi Ankrah
- National Reconstructive Plastic Surgery and Burns Centre, Korle Bu Teaching Hospital, Accra GA-221-1570, Ghana; (K.D.); (L.N.A.A.)
| | - Cynthia Akli-Nartey
- Department of Surgery, Korle Bu Teaching Hospital, Accra GA-221-1570, Ghana; (R.A.-D.); (C.A.-N.); (J.Y.A.); (J.D.-A.); (G.A.A.-A.)
| | - Jessie Yaoteokor Annan
- Department of Surgery, Korle Bu Teaching Hospital, Accra GA-221-1570, Ghana; (R.A.-D.); (C.A.-N.); (J.Y.A.); (J.D.-A.); (G.A.A.-A.)
| | - Jessica Dei-Asamoa
- Department of Surgery, Korle Bu Teaching Hospital, Accra GA-221-1570, Ghana; (R.A.-D.); (C.A.-N.); (J.Y.A.); (J.D.-A.); (G.A.A.-A.)
| | | | - Joe-Nat Clegg-Lamptey
- Department of Surgery, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra GA-221-1570, Ghana; (F.D.); (A.B.-B.); (J.-N.C.-L.)
- Department of Surgery, Korle Bu Teaching Hospital, Accra GA-221-1570, Ghana; (R.A.-D.); (C.A.-N.); (J.Y.A.); (J.D.-A.); (G.A.A.-A.)
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Palmquist E, Sevilimedu V, Garcia P, Le T, Zhang X, Pinker-Domenig K, Hanna MG, Nelson JA, Morrow M, El-Tamer M. Patient-Reported Outcomes in Patients Undergoing Lumpectomy With and Without Defect Closure. Ann Surg Oncol 2024; 31:1615-1622. [PMID: 38063989 PMCID: PMC10923194 DOI: 10.1245/s10434-023-14584-z] [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: 08/25/2023] [Accepted: 10/29/2023] [Indexed: 02/08/2024]
Abstract
BACKGROUND The effect of lumpectomy defect repair (a level 1 oncoplastic technique) on patient-reported breast satisfaction among patients undergoing lumpectomy has not yet been investigated. METHODS Patients undergoing lumpectomy at our institution between 2018 and 2020 with or without repair of their lumpectomy defect during index operation, comprised our study population. The BREAST-Q quality-of-life questionnaire was administered preoperatively, and at 6 months, 1 year, and 2 years postoperatively. Satisfaction and quality-of-life domains were compared between those who did and did not have closure of their lumpectomy defect, and compared with surgeon-reported outcomes. RESULTS A total of 487 patients met eligibility criteria, 206 (42%) had their partial mastectomy defect repaired by glandular displacement. Median breast volume, as calculated from the mammogram, was smaller in patients undergoing defect closure (826 cm3 vs. 895 cm3, p = 0.006). There were no statistically significant differences in satisfaction with breasts (SABTR), physical well-being of the chest (PWB-CHEST), or psychosocial well-being (PsychWB) scores between the two cohorts at any time point. While patients undergoing defect closure had significantly higher sexual well-being (SexWB) scores compared with no closure (66 vs. 59, p = 0.021), there were no predictors of improvement in SexWB scores over time on multivariable analysis. Patients' self-reported scores positively correlated with physician-reported outcomes. CONCLUSIONS Despite a larger lumpectomy-to-breast volume ratio among patients undergoing defect repair, satisfaction was equivalent among those whose defects were or were not repaired at 2 years postsurgery. Defect repair was associated with clinically relevant improvement in patient-reported sexual well-being.
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Affiliation(s)
- Emily Palmquist
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Surgery, University of Washington, Seattle, WA, USA
| | - Varadan Sevilimedu
- Biostatistics Service, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Paula Garcia
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Tiana Le
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Xinyi Zhang
- Biostatistics Service, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Katja Pinker-Domenig
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Matthew G Hanna
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jonas A Nelson
- Plastic and Reconstructive Surgical Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Monica Morrow
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Mahmoud El-Tamer
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
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Haussmann J, Budach W, Corradini S, Krug D, Jazmati D, Tamaskovics B, Bölke E, Pedotoa A, Kammers K, Matuschek C. Comparison of adverse events in partial- or whole breast radiotherapy: investigation of cosmesis, toxicities and quality of life in a meta-analysis of randomized trials. Radiat Oncol 2023; 18:181. [PMID: 37919752 PMCID: PMC10623828 DOI: 10.1186/s13014-023-02365-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 10/17/2023] [Indexed: 11/04/2023] Open
Abstract
PURPOSE/OBJECTIVE Adjuvant whole breast radiotherapy and systemic therapy are part of the current evidence-based treatment protocols for early breast cancer, after breast-conserving surgery. Numerous randomized trials have investigated the therapeutic effects of partial breast irradiation (PBI) compared to whole breast irradiation (WBI), limiting the treated breast tissue. These trials were designed to achieve equal control of the disease with possible reduction in adverse events, improvements in cosmesis and quality of life (QoL). In this meta-analysis, we aimed to investigate the differences between PBI and WBI in side effects and QoL. MATERIAL/METHODS We performed a systematic literature review searching for randomized trials comparing WBI and PBI in early-stage breast cancer with publication dates after 2009. The meta-analysis was performed using the published event rates and the effect-sizes for available acute and late adverse events. Additionally, we evaluated cosmetic outcomes as well as general and breast-specific QoL using the EORTC QLQ-C30 and QLQ-BR23 questionnaires. RESULTS Sixteen studies were identified (n = 19,085 patients). PBI was associated with a lower prevalence in any grade 1 + acute toxicity and grade 2 + skin toxicity (OR = 0.12; 95% CI 0.09-0.18; p < 0.001); (OR = 0.16; 95% CI 0.07-0.41; p < 0.001). There was neither a significant difference in late adverse events between the two treatments, nor in any unfavorable cosmetic outcomes, rated by either medical professionals or patients. PBI-technique using EBRT with twice-daily fractionation schedules resulted in worse cosmesis rated by patients (n = 3215; OR = 2.08; 95% CI 1.22-3.54; p = 0.007) compared to WBI. Maximum once-daily EBRT schedules (n = 2071; OR = 0.60; 95% CI 0.45-0.79; p < 0.001) and IORT (p = 0.042) resulted in better cosmetic results grade by medical professionals. Functional- and symptom-based QoL in the C30-scale was not different between PBI and WBI. Breast-specific QoL was superior after PBI in the subdomains of "systemic therapy side effects" as well as "breast-" and "arm symptoms". CONCLUSION The analysis of multiple randomized trials demonstrate a superiority of PBI in acute toxicity as well breast-specific quality of life, when compared with WBI. Overall, late toxicities and cosmetic results were similar. PBI-technique with a fractionation of twice-daily schedules resulted in worse cosmesis rated by patients.
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Affiliation(s)
- Jan Haussmann
- Department of Radiation Oncology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.
| | - Wilfried Budach
- Department of Radiation Oncology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Stefanie Corradini
- Department of Radiation Oncology, Ludwig Maximillian University, Munich, Germany
| | - David Krug
- Department of Radiation Oncology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Danny Jazmati
- Department of Radiation Oncology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Bálint Tamaskovics
- Department of Radiation Oncology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Edwin Bölke
- Department of Radiation Oncology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Alessia Pedotoa
- Department of Anesthesiology, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
| | - Kai Kammers
- Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine, Baltimore, USA
| | - Christiane Matuschek
- Department of Radiation Oncology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
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Pawloski KR, Srour MK, Moo TA, Sevilimedu V, Nelson JA, Garcia P, Kirstein LJ, Morrow M, Tadros AB. Timing of Chemotherapy and Patient-Reported Outcomes After Breast-Conserving Surgery and Mastectomy with Immediate Reconstruction. Ann Surg Oncol 2023; 30:2897-2909. [PMID: 36737530 PMCID: PMC11110643 DOI: 10.1245/s10434-023-13148-5] [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: 10/20/2022] [Accepted: 01/09/2023] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Receipt of chemotherapy is associated with decreased satisfaction after breast surgery, but whether timing as adjuvant versus neoadjuvant (NAC) affects patient-reported outcomes (PROs) is unclear. We examined associations between chemotherapy timing and PROs after breast-conserving surgery (BCS) and mastectomy with immediate reconstruction (M-IR). METHODS In this retrospective cohort study of patients with stage I-III breast cancer undergoing chemotherapy between January 2017 and December 2019, we compared satisfaction with breasts (SABTR) and chest physical well-being (PWB-CHEST) between chemotherapy groups in BCS and M-IR cohorts. Median SABTR and PWB-CHEST scores (scale 0-100) were compared between chemotherapy groups at baseline and for 3 years postoperatively. Factors associated with SABTR and PWB-CHEST at 1 and 2 years were assessed with multivariable linear regression. RESULTS Overall, 640 patients had BCS and 602 had M-IR; 210 (33%) BCS patients and 294 (49%) M-IR patients had NAC. Following BCS, SABTR was higher than baseline at all postoperative timepoints, whereas 3-year SABTR remained similar to baseline following M-IR, independent of chemotherapy timing. In both surgical cohorts, PWB-CHEST was lowest after NAC at 6 months compared with baseline but was similar to adjuvant counterparts by 3 years. NAC was not a statistically significant predictor of SABTR or PWB-CHEST in either surgical cohort on multivariable analysis. CONCLUSIONS For patients with breast cancer who require chemotherapy, neoadjuvant versus adjuvant timing does not impact long-term PROs in this study. These findings may inform shared decision making regarding the sequence of treatment in patients with operable disease.
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Affiliation(s)
- Kate R Pawloski
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Marissa K Srour
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Tracy-Ann Moo
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Varadan Sevilimedu
- Biostatistics Service, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jonas A Nelson
- Plastic and Reconstructive Surgical Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Paula Garcia
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Laurie J Kirstein
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Monica Morrow
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Audree B Tadros
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
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Álvarez-Pardo S, De Paz JA, Montserrat Romero-Pérez E, Portilla-Cueto KM, Horta-Gim MA, González-Bernal JJ, Fernández-Solana J, Mielgo-Ayuso J, García-Valverde A, González-Santos J. Factors Associated with Body Image and Self-Esteem in Mastectomized Breast Cancer Survivors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5154. [PMID: 36982062 PMCID: PMC10048946 DOI: 10.3390/ijerph20065154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 03/04/2023] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
Body image (BI) and self-esteem (SE) are two fundamental aspects in the evolution of breast cancer (BC), mainly due to surgery, treatment, and the patient's conception of BI. A dissatisfaction with BI and low SE decreases the subject's quality of life and increases the risk of recurrence and mortality by BC. The aim of this study is to find out if there is any degree of association between the sociodemographic data of the sample and their BI and SE. A cross-sectional, descriptive study was conducted with 198 women diagnosed with BC, aged 30-80 years, in Mexico. Women's BI and SE were assessed using two questionnaires, Hopwood Body Image Scale (S-BIS) and Rosenberg Self-Esteem Scale (RSES). The results show significant differences in several items when the variable sense of humor is taken into account, indicating that women with a sense of humor report higher satisfaction with their BI and higher SE. The age also indicates a significantly better BI in women over 50 years of age, as well as the education level variable, where those women who had studied up to secondary reported higher satisfaction with their BI; the family history shows that those women without a family history report better SE. All these data are supported by stepwise regression, which shows that educational level and sense of humor are predictors of BI, and family history along with breast reconstruction and sense of humor are predictors as of SE. In conclusion, it is important to take into account the characteristics of women with BC, particularly age and sense of humor, in order to reduce the impact of the disease on their BI and SE with the help of a multidisciplinary team.
