PO79 A novel strategy to equip health care providers serving young breast cancer patients

108 Background: Young breast cancer patients are at risk of temporary or permanent infertility following the administration of gonadotoxic cancer treatments. Currently patients do not feel they receive enough information to make informed fertility decisions before treatment. We aim to determine the fertility-related information health care providers and breast cancer survivors consider valuable to include in a Canadian decision aid (Can-DA) for young breast cancer patients by reviewing existing decision support resources. Methods: A qualitative descriptive approach was used to evaluate 6 decision support resources created in other jurisdictions. Using purposeful sampling, 8 multi-disciplinary health care providers and 8 breast cancer survivors from across Canada evaluated 1 to 2 decision support resources in structured interviews. Interviews were conducted in-person and by telephone from March to June 2016 and ranged in length from 30 to 90 minutes. Interviews were transcribed verbatim, organized in NVivo, and analyzed deductively using the pre-defined sections of the interview guide as a framework. Results: Each decision support resource had valuable components to adapt for the Can-DA. Participants valued the inclusion of Canadian-specific and accurate information on resources for additional support and the success rates and cost ranges of fertility preservation procedures. There were mixed views on the impact and value of including in-depth fertility information such as adoption and other fertility-related options after treatment. Discrepancies were also seen on the value of personal stories and an explicit values clarification exercise. There was consensus on the inclusion of only pertinent fertility-related information that does not replicate information in supplementary patient education material to avoid overwhelming patients. Conclusions: The evaluation provided valuable insight on the information and design features to consider for the Can-DA. Findings will be used in combination with the International Patient Decision Aid Standards criteria to ensure the Can-DA meets the fertility information needs of young breast cancer patients in Canada.

Download Full-text

(Ex-)breast cancer patients with (pre-existing) symptoms of anxiety and/or depression experience higher barriers to contact health care providers during the COVID-19 pandemic

Breast Cancer Research and Treatment ◽

10.1007/s10549-021-06112-y ◽

2021 ◽

Author(s):

Dieuwke R. Mink van der Molen ◽

◽

Claudia A. Bargon ◽

Marilot C. T. Batenburg ◽

Roxanne Gal ◽

...

Keyword(s):

Breast Cancer ◽

Health Care ◽

Cancer Patients ◽

Health Care Providers ◽

Access To Health Care ◽

Depression Scale ◽

Current Treatment ◽

Care Providers ◽

Breast Cancer Patients ◽

Cross Sectional

Abstract Purpose To identify factors associated with (perceived) access to health care among (ex-)breast cancer patients during the COVID-19 pandemic. Methods Cross-sectional study within a large prospective, multicenter cohort of (ex-)breast cancer patients, i.e., UMBRELLA. All participants enrolled in the UMBRELLA cohort between October 2013 and April 2020 were sent a COVID-19-specific survey, including the Hospital Anxiety and Depression Scale (HADS) questionnaire. Results In total, 1051 (66.0%) participants completed the survey. During COVID-19, 284 (27.0%) participants reported clinically relevant increased levels of anxiety and/or depression, i.e., total HADS score ≥ 12. Participants with anxiety and/or depression reported statistically significant higher barriers to contact their general practitioner (47.5% vs. 25.0%, resp.) and breast cancer physicians (26.8% vs. 11.2%, resp.) compared to participants without these symptoms. In addition, a higher proportion of participants with anxiety and/or depression reported that their current treatment or (after)care was affected by COVID-19 compared to those without these symptoms (32.7% vs. 20.5%, resp.). Factors independently associated with symptoms of anxiety and/or depression during COVID-19 were pre-existent anxiety (OR 6.1, 95% CI 4.1–9.2) or depression (OR 6.0, 95% CI 3.5–10.2). Conclusion During the COVID-19 pandemic, (ex-)breast cancer patients with symptoms of anxiety and/or depression experience higher barriers to contact health care providers. Also, they more often report that their health care was affected by COVID-19. Risk factors for anxiety and/or depression during COVID-19 are pre-existent symptoms of anxiety or depression. Extra attention—including mental health support—is needed for this group.

Download Full-text

Perceived Barriers to Early Diagnosis of Breast Cancer in South and South Western Ethiopia: a qualitative study

10.21203/rs.2.13446/v1 ◽

2019 ◽

Author(s):

Sefonias Getachew ◽

Aragaw Tesfaw ◽

Mirgissa Kaba ◽

Andreas Wienke ◽

Lesley Taylor ◽

...

