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Saarinen M, Ojala K, Suominen S, Repo J. Validation of the BODY-Q Chest module in Finnish trans men undergoing chest wall masculinization. Scand J Surg 2023; 112:180-186. [PMID: 37264645 DOI: 10.1177/14574969231176111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND AND OBJECTIVE The aim of gender affirmation surgery is to ease gender dysphoria. In transgender men, chest wall masculinization is the most common gender affirmation surgery. The BODY-Q Chest module is currently the only instrument developed to measure health-related quality of life (HRQL) in men undergoing chest wall surgery. Linguistic validation and cultural adaption to Finnish were performed previously. The study aims to validate the BODY-Q Chest module in transgender men who have undergone surgical chest wall masculinization. METHODS All transgender patients who underwent chest wall masculinization at Helsinki University Hospital between 2005 and 2018 were invited to the study. The BODY-Q Chest module comprises two scales-chest and nipple. Data were obtained using the BODY-Q Chest module, the 15D questionnaire, and specifically targeted items designed by the authors. The statistical analyses were conducted to exclude selection bias, evaluate validity of the instrument, and compare it to other instruments. RESULTS Of the 220 patients invited, 123 participated in the survey (response rate 56%). Ceiling effects were observed with 18.9% and 20.5% scoring maximum points. Cronbach's alpha was 0.92 and 0.88 for the chest and nipple scales, respectively. In exploratory factor analysis, both scales loaded to one factor confirming unidimensionality. Correlation with the generic 15D questionnaire was low. CONCLUSIONS The BODY-Q Chest module provides valid scores with sufficient consistency and reliability when measuring HRQL in transgender men undergoing chest wall masculinization. Moreover, it offers specificity that existing or generic instruments cannot provide. Ceiling effect was expected due to the postoperative status of participants.
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Affiliation(s)
- Mirjam Saarinen
- Department of Plastic SurgeryHelsinki University Hospital and the University of Helsinki P.O. Box 281Stenbackinkatu 1100029 Helsinki Finland
| | - Kaisu Ojala
- Department of Plastic Surgery, Helsinki University Hospital and the University of Helsinki, Helsinki, Finland
| | - Sinikka Suominen
- Department of Plastic Surgery, Helsinki University Hospital and the University of Helsinki, Helsinki, Finland
| | - Jussi Repo
- Department of Orthopedics and Traumatology, Unit of Musculoskeletal Surgery, Tampere University Hospital and the University of Tampere, Tampere, Finland
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Martínez-Pérez JL, Pascual-Dapena A, Pardo Y, Ferrer M, Pont À, López MJ, Nicolau P, Jiménez M, Masó P, Vernet-Tomás M, Argudo N. Validation of the Spanish electronic version of the BREAST-Q questionnaire. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2023; 49:1417-1422. [PMID: 37179146 DOI: 10.1016/j.ejso.2023.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 03/17/2023] [Accepted: 04/19/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND Patient-reported outcome measures (PROMs) have gained considerable interest in health care moving beyond traditional outcome measures of morbidity and mortality. In breast cancer surgery, women's' perceptions of appearance, function and quality of life have become increasingly important. The BREAST-Q questionnaire is a validated PROM for use in cosmetic and reconstructive breast surgery in clinical practice. The objective of this study was to validate the Spanish electronic version of the BREAST-Q questionnaire, to verify the measurement equivalence of digital and paper versions and to identify the possible disadvantages and advantages of implementing this new tool. METHODS The study population included 113 patients undergoing breast cancer survey at a single hospital in Barcelona (Spain) who were able to complete both the electronic and paper versions of the preoperative module of the BREAST-Q questionnaire. RESULTS The intraclass correlation coefficient (ICC) in the four domains of the questionnaire between the two versions of the questionnaire was >0.9, with a weighted kappa of >0.74 at item level. The reliability of the internal consistency was also excellent, with Cronbach's alpha coefficient of >0.70 in all domains. Age was a limiting factor for the delivery of the electronic version of BREAST-Q, with 69 years of age as the cut-off point to obtain reliable results. CONCLUSIONS The interchangeability of the electronic and paper versions of the BREAST-Q questionnaire facilitates implementation of this instrument in routine surgical oncological practice.
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Affiliation(s)
- Juan Luis Martínez-Pérez
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Ana Pascual-Dapena
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Yolanda Pardo
- Health Services Research Unit, Hospital Del Mar Medical Research Institute (IMIM), Barcelona, Spain; Department de Psiquiatria I Medicina legal, Universitat Autònoma de Barcelona, Spain; Centro de Investigación Biomédica en Red, Epidemiología y Salud Pública (CIBERESP), Spain.
| | - Montserrat Ferrer
- Health Services Research Unit, Hospital Del Mar Medical Research Institute (IMIM), Barcelona, Spain; Centro de Investigación Biomédica en Red, Epidemiología y Salud Pública (CIBERESP), Spain.
| | - Àngels Pont
- Health Services Research Unit, Hospital Del Mar Medical Research Institute (IMIM), Barcelona, Spain.
| | | | - Pau Nicolau
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain; Breast Diseases Unit, Hospital Del Mar, Barcelona, Spain; Department of Obstetrics and Gynecology Department, Hospital Del Mar, Barcelona, Spain.
| | - Marta Jiménez
- Breast Diseases Unit, Hospital Del Mar, Barcelona, Spain; Department of General Surgery, Hospital Del Mar, Barcelona, Spain.
| | - Paula Masó
- Breast Diseases Unit, Hospital Del Mar, Barcelona, Spain; Department of Obstetrics and Gynecology Department, Hospital Del Mar, Barcelona, Spain.
| | - María Vernet-Tomás
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain; Breast Diseases Unit, Hospital Del Mar, Barcelona, Spain; Department of Obstetrics and Gynecology Department, Hospital Del Mar, Barcelona, Spain.
| | - Nuria Argudo
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain; Breast Diseases Unit, Hospital Del Mar, Barcelona, Spain; Department of General Surgery, Hospital Del Mar, Barcelona, Spain.
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Coelho A, Kendir C, Barrenho E, Klazinga N, Paiva C, Abreu de Sousa J, Gonçalves-Monteiro S, Redondo P, Bastos A, Nogueira A, Guedes FB, Costa AS, Gaspar T. Patient-Reported Outcomes and Experiences Assessment in Women with Breast Cancer: Portuguese Case Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2931. [PMID: 36833626 PMCID: PMC9957006 DOI: 10.3390/ijerph20042931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/03/2023] [Accepted: 02/06/2023] [Indexed: 06/18/2023]
Abstract
In 2020, female breast cancer was the most commonly diagnosed cancer worldwide, representing the type of cancer with the highest incidence among women and the second most common cause of cancer death among women in all OECD countries. The conventional measures addressing the burden of breast cancer by measuring mortality, incidence, and survival do not entirely reflect the quality of life and patients experience when receiving breast cancer care. The main objective of this study is to capture patient-reported outcomes and experiences in women with breast cancer in Portugal using methods developed for international benchmarking purposes, such as the OECD Patient-reported Indicators Surveys. The study included 378 women with breast cancer, with the age distribution being 19.8% aged 15 to 49 years and 80.2% aged 50 years and over. The data collection procedure and analysis followed the "OECD Breast Cancer Patient Reported Outcomes Working Group" protocol, allowing subsequent comparability with data from other OECD member countries. Most women were satisfied with the treatment outcome regarding the shape of their lumpectomy breast when wearing a bra (96.1%) and with the equal size of both breasts (78.3%). Findings on the WHO QOL-BREF showed that women manifest a lower score in well-being when compared with the general population or populations living with chronic diseases. This study shows the feasibility of implementing and using patient-reported metrics (PROM and PREM) in breast cancer services in Portugal. Measuring PROMs and PREMs from Portuguese women receiving breast cancer care provides insightful evidence into the quality and value of cancer care.
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Affiliation(s)
- Anabela Coelho
- Comprehensive Health Research Centre (CHRC), Nursing Department, University of Évora, 7004-516 Évora, Portugal
- H&TRC-Health & Technology Research Center, ESTeSL-Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, 1549-020 Lisbon, Portugal
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, 1099-085 Lisbon, Portugal
| | - Candan Kendir
- Organisation for Economic Co-Operation and Development, 75016 Paris, France
| | - Eliana Barrenho
- Organisation for Economic Co-Operation and Development, 75016 Paris, France
| | - Niek Klazinga
- Department of Public and Occupational Health, Amsterdam UMC, Amsterdam Public Health Research Institute, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
| | - Cláudia Paiva
- Breast Unit, Centro Hospitalar e Universitário do Porto, 4099-001 Porto, Portugal
| | - Joaquim Abreu de Sousa
- Department of Surgical Oncology, Portuguese Oncology Institute of Porto (IPO Porto), 4200-072 Porto, Portugal
- Porto Comprehensive Cancer Center (Porto.CCC) & RISE@CI-IPOP (Health Research Network), 4200-072 Porto, Portugal
| | - Salomé Gonçalves-Monteiro
- Porto Comprehensive Cancer Center (Porto.CCC) & RISE@CI-IPOP (Health Research Network), 4200-072 Porto, Portugal
- Outcomes Research Lab, Management, Outcomes Research and Economics in Healthcare Group (MOREHealth), Portuguese Oncology Institute of Porto (IPO Porto), 4200-072 Porto, Portugal
| | - Patrícia Redondo
- Porto Comprehensive Cancer Center (Porto.CCC) & RISE@CI-IPOP (Health Research Network), 4200-072 Porto, Portugal
- Outcomes Research Lab, Management, Outcomes Research and Economics in Healthcare Group (MOREHealth), Portuguese Oncology Institute of Porto (IPO Porto), 4200-072 Porto, Portugal
| | - Ana Bastos
- Porto Comprehensive Cancer Center (Porto.CCC) & RISE@CI-IPOP (Health Research Network), 4200-072 Porto, Portugal
- Breast Clinic, Portuguese Oncology Institute of Porto (IPO Porto), 4200-072 Porto, Portugal
| | - Armanda Nogueira
- Porto Comprehensive Cancer Center (Porto.CCC) & RISE@CI-IPOP (Health Research Network), 4200-072 Porto, Portugal
- Quality of Life Office, Portuguese Oncology Institute of Porto (IPO Porto), 4200-072 Porto, Portugal
| | - Fábio Botelho Guedes
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
| | - Andreia Silva Costa
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon (ESEL), 1600-096 Lisbon, Portugal
- Católica Research Centre for Psychological, Family and Social Wellbeing, Faculdade de Ciências Humanas, Universidade Católica Portuguesa, 1649-023 Lisbon, Portugal
| | - Tânia Gaspar
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
- Digital Human-Environment Interaction Labs (HEI-LAB), Universidade Lusófona de Humanidades e Tecnologias, 1749-024 Lisbon, Portugal
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Choi WJ, Song WJ, Kang SG. A Comparative Analysis of Patient Satisfaction and Cosmetic Outcomes after Breast Reconstruction through BREAST-Q and the Judgment of Medical Panels: Does it Reflect Well in Terms of Aesthetics in Korean Patients? Arch Plast Surg 2022; 49:488-493. [PMID: 35919544 PMCID: PMC9340164 DOI: 10.1055/s-0042-1744417] [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: 11/06/2022] Open
Abstract
Background
Currently, the BREAST-Q can effectively measure patient's satisfaction on the quality of life from the patient's perspective in relation to different type of breast reconstruction. However, evaluation of patient satisfaction and cosmetic outcomes in breast reconstruction may have potential to led bias.
Methods
To maximize the benefits of using BREAST-Q to evaluate clinical outcome, we performed comparative study focused on the correlation between postoperative BREAST-Q and cosmetic outcomes assessed by medical professionals. For the current analysis, we used three postoperative BREAST-Q scales (satisfaction with breast, psychosocial well-being, and sexual well-being). The Ten-Point Scale by Visser et al was applied to provide reproducible grading of the postoperative cosmetic outcomes of the breast. The system includes six subscales that measured overall aesthetic outcome, volume, shape, symmetry, scarring, and nipple-areolar complex. The photographic assessments were made by five medical professionals who were shown photographs on a computer screen in a random order. Obtained data were stored in Excel and evaluated by Spearman's correlations using SPSS Statistics.