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Affiliation(s)
| | | | | | | | - Mario A. Horta-Gim
- Division of Biological Sciences and Health, University of Sonora, Hermosillo 83000, Mexico
| | | | | | - Juan Mielgo-Ayuso
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain
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Sadler SJ, Torio EF, Golby AJ. Global cancer surgery in low-resource settings: A strengths, weaknesses, opportunities, and threats analysis. Cancer 2023; 129:671-684. [PMID: 36597652 PMCID: PMC10069626 DOI: 10.1002/cncr.34630] [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: 10/21/2022] [Revised: 12/01/2022] [Accepted: 12/04/2022] [Indexed: 01/05/2023]
Abstract
Global cancer surgery is an essential and complex component of oncologic care. This study aims to describe global cancer surgery literature since the 2015 Lancet Commission on Global Surgery and Cancer Surgery and perform a strengths, weaknesses, opportunities, and threats (SWOT) analysis. A systematic search was performed in PubMed of global cancer surgery articles. Themes were extracted from the included studies based on the following criteria: (1) performed in low- or low-middle-income countries, (2) published during or after 2015, (3) published in peer-reviewed journals, (4) written in the English language, and (5) accessible to the authors. Themes were further grouped into strengths, weaknesses, opportunities, and threats (SWOT analysis). The search strategy identified 154 articles published from 1992 to 2022. Forty-six articles were included in the qualitative synthesis and SWOT analysis. Recurring themes included local epidemiologic studies, local innovations and feasibility studies, prioritizing quality of life outcomes, multidisciplinary team approaches, limited resources, health system gaps, lack of economic analyses, diverse cancer management strategies and priorities, inter-setting collaboration, research expansion, the coronavirus disease 2019 pandemic, and unchecked technological advancements. These strengths, weaknesses, opportunities, and threats were described and related to the themes of research, surgical systems strengthening, economics and financing, and political framing of the 2015 Lancet Commission on Global Cancer Surgery. SWOT analyses of global cancer surgery may be helpful in suggesting future strategies for this expanding field. PLAIN LANGUAGE SUMMARY: Cancer surgery is a resource-intensive yet essential component of cancer care. In the face of projected growth of cancer burden, the present gap in cancer surgery care in low-resource settings with stressed health care and surgical infrastructure risks further exacerbation. We present a strengths, weaknesses, opportunities, and threats analysis of recent global cancer surgery literature pertaining to low-resource settings.
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Affiliation(s)
| | - Erickson F. Torio
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Alexandra J. Golby
- Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
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Konara Mudiyanselage SP, Wu YL, Kukreti S, Chen CC, Lin CN, Tsai YT, Ku HC, Fang SY, Wang JD, Ko NY. Dynamic changes in quality of life, psychological status, and body image in women who underwent a mastectomy as compared with breast reconstruction: an 8-year follow up. Breast Cancer 2023; 30:226-240. [PMID: 36319889 DOI: 10.1007/s12282-022-01413-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 10/27/2022] [Indexed: 02/24/2023]
Abstract
BACKGROUND Surgical decisions and methods of surgery highly influence long term QoL for breast cancer (BC) survivors. This study is aimed towards an exploration of the dynamic changes in quality of life (QoL), anxiety/depression status, and body image (BI) among women with BC who received a mastectomy compared with those receiving breast reconstruction (BR) within an 8-year follow-up period. METHODS Women with major BC surgeries were invited to complete the World Health Organization Quality of Life-Brief (WHOQOL-BREF), the European quality of life five dimensions questionnaire (EQ-5D), and a body image scale within 8 years of surgery. Kernel smoothing methods were applied to describe dynamic changes in QoL, anxiety/depression, and BI at different time points. Linear mixed effects models were constructed to identify the interaction between time, different types of surgery, and the determinants of QoL in these patients. RESULTS After 1:10 propensity score matching, a total of 741 women who had undergone a BR and mastectomy were included. The BR group exhibited a high WHOQOL QoL score one to five years after surgery with some fluctuations. The mastectomy group had comparatively stable QoL scores on WHOQOL items and were less depressed/anxious. The BR group generally showed fluctuating, higher BI scores two years after surgery, but they exhibited more anxiety/depression during follow up for 8 years. Medical comorbidities, the status of anxiety/depression, and BI were the major factors influencing all domains and items of the WHOQOL BREF among women with BC. CONCLUSION The mastectomy group showed a decreased trend toward depression in patients with BC. The BR group showed a significant improvement in QoL in the first 5 years with massive fluctuations. These findings should be considered and discussed in patient participatory decision-making and promotion of QoL for breast cancer survivors.
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Affiliation(s)
- Sriyani Padmalatha Konara Mudiyanselage
- International Doctoral Program in Nursing, Department of Nursing, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC.,Operation Theatre Department, The National Hospital of Sri Lanka, Colombo, Sri Lanka
| | - Yi-Lin Wu
- International Doctoral Program in Nursing, Department of Nursing, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC.,Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC
| | - Shikha Kukreti
- Department of Public Health, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC.,Department of Public Health College of Medicine, National Cheng Kung University, No. 1, University Road, Tainan, 70101, Taiwan
| | - Chang-Chun Chen
- International Doctoral Program in Nursing, Department of Nursing, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC
| | - Chia-Ni Lin
- Department of Public Health, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC
| | - Yi-Tseng Tsai
- International Doctoral Program in Nursing, Department of Nursing, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC.,, No. 66, Sec. 2, Changhe Rd., Annan Dist., Tainan, 709, Taiwan
| | - Han-Chang Ku
- International Doctoral Program in Nursing, Department of Nursing, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC.,, No. 66, Sec. 2, Changhe Rd., Annan Dist., Tainan, 709, Taiwan
| | - Su-Ying Fang
- Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC.,Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jung-Der Wang
- Department of Public Health, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC.,Department of Public Health College of Medicine, National Cheng Kung University, No. 1, University Road, Tainan, 70101, Taiwan
| | - Nai-Ying Ko
- Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC. .,Department of Public Health, College of Medicine, National Cheng Kung University, No.1, Ta-Hsueh Road, Tainan, 701, Taiwan, ROC. .,Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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9
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McKevitt E, Saleeb M, Liu G, Warburton R, Pao JS, Dingee C, Bazzarelli A, Tang K, Crump T, Sutherland JM. Differences in Preoperative Health-Related Quality of Life between Women Receiving Mastectomy or Breast Conserving Surgery in a Prospectively Recruited Cohort of Breast Cancer Patients. Curr Oncol 2022; 30:118-129. [PMID: 36661659 PMCID: PMC9857337 DOI: 10.3390/curroncol30010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/06/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022] Open
Abstract
As rates of total mastectomy rise, the relationships between surgery modality with domains of health-related quality of life is not well understood. This study reports differences in depression, anxiety, pain, and health status among a cohort of women scheduled to receive total mastectomy or breast-conserving surgery. Patient-reported outcomes measured preoperative differences between patients receiving total mastectomy or breast-conserving surgery in a cross-sectional design. Regression analyses was used to model health outcomes and adjust for patient demographics on patient measures. Participants scheduled for total mastectomy were more likely to report more severe symptoms of depression and anxiety. This association was non-significant after adjusting for demographic differences. Younger participants were more likely to be scheduled for total mastectomy. Age was negatively associated with symptoms of depression and anxiety. Screening patients for mental health symptoms may be particularly important among younger patients who were more likely to report depression and anxiety before their surgery and were more likely to receive total mastectomy.
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Affiliation(s)
- Elaine McKevitt
- Department of Surgery, Faculty of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada
- Providence Breast Centre, Mount Saint Joseph Hospital, 3080 Prince Edward Street, Vancouver, BC V5T 3N4, Canada
| | - Maria Saleeb
- Centre for Health Services and Policy Research, University of British Columbia, 2206 East Mall, Vancouver, BC V6T 1Z3, Canada
| | - Guiping Liu
- Centre for Health Services and Policy Research, University of British Columbia, 2206 East Mall, Vancouver, BC V6T 1Z3, Canada
| | - Rebecca Warburton
- Department of Surgery, Faculty of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada
- Providence Breast Centre, Mount Saint Joseph Hospital, 3080 Prince Edward Street, Vancouver, BC V5T 3N4, Canada
| | - Jin-Si Pao
- Department of Surgery, Faculty of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada
- Providence Breast Centre, Mount Saint Joseph Hospital, 3080 Prince Edward Street, Vancouver, BC V5T 3N4, Canada
| | - Carol Dingee
- Department of Surgery, Faculty of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada
- Providence Breast Centre, Mount Saint Joseph Hospital, 3080 Prince Edward Street, Vancouver, BC V5T 3N4, Canada
| | - Amy Bazzarelli
- Department of Surgery, Faculty of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada
- Providence Breast Centre, Mount Saint Joseph Hospital, 3080 Prince Edward Street, Vancouver, BC V5T 3N4, Canada
| | - Katelynn Tang
- Department of Surgery, Faculty of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada
| | - Trafford Crump
- Department of Surgery, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada
| | - Jason M. Sutherland
- Centre for Health Services and Policy Research, University of British Columbia, 2206 East Mall, Vancouver, BC V6T 1Z3, Canada
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10
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Alvarez-Pardo S, Romero-Pérez EM, Camberos-Castañeda N, de Paz JA, Horta-Gim MA, González-Bernal JJ, Mielgo-Ayuso J, Simón-Vicente L, Fernández-Solana J, González-Santos J. Quality of Life in Breast Cancer Survivors in Relation to Age, Type of Surgery and Length of Time since First Treatment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16229. [PMID: 36498299 PMCID: PMC9741017 DOI: 10.3390/ijerph192316229] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/30/2022] [Accepted: 12/02/2022] [Indexed: 05/11/2023]
Abstract
(1) Background: Quality of life assessment is a critical aspect of breast cancer patient outcomes, as diagnosis, prognosis and treatment can have a major impact on quality of life. The aim of this study was to describe the characteristics of the sample and to verify the relationship between quality of life (QOL) in women diagnosed with breast cancer (BC) and their age, type or surgery and time since treatment; (2) Methods: a cross-sectional, descriptive study was conducted with 183 women diagnosed with BC, aged 30−80 years in Mexico. Women’s QOL was assessed using two questionnaires, The European Organization for Research and Treatment of Cancer-Quality of Life Core Questionnaire (EORTC QLQ-C30) and The Breast Cancer Module (EORTC QLQ-BR23). (3) Results: the results show significant differences in several items when the variable age is taken into account, indicating that younger women have poorer social and sexual function, as well as poorer sexual enjoyment and lower expectations of the future. The type of surgery also indicates a significantly better QOL in those women who receive conservative treatment versus a mastectomy; the time elapsed since surgery does not show any significant results, except for sexual functioning and breast-related symptoms where >5 years implies better scores on the items. (4) Conclusions: in conclusion, it is important to take into account the characteristics of women with BC, particularly at the time of treatment, in order to mitigate the impact of the disease on their QOL with the help of a multidisciplinary team.
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Affiliation(s)
| | | | | | | | | | | | - Juan Mielgo-Ayuso
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain
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11
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Cherian K, Acharya NR, Bhargavan RV, Augustine P, Krishnan JK. Quality of Life Post Breast Cancer Surgery: Comparison of Breast Conservation Surgery versus Modified Radical Mastectomy in a Developing Country. South Asian J Cancer 2022; 11:183-189. [PMID: 36588615 PMCID: PMC9803550 DOI: 10.1055/s-0042-1743420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Introduction Breast cancer survivors are the largest group of female cancer survivors. Oncologic breast surgery can have a profound impact on a woman's body image and sense of self that can significantly affect their quality of life (QOL). The paucity of data about the effect of type of surgery on QOL of Indian breast cancer survivors has led to this study. Materials and Methods This prospective study included consecutive female early breast cancer patients who underwent primary surgery, that is, breast conservation surgery (BCS) or modified radical mastectomy (MRM) from January 1, 2015 to December 31, 2015. The primary objective was the comparison of QOL using European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and EORTC QLQ-BR 23 between the two groups at 6 months and 1 year postsurgery with the baseline. Results One hundred and thirty-eight patients were included of which 62 underwent BCS and 76 underwent MRM. BCS patients fared better with respect to physical functioning, dyspnea, fatigue, appetite loss, and body image at 6 months ( p < 0.05) as compared with MRM. At 1 year postsurgery, BCS patients fared better with respect to physical functioning, role functioning, global health status, body image, sexual enjoyment, and dyspnea, while MRM patients fared better in emotional functioning and future prospectives ( p < 0.05). Conclusion Patients undergoing BCS have a better QOL with respect to various functional and symptom scales at 6 months and 1 year. However, patients undergoing MRM perform better in terms of future perspective and emotional functioning at 1 year.
