Clinically assessed posttraumatic stress in patients with breast cancer during the first year after diagnosis in the prospective, longitudinal, controlled COGNICARES study

2016 ◽  
Vol 26 (1) ◽  
pp. 74-80 ◽  
Author(s):  
Varinka Voigt ◽  
Franziska Neufeld ◽  
Judith Kaste ◽  
Markus Bühner ◽  
Philipp Sckopke ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Posttraumatic Stress ◽  
First Year ◽  
Prospective Longitudinal

Perioperative sleep disturbance following mastectomy: A longitudinal investigation of the relationship to pain, opioid use, treatment, and psychosocial symptoms.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 192-192
Author(s):  
Desiree Rachel Azizoddin ◽  
Mieke A. Soens ◽  
Meghan Beck ◽  
Kelsey Mikayla Flowers ◽  
Robert R. Edwards ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Positive Affect ◽  
Sleep Disturbance ◽  
Psychosocial Factors ◽  
First Year ◽  
Total Mastectomy ◽  
Opioid Use ◽  
Surgical Pain ◽  
Prospective Longitudinal ◽  
The Relationship

192 Background: Sleep disturbance negatively impacts quality of life and recovery. Our objective was to evaluate the relationship between individual patient factors (demographic, surgical, pain, opioid use, and psychosocial factors) and greater sleep disturbance. Methods: In this prospective longitudinal study, patients completed validated measures regarding their sleep disturbance, pain, opioid use, and psychological symptoms preoperatively and then 2 weeks, 6 and 12 months postoperatively. Objective pain sensitivity measures were evaluated at baseline using quantitative sensory testing. Univariable and multivariable generalized estimating equations (GEE) evaluated demographic, surgical, pain, and psychological predictors of sleep disturbance during the first year after surgery for breast cancer. Results: Female patients (n = 259) reported varying degrees of sleep disturbance, which were longitudinally associated with pain, psychosocial factors such as anxiety, depression, and affect. While the mean degree of sleep disturbance did not change substantially over time, the link to pain severity appeared to strengthen over the first postoperative year. Independent preoperative predictors of worse sleep disturbance on multivariable longitudinal GEE included younger age (B = -.09, p =.006), opioid use (B = 3.09, p =.02), higher pain (B =.19, p = <.001) and anxiety (B =.45, p = <.001) at baseline. On the other hand, higher basline positive affect (B = -.14, p = <.012) and the surgical category total mastectomy without reconstruction (B = -2.81, p = <.006) were indepently associated with lower sleep disturbance. Those with worse baseline sleep required more opioid analgesics during surgical recovery, and continued use of opioids at 2 weeks post-surgery was associated with disturbed sleep. Conclusions: Sleep disturbance in the first year following surgery for breast cancer varied substantially between individuals. Certain demographic, psychosocial, and pain factors explained more of this variance than surgical procedure, with the exception of total mastectomy without reconstruction that was associated with lower sleep disturbance. Sleep disturbance was associated with increased need for opioids in the perioperative period, and a propensity for more prolonged postoperative opioid use. Pre-surgical interventions in high risk individuals such as anxiety management, boosting positive affect, and controlling pain that have been shown to improve sleep quality could enhance postoperative recovery and decrease opioid use following breast surgery.

Breast cancer associated with pregnancy: a clinical case

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (1) ◽  
pp. 102-108
Author(s):  
Yu E Dobrokhotova ◽  
S E Arakelov ◽  
S Zh Danelyan ◽  
E I Borovkova ◽  
A E Zykov ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Clinical Case ◽  
First Trimester ◽  
First Year ◽  
Total Mastectomy ◽  
First Time

Associated with pregnancy is breast cancer, which was first detected during pregnancy, during the first year after childbirth or at any time against lactation. Diagnosis of the disease in the first trimester is an indication for abortion. The detection of the disease after 20 weeks and the desire of the woman to maintain pregnancy is the basis for conducting a total mastectomy followed by polychemotherapy with doxorubicin with cyclophosphamide or with fluorouracil. Radiation therapy during pregnancy is not applied. The timing and method of delivery are determined individually and depend on the stage of the process and the period of pregnancy, when it was identified. A clinical case of a patient with edematous-infiltrative form of breast cancer of the IV stage, diagnosed for the first time in 22 weeks of pregnancy, is presented.

scholarly journals An Evaluation of DNA Methyltransferase 1 (DNMT1) Single Nucleotide Polymorphisms and Chemotherapy-Associated Cognitive Impairment: A Prospective, Longitudinal Study

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Alexandre Chan ◽  
Angie Yeo ◽  
Maung Shwe ◽  
Chia Jie Tan ◽  
Koon Mian Foo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Cancer Patients ◽  
Dna Methyltransferase ◽  
Dna Methyltransferases ◽  
Breast Cancer Patients ◽  
Prospective Longitudinal Study ◽  
Cognitive Domains ◽  
Prospective Longitudinal