Results
We enrolled 92 women in this study, 10 did not respond to all scales of postoperative BREAST-Q, the remaining 82 women had undergone breast reconstruction. The correlation between BREAST-Q score and aesthetic score measured by Ten-Point Scale for the three BREAST-Q scales all show positive values in Spearman's correlation coefficient.
Conclusion
A significant correlation without any bias observed was found between the patient's satisfaction measured by BREAST-Q after breast reconstruction and the medical expert's aesthetic evaluation.
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Affiliation(s)
- Woo Jung Choi
- Departments of Plastic and Reconstructive Surgery and College of Medicine, Soonchunhyang University, Seoul, Korea
| | - Woo Jin Song
- Departments of Plastic and Reconstructive Surgery and College of Medicine, Soonchunhyang University, Seoul, Korea
| | - Sang Gue Kang
- Departments of Plastic and Reconstructive Surgery and College of Medicine, Soonchunhyang University, Seoul, Korea
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Saiga M, Hosoya Y, Utsunomiya H, Kuramoto Y, Watanabe S, Tomita K, Aihara Y, Muto M, Hikosaka M, Kawaguchi T, Miyaji T, Yamaguchi T, Zenda S, Goto A, Sakuraba M, Kusano T, Miyabe K, Kuroki T, Yano T, Taminato M, Sekido M, Tsunoda Y, Satake T, Doihara H, Kimata Y. Protocol for a multicentre, prospective, cohort study to investigate patient satisfaction and quality of life after immediate breast reconstruction in Japan: the SAQLA study. BMJ Open 2021; 11:e042099. [PMID: 33589456 PMCID: PMC7887355 DOI: 10.1136/bmjopen-2020-042099] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION The aim of breast reconstruction (BR) is to improve patients' health-related quality of life (HRQOL). Therefore, measuring patient-reported outcomes (PROs) would clarify the value and impact of BR on a patient's life and thus would provide evidence-based information to help decision-making. The Satisfaction and Quality of Life After Immediate Breast Reconstruction study aimed to investigate satisfaction and HRQOL in Japanese patients with breast cancer who undergo immediate breast reconstruction (IBR). METHODS AND ANALYSIS This ongoing prospective, observational multicentre study will assess 406 patients who had unilateral breast cancer and underwent mastectomy and IBR, and were recruited from April 2018 to July 2019. All participants were recruited from seven hospitals: Okayama University Hospital, Iwate Medical University Hospital, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Showa University Hospital, University of Tsukuba Hospital, Osaka University Hospital and Yokohama City University Medical Center. The patients will be followed up for 36 months postoperatively. The primary endpoint of this study will be the time-dependent changes in BREAST-Q satisfaction with breast subscale scores for 12 months after reconstructive surgery, which will be collected via an electronic PRO system. ETHICS AND DISSEMINATION This study will be performed in accordance with the Ethical Guidelines for Medical and Health Research Involving Human Subjects published by Japan's Ministry of Education, Science and Technology and the Ministry of Health, Labour and Welfare, the modified Act on the Protection of Personal Information and the Declaration of Helsinki. This study protocol was approved by the institutional ethics committee at the Okayama University Graduate School of Medicine, Dentistry, on 2 February 2018 (1801-039) and all other participating sites. The findings of this trial will be submitted to an international peer-reviewed journal. TRIAL REGISTRATION NUMBER UMIN000032177.
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Affiliation(s)
- Miho Saiga
- Department of Plastic and Reconstructive Surgery, Okayama University Hospital, Okayama, Japan
| | - Yuko Hosoya
- Department of Plastic and Reconstructive Surgery, Iwate Medical University, Morioka, Japan
| | - Hiroki Utsunomiya
- Department of Surgery and Plastic Surgery, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Yukiko Kuramoto
- Department of Plastic and Reconstructive Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Satoko Watanabe
- Department of Plastic and Reconstructive Surgery, Okayama University Hospital, Okayama, Japan
| | - Koichi Tomita
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yukiko Aihara
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Mayu Muto
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Makoto Hikosaka
- Department of Plastic and Reconstructive Surgery, National Center for Child Health and Development, Tokyo, Japan
| | - Takashi Kawaguchi
- Department of Practical Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Tempei Miyaji
- Department of Clinical Trial Data Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Sadamoto Zenda
- Division of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - Aya Goto
- Department of Plastic and Reconstructive Surgery, Iwate Medical University, Morioka, Japan
| | - Minoru Sakuraba
- Department of Plastic and Reconstructive Surgery, Iwate Medical University, Morioka, Japan
| | | | - Kenta Miyabe
- Department of Plastic and Reconstructive Surgery, Showa University Hospital, Tokyo, Japan
| | - Tomoaki Kuroki
- Department of Plastic and Reconstructive Surgery, Showa University Hospital, Tokyo, Japan
| | - Tomoyuki Yano
- Department of Plastic and Reconstructive Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Mifue Taminato
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Mitsuru Sekido
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yui Tsunoda
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Toshihiko Satake
- Department of Plastic and Reconstructive Surgery, Toyama University Hospital, Toyama, Japan
| | - Hiroyoshi Doihara
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan
| | - Yoshihiro Kimata
- Department of Plastic and Reconstructive Surgery, Okayama University Hospital, Okayama, Japan
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LaRiviere MJ, Chao HH, Doucette A, Kegelman TP, Taunk NK, Freedman GM, Vapiwala N. Factors Associated With Fatigue in Patients with Breast Cancer Undergoing External Beam Radiation Therapy. Pract Radiat Oncol 2020; 10:409-422. [PMID: 32531443 DOI: 10.1016/j.prro.2020.05.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 05/20/2020] [Accepted: 05/25/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE Cancer-related fatigue (CRF), a prevalent symptom among cancer patients, is a side effect of external beam radiation therapy (EBRT). Even when targeting organs unrelated to caloric intake or the central nervous system, radiation therapy can increase CRF, a poorly understood toxicity resulting from patient-specific, systemic therapy-related, and radiation-specific factors. We sought to determine factors associated with fatigue among patients receiving EBRT for breast cancer. METHODS AND MATERIALS To determine the variables associated with fatigue among patients with nonmetastatic breast cancer, we retrospectively analyzed prospectively collected toxicity data for a cohort of 1286 adult females with breast cancer who began curative-intent EBRT between April 4, 2010, and October 10, 2017. We hypothesized certain variables are associated with provider-reported Common Terminology Criteria for Adverse Events version 4 fatigue, graded 0 to 3, at baseline and over the course of radiation treatment. RESULTS All patients were women, with a median age of 57 (range, 24-90). Mean fatigue was low (0.35 [95% confidence interval, 0.32-0.38]) at the start of radiation, increasing weekly and peaking at week 6 (0.85 [0.81-0.90]). Baseline fatigue was associated with higher American Joint Committee on Cancer stage (P < .001), N-stage (P < .001), anxiolytics (P < .001), anticonvulsants (P = .002), antidepressants (P = .006), antihistamines (P < .001), and antipsychotics (P < .001). Chemotherapy was not associated with baseline fatigue. Over the course of treatment, on multivariable analysis, only lower dose per fraction (P < .001) was significantly associated with increasing fatigue. In a subgroup analysis, heart and lung mean, V5, and V20 doses were not found to be associated with increasing fatigue. CONCLUSIONS This work informs clinicians which factors are associated with CRF at the start of radiation therapy (more advanced disease and prescription of anxiolytics, anticonvulsants, antidepressants, antihistamines, and antipsychotics) and increase CRF over the course of radiation (smaller fraction size). This extensive analysis of factors associated with fatigue provides further evidence that hypofractionated radiation therapy for breast cancer is associated with less acute toxicity than conventionally fractionated treatment.
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Affiliation(s)
- Michael J LaRiviere
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania.
| | - Hann-Hsiang Chao
- Department of Radiation Oncology, Hunter Holmes McGuire Veterans Administration Medical Center, Richmond, Virginia
| | - Abigail Doucette
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Timothy P Kegelman
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Neil K Taunk
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Gary M Freedman
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Neha Vapiwala
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania
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Chapman BV, Lei X, Patil P, Tripathi S, Nicklaus KM, Grossberg AJ, Shaitelman SF, Thompson AM, Hunt KK, Buchholz TA, Merchant F, Markey MK, Smith BD, Reddy JP. Quantitative 3-Dimensional Photographic Assessment of Breast Cosmesis After Whole Breast Irradiation for Early Stage Breast Cancer: A Secondary Analysis of a Randomized Clinical Trial. Adv Radiat Oncol 2020; 5:824-833. [PMID: 33083644 PMCID: PMC7557136 DOI: 10.1016/j.adro.2020.04.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 04/14/2020] [Accepted: 04/16/2020] [Indexed: 11/19/2022] Open
Abstract
Purpose Our purpose was to use 3-dimensional (3D) surface photography to quantitatively measure breast cosmesis within the framework of a randomized clinical trial of conventionally fractionated (CF) and hypofractionated (HF) whole breast irradiation (WBI); to identify how 3D measurements are associated with patient- and physician-reported cosmesis; and to determine whether objective measures of breast symmetry varied by WBI treatment arm or transforming growth factor β 1 (TGFβ1) status. Methods and Materials From 2011 to 2014, 287 women age ≥40 with ductal carcinoma in situ or early-stage invasive breast cancer were enrolled in a multicenter trial and randomized to HF-WBI or CF-WBI with a boost. Three-dimensional surface photography was performed at 3 years posttreatment. Patient-reported cosmetic outcomes were recorded with the Breast Cancer Treatment Outcome Scale. Physician-reported cosmetic outcomes were assessed by the Radiation Therapy Oncology Group scale. Volume ratios and 6 quantitative measures of breast symmetry, termed F1-6C, were calculated using the breast contour and fiducial points assessed on 3D surface images. Associations between all metrics, patient- and physician-reported cosmesis, treatment arm, and TGFβ1 genotype were performed using the Kruskal-Wallis test and multivariable logistic regression models. Results Among 77 (39 CF-WBI and 38 HF-WBI) evaluable patients, both patient- and physician-reported cosmetic outcomes were significantly associated with the F1C vertical symmetry measure (both P < .05). Higher dichotomized F1C and volumetric symmetry measures were associated with improved patient- and physician-reported cosmesis on multivariable logistic regression (both P ≤ .05). There were no statistically significant differences in vertical symmetry or volume measures between treatment arms. Increased F6C horizontal symmetry was observed in the CF-WBI arm (P = .05). Patients with the TGFβ1 C-509T variant allele had lower F2C vertical symmetry measures (P = .02). Conclusions Quantitative 3D image-derived measures revealed comparable cosmetic outcomes with HF-WBI compared with CF-WBI. Our findings suggest that 3D surface imaging may be a more sensitive method for measuring subtle cosmetic changes than global patient- or physician-reported assessments.
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Affiliation(s)
- Bhavana V. Chapman
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Xiudong Lei
- Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Prithvi Patil
- Department of Engineering Technology, University of Houston, Houston, Texas
- The University of Texas Health Science Center at Houston, Houston, Texas
| | - Shikha Tripathi
- Department of Engineering Technology, University of Houston, Houston, Texas
| | - Krista M. Nicklaus
- Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, Texas
| | - Aaron J. Grossberg
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
- Department of Radiation Medicine, Oregon Health and Science University, Portland, Oregon
| | - Simona F. Shaitelman
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Alastair M. Thompson
- Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
- Department of Surgery, Division of Surgical Oncology, Baylor College of Medicine, Houston, Texas
| | - Kelly K. Hunt
- Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Thomas A. Buchholz
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
- Scripps MD Anderson Cancer Center, La Jolla, California
| | - Fatima Merchant
- Department of Engineering Technology, University of Houston, Houston, Texas
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, Texas
- Department of Computer Science, University of Houston, Houston, Texas
| | - Mia K. Markey
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, Texas
- Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Benjamin D. Smith
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
- Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jay P. Reddy
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
- Corresponding author: Jay P. Reddy, MD, PhD
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Abstract
OPINION STATEMENT Oncoplastic surgery (OPS) expands the indications and possibilities of breast-conserving surgery (BCS) by allowing for a wider cancer resection than lumpectomy. Ongoing investigation and reporting of OPS outcomes along with improvements in comprehensive training in breast surgical oncology will impact on awareness and lead to increased adoption of these techniques. Indications for OPS include concern about clear margins, poor tumor location (upper inner pole and lower quadrant), multifocality, need for skin excision, and poor candidacy for mastectomy and reconstruction. OPS has been proven to be oncological safe with comparable rates of complications, positive margins, and re-excisions with BCS. Additionally, OPS has a positive impact on the quality of life and self-esteem when compared with those patients that underwent BCT.