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Affiliation(s)
- Kurian Cherian
- Department of Surgical Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
| | - Nitish Rajan Acharya
- Department of Surgical Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
| | - Rexeena V. Bhargavan
- Department of Surgical Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India,Address for correspondence Rexeena V. Bhargavan, MCh Department of Surgical Oncology, Regional Cancer CentreThiruvananthapuram, Kerala, 695011India
| | - Paul Augustine
- Department of Surgical Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
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12
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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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13
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Carmona-Bayonas A, Calderón C, Hernández R, Fernández Montes A, Castelo B, Ciria-Suarez L, Antoñanzas M, Rogado J, Pacheco-Barcia V, Asensio Martínez E, Ivars A, Ayala de la Peña F, Jimenez-Fonseca P. Prediction of quality of life in early breast cancer upon completion of adjuvant chemotherapy. NPJ Breast Cancer 2021; 7:92. [PMID: 34257315 PMCID: PMC8277774 DOI: 10.1038/s41523-021-00296-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 06/09/2021] [Indexed: 01/05/2023] Open
Abstract
Quality of life (QoL) is a complex, ordinal endpoint with multiple conditioning factors. A predictive model of QoL after adjuvant chemotherapy can support decision making or the communication of information about the range of treatment options available. Patients with localized breast cancer (n = 219) were prospectively recruited at 17 centers. Participants completed the EORTC QLQ-C30 questionnaire. The primary aim was to predict health status upon completion of adjuvant chemotherapy adjusted for multiple covariates. We developed a Bayesian model with six covariates (chemotherapy regimen, TNM stage, axillary lymph node dissection, perceived risk of recurrence, age, type of surgery, and baseline EORTC scores). This model allows both prediction and causal inference. The patients with mastectomy reported a discrete decline on all QoL scores. The effect of surgery depended on the interaction with age. Women with ages on either end of the range displayed worse scores, especially with mastectomy. The perceived risk of recurrence had a striking effect on health status. In conclusion, we have developed a predictive model of health status in patients with early breast cancer based on the individual's profile.
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Affiliation(s)
- Alberto Carmona-Bayonas
- Department of Hematology and Medical Oncology, Hospital Universitario Morales Meseguer, University of Murcia, IMIB, Murcia, Spain.
| | - Caterina Calderón
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, University of Pais Vasco, Pais Vasco, Spain
| | - Raquel Hernández
- Department of Medical Oncology, Hospital Universitario de Canarias, Tenerife, Spain
| | - Ana Fernández Montes
- Department of Medical Oncology, Complejo Hospitalario Universitario de Orense, Orense, Spain
| | - Beatriz Castelo
- Department of Medical Oncology, Hospital Universitario La Paz, Madrid, Spain
| | - Laura Ciria-Suarez
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, Spain
| | - Mónica Antoñanzas
- Department of Medical Oncology, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - Jacobo Rogado
- Department of Medical Oncology, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - Vilma Pacheco-Barcia
- Department of Medical Oncology, Hospital Central de la Defensa Gomez Ulla, Madrid, Spain
| | | | - Alejandra Ivars
- Department of Hematology and Medical Oncology, Hospital Universitario Morales Meseguer, University of Murcia, IMIB, Murcia, Spain
| | - Francisco Ayala de la Peña
- Department of Hematology and Medical Oncology, Hospital Universitario Morales Meseguer, University of Murcia, IMIB, Murcia, Spain
| | - Paula Jimenez-Fonseca
- Department of Medical Oncology, Hospital Universitario Central of Asturias, ISPA Oviedo University of Pais Vasco, Pais Vasco, Spain
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14
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Soran A, Soyder A, Ozbas S, Ozmen V, Karanlik H, Igci A, Muslumanoglu M, Evrensel T, Canturk Z, Utkan Z, Ozaslan C, Uras C, Ugurlu U, Col C, Cabioglu N, Uzunkoy A, Gulluoglu BM, Erdem E, Konca C, Sezgin E. The role of loco-regional treatment in long-term quality of life in de novo stage IV breast cancer patients: protocol MF07-01Q. Support Care Cancer 2021; 29:3823-3830. [PMID: 33242163 DOI: 10.1007/s00520-020-05905-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 11/18/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND/OBJECTIVE Since more solid evidence has emerged supporting the effectiveness of loco-regional treatment (LRT), clinicians consider LRT a treatment option for selected de novo stage IV breast cancer (BC) patients. This is the first report on long-term quality of life (QoL) in a cohort of patients who were randomized to receive either LRT and then systemic treatment (ST) or ST alone in the protocol MF07-01. We aimed to evaluate QoL in patients living at least 3 years since randomization using scores from the SF-12 health survey. METHODS SF-12 (V2) forms were completed during visits of patients who were living 36 months after the randomization. We first calculated PCS-12 (Physical Health Composite Scale) and MCS-12 (Mental Health Composite Scale) scores from de novo stage IV BC patients and compared them with the scores of patients diagnosed with stage I-III BC who lived more than 3 years. Further, PCS-12 and MCS-12 scores were compared between the LRT and ST groups with de novo stage IV BC. Additionally, general health, physical functioning, role functioning, bodily pain, vitality, mental health, and social functioning were evaluated and compared between the groups. Considering age-related changes in QoL, we also compared PCS-12 and MCS-12 scores of patients below or above 55 and 65 years of age. Responses to four additional questions (compare your physical health, mental health, daily activities, and energy currently vs. at diagnosis of BC) were recorded, considering cultural differences. RESULTS There were 81 patients in this analysis; 68% of patients (n = 55) had LRT, and 32% (n = 26) received ST. General health was good or very good in 62% (n = 34) in the LRT group and 66% (n = 17) in the ST-only group (p = 0.63). Mean PCS-12 score was 40.8 + 1.6, and mean MCS-12 score was 43.4 + 2.0 (p = 0.34 and p = 0.54, respectively). PCS-12 and MCS-12 score difference was lower than that of the general Turkish population (PCS-12 = 49.3 + 12.8 and MCS-12 = 46.8 + 13.0) and stage I-III BC patients (PCS-12 = 51.1 ± 0.5, MCS-12 = 45.7 ± 0.6). PCS-12 and MCS-12 scores were similar between the LRT and ST-only groups in patients younger and older than 55 and 65, but QoL scores were much better in stage I-III BC patients younger than 65 when compared to the scores of those with de novo stage IV BC. Although treatment with or without LRT did not affect physical health, mental health, daily activities, and energy at 3 years vs. at diagnosis of BC in de novo stage IV BC patients (p > 0.05), these variables were significantly better in stage I-III BC patients (p < 0.001). CONCLUSION The current MF07-01Q study demonstrates that patient who had LRT has similar physical and mental health outcomes compared to ST only in a cohort of patients who lived longer than 3 years. Trial registration This study is registered on clinicaltrials.gov with identifier number NCT00557986.
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Affiliation(s)
- Atilla Soran
- Surgical Oncology, University of Pittsburgh, 300 Halket St Suite 2601, Pittsburgh, PA, 15213, USA.
- Department of Surgery, University of Pittsburgh Medical Center, Magee-Womens Hospital, Pittsburgh, PA, USA.
| | - Aykut Soyder
- Department of Surgery, Acibadem Altunizade Hospital, İstanbul, Turkey
| | - Serdar Ozbas
- Breast and Endocrine Surgeon, Private Practice, Ankara, Turkey
| | - Vahit Ozmen
- Department of Surgery, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Hasan Karanlik
- Surgical Oncology Unit, Istanbul University Institute of Oncology, Capa, Istanbul, Turkey
| | - Abdullah Igci
- Department of Surgery, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Mahmut Muslumanoglu
- Department of Surgery, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Turkkan Evrensel
- Department of Medical Oncology, Uludag University School of Medicine, Bursa, Turkey
| | - Zafer Canturk
- Department of Surgery, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Zafer Utkan
- Department of Surgery, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Cihangir Ozaslan
- Department of Surgery, Ankara Oncology Teaching and Research Hospital, Ankara, Turkey
| | - Cihan Uras
- Department of Surgery, Acibadem University School of Medicine, Istanbul, Turkey
| | - Umit Ugurlu
- Department of Surgery, Marmara University School of Medicine, Istanbul, Turkey
| | - Cavit Col
- Department of Surgery, Etimed Hospital, Etimesgut, Ankara, Turkey
| | - Neslihan Cabioglu
- Department of Surgery, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Ali Uzunkoy
- Department of Surgery, Harran University School of Medicine, Sanlıurfa, Turkey
| | - Bahadır M Gulluoglu
- Department of Surgery, Marmara University School of Medicine, Istanbul, Turkey
| | - Ergun Erdem
- Department of Surgery, Pamukkale University School of Medicine, Denizli, Turkey
| | - Can Konca
- Department of Surgery, Ankara University School of Medicine, Ankara, Turkey
| | - Efe Sezgin
- Department of Food Engineering, Laboratory of Nutrigenomics and Epidemiology, Izmir Institute of Technology, Izmir, Turkey
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15
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The Impact of Socioeconomic Determinants on the Quality of Life of Moroccan Breast Cancer Survivors Diagnosed Two Years Earlier at the National Institute of Oncology in Rabat. Obstet Gynecol Int 2021; 2021:9920007. [PMID: 34257668 PMCID: PMC8249154 DOI: 10.1155/2021/9920007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 06/11/2021] [Indexed: 01/30/2023] Open
Abstract
Introduction The objective of this study was to investigate the impact of socioeconomic determinants on the quality of life of Moroccan women with breast cancer two years after their diagnosis who are followed up at the National Institute of Oncology (INO) in Rabat. Methods This is a cross-sectional study that was conducted between May 2019 and September 2020. The sample size was 304 women. Data were collected using the EORTC QLQ-C30 and EORTC QLQ-BR 23 questionnaires in the Moroccan dialect. Results The mean age of participants was 53.5 ± 12.4 years, where the majority resided in urban areas and more than half were illiterate. Moreover, three-quarters of the survivors were not working, and almost all have basic medical coverage. Nearly one-third of the respondents had experienced discrimination from those around them, and nearly half attributed the decrease in income to their state of health. In addition, 38.2 percent of participants stated that they had great difficulty living on their monthly income after the illness, whereas more than half of the survivors had a good quality of life in terms of overall health (GHS/QOL). Besides, social function obtained the highest score, while emotional function obtained the lowest score. Furthermore, financial difficulty was the most distressing symptom. Indeed, income adjustment after the disease, discrimination, distance between home and treatment center, professional status, and medical coverage were correlated with GHS/QOL. Regression analysis revealed that income adjustment after illness and discrimination were significant predictors of GHS/QOL. Conclusion The data suggest establishing a financial support program and the development of education and awareness-raising policies to combat discrimination.
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16
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Evaluation of Late Postural Complications in Breast Cancer Patients Undergoing Breast-Conserving Therapy in Relation to the Type of Axillary Intervention-Cross-Sectional Study. J Clin Med 2021; 10:jcm10071432. [PMID: 33916060 PMCID: PMC8036801 DOI: 10.3390/jcm10071432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/12/2021] [Accepted: 03/22/2021] [Indexed: 11/17/2022] Open
Abstract
Purpose: The aim of the study was to evaluate posture in patients undergoing breast-conserving therapy (BCT) in relation to the type of surgical intervention to the axilla. Methods: The study was conducted on patients who had undergone breast-conserving surgical treatment for breast cancer 5–6 years earlier. In 54 patients, BCT+ALND (axillary lymph node dissection) was performed, while 63 patients were subjected to BCT+SLND (sentinel lymph node dissection). The control group consisted of 54 females. The study was conducted using digital postural assessment. Results: No statistically significant differences were observed with respect to the parameters between the BCT+SLNB and BCT+ALND groups (p > 0.05). However, the differences were highly significant between the CG (control group) and the studied groups (BCT+ALND, BCT+SLNB) for the following parameters: BETA angle of thoracolumbar spine inclination (p = 0.002), GAMMA angle of thoracic spine inclination (p = 0.0044), TKA (thoracic kyphosis angle) (p < 0.0001) and shoulder level inclination (p = 0.0004). The BCT+ALND patients were characterized by higher dependency of raised shoulder (p = 0.0028) and inferior angle of the scapula (p = 0.00018) on the operated side compared to BCT+SLNB patients. Conclusions: Postural imbalance occurs independent of the type of axillary intervention. Disturbances within the upper torso (abnormal position of shoulders and inferior angles of scapulae) are more pronounced in patients after ALND.