Abstract Strong evidence suggests that genetic variations in DNA methyltransferases (DNMTs) may alter the downstream expression and DNA methylation patterns of neuronal genes and influence cognition. This study investigates the association between a DNMT1 polymorphism, rs2162560, and chemotherapy-associated cognitive impairment (CACI) in a cohort of breast cancer patients. This is a prospective, longitudinal cohort study. From 2011 to 2017, 351 early-stage breast cancer patients receiving chemotherapy were assessed at baseline, the midpoint, and the end of chemotherapy. DNA was extracted from whole blood, and genotyping was performed using Sanger sequencing. Patients’ self-perceived cognitive function and cognitive performance were assessed at three different time points using FACT-Cog (v.3) and a neuropsychological battery, respectively. The association between DNMT1 rs2162560 and cognitive function was evaluated using logistic regression analyses. Overall, 33.3% of the patients reported impairment relative to baseline in one or more cognitive domains. Cognitive impairment was observed in various objective cognitive domains, with incidences ranging from 7.2% to 36.9%. The DNMT1 rs2162560 A allele was observed in 21.8% of patients and this was associated with lower odds of self-reported cognitive decline in the concentration (OR = 0.45, 95% CI: 0.25–0.82, P = 0.01) and functional interference (OR = 0.48, 95% CI: 0.24–0.95, P = 0.03) domains. No significant association was observed between DNMT1 rs2162560 and objective cognitive impairment. This is the first study to show a significant association between the DNMT1 rs2162560 polymorphism and CACI. Our data suggest that epigenetic processes could contribute to CACI, and further studies are needed to validate these findings.

Resource use and costs associated with different states of breast cancer

2007 ◽  
Vol 23 (2) ◽  
pp. 223-231 ◽  
Author(s):  
Mathias Lidgren ◽  
Nils Wilking ◽  
Bengt Jönsson ◽  
Clas Rehnberg
Keyword(s):  
Breast Cancer ◽  
Indirect Cost ◽  
Informal Care ◽  
Resource Use ◽  
Primary Breast Cancer ◽  
Primary Diagnosis ◽  
Patient Questionnaire ◽  
First Year ◽  
Medical Resource ◽  
Total Cost

Objectives: This study investigated the direct medical resource use and cost, informal care cost, and indirect cost associated with breast cancer in different states of the disease in normal clinical practice.Methods: A retrospective database analysis was used to estimate direct medical resource use and cost, and a patient questionnaire was used to evaluate informal care and work capacity in different states of breast cancer.Results: For patients younger than 65 years of age, the first year after a primary diagnosis total cost amounted to 280,000 SEK ($39,000) and the first year after a local or contralateral recurrence total cost was 351,000 SEK ($48,900). The second and following years after primary breast cancer or recurrence had substantially lower total cost, amounting to 94,000 SEK ($13,000). For patients with metastatic disease, the annual total cost was estimated to 334,000 SEK ($46,500). For patients older than 65 years of age, the total cost for the first year after a primary diagnosis amounted to 80,000 SEK ($11,200) and the total cost for the first year after a local or contralateral recurrence was 92,000 SEK ($12,900). The total cost for the second and following years after primary breast cancer or recurrence was estimated to 18,000 SEK ($2,600), and the total annual cost for patients with metastatic was 122,000 SEK ($17,000).Conclusions: Both direct medical costs and indirect cost vary substantially between disease states. For patients under 65 year of age, indirect costs accounted for more than 50 percent of the total cost.

scholarly journals Cognitive Complaints in Survivors of Breast Cancer After Chemotherapy Compared With Age-Matched Controls: An Analysis From a Nationwide, Multicenter, Prospective Longitudinal Study

2017 ◽  
Vol 35 (5) ◽  
pp. 506-514 ◽  
Author(s):  
Michelle C. Janelsins ◽  
Charles E. Heckler ◽  
Luke J. Peppone ◽  
Charles Kamen ◽  
Karen M. Mustian ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Reading Ability ◽  
Menopausal Status ◽  
Prospective Longitudinal Study ◽  
Cognitive Difficulties ◽  
Community Oncology ◽  
Prospective Longitudinal