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van de Voort EMF, Klem TMAL, Struik GM, Birnie E, Sinke RHJA, Ghandi A. Patient reported cosmetic outcome after vacuum assisted excision of benign breast lesions: a cross-sectional study. Br J Radiol 2020; 93:20190994. [PMID: 32649240 DOI: 10.1259/bjr.20190994] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE Better cosmetic outcome after vacuum assisted excision (VAE) compared to surgical excision of benign breast lesions is suggested in previous studies but has never been evaluated with validated outcome measures. In this study, patient reported cosmetic outcome after VAE was evaluated. METHODS Patients who underwent VAE between July 2017 and December 2018 were invited to complete the cosmetic subscale of the Dutch Breast Cancer Treatment Outcome Scale, comparing the treated with the untreated breast. Response mode ranged from 1 (no difference) to 4 (large difference) and cosmetic outcome was calculated as the unweighted mean. Clinical outcomes included: tumor size, number of cores, complications, residual lesions and recurrences. RESULTS Response rate was 73.4% (47 of 64 patients). Median tumor size was 15 mm (range 5-51 mm) and median number of cores 6.5 (range 1-85), complete excision was confirmed in all but two patients. Mean cosmetic outcome was good (mean score ≤1.75) in 74% of patients and no patients reported a poor cosmetic outcome (mean score >3.25). A hematoma occurred in five patients (one needed aspiration) and a skin rash in one patient, no patients developed an infection or seroma. CONCLUSION In this study VAE is safe and effective for tumors up to 5 cm and patient reported cosmetic outcome was good. Patients with benign lesions could benefit from VAE as an alternative for surgical excision. ADVANCES IN KNOWLEDGE A formal quantitative measurement of cosmetic outcome after vacuum assisted excision for benign breast lesions was still lacking. This study shows that this cosmetic outcome is overall good in benign lesions up to 5 cm.
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Affiliation(s)
| | - Taco M A L Klem
- Department of Surgery, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands
| | - Gerson M Struik
- Department of Surgery, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands.,Department of Surgery, Reinier de Graaf Gasthuis, Delft, The Netherlands
| | - Erwin Birnie
- Department of Statistics and Education, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands.,Department of Genetics, UMC Groningen, University of Groningen, Groningen, the Netherlands
| | - Renata H J A Sinke
- Department of Pathology, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands
| | - Ali Ghandi
- Department of Radiology, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands
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10
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Sousa H, Castro S, Abreu J, Pereira MG. A systematic review of factors affecting quality of life after postmastectomy breast reconstruction in women with breast cancer. Psychooncology 2019; 28:2107-2118. [DOI: 10.1002/pon.5206] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 08/09/2019] [Accepted: 08/12/2019] [Indexed: 01/04/2023]
Affiliation(s)
- Helena Sousa
- Family Health and Illness Research Group, School of PsychologyUniversity of Minho Braga Portugal
| | - Sónia Castro
- Breast Cancer Clinic/Psycho‐Oncology ServiceFrancisco Gentil Portuguese Institute of Oncology of Porto Porto Portugal
| | - Joaquim Abreu
- Breast Cancer Clinic/Head of the Surgical Oncology DepartmentFrancisco Gentil Portuguese Institute for Oncology of Porto Porto Portugal
| | - M. Graça Pereira
- Family Health and Illness Research Group, School of PsychologyUniversity of Minho Braga Portugal
- Research Center in Psychology (CIPsi), School of PsychologyUniversity of Minho Braga Portugal
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11
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Does 2-Stage Implant-Based Breast Reconstruction Allow for a Larger Volume of the Definite Implant Compared With 1-Stage Reconstruction? Ann Plast Surg 2019; 80:481-486. [PMID: 29443834 DOI: 10.1097/sap.0000000000001352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
INTRODUCTION Breast reconstruction using implants is still the main breast reconstruction technique worldwide. Current debate within implant-based breast reconstruction is whether to perform a 1-stage (direct implant) or 2-stage (tissue expander/implant) reconstruction. Volume differences between a woman's native breast and changes in volume after breast reconstruction might be an important factor for a patient's choice between these types of reconstruction. Three-dimensional imaging facilitates objective breast volume estimates. The goal of this study was to investigate differences between the patient's natural breast and the volume after completed breast reconstruction. One- and two-stage implant-based breast reconstruction techniques were compared. Finally, it was assessed whether patient satisfaction is causally related with the final breast volume after reconstruction. METHODS AND RESULTS A total of 38 patients were included in the study, including 35 two-stage breast reconstructions and 27 one-stage reconstructions. Preoperative and postoperative 3-dimensional images of the breast with the Vectra XT Imaging system were taken. Volume analysis was performed to estimate the patient's native breast volume. Implant size were derived from the operation report. A mean volume reduction for the 1-stage reconstruction group was found -1 mL, whereas an increase of +80 mL was found in the 2-stage reconstruction group (P < 0.005). Patient satisfaction related to volume outcome was not significantly different between both groups, using the Breast-Q questionnaire. CONCLUSIONS This study shows that a 2-stage breast reconstruction has the potential of an increased breast volume compared with a similar breast volume in 1-stage reconstruction.
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12
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Kairn T, Crowe SB. Retrospective analysis of breast radiotherapy treatment plans: Curating the 'non-curated'. J Med Imaging Radiat Oncol 2019; 63:517-529. [PMID: 31081603 DOI: 10.1111/1754-9485.12892] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 03/24/2019] [Indexed: 11/29/2022]
Abstract
INTRODUCTION This paper provides a demonstration of how non-curated data can be retrospectively cleaned, so that existing repositories of radiotherapy treatment planning data can be used to complete bulk retrospective analyses of dosimetric trends and other plan characteristics. METHODS A non curated archive of 1137 radiotherapy treatment plans accumulated over a 12-month period, from five radiotherapy centres operated by one institution, was used to investigate and demonstrate a process of clinical data cleansing, by: identifying and translating inconsistent structure names; correcting inconsistent lung contouring; excluding plans for treatments other than breast tangents and plans without identifiable PTV, lung and heart structures; and identifying but not excluding plans that deviated from the local planning protocol. PTV, heart and lung dose-volume metrics were evaluated, in addition to a sample of personnel and linac load indicators. RESULTS Data cleansing reduced the number of treatment plans in the sample by 35.7%. Inconsistent structure names were successfully identified and translated (e.g. 35 different names for lung). Automatically separating whole lung structures into left and right lung structures allowed the effect of contralateral and ipsilateral lung dose to be evaluated, while introducing some small uncertainties, compared to manual contouring. PTV doses were indicative of prescription doses. Breast treatment work was unevenly distributed between oncologists and between metropolitan and regional centres. CONCLUSION This paper exemplifies the data cleansing and data analysis steps that may be completed using existing treatment planning data, to provide individual radiation oncology departments with access to information on their own patient populations. Clearly, the well-planned and systematic recording of new, high quality data is the preferred solution, but the retrospective curation of non-curated data may be a useful interim solution, for radiation oncology departments where the systems for recording of new data have yet to be designed and agreed.
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Affiliation(s)
- Tanya Kairn
- Genesis Cancer Care, Auchenflower, Queensland, Australia.,Science and Engineering Faculty, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Scott B Crowe
- Science and Engineering Faculty, Queensland University of Technology, Brisbane, Queensland, Australia.,Cancer Care Services, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
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13
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Aristokleous I, Saddiq M. Quality of life after oncoplastic breast-conserving surgery: a systematic review. ANZ J Surg 2019; 89:639-646. [PMID: 30977582 DOI: 10.1111/ans.15097] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 12/11/2018] [Accepted: 01/07/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND Oncoplastic breast-conserving surgery (OBCS) has gained increasing attention as a treatment option for early breast cancer patients, aiming to achieve the best possible breast symmetry with concomitant oncological safety. This paper aims to systematically review the current literature on patient quality of life (QoL) after OBCS compared with QoL after breast-conserving surgery (BCS) alone. METHODS MEDLINE via Ovid, CINAHL via EBSCO and PsycINFO via OvidSP were searched to retrieve all relevant studies. The reference lists of identified eligible studies were manually examined to search for additional eligible studies. The methodological quality of the included studies was assessed using the Critical Appraisal Skills Programme. RESULTS A total of six articles met the inclusion criteria. Most of the studies used validated patient-reported outcome measures for assessing QoL with good response rates. However, only one study was of sufficiently good quality to provide good evidence (P < 0.05) in favour of OBCS, while the remainder were of low to moderate quality with differences in outcomes that were not statistically significant. CONCLUSION The review found that the current evidence base is limited and not adequate enough to support or to reject the assumption that OBCS is associated with improved QoL when compared with QoL post-BCS. However, the majority of studies show that OBCS is associated with a trend towards better patient QoL. The impact of OBCS on patient QoL needs to be more adequately investigated. Large prospective cohort studies to assess the impact of OBCS on QoL compared with QoL post-BCS are strongly recommended.
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Affiliation(s)
- Iliana Aristokleous
- Department of Surgery, Enköpings Hospital, Enköping, Uppsala County, Sweden.,School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | - Muhammad Saddiq
- School of Health and Related Research, The University of Sheffield, Sheffield, UK
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14
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Kindts I, Laenen A, van den Akker M, Weltens C. PROMs following breast-conserving therapy for breast cancer: results from a prospective longitudinal monocentric study. Support Care Cancer 2019; 27:4123-4132. [DOI: 10.1007/s00520-019-04698-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 02/11/2019] [Indexed: 11/12/2022]
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15
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Rajaram N, Lim ZY, Song CV, Kaur R, Mohd Taib NA, Muhamad M, Ong WL, Schouwenburg M, See MH, Teo SH, Saunders C, Yip CH. Patient-reported outcome measures among breast cancer survivors: A cross-sectional comparison between Malaysia and high-income countries. Psychooncology 2018; 28:147-153. [PMID: 30346074 DOI: 10.1002/pon.4924] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 09/06/2018] [Accepted: 10/17/2018] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Patient-reported outcomes (PROs) in high-income countries (HICs) suggest that physical, emotional, and psychological needs are important in cancer care. To date, there have been few inconsistent descriptions of PROs in low-income and middle-income Asian countries. Using a standard questionnaire developed by the International Consortium for Health Outcomes Measurement (ICHOM), we compared the perceived importance of PROs between patients in Malaysia and those in HICs and between clusters of Malaysian women. METHODS Breast cancer patients were recruited from three Malaysian hospitals between June and November 2017. We compared the proportion of patients who rated PROs as very important (scored 7-9 on a 9-point Likert scale) between Malaysian patients and data collected from patients in HICs via the ICHOM questionnaire development process, using logistic regression. A two-step cluster analysis explored differences in PROs among Malaysian patients. RESULTS The most important PROs for both cohorts were survival, overall well-being, and physical functioning. Compared with HIC patients (n = 1177), Malaysian patients (n = 969) were less likely to rate emotional (78% vs 90%), cognitive (76% vs 84%), social (72% vs 81%), and sexual (30% vs 56%) functioning as very important outcomes (P < 0.001). Cluster analysis suggests that older, parous, Malaysian women, who were less likely to have received breast reconstructive surgery, were more likely to rate body image and satisfaction with the breast as very important outcomes. CONCLUSION Taking into account the differences in PROs by cultural and socioeconomic settings could improve patient expectation of services and refine the assessment of cancer care outcomes.
