Validation of self-reported comorbidity status of breast cancer patients with medical records: the California Breast Cancer Survivorship Consortium (CBCSC)

Due to improvement in survival rates, breast cancer is the most prevalent female malignancy in Europe and hence the management of breast cancer survivorship is garnering significant attention. Most of the health issues associated with treatment result from iatrogenic estrogen deficiency and recognition of this in the recent National Institute for Health and Care Excellence (NICE) menopause guidance has resulted in the recommendation for referral of breast cancer patients to menopause specialists for appropriate counselling about and management of early menopause, estrogen deficiency symptoms and lifestyle risk modification. The latter has significant implications for both all-cause and breast cancer-specific mortality. Extending the role of health professionals with an interest in menopause to provide such service for breast cancer patients is necessary as this is not within the remit or expertise of specialist breast cancer teams; however it will in turn, require menopause specialists to expand and regularly update their knowledge of breast cancer and its treatment.

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Health after cancer: Early patient experience in a pilot survivorship clinic embedded in primary care.

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.34_suppl.180 ◽

2018 ◽

Vol 36 (34_suppl) ◽

pp. 180-180

Author(s):

Lidia Schapira ◽

Marcy Winget ◽

Siqi WU ◽

Jennifer Kim ◽

Cati Brown-Johnson

Keyword(s):

Breast Cancer ◽

Primary Care ◽

Cancer Survivors ◽

Cancer Patients ◽

Cancer Survivorship ◽

Primary Care Physicians ◽

Expert Knowledge ◽

Primary Care Clinic ◽

Breast Cancer Patients ◽

Care Clinic

180 Background: Prior research has identified barriers to provision of quality survivorship care in primary care settings such as lack of expert knowledge and training, primary care burden and insufficient communication with oncologists. We implemented a survivorship clinic at an academic medical center in the primary care division with the goal of defining the elements required for a seamless transition and co-management. Methods: The primary care physician received training in cancer survivorship based on the ASCO Curriculum, shadowing of 3 breast medical oncologists and 1 gynecologic oncologist, attendance at the 2018 Cancer Survivorship Symposium and NCCN’s Cancer Survivorship Advocacy Meeting. Patients with breast and gynecologic cancers were referred by their oncologists or APP (PA or NP) at various points in their cancer trajectory. Clinical characteristics of patients were abstracted from the electronic medical record and in-depth interviews were conducted with 2 patients. Results: 41 patients attended the survivorship clinic. The majority (88%) were breast (63%) or gynecologic (24%) cancer survivors. Patient age was evenly distributed with 8 age < 46, 11 age 46-59, and 7 age > = 60. 23 (56%) patients had stage < 3 at diagnosis. 21 (51%) had been cancer-free for five years + and 4 were referred by their oncologist to help with patient co-management during cancer treatment. Of the 8 breast cancer patients < 46 years old, 6 had a genetic mutation and 7 were interested in fertility. 15/26 breast cancer patients are currently on endocrine therapy. Interviewed patients expressed appreciation for receiving whole-person care and knowing there is bidirectional communication between clinicians. Conclusions: Cancer survivors are open to and interested in a survivorship visit based in a primary care clinic; this includes both patients who have been cancer-free > 5 years as well as those recently treated with curative intent. Greater efforts are needed to train primary care physicians to deliver survivorship visits that are customized to meet the needs of cancer survivors.

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Disparities in pretest genetic counseling among a population-based sample of young breast cancer patients.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.1579 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. 1579-1579

Author(s):

Sonya Reid-Lawrence ◽

Tuya Pal ◽

Ingrid A. Mayer ◽

Xiao-Ou Shu ◽

Ann Tezak ◽

...

