Quality of life and burden of disease of vulvar lichen sclerosus: A single-center retrospective study in China

OBJECTIVE

This study examined the quality of life and burden of disease of vulvar lichen sclerosus (VLS) patients in three states of menstruation to better understand VLS.

METHODS

A total of 607 VLS patients were enrolled into this retrospective study. According to the ages of onset, menarche and menopause, the patients were divided into three groups: prepubertal group (n = 96), reproductive group (n = 400) and postmenopausal group (n = 111). Data were collected by direct interview and clinical examination.

RESULTS

A total of 93% of patients had itching, with a median numerical rating scale score of five. In the prepubertal group, the median score was three. Nocturnal itching occurred in 49.6% patients. Nearly half of the patients (45.9%) thought the itching affected their sleep. However, this ratio was very different in the prepubertal group (20.7%). Some patients (12.8%) cleaned their vulva more than seven times per week. Only 17.2% of patients experienced no effect on their sex life. The median dermatology life quality index score in all patients was six, but it was only three in the prepubertal group. The median number of hospital visits was two times, and the number of clinic visits was three times. Previous expenses, in median, were 2000 RMB. For 84.3% patients, the gynecologic clinic was their first choice.

CONCLUSION

VLS places great physical, mental and economic burdens on patients. Patients in the prepubertal group had milder symptoms and dermatology life quality index score. VLS should arouse the attention of patients and specialists.

A Comparative Analysis of Body Mass Index with Estrogen Receptor, Progesterone Receptor and Human Epidermal Growth Factor Receptor 2 Status in Pre- and Postmenopausal Breast Cancer Patients

Background

Breast cancer is now the most common cancer among Indian women. Recent studies have suggested a possible link between risk factors like high BMI and molecular subtypes of breast cancer. Studies from Western and Asian population have shown varying relationship between post- menopausal obesity and expression of ER, PR, Her2-neu receptors in breast cancer patients.

Aim

This study was done with an aim to explore if overweight or obesity as defined by BMI and status of ER, PR and Her2-neu receptors differ in Indian pre-menopausal and post-menopausal breast cancer patients.

Methods and Material

This is a retrospective analysis of 446 breast cancer patients treated at Mahavir Cancer Sansthan, Patna from July to December 2019. Their case records were evaluated and data regarding age, menopausal status, height, weight and ER, PR & HER2-neu receptor status were extracted for analyses.

Statistical Analysis

Chi-square test was used to compare categorical variables between the pre-menopausal and post-menopausal group.

Results

The prevalence of obesity in the post-menopausal group was 2.3% more than the pre-menopausal group (P-value = 0.24). As compared to the pre-menopausal group, there was an increase in the ER/PR positivity in the postmenopausal group by 3.41% (P-value = 0.47) and in the Her2-neu positivity by 6.38% (P-value = 0.15). As compared to the pre-menopausal group, there was further increase in the ER/PR positivity in the post-menopausal group by 6.85% (P-value = 0.40) in sub-group of patients with BMI ≥ 25kg/m².

Conclusions

Our study showed slightly increased incidence of obesity in post-menopausal breast cancer patients. Overweight post-menopausal patients also had a higher percentage of ER/PR receptor positivity and lower percentage of Triple negative breast cancer. The percentage of Her2-neu receptor positivity was more in post-menopausal patients. A high BMI was found to be associated with a lower Her2neu positivity.