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17
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Martins Faria B, Martins Rodrigues I, Verri Marquez L, Da Silva Pires U, Vilges de Oliveira S. The impact of mastectomy on body image and sexuality in women with breast cancer: a systematic review. PSICOONCOLOGIA 2021. [DOI: 10.5209/psic.74534] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Objective: The study aims to evaluate the impact of mastectomy on body image and sexuality of women with breast cancer, as well as to provide a general understanding of their quality of life. Method: This review followed the PRISMA guidelines. The expression “Mastectomy AND (sexuality OR “body image”)” was searched in Lilacs, Scielo, Pubmed and Scopus databases. Articles published in English, Portuguese and Spanish between 2010 and 2020 were selected. The text analysis was carried out by peers. Results: 69.3% (43) of the studies presented mastectomy as a technique that worsens body image, sexual functioning and quality of life of women. Less radical procedures, such as breast-conserving surgery, showed lower impact on these indicators. Breast reconstruction is an alternative to mitigate breast surgery impacts. Conclusion: Mastectomy caused the major impacts on body image, sexual functioning and quality of life. These implications need to be considered during therapeutic choice.
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18
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Bonci EA, Țîțu Ș, Petrușan AM, Hossu C, Gâta VA, Ghomi MT, Kubelac PM, Bonci TI, Piciu A, Cosnarovici M, Hîțu L, Kirsch-Mangu AT, Pop DC, Lisencu IC, Achimaș-Cadariu P, Piciu D, Schmidt H, Fetica B. Does Surgical Margin Width Remain a Challenge for Triple-Negative Breast Cancer? A Retrospective Analysis. ACTA ACUST UNITED AC 2021; 57:medicina57030203. [PMID: 33652670 PMCID: PMC7996718 DOI: 10.3390/medicina57030203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 02/18/2021] [Accepted: 02/23/2021] [Indexed: 11/16/2022]
Abstract
Background and Objectives: Local and distant relapse (LR, DR) in breast cancer vary according to its molecular subtypes, with triple-negative breast cancer (TNBC) being the most aggressive. The surgical resection margin width (SRMW) for breast-conserving surgery (BCS) has been intensely debated, especially for the aforementioned subtype. The aim of this study was to examine the impact of SRMW on LR following BCS in TNBC patients. Materials and Methods: We conducted a retrospective study including all patients with TNBC for whom BCS was performed between 2005 and 2014. Results: Final analysis included a total of 92 patients, with a median tumor size of 2.5 cm (range 0-5 cm) and no distant metastasis at the time of diagnosis. A total of 87 patients had received neoadjuvant and/or adjuvant chemotherapy, and all patients had received adjuvant whole-breast radiotherapy. After a median follow-up of 110.7 months (95% CI, 95.23-126.166), there were 5 local recurrences and 8 regional/distant recurrences with an overall LR rate of 5.4%. The risk of LR and DR was similar between groups of patients with several SRMW cut-off values. Conclusions: Our study supports a safe "no ink on tumor" approach for TNBC patients treated with BCS.
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Affiliation(s)
- Eduard-Alexandru Bonci
- 11th Department of Oncological Surgery and Gynecological Oncology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (E.-A.B.); (Ș.Ț.); (V.A.G.); (M.T.G.); (T.I.B.); (A.P.); (M.C.); (L.H.); (A.T.K.-M.); (D.C.P.); (P.A.-C.); (D.P.); (B.F.)
- Department of Surgical Oncology, “Prof. Dr. Ion Chiricuță” Institute of Oncology, 400015 Cluj-Napoca, Romania; (A.M.P.); (C.H.)
| | - Ștefan Țîțu
- 11th Department of Oncological Surgery and Gynecological Oncology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (E.-A.B.); (Ș.Ț.); (V.A.G.); (M.T.G.); (T.I.B.); (A.P.); (M.C.); (L.H.); (A.T.K.-M.); (D.C.P.); (P.A.-C.); (D.P.); (B.F.)
- Department of Surgical Oncology, “Prof. Dr. Ion Chiricuță” Institute of Oncology, 400015 Cluj-Napoca, Romania; (A.M.P.); (C.H.)
| | - Alexandru Marius Petrușan
- Department of Surgical Oncology, “Prof. Dr. Ion Chiricuță” Institute of Oncology, 400015 Cluj-Napoca, Romania; (A.M.P.); (C.H.)
| | - Claudiu Hossu
- Department of Surgical Oncology, “Prof. Dr. Ion Chiricuță” Institute of Oncology, 400015 Cluj-Napoca, Romania; (A.M.P.); (C.H.)
| | - Vlad Alexandru Gâta
- 11th Department of Oncological Surgery and Gynecological Oncology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (E.-A.B.); (Ș.Ț.); (V.A.G.); (M.T.G.); (T.I.B.); (A.P.); (M.C.); (L.H.); (A.T.K.-M.); (D.C.P.); (P.A.-C.); (D.P.); (B.F.)
- Department of Surgical Oncology, “Prof. Dr. Ion Chiricuță” Institute of Oncology, 400015 Cluj-Napoca, Romania; (A.M.P.); (C.H.)
| | - Morvarid Talaeian Ghomi
- 11th Department of Oncological Surgery and Gynecological Oncology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (E.-A.B.); (Ș.Ț.); (V.A.G.); (M.T.G.); (T.I.B.); (A.P.); (M.C.); (L.H.); (A.T.K.-M.); (D.C.P.); (P.A.-C.); (D.P.); (B.F.)
| | - Paul Milan Kubelac
- 11th Department of Oncological Surgery and Gynecological Oncology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (E.-A.B.); (Ș.Ț.); (V.A.G.); (M.T.G.); (T.I.B.); (A.P.); (M.C.); (L.H.); (A.T.K.-M.); (D.C.P.); (P.A.-C.); (D.P.); (B.F.)
- Department of Medical Oncology, “Prof. Dr. Ion Chiricuță” Institute of Oncology, 400015 Cluj-Napoca, Romania
- Correspondence: (P.M.K.); (I.C.L.)
| | - Teodora Irina Bonci
- 11th Department of Oncological Surgery and Gynecological Oncology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (E.-A.B.); (Ș.Ț.); (V.A.G.); (M.T.G.); (T.I.B.); (A.P.); (M.C.); (L.H.); (A.T.K.-M.); (D.C.P.); (P.A.-C.); (D.P.); (B.F.)
| | - Andra Piciu
- 11th Department of Oncological Surgery and Gynecological Oncology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (E.-A.B.); (Ș.Ț.); (V.A.G.); (M.T.G.); (T.I.B.); (A.P.); (M.C.); (L.H.); (A.T.K.-M.); (D.C.P.); (P.A.-C.); (D.P.); (B.F.)
- Department of Medical Oncology, “Prof. Dr. Ion Chiricuță” Institute of Oncology, 400015 Cluj-Napoca, Romania
| | - Maria Cosnarovici
- 11th Department of Oncological Surgery and Gynecological Oncology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (E.-A.B.); (Ș.Ț.); (V.A.G.); (M.T.G.); (T.I.B.); (A.P.); (M.C.); (L.H.); (A.T.K.-M.); (D.C.P.); (P.A.-C.); (D.P.); (B.F.)
- Department of Medical Oncology, “Prof. Dr. Ion Chiricuță” Institute of Oncology, 400015 Cluj-Napoca, Romania
| | - Liviu Hîțu
- 11th Department of Oncological Surgery and Gynecological Oncology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (E.-A.B.); (Ș.Ț.); (V.A.G.); (M.T.G.); (T.I.B.); (A.P.); (M.C.); (L.H.); (A.T.K.-M.); (D.C.P.); (P.A.-C.); (D.P.); (B.F.)
| | - Alexandra Timea Kirsch-Mangu
- 11th Department of Oncological Surgery and Gynecological Oncology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (E.-A.B.); (Ș.Ț.); (V.A.G.); (M.T.G.); (T.I.B.); (A.P.); (M.C.); (L.H.); (A.T.K.-M.); (D.C.P.); (P.A.-C.); (D.P.); (B.F.)
- Department of Radiotherapy, “Prof. Dr. Ion Chiricuță” Institute of Oncology, 400015 Cluj-Napoca, Romania
| | - Diana Cristina Pop
- 11th Department of Oncological Surgery and Gynecological Oncology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (E.-A.B.); (Ș.Ț.); (V.A.G.); (M.T.G.); (T.I.B.); (A.P.); (M.C.); (L.H.); (A.T.K.-M.); (D.C.P.); (P.A.-C.); (D.P.); (B.F.)
- Department of Radiotherapy, “Prof. Dr. Ion Chiricuță” Institute of Oncology, 400015 Cluj-Napoca, Romania
| | - Ioan Cosmin Lisencu
- 11th Department of Oncological Surgery and Gynecological Oncology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (E.-A.B.); (Ș.Ț.); (V.A.G.); (M.T.G.); (T.I.B.); (A.P.); (M.C.); (L.H.); (A.T.K.-M.); (D.C.P.); (P.A.-C.); (D.P.); (B.F.)
- Department of Surgical Oncology, “Prof. Dr. Ion Chiricuță” Institute of Oncology, 400015 Cluj-Napoca, Romania; (A.M.P.); (C.H.)
- Correspondence: (P.M.K.); (I.C.L.)
| | - Patriciu Achimaș-Cadariu
- 11th Department of Oncological Surgery and Gynecological Oncology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (E.-A.B.); (Ș.Ț.); (V.A.G.); (M.T.G.); (T.I.B.); (A.P.); (M.C.); (L.H.); (A.T.K.-M.); (D.C.P.); (P.A.-C.); (D.P.); (B.F.)
- Department of Surgical Oncology, “Prof. Dr. Ion Chiricuță” Institute of Oncology, 400015 Cluj-Napoca, Romania; (A.M.P.); (C.H.)
| | - Doina Piciu
- 11th Department of Oncological Surgery and Gynecological Oncology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (E.-A.B.); (Ș.Ț.); (V.A.G.); (M.T.G.); (T.I.B.); (A.P.); (M.C.); (L.H.); (A.T.K.-M.); (D.C.P.); (P.A.-C.); (D.P.); (B.F.)
- Department of Nuclear Medicine, “Prof. Dr. Ion Chiricuță” Institute of Oncology, 400015 Cluj-Napoca, Romania
| | - Hank Schmidt
- Division of Breast Surgery, Tisch Cancer Institute, Mount Sinai Health System, New York, NY 10029, USA;
- Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Bogdan Fetica
- 11th Department of Oncological Surgery and Gynecological Oncology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (E.-A.B.); (Ș.Ț.); (V.A.G.); (M.T.G.); (T.I.B.); (A.P.); (M.C.); (L.H.); (A.T.K.-M.); (D.C.P.); (P.A.-C.); (D.P.); (B.F.)