Keyword(s):

Breast Cancer ◽

Genetic Counseling ◽

Genetic Testing ◽

Cancer Patients ◽

Hereditary Cancer ◽

Medical Records ◽

Population Based ◽

Racial Groups ◽

Breast Cancer Patients ◽

Young Breast Cancer

1579 Background: Per national practice guidelines, pre-test genetic counseling (GC) through a board-certified or credentialed genetics health professional (GHP) is recommended when testing for hereditary cancer. We sought to compare differences in rates of pre-test GC among young breast cancer (BC) patients tested with or without GHP involvement across three racial groups (Black, Hispanic and non-Hispanic white (NHW)). Methods: A population-based sample of Black, Hispanic and NHW women diagnosed with invasive BC ≤ age 50 from 2009 to 2012 were recruited through the Florida State Cancer Registry. Participants were asked to complete a baseline questionnaire and release medical records for verification of clinical information and genetic testing. We compared the rates of pre-test GC across racial groups in women tested with or without GHP involvement using Analysis of Variance. Multivariate logistic regression analysis was also conducted to adjust for potential confounders. Results: Of 1618 participants, 828 had genetic testing based on medical records and/or self-reported on their questionnaire. There were 170 (20.5%) with GHP involvement (either through consultation and/or test ordering) and the remaining 658 women (79.5%) had no documentation of GHP involvement. Among patients tested without GHP involvement, rates of pre-test GC were significantly lower among Black women (34.8%) compared to Hispanics (80%) and NHW (78.7%) (p < 0.001). In contrast, among those with GHP involvement, rates of pre-test GC were similar among Black (89.7%), Hispanic (81.1%) and NHW (84.6%) (p = 0.89). Conclusions: Our results suggest that among young breast cancer patients tested for hereditary cancer without GHP involvement, Blacks were significantly less likely to receive pre-test GC, compared to the other two groups. In contrast, rates of pre-test GC among those with GHP involvement were similar across all groups. These results suggest a disparity in receipt of pre-test GC (which is standard of care per national guidelines) among Blacks tested without GHP involvement. These findings are concerning given the need to offer guideline-adherent care to all patients receiving hereditary cancer testing.

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Treatment outcomes and its associated factors among breast cancer patients at Kitui Referral Hospital

SAGE Open Medicine ◽

10.1177/20503121211067857 ◽

2022 ◽

Vol 10 ◽

pp. 205031212110678

Author(s):

Mwendwa Dickson Wambua ◽

Amsalu Degu ◽

Gobezie T Tegegne

Keyword(s):

Breast Cancer ◽

Regression Analysis ◽

Confidence Interval ◽

Treatment Outcomes ◽

Cancer Patients ◽

Medical Records ◽

Cox Regression ◽

Breast Cancer Patients ◽

Cox Regression Analysis ◽

Study Setting

Objectives: Despite breast cancer treatment outcomes being relatively poor or heterogeneous among breast cancer patients, there was a paucity of data in the African settings, especially in Kenya. Hence, this study aimed to determine treatment outcomes among breast cancer patients at Kitui Referral Hospital. Methods: A hospital-based retrospective cohort study design was conducted among adult patients with breast cancer. All eligible breast cancer patients undergoing treatment from January 2015 to June 2020 in the study setting were included. Hence, a total of 116 breast cancer patients’ medical records were involved in the study. Patients’ medical records were retrospectively reviewed using a predesigned data abstraction tool. The data were entered, cleaned, and analyzed using SPSS (Statistical Package for Social Sciences) version 26 software. Descriptive analysis—such as percentage, frequency, mean, and figures—was used to present the data. Kaplan–Meier survival analysis was used to estimate the mean survival estimate across different variables. A Cox regression analysis was employed to determine factors associated with mortality. Results: The study showed that the overall survival and mortality rate was 62.9% (73) and 37.1% (43), respectively. The regression analysis showed that patients who had an advanced stage of disease had a 3.82 times risk of dying (crude hazard ratio= 3.82, 95% confidence interval = 1.5–9.8) than an early stage of the disease. Besides, patients with distant metastasis had 4.4 times more hazards of dying than (crude hazard ratio = 4.4, 95% confidence interval = 2.1–9.4) their counterparts. Conclusion: The treatment outcome of breast cancer patients was poor, and its overall mortality among breast cancer patients was higher in the study setting. In the multivariate Cox regression analysis, the tumor size was the only statistically significant predictor of mortality among breast cancer patients. Stakeholders at each stage should, therefore, prepare a relevant strategy to improve treatment outcomes.