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Affiliation(s)
- Nadia Rajaram
- Breast Cancer Research Group, Cancer Research Malaysia, Subang Jaya, Malaysia
| | - Zhi Ying Lim
- Breast Cancer Research Group, Cancer Research Malaysia, Subang Jaya, Malaysia
| | - Chin Vern Song
- Breast Cancer Research Group, Cancer Research Malaysia, Subang Jaya, Malaysia
| | - Ranjit Kaur
- Breast Cancer Welfare Association, Petaling Jaya, Malaysia
| | - Nur Aishah Mohd Taib
- Department of Surgery, University Malaya Cancer Research Institute, Kuala Lumpur, Malaysia
| | - Mazanah Muhamad
- KanWork Cancer Society, Seri Kembangan, Malaysia.,Faculty of Education, Universiti Putra Malaysia, Seri Kembangan, Malaysia
| | - Wee Loon Ong
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Maartje Schouwenburg
- Breast Cancer Working Group, International Consortium for Health Outcomes Measurement, Cambridge, Massachusetts, USA.,Dutch Institute for Clinical Auditing, Amsterdam, The Netherlands
| | - Mee Hoong See
- Department of Surgery, University Malaya Cancer Research Institute, Kuala Lumpur, Malaysia
| | - Soo-Hwang Teo
- Breast Cancer Research Group, Cancer Research Malaysia, Subang Jaya, Malaysia.,Department of Surgery, University Malaya Cancer Research Institute, Kuala Lumpur, Malaysia
| | | | - Cheng Har Yip
- Department of Surgery, Subang Jaya Medical Centre, Subang Jaya, Malaysia
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Brandini da Silva FC, José da Silva J, Sarri AJ, Paiva CE, Aloisio da Costa Vieira R. Comprehensive Validation Study of Quality-of-Life Questionnaire Using Objective Clinical Measures: Breast Cancer Treatment Outcome Scale (BCTOS), Brazilian Portuguese Version. Clin Breast Cancer 2018; 19:e85-e100. [PMID: 30473244 DOI: 10.1016/j.clbc.2018.10.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Revised: 10/19/2018] [Accepted: 10/21/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION When evaluating a quality-of-life questionnaire (QLQ), many validation studies do not correlate quality-of-life scores with objective measurements of complications associated with treatment. PATIENTS AND METHODS We performed a cross-sectional observational study with 300 patients submitted to breast-conserving therapy. The patients answered the European Organization for Research and Treatment of Cancer (EORTC) QLQs C-30 and BR23, as well as the Brazilian Portuguese version of the Breast Cancer Treatment Outcome Scale (BCTOS) questionnaire. Retest, internal consistency, factorial analysis, convergent/divergent analysis, and Rasch evaluation were performed. All patients underwent physical evaluations to assess lymphedema, handgrip strength, shoulder range of motion, breast cosmesis, and breast pain, and these groups were compared on the basis of BCTOS scores. Receiver operating characteristic curve determined the predictive value of BCTOS scores associated with clinical practice. RESULTS The internal consistencies of the BCTOS domains ranged from 0.785 to 0.895. Factor analysis grouped according to the original questionnaire. Convergent validation showed differences in the sexual functioning and sexual enjoyment domains of the EORTC BR23. Analysis of known groups found that in most domains, the scores were higher in patients with lymphedema, strength deficit, shoulder range-of-motion alteration, poor breast cosmesis, breast pain, and axillary lymphadenectomy. Using a cutoff of 1.26, lymphedema was associated with the edema domain; using a cutoff of 1.33, Late Effects Normal Tissue Task Force/Subjective, Objective, Management, Analytic pain was associated with the pain domain; and using a cutoff of 2.37, the cosmetic domain was associated with subjective cosmesis. CONCLUSION The association of objective measurements in a validation study of quality of life qualified the study and allowed us to develop better parameters for comparisons of results of breast-conserving therapy between populations.
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Affiliation(s)
- Fabíola Cristina Brandini da Silva
- Postgraduate Program of Oncology, Barretos Cancer Hospital, Barretos, Brazil; Department of Physiotherapy, Barretos Cancer Hospital, Barretos, Brazil
| | - Jonathas José da Silva
- Postgraduate Program of Oncology, Barretos Cancer Hospital, Barretos, Brazil; Department of Physiotherapy, Barretos Cancer Hospital, Barretos, Brazil
| | - Almir José Sarri
- Department of Physiotherapy, Barretos Cancer Hospital, Barretos, Brazil
| | - Carlos Eduardo Paiva
- Postgraduate Program of Oncology, Barretos Cancer Hospital, Barretos, Brazil; Department of Clinical Oncology, Barretos Cancer Hospital, Barretos, Brazil
| | - René Aloisio da Costa Vieira
- Postgraduate Program of Oncology, Barretos Cancer Hospital, Barretos, Brazil; Department of Mastology and Breast Reconstruction, Barretos Cancer Hospital, Barretos, Brazil.
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17
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Comparison of brachytherapy and external beam radiotherapy boost in breast-conserving therapy: Patient-reported outcome measures and aesthetic outcome. Strahlenther Onkol 2018; 195:21-31. [DOI: 10.1007/s00066-018-1346-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 07/30/2018] [Indexed: 11/12/2022]
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18
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Schäfer R, Strnad V, Polgár C, Uter W, Hildebrandt G, Ott OJ, Kauer-Dorner D, Knauerhase H, Major T, Lyczek J, Guinot JL, Dunst J, Miguelez CG, Slampa P, Allgäuer M, Lössl K, Kovács G, Fischedick AR, Fietkau R, Resch A, Kulik A, Arribas L, Niehoff P, Guedea F, Schlamann A, Gall C, Polat B. Quality-of-life results for accelerated partial breast irradiation with interstitial brachytherapy versus whole-breast irradiation in early breast cancer after breast-conserving surgery (GEC-ESTRO): 5-year results of a randomised, phase 3 trial. Lancet Oncol 2018; 19:834-844. [PMID: 29695348 DOI: 10.1016/s1470-2045(18)30195-5] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 02/27/2018] [Accepted: 03/01/2018] [Indexed: 01/28/2023]
Abstract
BACKGROUND Previous results from the GEC-ESTRO trial showed that accelerated partial breast irradiation (APBI) using multicatheter brachytherapy in the treatment of early breast cancer after breast-conserving surgery was non-inferior to whole-breast irradiation in terms of local control and overall survival. Here, we present 5-year results of patient-reported quality of life. METHODS We did this randomised controlled phase 3 trial at 16 hospitals and medical centres in seven European countries. Patients aged 40 years or older with 0-IIA breast cancer were randomly assigned (1:1) after breast-conserving surgery (resection margins ≥2 mm) to receive either whole-breast irradiation of 50 Gy with a boost of 10 Gy or APBI using multicatheter brachytherapy. Randomisation was stratified by study centre, tumour type, and menopausal status, with a block size of ten and an automated dynamic algorithm. There was no masking of patients or investigators. The primary endpoint of the trial was ipsilateral local recurrence. Here, we present 5-year results of quality of life (a prespecified secondary endpoint). Quality-of-life questionnaires (European Organisation for Research and Treatment of Cancer QLQ-C30, breast cancer module QLQ-BR23) were completed before radiotherapy (baseline 1), immediately after radiotherapy (baseline 2), and during follow-up. We analysed the data according to treatment received (as-treated population). Recruitment was completed in 2009, and long-term follow-up is continuing. The trial is registered at ClinicalTrials.gov, number NCT00402519. FINDINGS Between April 20, 2004, and July 30, 2009, 633 patients had accelerated partial breast irradiation and 551 patients had whole-breast irradiation. Quality-of-life questionnaires at baseline 1 were available for 334 (53%) of 663 patients in the APBI group and 314 (57%) of 551 patients in the whole-breast irradiation group; the response rate was similar during follow-up. Global health status (range 0-100) was stable in both groups: at baseline 1, APBI group mean score 65·5 (SD 20·6) versus whole-breast irradiation group 64·6 (19·6), p=0·37; at 5 years, APBI group 66·2 (22·2) versus whole-breast irradiation group 66·0 (21·8), p=0·94. The only moderate, significant difference (difference of 10-20 points) between the groups was found in the breast symptoms scale. Breast symptom scores were significantly higher (ie, worse) after whole-breast irradiation than after APBI at baseline 2 (difference of means 13·6, 95% CI 9·7-17·5; p<0·0001) and at 3-month follow-up (difference of means 12·7, 95% CI 9·8-15·6; p<0·0001). INTERPRETATION APBI with multicatheter brachytherapy was not associated with worse quality of life compared with whole-breast irradiation. This finding supports APBI as an alternative treatment option after breast-conserving surgery for patients with early breast cancer. FUNDING German Cancer Aid.
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Affiliation(s)
- Rebekka Schäfer
- Department of Radiation Oncology, University Hospital Würzburg, Würzburg, Germany.
| | - Vratislav Strnad
- Department of Radiation Oncology, University Hospital Erlangen, Erlangen, Germany
| | - Csaba Polgár
- Center of Radiotherapy, National Institute of Oncology, Budapest, Hungary; Department of Oncology, Semmelweis University, Budapest, Hungary
| | - Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology, University Erlangen-Nuremberg, Erlangen, Germany
| | - Guido Hildebrandt
- Department of Radiation Oncology, University Hospital Leipzig, Leipzig, Germany; Department of Radiation Oncology, University Hospital Rostock, Rostock, Germany
| | - Oliver J Ott
- Department of Radiation Oncology, University Hospital Erlangen, Erlangen, Germany
| | | | - Hellen Knauerhase
- Department of Radiation Oncology, University Hospital Rostock, Rostock, Germany
| | - Tibor Major
- Center of Radiotherapy, National Institute of Oncology, Budapest, Hungary
| | - Jaroslaw Lyczek
- Podkarpacki Hospital Cancer Center Brzozow, Brzozow, Poland; Brachytherapy Department, Centrum Onkologii-Instytut im Marii Skłodowskiej, Warsaw, Poland
| | - Jose Luis Guinot
- Department of Radiation Oncology, Valencian Institute of Oncology, Valencia, Spain
| | - Jürgen Dunst
- Department of Radiation Oncology, University Hospital Kiel, Kiel, Germany
| | | | - Pavel Slampa
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute and Faculty of Medicine, Brno, Czech Republic
| | - Michael Allgäuer
- Department of Radiation Oncology, Hospital Barmherzige Brüder, Regensburg, Germany
| | - Kristina Lössl
- Department of Radiation Oncology, University Hospital Bern, Inselspital, Switzerland
| | - György Kovács
- Interdisciplinary Brachytherapy Unit, University of Lubeck/Universitätsklinikum Schleswig-Holstein Campus Lubeck, Lubeck, Germany
| | | | - Rainer Fietkau
- Department of Radiation Oncology, University Hospital Erlangen, Erlangen, Germany; Department of Radiation Oncology, University Hospital Rostock, Rostock, Germany
| | - Alexandra Resch
- Department of Radiation Oncology, University Hospital AKH Wien, Vienna, Austria
| | - Anna Kulik
- Brachytherapy Department, Centrum Onkologii-Instytut im Marii Skłodowskiej, Warsaw, Poland
| | - Leo Arribas
- Department of Radiation Oncology, Valencian Institute of Oncology, Valencia, Spain
| | - Peter Niehoff
- Department of Radiation Oncology, University Hospital Kiel, Kiel, Germany; Department of Radiotherapy, Sana Hospital Offenbach, Offenbach, Germany
| | - Ferran Guedea
- Department of Radiation Oncology, Catalan Institute of Oncology, Barcelona, Spain
| | - Annika Schlamann
- Department of Radiation Oncology, University Hospital Leipzig, Leipzig, Germany
| | - Christine Gall
- Department of Medical Informatics, Biometry and Epidemiology, University Erlangen-Nuremberg, Erlangen, Germany
| | - Bülent Polat
- Department of Radiation Oncology, University Hospital Würzburg, Würzburg, Germany
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Kanatas A, Lowe D, Velikova G, Roe B, Horgan K, Shaw RJ, Rogers SN. Issues Patients would like to Discuss at their Review Consultation in Breast Cancer Clinics – a Cross-sectional Survey. TUMORI JOURNAL 2018. [DOI: 10.1177/1660.18184] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Anastasios Kanatas
- Leeds Teaching Hospitals and St James's Institute of Oncology, Leeds General Infirmary, Leeds
| | - Derek Lowe
- Evidence-Based Practice Research Centre (EPRC), Faculty of Health, Edge Hill University, Ormskirk
| | | | - Brenda Roe
- Health Research, Edge Hill University, Ormskirk
- PSSRU, University of Manchester, Manchester
| | - Kieran Horgan
- Leeds Teaching Hospitals, Breast Surgery Department, Leeds General Infirmary, Leeds
| | - Richard J Shaw
- Department of Head and Neck Surgery, Liverpool CR-UK Centre, Department of Molecular and Clinical Cancer Medicine, Liverpool
| | - Simon N Rogers
- Evidence-Based Practice Research Centre (EPRC), Faculty of Health, Edge Hill University, Ormskirk
- Regional Maxillofacial Unit, University Hospital Aintree, Liverpool, UK
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Trenerry C, Peters MDJ, Corsini N, Damarell RA, Wilson C, Flight I. Patient-reported outcomes following neoadjuvant chemotherapy or chemoradiotherapy treatment for esophageal cancer: a scoping review protocol. ACTA ACUST UNITED AC 2018. [PMID: 28628507 DOI: 10.11124/jbisrir-2016-003240] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
REVIEW OBJECTIVE The objective of this scoping review is to identify, describe and compare studies investigating patient-reported outcomes (PROs) in esophageal cancer patients following neoadjuvant (preoperative) chemotherapy (CT) and surgery or neoadjuvant chemoradiotherapy (CRT) and surgery.After preliminary searching of the literature and consultation with experts in the fields of esophageal cancer surgery, behavioral science, information systems and scoping review methodology, the following research objectives were defined as follows.