- Department of Anatomical Pathology, “Prof. Dr. Ion Chiricuță” Institute of Oncology, 400015 Cluj-Napoca, Romania
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Zhou Y, Liu Y, Wang Y, Wu Y. Comparison of Oncoplastic Breast-Conserving Therapy and Standard Breast-Conserving Therapy in Early-Stage Breast Cancer Patients. Med Sci Monit 2021; 27:e927015. [PMID: 33384404 PMCID: PMC7784144 DOI: 10.12659/msm.927015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background The aim of this study was to compare the efficacy and safety of oncoplastic breast-conserving therapy (OBCT) and SBCT (standard breast-conserving therapy) in breast cancer surgery. Material/Methods We enrolled 192 breast cancer patients who underwent breast-conserving surgery during January 2015 to April 2018. The surgery strategies of OBCT and SBCT were performed according to the patients’ condition. For measurement of surgical cosmetic effects, the Harris scale, the modified objective scores, and the subjective evaluation were all used. The basic clinical characteristics, intraoperative indices, postoperative complications, metastasis, and recurrence during the 2-year follow-up were recorded. Results The mean surgical time was remarkably longer and the resected volume was markedly larger in the OBCT group than in the SBCT group. The excellent and good ratios of Harris scale, the modified objective scores, and the ratio of very satisfied and satisfied patients by subjective scale were all significantly higher in the OBCT group than in the SBCT group. The occurrence rates of seroma and poor incision healing were remarkably lower in the OBCT group. No significant difference was found for metastasis and recurrence. Conclusions OBCT had better cosmetic effects, fewer complications, and no adverse effects on metastasis and recurrence.
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Affiliation(s)
- Yuan Zhou
- Department of General Surgery, The Affiliated Hospital of Jiaxing University and The First Hospital of Jiaxing, Jiaxing, Zhejiang, China (mainland)
| | - Yixiao Liu
- Department of Stomatology, The Affiliated Hospital of Jiaxing University and The First Hospital of Jiaxing, Jiaxing, Zhejiang, China (mainland)
| | - Yu Wang
- Department of Burn and Plastic Surgery, The Affiliated Hospital of Jiaxing University and The First Hospital of Jiaxing, Jiaxing, Zhejiang, China (mainland)
| | - Yanfei Wu
- College of Foreign Studies, Jiaxing University Jiaxing, Jiaxing, Zhejiang, China (mainland)
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20
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Jankowska-Polańska B, Świątoniowska-Lonc N, Ośmiałowska E, Gałka A, Chabowski M. The Association Between Illness Acceptance and Quality of Life in Women with Breast Cancer. Cancer Manag Res 2020; 12:8451-8464. [PMID: 32982439 PMCID: PMC7500846 DOI: 10.2147/cmar.s261624] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 07/30/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction Breast cancer is the most common cause of cancer death in women. Aim The aim of the study was to investigate the association between illness acceptance and quality of life (QoL) in patients with breast cancer. Patients and Methods The study included 150 patients who had undergone surgery for breast cancer. The following standardized questionnaires were used: the Acceptance of Illness Scale (AIS), the EORT QLQ-C30 (The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30), and the EORT QL-BR 23 (Quality of Life Questionnaire for Breast Cancer) for QoL evaluation. Socio-clinical data were obtained from the patients' medical records. Results In the study group, the overall QoL score was 62.67±17.11 in the BCT group, 63±14.3 in the MTX group, and the highest: 65.5±20.2 in the reconstruction group. Comparative analysis showed that patients in the BCT group reported significantly more fatigue (p=0.007) and appetite loss (p=0.032) than those in the MTX+R group. Patients in the MTX group were significantly less satisfied with their body image (p=0.001) and experienced more financial troubles (p=0.013) than the remaining patients. Patients in the MTX+R group reported significantly better sexual function and more sexual enjoyment than the remaining patients (p<0.001). All patients scored high for illness acceptance, though patients in the MTX group had lower scores (28.17±7.2) than the others: 31.84±6.51 in the BCT group and 32.78±7.97 in the MTX+R group. The comparative analysis of QoL according to the level of AIS showed the significantly better QoL and less intense symptoms within all the domains except for the insomnia and hair loss domains in the group of high AIS in comparison with medium and lack of AIS. Acceptance of illness significantly correlated with 4 domains of the QLQ-C30 (p<0.05). The correlation between illness acceptance and overall QoL was positive (r=0.243; p=0.003) - the higher the acceptance, the better the QoL. Correlations with pain, diarrhoea, and financial difficulties were negative. Illness acceptance was positively correlated with QoL in 3 domains of the EORTC-BR23: body image (p<0.001), sexual function (p=0.015), and sexual enjoyment (p=0.047), and negatively with the "treatment side effects" (p=0.011). Conclusion The level of illness acceptance varies depending on the treatment method, and is the lowest in the group of women having undergone a mastectomy, and the highest in patients after a mastectomy with immediate breast reconstruction. Acceptance of illness improves the QoL of women treated for breast cancer, regardless of the specific treatment method.
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Affiliation(s)
- Beata Jankowska-Polańska
- Division of Nervous System Diseases, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw 51-618, Poland
| | - Natalia Świątoniowska-Lonc
- Division of Nervous System Diseases, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw 51-618, Poland
| | - Edyta Ośmiałowska
- Division of Nervous System Diseases, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw 51-618, Poland
| | - Aneta Gałka
- Division of Nervous System Diseases, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw 51-618, Poland
| | - Mariusz Chabowski
- Division of Oncology and Palliative Care, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw 51-618, Poland.,Department of Surgery, 4th Military Teaching Hospital, Wroclaw 50-981, Poland
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Bajonero-Canonico P, Ferrigno AS, Saldaña-Rodriguez JA, Hinojosa-Gonzalez DE, de la O-Maldonado CG, de la Cruz-de la Cruz C, Moreno-Jaime B, Hernandez-Pavon M, Moral-de la Rubia J, Miaja-Avila M, Villarreal-Garza C. Factors associated with the desire to undergo post-mastectomy breast reconstruction in a Mexican breast cancer center. Support Care Cancer 2020; 29:2679-2688. [PMID: 32975644 DOI: 10.1007/s00520-020-05784-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 09/14/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE To assess the proportion of breast cancer patients treated with total mastectomy who are interested in undergoing breast reconstruction, the factors associated with their desire to undergo this procedure, and the motives stated for their decision. METHODS Women with stage I-III breast cancer, public health insurance, and history of total mastectomy treated at a center in Monterrey, Mexico, were invited to answer a series of questionnaires regarding their clinical and demographic characteristics, information received about breast reconstruction, body image, and relationship satisfaction. RESULTS A total of 100 patients were interviewed, of which 68% desired to undergo breast reconstruction. Only 35% recalled talking about this procedure with a physician and 85% claimed not to have enough information to make an informed decision. Those who desired breast reconstruction were younger (p < 0.001), more likely to be in a relationship (p = 0.025), and had a higher probability of having talked to a physician about the procedure (p = 0.019). Furthermore, they felt less sexually attractive (p < 0.001), more deformed (p = 0.006), and less feminine (p = 0.005) since the mastectomy. The main motives to undergo this procedure were to have breast symmetry and greater freedom on which clothes to wear, while the main deterrent was the high economical cost. CONCLUSIONS Insufficient information about the procedure and high economical cost were identified as potential barriers to undergo breast reconstruction. The findings of this study emphasize the pressing need to optimize patient care by providing information in a standardized manner and improving access to breast reconstruction within the Mexican public healthcare system.
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Affiliation(s)
- Paulina Bajonero-Canonico
- Breast Cancer Center, Hospital Zambrano Hellion TecSalud, Tecnologico de Monterrey, Av. Batallon de San Patricio 112, 66278, San Pedro Garza Garcia, Nuevo Leon, Mexico
| | - Ana S Ferrigno
- Breast Cancer Center, Hospital Zambrano Hellion TecSalud, Tecnologico de Monterrey, Av. Batallon de San Patricio 112, 66278, San Pedro Garza Garcia, Nuevo Leon, Mexico
| | | | | | | | | | - Brizio Moreno-Jaime
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo Leon, Mexico
| | - Mariela Hernandez-Pavon
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo Leon, Mexico
| | - Jose Moral-de la Rubia
- Psychology Department, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo Leon, Mexico
| | - Melina Miaja-Avila
- Breast Cancer Center, Hospital Zambrano Hellion TecSalud, Tecnologico de Monterrey, Av. Batallon de San Patricio 112, 66278, San Pedro Garza Garcia, Nuevo Leon, Mexico. .,Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo Leon, Mexico.
| | - Cynthia Villarreal-Garza
- Breast Cancer Center, Hospital Zambrano Hellion TecSalud, Tecnologico de Monterrey, Av. Batallon de San Patricio 112, 66278, San Pedro Garza Garcia, Nuevo Leon, Mexico.
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Van Hulle H, Vakaet V, Bultijnck R, Deseyne P, Schoepen M, Van Greveling A, Post G, De Neve W, Monten C, Lievens Y, Veldeman L. Health-related quality of life after accelerated breast irradiation in five fractions: A comparison with fifteen fractions. Radiother Oncol 2020; 151:47-55. [PMID: 32663539 DOI: 10.1016/j.radonc.2020.07.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/06/2020] [Accepted: 07/06/2020] [Indexed: 12/21/2022]
Abstract
INTRODUCTION In breast cancer patients, duration of illness and treatment have a negative impact on the quality of life. The duration of radiotherapy can be shortened by reducing the number of treatment fractions. In this study, the impact of an accelerated breast irradiation schedule in 5 fractions over 10 to 12 days on health-related quality of life (HRQoL) was investigated and compared to a standard hypofractionation schedule of 15 fractions. METHODOLOGY The study population was composed of 530 patients treated in 15 fractions and 196 patients treated in 5 fractions. Patients were included in different trials evaluating HRQoL. Radiotherapy-related items of the EORTC QLQ-C30 and BR23 and Breast-Q questionnaires were evaluated by comparing baseline scores to scores at 2-4 weeks and 1 year after radiotherapy. Clinically important improvements and deteriorations of HRQoL were compared between the 2 radiation schedules. RESULTS Patients treated in 5 fractions show less deterioration of physical well-being 2-4 weeks after radiotherapy. One year after radiotherapy, the 5 fractions schedule results in more patients reporting a clinically important improvement in pain, arm and breast symptoms and future perspective. CONCLUSION Radiotherapy in 5 fractions over 10-12 days results in more improvement and less deterioration of HRQoL than a 15 fractions schedule over 3 weeks.
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Affiliation(s)
- Hans Van Hulle
- Department of Human Structure and Repair, Ghent University, Belgium.
| | - Vincent Vakaet
- Department of Human Structure and Repair, Ghent University, Belgium; Department of Radiation Oncology, Ghent University Hospital, Belgium.
| | - Renée Bultijnck
- Department of Human Structure and Repair, Ghent University, Belgium.
| | - Pieter Deseyne
- Department of Human Structure and Repair, Ghent University, Belgium; Department of Radiation Oncology, Ghent University Hospital, Belgium.
| | - Max Schoepen
- Department of Human Structure and Repair, Ghent University, Belgium; Department of Industrial Systems Engineering and Product Design, Kortrijk, Belgium.
| | | | - Giselle Post
- Department of Human Structure and Repair, Ghent University, Belgium.
| | - Wilfried De Neve
- Department of Human Structure and Repair, Ghent University, Belgium; Department of Radiation Oncology, Ghent University Hospital, Belgium.
| | - Chris Monten
- Department of Human Structure and Repair, Ghent University, Belgium; Department of Radiation Oncology, Ghent University Hospital, Belgium.
| | - Yolande Lievens
- Department of Human Structure and Repair, Ghent University, Belgium; Department of Radiation Oncology, Ghent University Hospital, Belgium.
| | - Liv Veldeman
- Department of Human Structure and Repair, Ghent University, Belgium; Department of Radiation Oncology, Ghent University Hospital, Belgium.
