Quality of life assessment in women with breast cancer: a prospective study including hormonal therapy

A Hypofractionated Radiotherapy Schedule with a Simultaneous Integrated Boost for Breast Cancer: Outcomes including Late Toxicity and Health Quality

Introduction: This study aimed to evaluate the long-term adverse effects on the physical appearance and overall well-being of breast cancer patients who receive hypofractionated radiotherapy as whole breast and simultaneous integrated boost (SIB) treatment, utilizing intensive modulated radiotherapy (IMRT), volumetric modulated arc therapy (VMAT), or a hybrid therapy approach. Material/Methods: This investigation involved administering hypofractionated SIB-VMAT therapy to individuals diagnosed with early-stage breast cancer. Treatment was carried out over a three-week period in which a total dose of 48.06 Gy was given to the entire breast and 54 Gy was given to the tumor bed. Data on skin toxicity and cosmetic outcomes were analyzed both during the acute phase and during the three-month and five-year follow-up periods after treatment. Results: A total of 125 patients treated between December 2014 and December 2016 were included in the study. The data of these patients with at least 5 years of follow-up were analyzed. Conclusions: Considering these long-term results, hypofractionated SIB-VMAT can be considered a viable treatment choice, even for patients with unfavorable conditions.

Quality of Life in an e-Cohort of Women Treated by Endocrine Therapy for Early Breast Cancer

OBJECTIVE

The objective of our study was to analyze quality of life (QOL) in an e-cohort of patients treated for breast cancer (BC) by endocrine therapy (ET), by means of validated quality of life questionnaires.

STUDY DESIGN AND SETTING

A retrospective, observational, e-cohort study was conducted (Seintinelles platform). Female patients treated for nonmetastatic and nonrecurrent BC, treated in France after 2005, filled in online questionnaires concerning: QOL (QLQ-C30 and QLQ-BR23), tolerability of treatment and demographic characteristics. A multivariate analysis including variables significant on univariate analysis (P < .05) to select QOL predictors was performed.

RESULTS

We included 1,198 patients, 1140 of whom declared that they were taking ET (37.7% tamoxifen, 17.1% aromatase inhibitor (AI), 5.6% LHRH-agonist and 39.6% sequential tamoxifen and AI). Different tolerability profiles were observed when comparing the tamoxifen and AI groups. Treatment adherence was similar in the 2 groups. QOL varied slightly according to the type of ET. On multivariate analysis, ET had no impact on QOL. However, individual patient characteristics (socioeconomic, education and age) were significantly associated with QOL CONCLUSION: Using a real-life study questionnaire on a large e-cohort, individual patient characteristics were strongly associated with deterioration of QOL. The use of e-cohorts must be encouraged to modulate the conclusions of randomized trials.

Socio-Demographic and General Health Factors Associated with Quality of Life in Long-Term Breast Cancer Survivors from Southwestern Poland

Background: Identification of factors associated with quality of life (QOL) in breast cancer survivors can contribute to better functioning in this group of patients. The study aimed to assess the association between QOL and anthropometric, sociodemographic, and medical characteristics in postmastectomy women from southwestern Poland, 9.4 (±6.5) years after completed treatment. Materials and methods: QOL was estimated with the SF-36v2 questionnaire in 250 survivors aged 62.8 (±8.0) years with previously histologically confirmed invasive breast cancer. Results: Women in this study rated their overall QOL with an average of 60.7 (±17.9), Mental Component Summary of 62.8 (±19.8), and Physical Component Summary of 57.5 (±18.8) points. The use of multivariate regression analysis revealed that depression, chronic diseases, abdominal obesity, and pregnancy history have a statistically significant negative effect on the QOL of women after mastectomy, whereas participation in regular physical activity, living with a partner, the education level ≥ 12 years, and living in the city were associated with a higher QOL assessment. There were no significant relationships between QOL and the age, time since surgery, type of treatment, smoking, and occupational status of the patients. Conclusions: Health education, greater social support, specialist care in the treatment of comorbidities, and propagation of a physically active lifestyle can improve the physical and mental functioning of breast cancer survivors long after diagnosis and treatment.