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Affiliation(s)
- Camilla Trenerry
- 1The Flinders Centre for Innovation in Cancer, School of Medicine, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Adelaide, Australia 2The Joanna Briggs Institute, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia 3Cancer Council SA, Australia 4School of Health Sciences, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Adelaide, Australia
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21
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Cereijo-Garea C, Pita-Fernández S, Acea-Nebril B, Rey-Villar R, García-Novoa A, Varela-Lamas C, Builes-Ramirez S, Seoane-Pillado T, Balboa-Barreiro V. Predictive factors of satisfaction and quality of life after immediate breast reconstruction using the BREAST-Q©. J Clin Nurs 2018; 27:1464-1474. [DOI: 10.1111/jocn.14291] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2018] [Indexed: 01/15/2023]
Affiliation(s)
- Carmen Cereijo-Garea
- Breast Unit; Complexo Hospitalario Universitario A Coruña (CHUAC); SERGAS; A Coruña Spain
| | - Salvador Pita-Fernández
- Clinical Epidemiology and Biostatistics Research Group; Instituto de Investigación Biomédica de A Coruña (INIBIC); Complexo Hospitalario Universitario de A Coruña (CHUAC); SERGAS; Universidade da Coruña; A Coruña Spain
| | - Benigno Acea-Nebril
- Department of Surgery; Breast Unit; Complexo Hospitalario Universitario A Coruña (CHUAC); SERGAS; A Coruña Spain
| | - Raquel Rey-Villar
- Breast Unit; Complexo Hospitalario Universitario A Coruña (CHUAC); SERGAS; A Coruña Spain
| | - Alejandra García-Novoa
- Department of Surgery; Breast Unit; Complexo Hospitalario Universitario A Coruña (CHUAC); SERGAS; A Coruña Spain
| | - Cristina Varela-Lamas
- Department of Surgery; Breast Unit; Complexo Hospitalario Universitario A Coruña (CHUAC); SERGAS; A Coruña Spain
| | - Sergio Builes-Ramirez
- Department of Surgery; Breast Unit; Complexo Hospitalario Universitario A Coruña (CHUAC); SERGAS; A Coruña Spain
| | - Teresa Seoane-Pillado
- Clinical Epidemiology and Biostatistics Research Group; Instituto de Investigación Biomédica de A Coruña (INIBIC); Complexo Hospitalario Universitario de A Coruña (CHUAC); SERGAS; Universidade da Coruña; A Coruña Spain
| | - Vanesa Balboa-Barreiro
- Clinical Epidemiology and Biostatistics Research Group; Instituto de Investigación Biomédica de A Coruña (INIBIC); Complexo Hospitalario Universitario de A Coruña (CHUAC); SERGAS; Universidade da Coruña; A Coruña Spain
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22
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Tian J, Xue J, Hu X, Han Q, Zhang Y. CHF-PROM: validation of a patient-reported outcome measure for patients with chronic heart failure. Health Qual Life Outcomes 2018; 16:51. [PMID: 29554963 PMCID: PMC5859646 DOI: 10.1186/s12955-018-0874-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 02/27/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Due to a lack of an appropriate disease-specific patient-reported outcome (PRO) instrument for chronic heart failure including its social support and treatment aspects in China, this study was performed to develop a patient-reported outcome measure (PROM) for patients with chronic heart failure and evaluate its reliability, validity, and feasibility. METHODS According to the standard PROM guidelines established by the Food and Drug Administration, an item pool was formed by reviewing a large amount of relevant literature and interviewing patients with chronic heart failure about their main symptoms. Thus, the primary scale was created after adjusting the items and language with the help of patients and experts in the field. Next, 155 patients from 8 hospitals in different districts were recruited for a pilot survey using questionnaires containing these items. The patients' responses were analyzed using the classical test theory and item response theory to select high-quality items and determine the subdomains of the scale. This was followed by a formal investigation in the same eight hospitals. In total, 360 patients and 100 healthy subjects were included to evaluate the reliability, validity, and feasibility of the items. Through this process, the final scale was established. RESULTS The final scale comprised 12 subdomains with 57 items related to physical, psychological, social, and therapeutic areas. The data analysis results of the formal investigation showed that the PROM for chronic heart failure had good reliability, validity, and feasibility. Reliability was verified by Cronbach's alpha coefficient, which was 0.913 for the total scale, 0.903 for the physical domain, 0.941 for the psychological domain, 0.827 for the social domain, and 0.839 for the therapeutic domain. The construct validity results met the relative criteria of confirmatory factor analysis. Discriminant validity was represented by score comparisons of nine subdomains. The response rate and the effective rate of return of the CHF-PROM were 98.94% and 98.92%, respectively. CONCLUSIONS The final scale coincides with the theoretical framework and better reflects the overall quality of life of patients with chronic heart failure. This scale can be used as a valid instrument to evaluate clinical treatment and clinical trials of chronic heart failure.
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Affiliation(s)
- Jing Tian
- Department of Cardiology, The 1st Hospital of Shanxi Medical University, 85 South Jiefang Road, Taiyuan, Shanxi Province 030001 China
| | - Jiangping Xue
- Department of Health Statistics, School of Public Health, Shanxi Medical University, 56 South XinJian Road, Taiyuan, Shanxi Province 030001 China
| | - Xiaojuan Hu
- Department of Health Statistics, School of Public Health, Shanxi Medical University, 56 South XinJian Road, Taiyuan, Shanxi Province 030001 China
| | - Qinghua Han
- Department of Cardiology, The 1st Hospital of Shanxi Medical University, 85 South Jiefang Road, Taiyuan, Shanxi Province 030001 China
| | - Yanbo Zhang
- Department of Health Statistics, School of Public Health, Shanxi Medical University, 56 South XinJian Road, Taiyuan, Shanxi Province 030001 China
- Shanxi Medical University molecular imaging precision medicine Collaborative Innovation Center, Taiyuan, Shanxi Province 030001 China
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23
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Teo I, Reece GP, Huang SC, Mahajan K, Andon J, Khanal P, Sun C, Nicklaus K, Merchant F, Markey MK, Fingeret MC. Body image dissatisfaction in patients undergoing breast reconstruction: Examining the roles of breast symmetry and appearance investment. Psychooncology 2017; 27:857-863. [PMID: 29152816 DOI: 10.1002/pon.4586] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Revised: 11/03/2017] [Accepted: 11/06/2017] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Reconstruction as part of treatment for breast cancer is aimed at mitigating body image concerns after mastectomy. Although algorithms have been developed to objectively assess breast reconstruction outcomes, associations between objectively quantified breast aesthetic appearance and patient-reported body image outcomes have not been examined. Further, the role of appearance investment in explaining a patient's body image is not well understood. We investigated the extent to which objectively quantified breast symmetry and patient-reported appearance investment were associated with body image dissatisfaction in patients undergoing cancer-related breast reconstruction. METHODS Breast cancer patients in different stages of reconstruction (n = 190) completed self-report measures of appearance investment and body image dissatisfaction. Vertical extent and horizontal extent symmetry values, which are indicators of breast symmetry, were calculated from clinical photographs. Associations among breast symmetry, appearance investment, body image dissatisfaction, and patient clinical factors were examined. Multi-variable regression was used to evaluate the extent to which symmetry and appearance investment were associated with body image dissatisfaction. RESULTS Vertical extent symmetry, but not horizontal extent symmetry, was associated with body image dissatisfaction. Decreased vertical extent symmetry (β = -.19, P < .05) and increased appearance investment (β = .45, P < .001) were significantly associated with greater body image dissatisfaction while controlling for clinical factors. CONCLUSIONS Breast symmetry and patient appearance investment both significantly contribute to an understanding of patient-reported body image satisfaction during breast reconstruction treatment.
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Affiliation(s)
- Irene Teo
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
| | - Gregory P Reece
- Department of Plastic Surgery, MD Anderson Cancer Center, Houston TX, USA
| | - Sheng-Cheng Huang
- Department of Biomedical Engineering, University of Texas, Austin TX, USA
| | - Kanika Mahajan
- Department of Behavioral Sciences, MD Anderson Cancer Center, Houston TX, USA
| | - Johnny Andon
- Department of Engineering Technology, University of Houston, Houston TX, USA
| | - Pujjal Khanal
- Department of Engineering Technology, University of Houston, Houston TX, USA
| | - Clement Sun
- Department of Biomedical Engineering, University of Texas, Austin TX, USA
| | - Krista Nicklaus
- Department of Biomedical Engineering, University of Texas, Austin TX, USA
| | - Fatima Merchant
- Department of Engineering Technology, University of Houston, Houston TX, USA
| | - Mia K Markey
- Department of Biomedical Engineering, University of Texas, Austin TX, USA
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24
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Winters ZE, Afzal M, Rutherford C, Holzner B, Rumpold G, da Costa Vieira RA, Hartup S, Flitcroft K, Bjelic-Radisic V, Oberguggenberger A, Panouilleres M, Mani M, Catanuto G, Douek M, Kokan J, Sinai P, King MT, Spillane A, Snook K, Boyle F, French J, Elder E, Chalmers B, Kabir M, Campbell I, Wong A, Flay H, Scarlet J, Weis J, Giesler J, Bliem B, Nagele E, del Angelo N, Andrade V, Assump¸ão Garcia D, Bonnetain F, Kjelsberg M, William-Jones S, Fleet A, Hathaway S, Elliott J, Galea M, Dodge J, Chaudhy A, Williams R, Cook L, Sethi S, Turton P, Henson A, Gibb J, Bonomi R, Funnell S, Noren C, Ooi J, Cocks S, Dawson L, Patel H, Bailey L, Chatterjee S, Goulden K, Kirk S, Osborne W, Harter L, Sharif MA, Corcoran S, Smith J, Prasad R, Doran A, Power A, Devereux L, Cannon J, Latham S, Arora P, Ridgway S, Coulding M, Roberts R, Absar M, Hodgkiss T, Connolly K, Johnson J, Doyle K, Lunt N, Cooper M, Fuchs I, Peall L, Taylor L, Nicholson A. International validation of the European Organisation for Research and Treatment of Cancer QLQ-BRECON23 quality-of-life questionnaire for women undergoing breast reconstruction. Br J Surg 2017; 105:209-222. [PMID: 29116657 DOI: 10.1002/bjs.10656] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 03/02/2017] [Accepted: 06/23/2017] [Indexed: 11/12/2022]
Abstract
Abstract
Background
The aim was to carry out phase 4 international field-testing of the European Organisation for Research and Treatment of Cancer (EORTC) breast reconstruction (BRECON) module. The primary objective was finalization of its scale structure. Secondary objectives were evaluation of its reliability, validity, responsiveness, acceptability and interpretability in patients with breast cancer undergoing mastectomy and reconstruction.