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Qin L, Fu Y, Li C, Chen S, Lv Y, Hao M, Zhang H, Wang Y. Analysis of risk factors for high postoperative D-dimer levels: A single-center nurse-observational study. Int J Biol Markers 2020; 35:23-28. [PMID: 32567475 DOI: 10.1177/1724600820931861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND As an elevated D-dimer level is directly proportional to the degrees of trauma and coagulation, it is often used to assess the severity of the trauma as well as the risk of thrombosis. This study aimed to investigate the risk factors for a high postoperative D-dimer level. METHODS A total of 623 patients undergoing radical mastectomy were included. The association between various clinicopathological factors and D-dimer variation was examined. RESULTS Age, neoadjuvant chemotherapy, diabetes, and elevated neutrophil count were significant risk factors for D-dimer variation, after adjusting for other factors. CONCLUSIONS This study has identified the characteristics of patients who are likely to experience considerable postoperative increases in the D-dimer level. The development of effective nursing interventions for these patients is the focus of future studies.
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Affiliation(s)
- Ling Qin
- Department of Operation Room, Second Hospital of Dalian Medical University, Dalian 116027, China
| | - Yan Fu
- Department of Breast Surgery, Second Hospital of Dalian Medical University, Dalian 116027, China
| | - Cong Li
- Department of Digestive Oncology, Second Hospital of Dalian Medical University, Dalian 116027, China
| | - Shuang Chen
- Department of Breast Surgery, Second Hospital of Dalian Medical University, Dalian 116027, China
| | - Ying Lv
- Department of Respiratory, Second Hospital of Dalian Medical University, Dalian 116027, China
| | - Meijuan Hao
- Department of Breast Surgery, Second Hospital of Dalian Medical University, Dalian 116027, China
| | - Hao Zhang
- Department of Breast Surgery, Second Hospital of Dalian Medical University, Dalian 116027, China
| | - Yanqiu Wang
- Department of Breast Surgery, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang 110042, China
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Gutnik L, Allen CM, Presson AP, Matsen CB. Breast Cancer Surgery Decision Role Perceptions and Choice of Surgery. Ann Surg Oncol 2020; 27:3623-3632. [PMID: 32495282 DOI: 10.1245/s10434-020-08485-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Indexed: 01/11/2023]
Abstract
BACKGROUND Retrospective studies have reported that breast cancer patients who perceived more personal responsibility for the surgery decision were more likely to undergo aggressive surgery. We examined this in a prospective study. METHODS 100 newly diagnosed breast cancer patients identified their decision- making role using the Patient Preference Scale. Chart review captured the initial surgery received. Patient decision role preference, role perception, role concordance, and provider role perception were compared with type of surgery to assess differences between mastectomy and lumpectomy groups and unilateral versus bilateral mastectomy. We compared type of surgery and patient role concordance. Satisfaction with Decision immediately after the visit, Decision Regret and FACT-B quality of life at 2 weeks and 6 months were assessed and compared with type of surgery. RESULTS Patient decision role preference (p = 0.49) and perception (p = 0.16) were not associated with type of surgery. Provider perception of patient role was associated with type of surgery, with providers perceiving more passive patient roles in the mastectomy group (p = 0.026). Patient role preference varied significantly by stage of disease (= 0.024), with stage 0 (64%, N = 6) and stage III (60%, N = 6) patients preferring active roles and stage I (60%, N = 25) and stage II (52%, N = 16) patients preferring a collaborative role. CONCLUSIONS Patient role preference and perception were not associated with type of surgery, while provider perception of patient role was. Patient role preference varied by stage of disease. Further study is warranted to better understand how disease factors and provider interactions affect decision role preferences and perceptions and surgical choice. TRIAL REGISTRATION The study was registered with clinicaltrials.gov (NCT03350854). https://clinicaltrials.gov/ct2/show/NCT03350854 .
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Affiliation(s)
- Lily Gutnik
- Department of Surgery, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Chelsea McCarty Allen
- Division of Epidemiology, Department of Internal Medicine, Huntsman Cancer Institute, University of Utah, Salt Lake City, USA
| | - Angela P Presson
- Division of Epidemiology, Department of Internal Medicine, Huntsman Cancer Institute, University of Utah, Salt Lake City, USA
| | - Cindy B Matsen
- Department of Surgery, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.
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Chu CN, Wang YC, Chang WS, Wang ZH, Liu LC, Wang SC, Lin CC, Liu TY, Chang JG, Tsai CW, Yu CC, Bau DAT. Association of Interleukin-4 Polymorphisms With Breast Cancer in Taiwan. In Vivo 2020; 34:1111-1116. [PMID: 32354899 DOI: 10.21873/invivo.11882] [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: 01/31/2020] [Revised: 02/25/2020] [Accepted: 02/26/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM The present study aimed at evaluating the contribution of IL-4 promoter T-1099G (rs2243248), C-589T (rs2243250), C-33T (rs2070874) genotypes to the risk of breast cancer in Taiwanese. MATERIALS AND METHODS A total of 1232 breast cancer patients and 1232 age-matched controls were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) methodology. RESULTS Genotypic frequencies of IL-4 rs2243248, rs2243250 and rs2070874 were not differentially distributed between case and control groups. Consistently, there was no difference in the distribution of allelic frequencies among patients and controls. CONCLUSION IL-4 rs2243248, rs2243250 and rs2070874 do not confer breast cancer susceptibility in Taiwanese.
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Affiliation(s)
- Chin-Nan Chu
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan, R.O.C.,Division of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Yun-Chi Wang
- Terry Fox Cancer Research Laboratory, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Wen-Shin Chang
- Terry Fox Cancer Research Laboratory, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Zhi-Hong Wang
- Department of Food Nutrition and Health Biotechnology, Asia University, Taichung, Taiwan, R.O.C
| | - Liang-Chih Liu
- Terry Fox Cancer Research Laboratory, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Shao-Chun Wang
- Terry Fox Cancer Research Laboratory, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Cheng-Chieh Lin
- Terry Fox Cancer Research Laboratory, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Ting-Yuan Liu
- Terry Fox Cancer Research Laboratory, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Jan-Gowth Chang
- Terry Fox Cancer Research Laboratory, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Chia-Wen Tsai
- Terry Fox Cancer Research Laboratory, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Chien-Chih Yu
- School of Pharmacy, China Medical University, Taichung, Taiwan, R.O.C
| | - DA-Tian Bau
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan, R.O.C. .,Terry Fox Cancer Research Laboratory, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan, R.O.C.,Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan, R.O.C
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Coelho S, Rego IB, Dionísio MR, Cavaco-Silva J, Semedo PM, Pavão F, Leite RB, Costa L. 360 Health Analysis (H360) - A Proposal for an Integrated Vision of Breast Cancer in Portugal. Eur J Breast Health 2020; 16:91-98. [PMID: 32285029 PMCID: PMC7138355 DOI: 10.5152/ejbh.2020.5144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 12/22/2019] [Indexed: 12/31/2022]
Abstract
H360 aims to provide a comprehensive picture of breast cancer management in Portugal by retrieving real-world data from 10 Portuguese hospitals and deriving a snapshot from the medical interpretation of evidence-based data to patient perspective on the quality and effectiveness of medical care provided. This article reviews evidence on breast cancer clinical practice and quality of care and disease management in Portugal. A review of evidence on breast cancer clinical practice and quality of care over the last 10 years was performed in PubMed using the query "Organization and Administration"[Mesh] AND "breast cancer"[All Fields] NOT "Review" [ptyp]. National cancer initiatives relevant for quality of care and national and international guidelines and consensus were analyzed. Retrieved results showed that breast cancer incidence is still increasing, including in Portugal. Studies investigating disease outcomes seek to derive improvements to clinical practice and better financial resource allocation. Setting performance measures (KPIs) in institutions treating cancer is not a reality in Portugal yet, but has potential to leverage the quality of clinical performance. A multidisciplinary approach within one health structure is also desirable. More investment in clinical (including academic) research is key to optimize the quality of care. Implementation of clinical practice guidelines (largely based on ESMO guidelines in Portugal) is crucial to improve patient outcomes. Not less importantly, quality of life is a treatment goal on its own in breast cancer care. Breast cancer remains a health challenge and a multidimensional, 360-degree appraisal, beyond the exclusively clinical perspective, may provide new insights towards an optimal patient-centered approach.
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Affiliation(s)
- Sara Coelho
- Instituto Português de Oncologia do Porto Francisco Gentil EPE, Porto, Portugal
| | - Inês Brandão Rego
- Instituto Português de Oncologia de Coimbra Francisco Gentil EPE, Coimbra, Portugal
| | | | | | | | - Francisco Pavão
- Universidade Católica Portuguesa, Institute of Health Sciences, Lisbon, Portugal
| | - Ricardo Baptista Leite
- Maastricht University, Faculty of Health, Medicine and Life Sciences, Maastricht, Netherlands
| | - Luís Costa
- Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Luis Costa Lab, Lisbon, Portugal
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Hou IC, Lin HY, Shen SH, Chang KJ, Tai HC, Tsai AJ, Dykes PC. Quality of Life of Women After a First Diagnosis of Breast Cancer Using a Self-Management Support mHealth App in Taiwan: Randomized Controlled Trial. JMIR Mhealth Uhealth 2020; 8:e17084. [PMID: 32130181 PMCID: PMC7081131 DOI: 10.2196/17084] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 12/25/2019] [Accepted: 01/26/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND There are over 2 million newly diagnosed patients with breast cancer worldwide with more than 10,000 cases in Taiwan each year. During 2017-2018, the National Yang-Ming University, the Taiwan University of Science and Technology, and the Taiwan Breast Cancer Prevention Foundation collaborated to develop a breast cancer self-management support (BCSMS) mHealth app for Taiwanese women with breast cancer. OBJECTIVE The aim of this study was to investigate the quality of life (QoL) of women with breast cancer in Taiwan after using the BCSMS app. METHODS After receiving a first diagnosis of breast cancer, women with stage 0 to III breast cancer, who were recruited from social networking sites or referred by their oncologists or oncology case managers, were randomized 1:1 into intervention and control groups. Intervention group subjects used the BCSMS app and the control group subjects received usual care. Two questionnaires-the European Organization for Research and Treatment of Cancer (EORTC) Quality-of-Life Questionnaire Core 30 (QLQ-C30) and the EORTC Breast Cancer-Specific Quality-of-Life Questionnaire (QLQ-BR23)-were distributed to subjects in both arms. Paper-based questionnaires were used at baseline; paper-based or Web-based questionnaires were used at 1.5-month and 3-month follow-up evaluations. All evaluations were self-assessed and anonymous, and participants were blinded to their allocation groups. Descriptive analysis, the Pearson chi-square test, analysis of variance, and the generalized estimating equation were used to analyze the data. Missing values, with and without multi-imputation techniques, were used for sensitivity analysis. RESULTS A total of 112 women were enrolled and randomly allocated to either the experimental group (n=53) or control group (n=59). The follow-up completion rate was 89.3% (100/112). The demographic data showed homogeneity between the two groups in age (range 50-64 years), breast cancer stage (stage II), marital status (married), working status (employed), and treatment status (receiving treatments). The mean total QoL summary scores from the QLQ-C30 (83.45 vs 82.23, P=.03) and the QLQ-BR23 (65.53 vs 63.13, P=.04) were significantly higher among the experimental group versus the control group, respectively, at 3 months. CONCLUSIONS This research provides support for using a mobile health care app to promote the QoL among women in Taiwan after a first diagnosis of breast cancer. The BCSMS app could be used to support disease self-management, and further evaluation of whether QoL is sustained is warranted. TRIAL REGISTRATION ClinicalTrials.gov NCT004174248; https://clinicaltrials.gov/ct2/show/NCT04174248.