Purpose Cancer-related cognitive impairment is an important problem for patients with breast cancer, yet its trajectory is not fully understood. Some previous cancer-related cognitive impairment research is limited by heterogeneous populations, small samples, lack of prechemotherapy and longitudinal assessments, use of normative data, and lack of generalizability. We addressed these limitations in a large prospective, longitudinal, nationwide study. Patients and Methods Patients with breast cancer from community oncology clinics and age-matched noncancer controls completed the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) at prechemotherapy and postchemotherapy and at a 6-month follow-up as an a priori exploratory aim. Longitudinal models compared FACT-Cog scores between patients and controls at the three assessments and adjusted for age, education, race, menopausal status, and baseline reading ability, anxiety, and depressive symptoms. A minimal clinically important difference cutoff determined percentages of impairment over time. Results Of patients, 581 patients with breast cancer (mean age, 53 years; 48% anthracycline-based regimens) and 364 controls (mean age, 53 years) were assessed. Patients reported significantly greater cognitive difficulties on the FACT-Cog total score and four subscales from prechemotherapy to postchemotherapy compared with controls as well as from prechemotherapy to 6-month follow-up (all P < .001). Increased baseline anxiety, depression, and decreased cognitive reserve were significantly associated with lower FACT-Cog total scores. Treatment regimen, hormone, or radiation therapy was not significantly associated with FACT-Cog total scores in patients from postchemotherapy to 6-month follow-up. Patients were more likely to report a clinically significant decline in self-reported cognitive function than were controls from prechemotherapy to postchemotherapy (45.2% v 10.4%) and from prechemotherapy to 6-month follow-up (36.5% v 13.6%). Conclusion Patients with breast cancer who were treated in community oncology clinics report substantially more cognitive difficulties up to 6 months after treatment with chemotherapy than do age-matched noncancer controls.

scholarly journals Symptoms of Posttraumatic Stress Disorder and Associated Risk Factors in Patients With Lung Cancer: A Longitudinal Observational Study

2018 ◽  
Vol 17 (4) ◽  
pp. 1195-1203 ◽  
Author(s):  
Jun Ni ◽  
Jian Feng ◽  
Linda Denehy ◽  
Yi Wu ◽  
Liqin Xu ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Posttraumatic Stress Disorder ◽  
Observational Study ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Ptsd Symptoms ◽  
Newly Diagnosed ◽  
Cancer Symptoms ◽  
Longitudinal Observational Study ◽  
Prospective Longitudinal

Purpose. This study aimed to measure symptoms of posttraumatic stress disorder (PTSD) in Chinese patients following a new diagnosis of lung cancer. Secondary aims were to explore factors at diagnosis that may predict PTSD symptoms at 6 months. Methods. This was a prospective longitudinal observational study that included 93 patients with newly diagnosed lung cancer. PTSD symptomology was assessed using the PTSD Checklist Civilian Version (PCL-C) and health-related quality of life (HRQoL) was assessed with the European Organisation for the Research and Treatment of Cancer questionnaire. Measures were completed at diagnosis and 6 months. Results. No patient had PTSD at baseline or 6 months as measured by a score of ⩾50 in the PCL-C. However, at diagnosis, 44% of patients had “mild” symptoms of PTSD. At 6 months, 64% of patients had “mild” and 8% had “moderate” PTSD symptoms. PTSD symptom scores significantly worsened over 6 months (mean difference [95% CI] = 7.2 [5.4 to 9.0]). Six months after diagnosis, higher PTSD scores were seen in people who at diagnosis were younger ( P = .003), had a lower smoking pack history ( P = .012), displayed less sedentary behavior ( P < .005), or initially had worse cancer symptoms, including fatigue ( P = .001) and poorer HRQoL ( P = .004). Conclusions. Mild PTSD symptoms are common in patients with lung cancer 6 months after treatment; however, a full diagnosis of PTSD is uncommon. Screening for PTSD symptoms may be considered for at-risk patients with newly diagnosed lung cancer.

scholarly journals Associated Factors with Adopting Preventive Behaviors for Breast Cancer in Iran

2020 ◽  
pp. 33-39
Author(s):  
Marzieh Hajikarimbaba ◽  
Rahman Panahi ◽  
Leila Dehghankar
Keyword(s):  
Breast Cancer ◽  
Physical Activity ◽  
Significant Relationship ◽  
Cross Sectional Study ◽  
First Year ◽  
Preventive Behaviors ◽  
Cross Sectional ◽  
First Year Students ◽  
Good Level ◽  
Study Population

Background: Considering the remarkable role of students in society and the relatively high prevalence of breast cancer in women, this study aimed to determine the factors related to adopting preventive behaviors for breast cancer in students.Methods: This was a descriptive cross-sectional study. The study population consisted of 375 female students of Qazvin city, who were selected by stratified random sampling during the year 2019. Data collection tools included a demographic and contextual questionnaire and a valid and reliable questionnaire for measuring breast cancer preventive behaviors. Data were analyzed using SPSS 23 software program, descriptive statistics and logistic regression.Results: Using there was a statistically significant relationship between adopting preventive behaviors against breast cancer and physical activity (P <0.001), so that the chances of adopting good preventive behaviors in students with "occasionally", "rarely" and "never" physical activity were respectively 0.410, 0.113, and 0.098 times chance for the students with daily physical activity. There was a significant relationship between breast cancer prevention and academic years (p= 0.027), so that the chances of adopting good-level preventive behaviors in the senior students was 1.498 times higher than the first year students. There was also a significant relationship between adopting preventive behaviors and employment (P = 0.017), so that the chances of adopting good-level preventive behaviors in unemployed students was 1.725 times higher than that of the employed students.Conclusion: Students with lower education and less physical activity and the employed individuals less commonly adopted preventive behaviors. Therefore, it is necessary to pay more attention to these students in designing educational programs.

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