Methods
The EORTC module development guidelines were followed. Patients were recruited from 28 centres in seven countries. A prospective cohort completed the QLQ-BRECON15 before mastectomy and the QLQ-BRECON24 at 4–8 months after reconstruction. The cross-sectional cohort completed the QLQ-BRECON24 at 1–5 years after reconstruction, and repeated this 2–8 weeks later (test–retest reliability). All participants completed debriefing questionnaires.
Results
A total of 438 patients were recruited, 234 in the prospective cohort and 204 in the cross-sectional cohort. A total of 414 reconstructions were immediate, with a comparable number of implants (176) and donor-site flaps (166). Control groups comprised patients who underwent two-stage implant procedures (72, 75 per cent) or delayed reconstruction (24, 25 per cent). Psychometric scale validity was supported by moderate to high item-own scale and item-total correlations (over 0·5). Questionnaire validity was confirmed by good scale-to-sample targeting, and computable scale scores exceeding 50 per cent, except nipple cosmesis (over 40 per cent). In known-group comparisons, QLQ-BRECON24 scales and items differentiated between patient groups defined by clinical criteria, such as type and timing of reconstruction, postmastectomy radiotherapy and surgical complications, with moderate effect sizes. Prospectively, sexuality and surgical side-effects scales showed significant responsiveness over time (P < 0·001). Scale reliability was supported by high Cronbach's α coefficients (over 0·7) and test–retest (intraclass correlation more than 0·8). One item (finding a well fitting bra) was excluded based on high floor/ceiling effects, poor test–retest and weak correlations in factor analysis (below 0·3), thus generating the QLQ-BRECON23 questionnaire.
Conclusion
The QLQ-BRECON23 is an internationally validated tool to be used alongside the EORTC QLQ-C30 (cancer) and QLQ-BR23 (breast cancer) questionnaires for evaluating quality of life and satisfaction after breast reconstruction.
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Affiliation(s)
- Z E Winters
- Breast Cancer Surgery Patient-Reported and Clinical Outcomes Research Group, University of Bristol, School of Clinical Sciences, Southmead Hospital, Bristol, UK
- Surgical and Interventional Trials Unit, Division of Surgical Sciences, University College London, London, UK
- Quality of Life Office, School of Psychology, Faculty of Science, University of Sydney, New South Wales, Australia
| | - M Afzal
- Breast Cancer Surgery Patient-Reported and Clinical Outcomes Research Group, University of Bristol, School of Clinical Sciences, Southmead Hospital, Bristol, UK
| | - C Rutherford
- Quality of Life Office, School of Psychology, Faculty of Science, University of Sydney, New South Wales, Australia
| | - B Holzner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Innsbruck, Austria
| | - G Rumpold
- Department of Medical Psychology, Evaluation Software Development, Rum, Austria
| | | | - S Hartup
- St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - K Flitcroft
- Breast and Surgical Oncology, Poche Centre, University of Sydney, New South Wales, Australia
| | - V Bjelic-Radisic
- Department of Breast Surgery and Gynaecology, Medical University Graz, Graz, Austria
| | - A Oberguggenberger
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Innsbruck, Austria
| | - M Panouilleres
- Department of Plastic Surgery, Besançon University Hospital, Besançon, France
| | - M Mani
- Department of Surgical Sciences, Plastic and Reconstructive Surgery, Uppsala University, Uppsala, Sweden
| | - G Catanuto
- Multidisciplinary Breast Care, Cannizzaro Hospital, Catania, Italy
| | - M Douek
- Department of Surgical Oncology, Guy's Hospital, London, London, UK
| | - J Kokan
- Cancer Resource Centre, Macclesfield Hospital, Macclesfield, UK
| | - P Sinai
- Breast Cancer Surgery Patient-Reported and Clinical Outcomes Research Group, University of Bristol, School of Clinical Sciences, Southmead Hospital, Bristol, UK
| | - M T King
- Quality of Life Office, School of Psychology, Faculty of Science, University of Sydney, New South Wales, Australia
- Sydney Medical School, Faculty of Medicine, University of Sydney, New South Wales, Australia
| | - A Spillane
- Poche Centre, Sydney, New South Wales, Australia
| | - K Snook
- Poche Centre, Sydney, New South Wales, Australia
| | - F Boyle
- Poche Centre, Sydney, New South Wales, Australia
| | - J French
- The Crown Princess Mary Westmead Breast Cancer Centre and Specialist Services, Sydney, New South Wales, Australia
| | - E Elder
- The Crown Princess Mary Westmead Breast Cancer Centre and Specialist Services, Sydney, New South Wales, Australia
| | - B Chalmers
- The Crown Princess Mary Westmead Breast Cancer Centre and Specialist Services, Sydney, New South Wales, Australia
| | - M Kabir
- The Crown Princess Mary Westmead Breast Cancer Centre and Specialist Services, Sydney, New South Wales, Australia
| | | | - A Wong
- Waikato Hospital, Hamilton, New Zealand
| | - H Flay
- Waikato Hospital, Hamilton, New Zealand
| | - J Scarlet
- Waikato Hospital, Hamilton, New Zealand
| | - J Weis
- University of Freiburg, Freiberg, Germany
| | - J Giesler
- University of Freiburg, Freiberg, Germany
| | - B Bliem
- Medical University Graz, Graz, Austria
| | - E Nagele
- Medical University Graz, Graz, Austria
| | | | - V Andrade
- Barretos Cancer Hospital, Sao Paolo, Brazil
| | | | - F Bonnetain
- Besançon University Hospital, Besançon, France
| | | | - S William-Jones
- Clinical Research Network, West Midlands, Queen-s Hospital, Burton upon Trent, UK
| | - A Fleet
- Clinical Research Network, West Midlands, Queen-s Hospital, Burton upon Trent, UK
| | - S Hathaway
- Clinical Research Network, West Midlands, Queen-s Hospital, Burton upon Trent, UK
| | - J Elliott
- Clinical Research Network, West Midlands, Queen-s Hospital, Burton upon Trent, UK
| | - M Galea
- Cancer Research Unit, Great Western Hospital, Swindon, UK
| | - J Dodge
- Cancer Research Unit, Great Western Hospital, Swindon, UK
| | - A Chaudhy
- Cancer Research Unit, Great Western Hospital, Swindon, UK
| | | | - L Cook
- Guy's Hospital, London, UK
| | | | - P Turton
- Leeds Teaching Hospital, Leeds, UK
| | - A Henson
- Leeds Teaching Hospital, Leeds, UK
| | - J Gibb
- Leeds Teaching Hospital, Leeds, UK
| | - R Bonomi
- Worthing Hospital, Western Sussex Hospitals, Worthing, UK
| | - S Funnell
- Worthing Hospital, Western Sussex Hospitals, Worthing, UK
| | - C Noren
- Worthing Hospital, Western Sussex Hospitals, Worthing, UK
| | - J Ooi
- Royal Bolton Hospital, Bolton, UK
| | - S Cocks
- Royal Bolton Hospital, Bolton, UK
| | - L Dawson
- Royal Bolton Hospital, Bolton, UK
| | - H Patel
- Royal Bolton Hospital, Bolton, UK
| | - L Bailey
- Royal Bolton Hospital, Bolton, UK
| | | | | | - S Kirk
- Salford Royal Hospital, UK
| | | | | | | | | | - J Smith
- Stepping Hill Hospital, Stockport, UK
| | - R Prasad
- Royal AlbertEdward Infirmary, Wigan, UK
| | - A Doran
- Royal AlbertEdward Infirmary, Wigan, UK
| | - A Power
- Royal AlbertEdward Infirmary, Wigan, UK
| | | | - J Cannon
- Royal AlbertEdward Infirmary, Wigan, UK
| | - S Latham
- Royal AlbertEdward Infirmary, Wigan, UK
| | - P Arora
- Tameside General Hospital, Ashton-under-Lyne, UK
| | - S Ridgway
- Tameside General Hospital, Ashton-under-Lyne, UK
| | - M Coulding
- Tameside General Hospital, Ashton-under-Lyne, UK
| | - R Roberts
- Tameside General Hospital, Ashton-under-Lyne, UK
| | - M Absar
- North ManchesterGeneral Hospital, Manchester, UK
| | - T Hodgkiss
- North ManchesterGeneral Hospital, Manchester, UK
| | - K Connolly
- North ManchesterGeneral Hospital, Manchester, UK
| | - J Johnson
- North ManchesterGeneral Hospital, Manchester, UK
| | - K Doyle
- North ManchesterGeneral Hospital, Manchester, UK
| | - N Lunt
- Cancer Resource Centre, Macclesfield Hospital, Macclesfield, UK
| | - M Cooper
- Bristol Breast Care Centre, Southmead Hospital, Bristol, UK
| | - I Fuchs
- Bristol Breast Care Centre, Southmead Hospital, Bristol, UK
| | - L Peall
- Bristol Breast Care Centre, Southmead Hospital, Bristol, UK
| | - L Taylor
- Bristol Breast Care Centre, Southmead Hospital, Bristol, UK
| | - A Nicholson
- Bristol Breast Care Centre, Southmead Hospital, Bristol, UK
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25
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Sharma R, Shulman LN, James T. The Future of Quality Improvement in Breast Cancer: Patient-Reported Outcomes. Am J Med Qual 2017; 32:469-471. [PMID: 28766360 DOI: 10.1177/1062860617723707] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Ranjna Sharma
- 1 Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | | | - Ted James
- 1 Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
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26
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O'Connell RL, Di Micco R, Khabra K, Wolf L, deSouza N, Roche N, Barry PA, Kirby AM, Rusby JE. The potential role of three-dimensional surface imaging as a tool to evaluate aesthetic outcome after Breast Conserving Therapy (BCT). Breast Cancer Res Treat 2017; 164:385-393. [PMID: 28447239 PMCID: PMC5487698 DOI: 10.1007/s10549-017-4256-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Accepted: 04/17/2017] [Indexed: 11/13/2022]
Abstract
PURPOSE To establish whether objective measurements of symmetry of volume and shape using three-dimensional surface imaging (3D-SI) can be used as surrogate markers of aesthetic outcome in patients who have undergone breast conserving therapy (BCT). METHODS Women who had undergone unilateral BCT in the preceding 1-6 years were invited to participate. Participants completed a satisfaction questionnaire (BREAST-Q) and underwent 3D-SI. Volume and surface symmetry were measured on the images. Assessment of aesthetic outcome was undertaken by a panel of clinicians. The Kruskal-Wallis test was used to assess the relationship between volume and shape symmetry measurements with the panel score. Spearman's rho correlations were used to assess the relationship between the measurements and patient satisfaction. RESULTS 200 women participated. Median volume symmetry was 87% (IQR 78-93) and shape symmetry was 5.9 mm (IQR 4.2-8.0). The participants were grouped according to panel assessment of aesthetic outcome (poor, fair, good, excellent) and the median volume and shape symmetry was calculated for each group. Volume symmetry significantly differed between the groups. Post hoc pairwise comparisons demonstrated that these differences existed between panel scores of fair versus good and good versus excellent. Median shape symmetry also differed according to patient panel groups with four significant pairwise comparisons between poor versus good, poor versus excellent, fair versus good and fair versus excellent. There was a significant but weak correlation of both volume symmetry and surface asymmetry with BREAST-Q scores (correlation coefficients 0.187 and -0.229, respectively). CONCLUSION Breast volume and shape symmetry are both associated with panel assessment scores and patient satisfaction. The objective volume and shape symmetry measures were strongly associated with panel assessment scores, such that a 3D-SI tool could replace panel assessment as a faster and more objective method of evaluating aesthetic outcomes.