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Affiliation(s)
- I-Ching Hou
- School of Nursing, National Yang-Ming University, Taipei City, Taiwan
| | - Hsin-Yi Lin
- School of Nursing, National Yang-Ming University, Taipei City, Taiwan
- Department of Nursing, Hsinchu Mackay Memorial Hospital, Hsinchu, Taiwan
| | - Shan-Hsiang Shen
- Department of Computer Science and Information Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan
| | | | - Hao-Chih Tai
- Department of Surgery, National Taiwan University, Taipei, Taiwan
| | - Ay-Jen Tsai
- Taiwan Breast Cancer Foundation, Taipei, Taiwan
| | - Patricia C Dykes
- Center for Patient Safety Research and Practice, Brigham and Women's Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
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Qiu H, Xu WH, Kong J, Ding XJ, Chen DF. Effect of breast-conserving surgery and modified radical mastectomy on operation index, symptom checklist-90 score and prognosis in patients with early breast cancer. Medicine (Baltimore) 2020; 99:e19279. [PMID: 32176051 PMCID: PMC7220131 DOI: 10.1097/md.0000000000019279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
The present study aims to analyze the effects of breast-conserving surgery and modified radical mastectomy on operation indexes, Symptom checklist-90 scores and prognosis in patients with early breast cancer.The clinical data of 128 patients with breast cancer who were treated in our hospital from May 2015 to May 2016 were included into the analysis. These patients were divided into 2 groups, according to the different modes of operation (n = 64): control group, patients underwent modified radical mastectomy; observation group, patients underwent early breast conserving surgery. Then, the surgical indexes and prognosis were compared between these 2 groups.Intraoperative bleeding volume, incision length and hospitalization duration were better in the observation group than in the control group (P < .05). Furthermore, postoperative symptom checklist-90 scores in the observation group were better than scores before the operation, and were better than the scores in the control group (P < .05). Moreover, the incidence of postoperative complications was lower in the observation group (3.13%) than in the control group (21.88%, P < .05).Early breast-conserving surgery is more advantageous for breast cancers and results to lesser bleeding, rapid recovery, and fewer complications.
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Affiliation(s)
| | - Wen-Hui Xu
- Gastrointestinal Surgery Department, The Second Clinical Medical College, Yangtze University, Jingzhou, China
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29
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Lagendijk M, Mittendorf E, King TA, Gibbons C, Pusic A, Dominici LS. Incorporating Patient-Reported Outcome Measures into Breast Surgical Oncology: Advancing Toward Value-Based Care. Oncologist 2019; 25:384-390. [PMID: 31848315 DOI: 10.1634/theoncologist.2019-0355] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 10/30/2019] [Indexed: 11/17/2022] Open
Abstract
Value in health care is defined as the health outcome achieved per unit of cost. For health care systems, improving value means achieving better outcomes at lower costs. Improving outcomes, including patient-reported outcomes (PROs), as well as more established metrics such as mortality and complication rates, ensures high-quality care. This is particularly true in breast cancer surgery, where survival and recurrence rates are comparable across different surgical approaches. Outcomes reflecting survivorship quality may therefore better inform decision making regarding surgical approaches. PROs can be assessed using validated instruments known as patient-reported outcome measures (PROMs). They are obtained directly from patients reflecting their health-related quality of life (HRQOL). Ongoing initiatives strive to define PROMs that accurately reflect HRQOL and demonstrate value, with the goal of establishing benchmarks for quality of care. Clinicians caring for patients with breast cancer are well positioned to be involved in defining meaningful measures of value-based breast cancer care. This article reviews value-based breast cancer care in the context of locoregional therapy, with attention paid to the work done by the International Consortium of Health Outcome Measures in which a "standard set" of value-based patient-centered outcomes for breast cancer for international use is defined. In addition, an overview is provided of relevant PROMs and previously reported scores. Recommendations and future challenges for implementation of routine collection of PROs are also discussed. IMPLICATIONS FOR PRACTICE: Opportunity exists to act as early adopters of the routine collection of longitudinal patient-reported outcome data for breast cancer, allowing transition of current care to value-based cancer care.
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Affiliation(s)
- Mirelle Lagendijk
- Department of Surgery, Erasmus MC, Rotterdam, The Netherlands
- Department of Surgery, Amphia Hospital, Breda, The Netherlands
| | - Elizabeth Mittendorf
- Division of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Breast Oncology Program, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts, USA
| | - Tari A King
- Division of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Breast Oncology Program, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts, USA
| | - Christopher Gibbons
- Division of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Patient-Reported Outcomes, Value & Experience (PROVE) Center, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Andrea Pusic
- Patient-Reported Outcomes, Value & Experience (PROVE) Center, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Division of Plastic Surgery, Brigham and Women's Hospital, Boston, MA, USA
| | - Laura S Dominici
- Division of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Breast Oncology Program, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts, USA
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30
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Wu TY, Chang TW, Chang SM, Lin YY, Wang JD, Kuo YL. Dynamic Changes Of Body Image And Quality Of Life In Breast Cancer Patients. Cancer Manag Res 2019; 11:10563-10571. [PMID: 31908528 PMCID: PMC6925559 DOI: 10.2147/cmar.s223314] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 11/07/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose Dynamic changes of body image and quality of life (QoL) in breast cancer patients were not commonly investigated. We aimed to compare the dynamic changes in QoL and body image of breast cancer survivors receiving breast-conserving surgery or total mastectomy within 5–10 years after surgery. Methods Patients with non-metastatic breast cancer who received surgery were invited to complete the World Health Organization Quality of Life–Brief (WHOQOL-BREF) questionnaire and the Body Image Scale (BIS) within 10 years after surgery. We applied kernel smoothing methods to capture the dynamic changes of the patients’ QoL and body image within 5 years after surgery. We also constructed multiple linear regression models to identify predictive factors for QoL and body image. Results A total of 581 patients were collected, and 211 of them received breast-conserving surgery. There were no statistically significant differences in QoL and body image for breast-conserving surgery versus total mastectomy, but the former showed fluctuating trends. BIS was a predictor of every item and domain in the WHOQOL-BREF in the multiple linear regression model, and explanatory of the trends of dynamic change over time. Patients without lymph node dissection seemed to have less positive feelings but were more satisfied with sexual activities. Conclusion Body image is predictive of the QoL of breast cancer patients. Dynamic changes of body image and QoL would be useful for shared decision-making regarding surgery in breast cancer patients.
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Affiliation(s)
- Tzu-Yi Wu
- Department of Occupational Therapy, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Tsai-Wang Chang
- Division of Breast Surgery, Department of Surgery, Tainan Municipal An-Nan Hospital - China Medical University, Tainan, Taiwan
| | - Sheng-Mao Chang
- Department of Statistics, National Cheng Kung University, Tainan, Taiwan
| | - Yun-Ying Lin
- Department of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jung-Der Wang
- Departments of Internal Medicine and Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.,Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yao-Lung Kuo
- Department of Surgery, National Cheng-Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan and Dou-Liou, Taiwan
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Comparing Quality of Life in Breast Cancer Patients Who Underwent Mastectomy Versus Breast-Conserving Surgery: A Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16244970. [PMID: 31817811 PMCID: PMC6950729 DOI: 10.3390/ijerph16244970] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 12/01/2019] [Accepted: 12/03/2019] [Indexed: 12/11/2022]
Abstract
: The purpose of our study was to carry out a meta-analysis of current literature to determine whether total mastectomy and breast-conserving surgery induce different outcomes in quality of life, based on the breast-cancer-specific module of the European Organizaation for Research and Treatment of Cancer core questionnaire (EORTC QLQ-BR23) used postoperatively. A systematic literature search of PubMed and EMBASE was conducted. Observational clinical studies that compared the quality of life in different surgery groups and presented empirical findings were selected. Six studies met the inclusion criteria. Breast-conserving surgery has statistically significant better outcomes than mastectomy in three of the eight outcomes measured in the EORTC QLQ-BR23, namely body image (standard mean difference, SMD = 1.742, 95% CI 0.579-2.905, p = 0.003), future perspective (SMD = 0.606, 95% CI 0.075-1.138, p = 0.025) and systemic therapy side effects (SMD = -0.641, 95% CI 0.101-1.181, p = 0.020). Our study highlighted that breast-conserving surgery was preferred over mastectomy because breast-conserving surgery leads to better outcomes in body image, future perspectives and less systemic side effects.
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32
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Fuzissaki MDA, Paiva CE, Oliveira MAD, Lajolo Canto PP, Paiva Maia YCD. The Impact of Radiodermatitis on Breast Cancer Patients' Quality of Life During Radiotherapy: A Prospective Cohort Study. J Pain Symptom Manage 2019; 58:92-99.e1. [PMID: 30974233 DOI: 10.1016/j.jpainsymman.2019.03.017] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 03/20/2019] [Accepted: 03/25/2019] [Indexed: 12/27/2022]
Abstract
CONTEXT In the oncology field, quality of life (QoL) is recognized as an essential component. However, few studies have evaluated radiotherapy (RT) and its adverse events, specifically radiodermatitis. OBJECTIVES The objective of this study was to investigate the influence of radiodermatitis severity on QoL of women with breast cancer (BC) throughout RT. METHODS A prospective cohort study was conducted with 100 BC patients evaluated weekly during RT. The Dermatology Life Quality Index questionnaire and the Radiation Therapy Oncology Group scale were used. The generalized estimated equations were used to examine the association between the total score of QoL and their domains, time of RT, and the radiodermatitis score, controlled by confounding factors. Estimated marginal means and 95% CIs were compared pairwise by applying Sequential Sidak. RESULTS The total QoL score and their domains (work/school, leisure, daily activities, symptoms, and feelings) were significantly associated with the evaluation times of RT (P < 0.001), the radiodermatitis score (P ≤ 0.002), and the interaction between timing (T) of treatment and radiodermatitis score (P < 0.001). When assessing post hoc, it was identified that the worst QoL scores were in the presence of Grade 3 (mean = 6.00) in T3 and Grade 4 (6.50; 7.00) in T5 and T6, respectively, and this difference was statistically significant. CONCLUSIONS RT negatively influenced the QoL of women with BC, with the greatest impact resulting from severe radiodermatitis. Actions aimed at minimizing the impairment on QoL need to be adopted to make this exhausting process less traumatic and easier to complete.
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Affiliation(s)
- Marceila de Andrade Fuzissaki
- Graduate Program in Health Science, Medical School, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | - Carlos Eduardo Paiva
- Division of Breast and Gynecology, Department of Clinical Oncology, Barretos Cancer Hospital, São Paulo, Brazil
| | | | - Paula Philbert Lajolo Canto
- Department of Clinical Oncology, Clinics Hospital, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | - Yara Cristina de Paiva Maia
- Graduate Program in Health Science, Medical School, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil.
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Lefeuvre D, Catajar N, Le Bihan Benjamin C, Ifrah N, De Bels F, Viguier J, Bousquet PJ. Breast cancer screening: Impact on care pathways. Cancer Med 2019; 8:4070-4078. [PMID: 31172693 PMCID: PMC6639186 DOI: 10.1002/cam4.2283] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 04/01/2019] [Accepted: 05/06/2019] [Indexed: 02/03/2023] Open
Abstract
Background Controversy persists concerning screening programs (SPs), related to a potential risk of overdiagnosis or the impact on survival. One of the main questions to be addressed concerns the aggressiveness of the related treatments. Methods Using the "Cancer Cohort,” a national‐based cohort (medico‐administrative database), all women between the ages of 50 and 74 years and treated in 2014 for incident breast cancer were compared, according to whether their diagnosis was made following a mammogram performed within the framework of the SP (SP group) or outside it (NSP group). Results A total of 23 788 women were identified: 13 530 (57%) in the SP group and 10 258 (43%) in the NSP group. The women in the SP group had a higher rate of in situ or localized invasive breast cancer. They had a higher rate of breast‐conserving surgery (82% vs 70%), and a lower rate of chemotherapy (34% vs 53%). These findings were observed irrespective of the stage. They had a higher rate of pathways involving breast‐conserving surgery followed by radiotherapy. Among women with metastatic cancer, those in the SP group had a lower proportion of liver, lung, brain, and bone metastases, and a higher proportion of lymph node metastases (other than axillary), irrespective of the time to onset of the metastases. Conclusion The women in whom cancer was diagnosed following a mammogram performed in the context of the SP had less advanced cancer and less aggressive treatments. This observational study helps illustrate the benefit of the SP in France using a different approach.