The impact of occupation-based problem-solving strategies training in women with breast cancer

BACKGROUND

By identifying the occupations of women with breast cancer who have performance problems, to examine the impact of the application of occupation-based problem-solving strategies (OB-PSS) training on cancer-related fatigue, depression, and quality of life.

METHODS

The study comprises 22 women outpatients in the clinic. Socio- demographic and Clinical Features Information Collection Form, Canadian Occupational Performance Measure (COPM), Cancer Fatigue Scale (CFS), Beck Depression Inventory (BDI), The European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire C-30 and BR23 (EORTC QOL-C30 - EORT QOL-BR23) tests have been applied to survivors. OB-PSS training was conducted on a face-to-face basis once a week for 6 weeks.

RESULTS

When activity distribution results in accordance with the performance areas are studied, women with breast cancer were seen to suffer problems mostly in their most productive areas (housework management). As a means of solving these performance problems, they developed adaptive strategies like including additional new steps to these activities. Statistically meaningful results have been obtained between measurements before and after the treatment process through all tests (p < 0.01).

CONCLUSIONS

OB-PSS provides positive gains in women with breast cancer in terms of a reduction in the degree of cancer-related fatigue and depression, and a progress in performance and satisfaction levels particularly in activities where performance problems are experienced and an improvement in quality of life. OB-PSS training could be used as an appropriate rehabilitation approach for coping with problems in women' life with breast cancer.

Urban-Rural Variations in Quality-of-Life in Breast Cancer Survivors Prescribed Endocrine Therapy

The number of breast cancer survivors has increased as a result of rising incidence and increased survival. Research has revealed significant urban-rural variation in clinical aspects of breast cancer but evidence in the area of survivorship is limited. We aimed to investigate whether quality of life (QoL) and treatment-related symptoms vary between urban and rural breast cancer survivors prescribed endocrine therapy. Women with a diagnosis of stages I-III breast cancer prescribed endocrine therapy were identified from the National Cancer Registry Ireland and invited to complete a postal survey (N = 1606; response rate = 66%). A composite measure of urban-rural classification was created using settlement size, population density and proximity to treatment hospital. QoL was measured using the Functional Assessment of Cancer Therapy (FACT-G) and an endocrine subscale. The association between urban-rural residence/status and QoL and endocrine symptoms was assessed using linear regression with adjustment for socio-demographic and clinical covariates. In multivariable analysis, rural survivors had a statistically significant higher overall QoL (β = 3.81, standard error (SE) 1.30, p < 0.01), emotional QoL (β = 0.70, SE 0.21, p < 0.01) and experienced a lower symptom burden (β = 1.76, SE 0.65, p < 0.01) than urban survivors. QoL in breast cancer survivors is not simply about proximity and access to healthcare services but may include individual and community level psychosocial factors.

Endocrine therapy adherence: a cross-sectional study of factors affecting adherence and discontinuation of therapy

BACKGROUND/AIMS

Adjuvant endocrine therapy for at least 5 years improves oncological outcomes in oestrogen receptor-positive breast cancer. Adherence rates to prescribed endocrine therapy are low and the search for modifiable causes of this continues. The aim of this study was to assess adherence rates in an Irish cohort of breast cancer patients prescribed adjuvant endocrine therapy and to assess modifiable factors associated with suboptimal adherence.

METHODS

A cross-sectional anonymous survey was performed on 261 patients currently prescribed endocrine therapy. Data were collected regarding demographics, treatment, social and emotional factors and medication side effects. Each patient completed a medication adherence score and provided information about discontinuation of therapy and reasons for same.

RESULTS

Only 67.8 % of patients assessed demonstrated complete medication adherence on the medication adherence scale. Twenty-nine patients (10.9 %) permanently stopped taking their prescribed endocrine therapy. Suboptimal adherence was more likely in younger patients (p < 0.001), those in employment (p = 0.005), those who experienced side effects (p = 0.006), those who perceived themselves to have low levels of emotional support (p < 0.001) and those who use the internet to read about their illness (p = 0.003).

CONCLUSIONS

Endocrine therapy adherence is suboptimal in almost one-third of patients in our cohort. Appropriate assessment and management of side effects and negative emotions, combined with direction of patients to accurate internet sources of information, could help improve endocrine therapy adherence in women with early-stage breast cancer.