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Affiliation(s)
- Rachel L O'Connell
- Department of Breast Surgery, The Royal Marsden NHS Foundation Trust, Orchard House, Downs Road, Sutton, SM2 5PT, UK
| | - Rosa Di Micco
- Department of Breast Surgery, The Royal Marsden NHS Foundation Trust, Orchard House, Downs Road, Sutton, SM2 5PT, UK
- Department of Medicine and Surgery, University of Naples Federico II, Via S. Pansini 5, 80131, Naples, Italy
| | - Komel Khabra
- Department of Statistics, The Royal Marsden NHS Foundation Trust, Sutton, UK
| | - Lisa Wolf
- Department of Breast Surgery, The Royal Marsden NHS Foundation Trust, Orchard House, Downs Road, Sutton, SM2 5PT, UK
| | - Nandita deSouza
- Cancer Research UK Cancer Imaging Centre, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, UK
| | - Nicola Roche
- Department of Breast Surgery, The Royal Marsden NHS Foundation Trust, Orchard House, Downs Road, Sutton, SM2 5PT, UK
| | - Peter A Barry
- Department of Breast Surgery, The Royal Marsden NHS Foundation Trust, Orchard House, Downs Road, Sutton, SM2 5PT, UK
| | - Anna M Kirby
- Department of Clinical Oncology, The Royal Marsden NHS Foundation Trust, Sutton, UK
| | - Jennifer E Rusby
- Department of Breast Surgery, The Royal Marsden NHS Foundation Trust, Orchard House, Downs Road, Sutton, SM2 5PT, UK.
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27
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Abstract
Key issues of treatment for patients with breast cancer such as patient satisfaction with treatments, compliance, and some side effects are essential for evaluating quality of life by patient-reported outcomes in clinical trials. The study aimed to develop and evaluate a specific patient-reported measure which included physical, psychological, social, and therapeutic domain for assessing the survival of patients with breast cancer.The pool of items was drafted after a theoretical revision and cognitive interviews with women with breast cancer. The draft scale was formed after the adjustment of the items and dimensions, and the selected items were submitted to expert's judgments. Five statistical methods were used to select these items by 2 validation samples. The final scale was administered to a sample of 417 patients from 8 hospitals and 135 controls for reliability, validity, and responsive analyses.The final BC-PROM consisted of 52 items, 13 subdomains, and 4 domains, being developed after preexamination and formal examination. Cronbach alpha coefficient was 0.902 and 0.712 for the full scale and therapeutic domain. The structural validity results showed that the multidimensional measurement of the scale fulfilled expectations. Differences in the BC-PROM mean scores were significant between cancer patients and healthy participants in 13 subdomains (P < .05), indicating good responsiveness. Among the sample survey of patients, the scale copy acceptance rate was 98.2%, completion rate 94.6%, and average filling time 10 minutes.The new and reliable BC-PROM was developed in patients with breast cancer and applied to clinical treatment evaluation and clinical trials for such patients.
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28
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Olsson M, Nilsson M, Fugl-Meyer K, Petersson LM, Wennman-Larsen A, Kjeldgård L, Alexanderson K. Life satisfaction of women of working age shortly after breast cancer surgery. Qual Life Res 2017; 26:673-684. [PMID: 28070803 PMCID: PMC5309315 DOI: 10.1007/s11136-016-1479-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2016] [Indexed: 12/21/2022]
Abstract
Purpose To explore, among women of working age, satisfaction with life as a whole and with different life domains, and its associations with social and health variables, shortly after breast cancer surgery. Methods This cross-sectional study included 605 women, aged 20–63 years, who had had breast cancer surgery with no distant metastasis, pre-surgical chemotherapy, or previous breast cancer. Associations between LiSat-11 and demographic and social factors as well as health- and treatment-related variables were analysed by multivariable logistic regression. Results Compared with Swedish reference levels, the women were, after breast cancer surgery, less satisfied with life, particularly sexual life. Women working shortly after breast cancer surgery were more often satisfied with life in provision domains compared with the reference population. Although most included variables showed associations with satisfaction, after adjustment for all significantly associated variables, only six variables—having children, being in work, having emotional and informational social support, and having good physical and emotional functioning—were positively associated with satisfaction with life as a whole. The odds ratios for satisfaction were higher in most life domains if the woman had social support and good emotional and cognitive functioning. Conclusions One month after breast cancer surgery, satisfaction with different life domains was associated primarily with social support and health-related functioning. However, this soon after surgery, treatment-related variables showed no significant associations with life satisfaction. These results are useful for planning interventions to enhance e.g. social support and emotional as well as cognitive functioning.
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Affiliation(s)
- Mariann Olsson
- Division of Social Work, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
| | - Marie Nilsson
- Division of Social Work, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Department of Social Work, Karolinska University Hospital, Stockholm, Sweden.,Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Kerstin Fugl-Meyer
- Division of Social Work, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Department of Social Work, Karolinska University Hospital, Stockholm, Sweden
| | - Lena-Marie Petersson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Agneta Wennman-Larsen
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Sophiahemmet University, Stockholm, Sweden
| | - Linnea Kjeldgård
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Kristina Alexanderson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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29
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Duraes EFR, Durand P, Duraes LC, Orra S, Moreira-Gonzalez A, Sousa JBD, Djohan RS, Zins J, Bernard S, Schwarz GS. Comparison of preoperative quality of life in breast reconstruction, breast aesthetic and non-breast plastic surgery patients: A cross-sectional study. J Plast Reconstr Aesthet Surg 2016; 69:1478-1485. [PMID: 27650121 DOI: 10.1016/j.bjps.2016.08.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Revised: 03/11/2016] [Accepted: 08/22/2016] [Indexed: 11/25/2022]
Abstract
A breast cancer diagnosis imposes significant emotional and psychological duress. The purpose of this study is to assess the baseline quality of life (QOL) of immediate, delayed, and secondary breast reconstruction patients, comparing these results with QOL in women seeking plastic surgery for cosmetic breast, and non-breast procedures. From 2012 through 2013, immediate (group 1), delayed (group 2), and secondary (Group 3) reconstruction patients, aesthetic breast (group 4) and non-breast plastic surgery patients (group 5) answered Breast-Q questionnaires. Groups 1, 2, 3, 4, and 5 answered 141, 12, 23, 72 and 160 preoperative questionnaires respectively. There was no difference (p = NS) in breast satisfaction, psychosocial well-being, physical well-being-chest, and sexual well-being between groups 1 and 5. Group 1 had higher satisfaction with breast (p < 0.01), psychosocial (p < 0.01) and sexual well-being (p < 0.01) when compared to groups 2 and 4. Group 1 had higher satisfaction with breasts (p < 0.01) compared to group 3. Group 4 did not differ in satisfaction with breasts, psychosocial, and sexual well-being, compared to groups 2 and 3. Group 4 had lower scores in all domains, compared to groups 1 and 5 (p < 0.01). No significant difference in QOL was found between groups 2 and 3. Preoperatively, immediate reconstruction patients had similar satisfaction with breasts, psychosocial well-being, and chest physical well-being, compared to non-breast plastic surgery patients. Aesthetic breast surgery patients demonstrate similar low scores in satisfaction with breasts, psychosocial well-being, and sexual well-being to those of patients prior to delayed breast reconstruction, or secondary salvage procedures.
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Affiliation(s)
- Eliana F R Duraes
- Cleveland Clinic, Cleveland, USA; University of Brasilia - Brasilia, Distrito Federal, Brazil.
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30
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Moloney N, Sung JMW, Kilbreath S, Dylke E. Prevalence and risk factors associated with pain 21 months following surgery for breast cancer. Support Care Cancer 2016; 24:4533-9. [PMID: 27271868 DOI: 10.1007/s00520-016-3292-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Accepted: 05/30/2016] [Indexed: 12/21/2022]
Abstract
PURPOSE This study investigated (1) the prevalence of pain following breast cancer treatment including moderate-to-severe persistent pain and (2) the association of risk factors, present 1 month following surgery, with pain at 21 months following surgery. This information may aid the development of clinical guidelines for early pain assessment and intervention in this population. METHODS This study was a retrospective analysis of core and breast modules of the European Organisation for Research and Treatment of Cancer (EORTC) questionnaire from 121 participants with early breast cancer. The relationships between potential risk factors (subscales derived from the EORTC), measured within 1 month following surgery, and pain at 21 months following surgery were analysed using univariable and multi-variable logistic regression. RESULTS At 21 months following surgery, 46.3 % of participants reported pain, with 24 % categorised as having moderate or severe pain. Prevalence of pain was similar between those who underwent axillary lymph node dissection versus biopsy. Univariate logistic regression identified baseline pain (odds ratio (95 % CI): 2.7 (1.1 to 6.4)); baseline arm symptoms (11.2 (1.4 to 89.8)); emotional function (0.4 (0.1 to 0.8)) and insomnia (2.3 (1.1 to 4.7) as significantly associated with pain at 21 months. In multi-variable analysis, two factors were independently associated with pain at 21 months-baseline arm symptoms and emotional subscale scores. CONCLUSION Pain is a significant problem following breast cancer treatment in both the early post-operative period and months following surgery. Risk factors for pain at long-term follow-up included arm symptoms and higher emotional subscale scores at baseline.
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Affiliation(s)
- Niamh Moloney
- Discipline of Physiotherapy, Faculty of Health Sciences, University of Sydney, Sydney, Australia. .,Department of Health Professions, Faculty of Medicine and Health Sciences, Macquarie University, Ground Floor, 75 Talavera Road, Sydney, NSW, 2113, Australia.
| | - Jennie Man Wai Sung
- Discipline of Physiotherapy, Faculty of Health Sciences, University of Sydney, Sydney, Australia
| | - Sharon Kilbreath
- Discipline of Physiotherapy, Faculty of Health Sciences, University of Sydney, Sydney, Australia
| | - Elizabeth Dylke
- Discipline of Physiotherapy, Faculty of Health Sciences, University of Sydney, Sydney, Australia
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Development of a Japanese version of the BREAST-Q and the traditional psychometric test of the mastectomy module for the assessment of HRQOL and patient satisfaction following breast surgery. Breast Cancer 2016; 24:288-298. [PMID: 27179527 DOI: 10.1007/s12282-016-0703-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 05/08/2016] [Indexed: 01/22/2023]
Abstract
BACKGROUND An understanding of health-related quality of life (HRQOL) is of utmost importance in both oncological and esthetic breast surgery. The BREAST-Q is a patient-reported outcome (PRO) measure that investigates HRQOL and patient satisfaction before and after breast surgery. The aim of this study was to develop a Japanese version of the BREAST-Q including the mastectomy module, the reconstruction module, the augmentation module and the reduction/mastopexy module, and to assess the psychometric properties of the mastectomy module among Japanese women. METHODS The Japanese version of the BREAST-Q was developed through forward translation, backward translation and patient testing. Traditional psychometric testing of the mastectomy module was administered to 45 post-mastectomy patients. RESULTS The mastectomy, reconstruction, augmentation and reduction/mastopexy modules were formally developed into Japanese. Despite cultural difference between Japanese women and original target population, the contents were considered to be valid among Japanese woman. With the exception of the sexual well-being subscale, good reliability and validity were evident for the mastectomy module (Test-retest reliability 0.76-0.95, Chronbach's alpha coefficient 0.77-0.98). CONCLUSIONS The BREAST-Q Japanese version is a useful PRO measure for investigating the impact of breast surgery on HRQOL and patient satisfaction. Further validation in younger Japanese women is needed to determine the usefulness of the sexual well-being subscale.