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Affiliation(s)
- Delphine Lefeuvre
- Health Data and Assessment Department, Survey, Data Science and Assessment Division, Institut National du Cancer (French National Cancer Institute), Boulogne-Billancourt, France
| | - Nathalie Catajar
- Screening Department, Public Health and Healthcare Division, Institut National du Cancer (French National Cancer Institute), Boulogne-Billancourt, France
| | - Christine Le Bihan Benjamin
- Health Data and Assessment Department, Survey, Data Science and Assessment Division, Institut National du Cancer (French National Cancer Institute), Boulogne-Billancourt, France
| | - Norbert Ifrah
- Presidency, Institut National du Cancer (French National Cancer Institute), Boulogne-Billancourt, France
| | - Frédéric De Bels
- Screening Department, Public Health and Healthcare Division, Institut National du Cancer (French National Cancer Institute), Boulogne-Billancourt, France
| | - Jérôme Viguier
- Public Health and Healthcare Division, Institut National du Cancer (French National Cancer Institute), Boulogne-Billancourt, France
| | - Philippe Jean Bousquet
- Survey, Data Science and Assessment Division, Institut National du Cancer (French National Cancer Institute), Boulogne-Billancourt, France.,Aix Marseille Univ, INSERM, IRD, Economics and Social Sciences Applied to Health & Analysis of Medical Information, Marseille, France
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Lavdaniti M, Owens DA, Liamopoulou P, Marmara K, Zioga E, Mantzanas MS, Evangelidou E, Vlachou E. Factors Influencing Quality of Life in Breast Cancer Patients Six Months after the Completion of Chemotherapy. Diseases 2019; 7:diseases7010026. [PMID: 30813488 PMCID: PMC6473656 DOI: 10.3390/diseases7010026] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 02/17/2019] [Accepted: 02/22/2019] [Indexed: 12/13/2022] Open
Abstract
Purpose: To assess breast cancer patients’ quality of life six months after the completion of adjuvant chemotherapy, and to investigate factors affecting this. Methods: The study was conducted in one large hospital located in a major Greek city. A convenience sample of 61 breast cancer outpatients was recruited. A questionnaire, including the SF-36 scale and questions regarding demographic and clinical information, was used to collect data. Results: The mean age of the patients was 51.52 ± 12.10. The effect of age on the physical role was significant (p = 0.003). Τhe effect of menopausal status on physical role was also found to be significant (p = 0.003); this might be explained by age. Regarding the treatment type, patients who received hormone therapy in addition to surgery and chemotherapy reported a significantly higher quality of life in terms of bodily pain (p = 0.04) and vitality (p = 0.04) than patients who underwent only surgery and chemotherapy. Conclusions: Quality of life is affected by factors such as age, menopausal status, and previous therapy. Health care professionals should be more aware of the factors that influence the quality of life domains (physical role, bodily pain, vitality) within this group of cancer patients in order to meet their needs following acute treatment.
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Affiliation(s)
- Maria Lavdaniti
- Nursing Department, Alexander Technological Educational Institute, 57400 Thessaloniki, Greece.
| | | | - Polixeni Liamopoulou
- Nursing Department, Alexander Technological Educational Institute, 57400 Thessaloniki, Greece.
| | - Kalliopi Marmara
- Faculty of Physical Education, Aristotele University of Thessaloniki, 54124 Thermi Thessaloniki, Greece.
| | | | - Michael S Mantzanas
- Department of University Orthopedic, MSc, MHSc, PhD, General Hospital of Nea Ionia "Konstantopouleio-Patision", 14233 Athens, Greece.
| | - Eftychia Evangelidou
- Department of Infection Control, MSc, MHSc, PhD(c), General Hospital of Nea Ionia "Konstantopouleio-Patision", 14233 Athens, Greece.
| | - Eugenia Vlachou
- Nursing Department, University of West Attica, 12243 Athens, Greece.
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Walstra CJEF, Schipper RJ, Poodt IGM, van Riet YE, Voogd AC, van der Sangen MJC, Nieuwenhuijzen GAP. Repeat breast-conserving therapy for ipsilateral breast cancer recurrence: A systematic review. Eur J Surg Oncol 2019; 45:1317-1327. [PMID: 30795956 DOI: 10.1016/j.ejso.2019.02.008] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 01/27/2019] [Accepted: 02/06/2019] [Indexed: 12/23/2022] Open
Abstract
The standard of care for patients with an ipsilateral breast tumour recurrence (IBTR) after breast-conserving therapy (BCT) is a salvage mastectomy. However, there is growing interest in the feasibility of repeat BCT for these patients. This systematic review contains the latest insights on BCT options for patients with an IBTR after initial BCT. A PubMed literature search was performed for articles on BCT options for IBTR after primary lumpectomy followed by radiotherapy. Weighted estimates were calculated for 5- and 10-year local control, distant metastasis-free and overall survival rates. Secondary outcomes were toxicity, cosmesis and quality of life. In total, 34 studies were eligible for analysis, of which 5 reported on repeat breast-conserving surgery (BCS) alone, 10 with mixed populations (BCS ± RT and/or mastectomy), 18 on repeat BCS followed by re-irradiation (whole-breast or partial) and one on quality of life. The weighted estimates for 5-year overall survival for repeat BCS and repeat BCS followed by reirradiation were 77% and 87%, respectively. Five-year local control was 76% for repeat BCS alone and 89% for repeat BCS followed by re-irradiation. Grade III-IV toxicity rates after re-irradiation varied from 0 to 21%, whereas the cosmesis was excellent-good in 29-100% of patients and unacceptable in 0-18%. Repeat BCS followed by re-irradiation, with either whole breast or partial breast re-irradiation, seems a feasible alternative to mastectomy in case of IBTR, in selected patients. Toxicity rates are low and the cosmetic outcome is good, but the size and follow-up of the published patient series is limited.
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Affiliation(s)
| | | | - Ingrid G M Poodt
- Department of Surgery, Catharina Hospital Eindhoven, the Netherlands
| | - Yvonne E van Riet
- Department of Surgery, Catharina Hospital Eindhoven, the Netherlands
| | - Adri C Voogd
- Department of Epidemiology, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands; GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands
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36
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Hsiao CL, Liu LC, Shih TC, Lai YL, Hsu SW, Wang HC, Pan SY, Shen TC, Tsai CW, Chang WS, Su CH, Way TDER, Chung JG, Bau DAT. The Association of Matrix Metalloproteinase-1 Promoter Polymorphisms with Breast Cancer. ACTA ACUST UNITED AC 2018; 32:487-491. [PMID: 29695550 DOI: 10.21873/invivo.11265] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 03/11/2018] [Accepted: 03/12/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND/AIM The family of matrix metalloproteinases (MMPs) are responsible for the homeostasis of extracellular matrix components and their genetic polymorphisms may be associated with cancer susceptibility. The serum levels of MMP-1 have been reported to be lower in breast cancer patients than healthy subjects. In the current study, we aimed at investigating the contribution of a polymorphism in the promoter region of MMP-1 to breast cancer in Taiwan. MATERIALS AND METHODS The MMP-1 rs1799705 polymorphic genotypes were genotyped among 1,232 breast cancer patients and 1,232 healthy controls by the typical polymerase chain reaction-restriction fragment length polymorphism methodology. RESULTS The percentages of 2G/2G, 1G/2G, and 1G/1G for MMP1 -1607 genotypes were 35.4, 40.6 and 24.0% in the breast cancer group and 34.1, 43.6, and 22.3% in the healthy control group (p trend=0.3025), respectively. The odds ratios (ORs) after adjusting for age, smoking and alcohol drinking status for those carrying 1G/2G and 1G/1G genotypes at MMP1 -1607 were 0.93 (95%CI=0.76-1.11, p=0.2390) and 1.01 (95%CI=0.77-1.23, p=0.7377), respectively, compared to those carrying the wild-type 2G/2G genotype. Supporting this finding, the adjusted OR for those carrying the 1G allele at MMP-1 -1607 was 1.03 (95%CI=0.91-1.18, p=0.8860), compared to those carrying the wild-type 2G allele. Our findings suggest that the polymorphic genotypes at MMP1 promoter -1607 investigated in the current study, may not play a major role in determining cancer susceptibility to breast cancer in Taiwan. Other early diagnostic and predictive markers are urgently needed for personalized and precise breast cancer detection and therapy.
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Affiliation(s)
- Chieh-Lun Hsiao
- Terry Fox Cancer Research Laboratory, Translational Medical Research Center, China Medical University Hospital, Taichung, Taiwan, R.O.C.,Ph.D. Program for Biotechnology Industry, China Medical University, Taichung, Taiwan, R.O.C.,Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan, R.O.C
| | - Liang-Chih Liu
- Department of Breast Surgery, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Tzu-Ching Shih
- Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan, R.O.C
| | - Yi-Liang Lai
- Taichung Armed Forces General Hospital, Taichung, Taiwan, R.O.C
| | - Shih-Wei Hsu
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan, R.O.C.,Taichung Armed Forces General Hospital, Taichung, Taiwan, R.O.C
| | - Hwei-Chung Wang
- Terry Fox Cancer Research Laboratory, Translational Medical Research Center, China Medical University Hospital, Taichung, Taiwan, R.O.C.,Department of Breast Surgery, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Su-Yi Pan
- Terry Fox Cancer Research Laboratory, Translational Medical Research Center, China Medical University Hospital, Taichung, Taiwan, R.O.C.,Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan, R.O.C
| | - Te-Chun Shen
- Terry Fox Cancer Research Laboratory, Translational Medical Research Center, China Medical University Hospital, Taichung, Taiwan, R.O.C.,Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan, R.O.C
| | - Chia-Wen Tsai
- Terry Fox Cancer Research Laboratory, Translational Medical Research Center, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Wen-Shin Chang
- Terry Fox Cancer Research Laboratory, Translational Medical Research Center, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Chen-Hsien Su
- Terry Fox Cancer Research Laboratory, Translational Medical Research Center, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Tzong-DER Way
- Ph.D. Program for Biotechnology Industry, China Medical University, Taichung, Taiwan, R.O.C
| | - Jing-Gung Chung
- Ph.D. Program for Biotechnology Industry, China Medical University, Taichung, Taiwan, R.O.C
| | - DA-Tian Bau
- Terry Fox Cancer Research Laboratory, Translational Medical Research Center, China Medical University Hospital, Taichung, Taiwan, R.O.C. .,Ph.D. Program for Biotechnology Industry, China Medical University, Taichung, Taiwan, R.O.C.,Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan, R.O.C.,Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan, R.O.C
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37
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Cieślak K, Golusiński W. Coping with loss of ability vs. emotional control and self-esteem in women after mastectomy. Rep Pract Oncol Radiother 2018; 23:168-174. [PMID: 29765264 DOI: 10.1016/j.rpor.2018.02.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Revised: 01/14/2018] [Accepted: 02/13/2018] [Indexed: 11/28/2022] Open
Abstract
Aim Does coping with the loss of ability depend on self-esteem and emotional control? Background Persons who experience losses in two dimensions, i.e. health and ability can deal with the loss by physical therapy, and also by mental and socio-professional rehabilitation. But far and foremost, it is the personality of the person who experiences the loss that matters most. Materials and methods The study included 37 patients after mastectomy. They were divided into two groups according to the time elapsed from cancer diagnosis. The study was conducted using the Questionnaire on Coping With Ability Loss (P. Wolski), Self-Esteem Loss (M. Rosenberg,) and the Courtauld Emotional Control Scale - CECS. Results In Group I, the higher level of acceptance in the QCAL test, the higher self-esteem. The more depression experienced by individuals, the lower is their level of self-esteem or the less depression experienced, the higher the self-esteem. In Group II, the higher the level of depression, the lower the level of anger. The greater the struggle, the lower level of anger. The lower the level of depression and struggle, the higher the level of emotion control. Conclusions Women diagnosed no longer than five years back do not differ from those diagnosed further back in terms of copying with the loss of ability, self-esteem and emotional control.
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Affiliation(s)
- Katarzyna Cieślak
- Clinical Psychology Unit, Greater Poland Cancer Centre, Garbary 15, 61-866 Poznań, Poland
| | - Wojciech Golusiński
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, Greater Poland Cancer Centre, Garbary 15, Poznań, Poland
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