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Acupuncture and Reflexology for Chemotherapy-Induced Peripheral Neuropathy in Breast Cancer

Integrative Cancer Therapies ◽

10.1177/1534735417690254 ◽

2017 ◽

Vol 16 (3) ◽

pp. 258-262 ◽

Cited By ~ 16

Author(s):

Idan Ben-Horin ◽

Peretz Kahan ◽

Larisa Ryvo ◽

Moshe Inbar ◽

Shahar Lev-Ari ◽

...

Keyword(s):

Breast Cancer ◽

Peripheral Neuropathy ◽

Cancer Patients ◽

Medical Records ◽

Preventive Intervention ◽

Sensory Neuropathy ◽

Control Group ◽

Motor Neuropathy ◽

Breast Cancer Patients ◽

Treatment Results

Background: Treatment of chemotherapy-induced peripheral neuropathy (CIPN), which affects approximately 30% to 40% of patients treated with neuropathy-causing agents, is mainly symptomatic. Currently available interventions are of little benefit. Study Design: This study was conducted as a retrospective analysis of the efficacy of acupuncture and reflexology in alleviating CIPN in breast cancer patients. Methods: Medical records of 30 consecutive breast cancer patients who received both chemotherapy and treatment for CIPN according to our Acupuncture and Reflexology Treatment for Neuropathy (ART-N) protocol between 2011 and 2012 were reviewed. Symptom severity was rated at baseline, during, and after treatment. Results: The records of 30 breast cancer patients who had been concomitantly treated with chemotherapy and ART-N for CIPN were retrieved. Two records were incomplete, leaving a total of 28 patients who were enrolled into the study. Twenty patients (71%) had sensory neuropathy, 7 (25%) had motor neuropathy, and 1 (4%) had both sensory and motor neuropathy. Only 2 (10%) of the 20 patients with grades 1 to 2 neuropathy still reported symptoms at 12 months since starting the ART-N protocol. All 8 patients who presented with grades 3 to 4 neuropathy were symptom-free at the 12-month evaluation. Overall, 26 patients (93%) had complete resolution of CIPN symptoms. Conclusion: The results of this study demonstrated that a joint protocol of acupuncture and reflexology has a potential to improve symptoms of CIPN in breast cancer patients. The protocol should be validated on a larger cohort with a control group. It also warrants testing as a preventive intervention.

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Narratives of Survivorship: A Study of Breast Cancer Pathographies and Their Place in Cancer Rehabilitation

Current Oncology ◽

10.3390/curroncol28040249 ◽

2021 ◽

Vol 28 (4) ◽

pp. 2840-2851

Author(s):

Åsa Mohlin ◽

Katarina Bernhardsson

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Medical Knowledge ◽

Cancer Rehabilitation ◽

Breast Cancer Patients ◽

Breast Cancer Survivorship ◽

Individualized Approach ◽

Multiple Challenges ◽

Personal Accounts ◽

Rehabilitation Needs

The focus on cancer rehabilitation has increased, but breast cancer patients still report unmet rehabilitation needs. Since many women today will live long beyond their diagnosis, there are multiple challenges for the healthcare system in supporting these women in their new life situation. A more individualized approach is seen as necessary to optimize the rehabilitation for survivors. Pathographies, i.e., autobiographical or biographical accounts of experiences of illness, expose us to personal accounts of the journey through illness and treatment, offering us details, emotions, phrasings, and imagery from an individual perspective. In this literary study, we have analyzed two contemporary Swedish-speaking pathographies about breast cancer. In our analysis, we have presented perspectives on survivorship, and the authors’ ways of conveying their breast cancer experiences through narrative. The pathographies envision the prominent impact the breast cancer has on the authors’ lives. Narratives of survivorship have the potential to complement the more general medical knowledge with their nuanced and multifaceted stories of breast cancer. Learning from this type of material may improve the understanding of the complexity of breast cancer survivorship issues. This may be a way to become more attuned to identifying individual needs and preferences of breast cancer patients.