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Hepatic Lesions Detected after Mastectomy, in Breast Cancer Patients with Hepatitis Background May Need to Undergo Liver Biopsy to Rule Out Second Primary Hepatocellular Carcinoma. PLoS One 2016; 11:e0139782. [PMID: 26766567 PMCID: PMC4713225 DOI: 10.1371/journal.pone.0139782] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Accepted: 09/17/2015] [Indexed: 02/06/2023] Open
Abstract
PURPOSE Liver metastasis is a common phenomenon in breast cancer patients. Hepatic lesions detected in breast cancer patients may be easily misdiagnosed as metastatic sites, rather than being treated as primary foci. This descriptive study aims to investigate the clinicopathological characteristics of second primary hepatocellular carcinoma in breast cancer patients and to infer in which circumstances liver biopsy is needed. METHODS Eighty-one consecutive breast cancer patients with hepatic lesions admitted to our department were retrospectively studied and analyzed from January 2009 to March 2014 according to Warren and Gates' criteria for second primary cancers. RESULTS Second primary hepatocellular carcinoma was observed in sixteen of seventy eight patients with breast cancer. There was a significant difference in HBV status between the second HCC group and liver metastases group (P<0.0001). There was no significant difference in age (P = 0.2254) and family history (P = 0.1160) between second primary HCC and metastases group. Two of these patients had synchronous second primary hepatocellular carcinoma and the remaining fourteen patients had metachronous second primary HCC. All sixteen patients were infected with hepatitis, including hepatitis virus B and C, or resolved HBV infection. CONCLUSIONS Breast cancer patients with either HBV infection or resolved HBV infection, regardless of an elevated AFP level, may receive liver biopsy to avoid unnecessary and inappropriate treatments for metastasis. Awareness of second primary HCC in breast cancer patients needs to be emphasized.
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Zhang J, Yao YF, Zha XM, Pan LQ, Bian WH, Tang JH. Development and Evaluation of a Patient-Reported Outcome (PRO) Scale for Breast Cancer. Asian Pac J Cancer Prev 2016; 16:8573-8. [PMID: 26745119 DOI: 10.7314/apjcp.2015.16.18.8573] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study was guided by principles of the theoretical system of evidence-based medicine. In particular, when searching for evidence of breast cancer, a measuring scale is an instrument for evaluating curative effects in accordance with the laws and characteristics of medicine and exploring the establishment of a system for medically assessing curative effects. At present, there exist few tools for evaluating curative effects. Patient- reported outcomes (PROs) refer to outcomes directly reported by patients (without input or explanations from doctors or other intermediaries) with respect to all aspects of their health. Data obtained from PROs provide evidence of treatment effects. MATERIALS AND METHODS In accordance with the tenets of theoretical medicine and ancient medical theory regarding breast cancer, principles for developing a PRO scale were established, and a theoretical model was developed and a literature review was performed, items from this pool were combined and split, and an initial scale was constructed. After a pilot survey and additional modifications, a pre-questionnaire scale was formed and used in a field investigation. After the application of statistical methods, the item pool was used to create a formal scale. The reliability, validity and feasibility of this formal scale were then assessed. RESULTS In a clinical investigation, 479 responses were recovered, with an acceptance rate of 95%. a combination of various methods was employed, and the items that were selected by all methods or more than half of the methods were employed in the questionnaire. In these cases, the screening methods were combined with certain features of the item, A total of four domains and 38 items were reserved. The reliability analysis indicated that the PRO scale was relatively reliable. CONCLUSIONS Scientific assessment proved that the proposed scale exhibited good reliability and validity. This scale was readily accepted and could be used to assess the curative effects of medical therapy. However, given the limited scope of this investigation, the capacity for adapting this scale to incorporate other theories could not be determined.
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Affiliation(s)
- Jun Zhang
- Department of General Surgery, Nanjing Medical University Affiliated Cancer Hospital, Cancer Institute of Jiangsu Province, Jiangsu, China E-mail :
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Adaptation of the Body Image after Breast Cancer Questionnaire in the Polish context: factorial structure and validity of the scale. HEALTH PSYCHOLOGY REPORT 2016. [DOI: 10.5114/hpr.2016.56837] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Review of three-dimensional (3D) surface imaging for oncoplastic, reconstructive and aesthetic breast surgery. Breast 2015; 24:331-42. [DOI: 10.1016/j.breast.2015.03.011] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Revised: 02/18/2015] [Accepted: 03/22/2015] [Indexed: 11/22/2022] Open
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Thanarpan P, Somrit M, Rungarun J, Paytai R, Duangjai S, Chanon K, Puttisak P. Cosmetic Outcomes and Quality of Life in Thai Women Post Breast Conserving Therapy for Breast Cancer. Asian Pac J Cancer Prev 2015; 16:4685-90. [DOI: 10.7314/apjcp.2015.16.11.4685] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Christophe V, Duprez C, Congard A, Antoine P, Lesur A, Fournier E, Vanlemmens L. The subjective experience of young women with non-metastatic breast cancer: the Young Women with Breast Cancer Inventory. Health Qual Life Outcomes 2015; 13:73. [PMID: 26036192 PMCID: PMC4451721 DOI: 10.1186/s12955-015-0273-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 05/23/2015] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The subjective experience of young women with breast cancer has some particular features linked to the impact of the disease and its treatment on their age-related issues (e.g. desire for a child, couple relationship, career management). Despite these specific concerns, no questionnaire currently targets the young breast cancer patient's quality of life, subjective experience or common problems when facing cancer. This study presents the psychometric validation of an inventory that aimed to measure the impact of breast cancer on the quality of life of young women (<45 years of age) with non-metastatic disease. METHODS 546 women aged <45 years when diagnosed with a non-metastatic breast cancer were recruited in 27 French cancer research and treatment centers. They answered a self-reported questionnaire created from verbatim collected by non-directive interviews carried out with 69 patients in a first qualitative study. Exploratory and confirmatory analyses were conducted in order to obtain the final structure of the scale. Internal consistency, test-retest reliability and concurrent validity with quality of life questionnaires currently used (QLQ-C30 and the QLQ-BR23 module) were then assessed. RESULTS The YW-BCI36 contains 36 items and highlights 8 factors: 1) feeling of couple cohesion, 2) negative affectivity and apprehension about the future, 3) management of child(ren) and of everyday life, 4) sharing with close relatives, 5) body image and sexuality, 6) financial difficulties, 7) deterioration of relationships with close relatives, and 8) career management. Psychometric analyses indicated good internal consistency (Cronbach's alpha values ranging from 0.76 to 0.91) and temporal reliability (Bravais-Pearson correlations ranging from 0.66 to 0.85). As expected, there were quite strong correlations between the YW-BCI36 and the QLQ-C30 and QLQ-BR23 scores (r ranging from 0.20 to -0.66), indicating adequate concurrent validity. CONCLUSIONS The YW-BCI36 was confirmed as a valid scale for evaluating the subjective experience of breast cancer in young women. This instrument could help to identify the problems of these women more precisely, in order to respond to them better by an optimal care management. This scale may improve the medical, psychological and social care of breast cancer patients.
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Affiliation(s)
- V Christophe
- Université de Lille - SCALab UMR CNRS 9193, Rue du Barreau, BP 60149, F-59653, Villeneuve d'Ascq cedex, France. .,SIRIC ONCOLille - Maison Régionale de la Recherche Clinique - 6, rue du Professeur Laguesse, 59037, Lille cedex, France.
| | - C Duprez
- Université de Lille - SCALab UMR CNRS 9193, Rue du Barreau, BP 60149, F-59653, Villeneuve d'Ascq cedex, France. .,SIRIC ONCOLille - Maison Régionale de la Recherche Clinique - 6, rue du Professeur Laguesse, 59037, Lille cedex, France.
| | - A Congard
- Aix-Marseille Université, Centre de Recherche PsyCLÉ (EA 3273), 29, avenue Robert Schuman, F-13621, Aix en Provence cedex 1, France.
| | - P Antoine
- Université de Lille - SCALab UMR CNRS 9193, Rue du Barreau, BP 60149, F-59653, Villeneuve d'Ascq cedex, France.
| | - A Lesur
- Institut de Cancérologie de Lorraine- Centre Alexis Vautrin, 6 Avenue de Bourgogne, 54519, Vandoeuvre-lès-Nancy, France.
| | - E Fournier
- Université de Lille - SCALab UMR CNRS 9193, Rue du Barreau, BP 60149, F-59653, Villeneuve d'Ascq cedex, France.
| | - L Vanlemmens
- Centre Oscar Lambret - Département de Sénologie, BP 307, F-59020, Lille cedex, France.
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Rivera E, Cianfrocca M. Overview of neuropathy associated with taxanes for the treatment of metastatic breast cancer. Cancer Chemother Pharmacol 2015; 75:659-70. [PMID: 25596818 PMCID: PMC4365177 DOI: 10.1007/s00280-014-2607-5] [Citation(s) in RCA: 102] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 10/07/2014] [Indexed: 12/26/2022]
Abstract
Taxanes are an established option in the standard treatment paradigm for patients with metastatic breast cancer (MBC). Neuropathy is a common, dose-limiting side effect of taxane therapy that is often managed by dose reductions and delays. The severity, time to onset, and improvement in neuropathy are important considerations for patient management and vary among currently approved taxanes. The rate of grade ≥3 neuropathy with taxanes has been shown to be dose and schedule dependent; however, time to improvement to grade ≤1 is typically shorter for nab-paclitaxel than for other taxanes in patients with MBC. Many tools for assessing patient-reported neuropathy exist. Because MBC is incurable and patient quality of life must be critically considered when making treatment decisions, there is a need for more prospective trials to assess patient-reported neuropathy. Validated predictors of taxane-related neuropathy may play an important role in treatment decisions in the future. This review will focus on the toxicity profile (i.e., neuropathy) of each of the taxanes used in the treatment of MBC, will provide updates on tools used for the assessment of neuropathy, and will highlight newly discovered predictors of taxane-related neuropathy.
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Affiliation(s)
- Edgardo Rivera
- Banner MD Anderson Cancer Center, 2946 E. Banner Gateway Drive, Gilbert, AZ, 85234, USA,
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Patient-reported outcome measures in reconstructive breast surgery: is there a role for generic measures? Plast Reconstr Surg 2015; 135:479e-490e. [PMID: 25719712 DOI: 10.1097/prs.0000000000000954] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Patient-reported outcomes provide an invaluable tool in the assessment of outcomes in plastic surgery. Traditionally, patient-reported outcomes have consisted of either generic or ad hoc measures; however, more recently, there has been interest in formally constructed and validated questionnaires that are specifically designed for a particular patient population. The purpose of this systematic review was to determine whether generic measures still have a role in the evaluation of breast reconstruction outcomes, given the recent popularity and push for use of specific measures. METHODS A systematic review was performed to identify all articles using patient-reported outcomes in the assessment of postmastectomy breast reconstruction. Frequency of use was tabulated and the most frequently used tools were assessed for success of use, using criteria described previously by the Medical Outcomes Trust. RESULTS To date, the most frequently used measures are still generic measures. The 36-Item Short-Form Health Survey was the most frequently used and most successfully applied showing evidence of responsiveness in multiple settings. Other measures such as the Hospital Anxiety and Depression Scale, the Hopwood Body Image Scale, and the Rosenberg Self-Esteem Scale were able to show responsiveness in certain settings but lacked evidence as universal tools for the assessment of outcomes in reconstructive breast surgery. CONCLUSIONS Despite the recent advent of measures designed specifically to assess patient-reported outcomes in the breast reconstruction population, there still appears to be a role for the use of generic instruments. Many of these tools would benefit from undergoing formal validation in the breast reconstruction population.
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Scott B, Ghazali N, Lowe D, Bekiroglu F, Rogers SN. The Patients Concerns Inventory in head and neck cancer: Comparison between self-completed paper and touch screen versions in the clinic setting. Eur J Oncol Nurs 2013; 17:863-9. [DOI: 10.1016/j.ejon.2013.05.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Revised: 04/19/2013] [Accepted: 05/05/2013] [Indexed: 10/26/2022]
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