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Abstract P1-12-14: Quality of life, fear of recurrence, impact of cancer, and dietary habits in breast cancer patients during the early survivorship period - Initial data from the pilot Cas-PET (Cancer Survivorship Patient Engagement Toolkit) study

10.1158/1538-7445.sabcs18-p1-12-14 ◽

2019 ◽

Author(s):

PY Rosenblatt ◽

M McQuaige ◽

K Miller ◽

E-S Nahm ◽

L Hertsenberg

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Initial Data ◽

Cancer Patients ◽

Cancer Survivorship ◽

Patient Engagement ◽

Dietary Habits ◽

Fear Of Recurrence ◽

Breast Cancer Patients

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Abstract P2-13-11: Use of cancer survivorship patient engagement toolkit (CaS-PET) in breast cancer patients

10.1158/1538-7445.sabcs19-p2-13-11 ◽

2020 ◽

Author(s):

Paula Rosenblatt ◽

Lindsey Hertsenberg ◽

Hyojin Son ◽

Mary McQuaige ◽

Kenneth Miller ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Cancer Survivorship ◽

Patient Engagement ◽

Breast Cancer Patients

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Prognostic significance of NLR kinetics in operable triple negative breast cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.e14201 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. e14201-e14201

Author(s):

Ranga Raman Ganta ◽

Srividya Nasaka

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Triple Negative Breast Cancer ◽

Medical Records ◽

Triple Negative ◽

Prognostic Significance ◽

Small Sample ◽

Cancer Center ◽

Breast Cancer Patients ◽

Significant Difference

e14201 Background: Inflammatory response exacerbates mechanisms linked to tumor growth and dissemination. As an index of systemic inflammatory marker, neutrophil lymphocyte ratio (NLR) may be a predictive biomarker of both prognosis and outcome in several malignancies. However very few reports have addressed the association of change in NLR and outcome in operable breast cancer. We evaluated preoperative NLR and postoperative NLR to assess which one would be predictive of disease outcome in triple negative breast cancer patients. Methods: This study included 67 stage I-III triple negative breast cancer patients diagnosed at HCG Cancer center, between 2013 to 2015. Those patients who underwent upfront surgery were included in the study. Patients who received neoadjuvant chemotherapy and those without adequate medical records were excluded. The NLR was calculated from the differential count by dividing neutrophil percentage with lymphocyte percentage. All preoperative NLRs were calculated from medical records, at the first visit. Postoperative NLR was obtained before first cycle chemotherapy. The NLR was divided into high if ratio is > 3 and low if it is ≤ 3. We evaluated prognostic value of NLR on 3 year DFS. Results: The median preoperative NLR was 2.52 (Range 0.77-8.6). The pre op NLR was high in 19 patients (28%) and low in 48 patients (72%). There was no significant difference between two groups in baseline characteristics. Among the preoperative High and low NLR groups, 3 year DFS is statistically significant. The median postoperative NLR was 2.23 (Range 0.89-8.1). The post operative NLR was high in 7 patients (11%) and low in 60 patients (89%). Among the postoperative High and low NLR groups, 3 year DFS is statistically not significant. The 12 (63%) patients in the high preoperative NLR patients were converted to of the low NLR after surgery. Conclusions: Preoperative NLR correlated with outcome in operable triple negative breast cancer than postoperative NLR. The NLR kinetics might be an index of response to the treatment which needs to be evaluated in prospective studies. Drawbacks of the study: single centre, retrospective study and small sample size.[Table: see text][Table: see text]

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