Keyword(s):

Breast Cancer ◽

Health Care ◽

Early Diagnosis ◽

Health Care Providers ◽

Rural Areas ◽

Diagnostic Tests ◽

Perceived Barriers ◽

Care Providers ◽

Breast Cancer Patients ◽

Southwestern Ethiopia

Abstract Background Early diagnosis is a key determinant of breast cancer prognosis and survival. More than half of breast cancer cases are diagnosed at an advanced stage in Ethiopia, and the barriers to early diagnosis in this country are not well understood. We aimed to identify the perceived barriers to early diagnosis of breast cancer from the perspective of patients and health care providers in south and southwestern Ethiopia. Methods A qualitative study was conducted from March to April 2018 using in-depth interviews of breast cancer patients and breast cancer health care providers from six public hospitals located in urban and rural areas of south and southwestern Ethiopia. All participants proved verbal consent before participating. A thematic analysis was performed using Open Code 4.02. Results Twelve breast cancer patients and thirteen health care providers were included in the study. Patient and health-system related barriers to early diagnosis of breast cancer were identified. Patient-related barriers were lack of knowledge and awareness of breast cancer, belief in traditional medicine and religious practices for treatment, and lack of social and financial support to seek care at a medical facility. Health-system related barriers were misdiagnosis of breast cancer, long distance to referral facilities, high cost of diagnostic services, long waiting time for diagnostic tests, and lack of screening and diagnostic tests in local facilities. Conclusions Early diagnosis of breast cancer is affected by multiple barriers in south and southwestern Ethiopia. Awareness campaigns and education about the disease, prevention, and early detection are needed to increase early diagnosis of breast cancer. Opportunities exist to improve early diagnosis and timely treatment in rural areas.

Download Full-text

Perceived Barriers to Early Diagnosis of Breast Cancer in South and South Western Ethiopia: a qualitative study

10.21203/rs.2.13446/v2 ◽

2019 ◽

Author(s):

Sefonias Getachew ◽

Aragaw Tesfaw ◽

Mirgissa Kaba ◽

Andreas Wienke ◽

Lesley Taylor ◽

...

Keyword(s):

Breast Cancer ◽

Health Care ◽

Early Diagnosis ◽

Health Care Providers ◽

Rural Areas ◽

Diagnostic Tests ◽

Perceived Barriers ◽

Care Providers ◽

Breast Cancer Patients ◽

Southwestern Ethiopia

Abstract Background Early diagnosis is a key determinant of breast cancer prognosis and survival. More than half of breast cancer cases are diagnosed at an advanced stage in Ethiopia, and the barriers to early diagnosis in this country are not well understood. We aimed to identify the perceived barriers to early diagnosis of breast cancer from the perspective of patients and health care providers in south and southwestern Ethiopia. Methods A qualitative study was conducted from March to April 2018 using in-depth interviews of breast cancer patients and breast cancer health care providers from six public hospitals located in urban and rural areas of south and southwestern Ethiopia. All participants proved verbal consent before participating. A thematic analysis was performed using Open Code 4.02. Results Twelve breast cancer patients and thirteen health care providers were included in the study. Patient and health-system related barriers to early diagnosis of breast cancer were identified. Patient-related barriers were lack of knowledge and awareness of breast cancer, belief in traditional medicine and religious practices for treatment, and lack of social and financial support to seek care at a medical facility. Health-system related barriers were misdiagnosis of breast cancer, long distance to referral facilities, high cost of diagnostic services, long waiting time for diagnostic tests, and lack of screening and diagnostic tests in local facilities. Conclusions Early diagnosis of breast cancer is affected by multiple barriers in south and southwestern Ethiopia. Awareness campaigns and education about the disease, prevention, and early detection are needed to increase early diagnosis of breast cancer. Opportunities exist to improve early diagnosis and timely treatment in rural areas.

Download Full-text

Social Relationships and Its Association With Affective Symptoms of Women With Breast Cancer: a Scoping Review

10.21203/rs.3.rs-1005008/v1 ◽

2021 ◽

Author(s):

Yesol Yang ◽

Yufen Lin ◽

Grace Sikapokoo ◽

Se Hee Min ◽

Nicole Caviness-Ashe ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Social Relationships ◽

Health Care Providers ◽

Scoping Review ◽

Sample Type ◽

Cognitive Symptoms ◽

Care Providers ◽

Breast Cancer Patients ◽

Affective Symptoms

Abstract Background: Problems in affective and cognitive functioning are among the most common concurrent symptoms that breast cancer patients report. Social relationships may provide some explanations of the clinical variability in affective-cognitive symptoms. Evidence suggests that social relationships (functional and structural aspects) can be associated with patients’ affective-cognitive symptoms; however, such an association has not been well studied in the context of breast cancer. The purpose of this scoping review was to address the following question: What social relationships are associated with affective-cognitive symptoms of women with breast cancer? This scoping review used the framework proposed by Arksey and O’Malley and PRISMA-Sc. Extracted data included research aims, design, sample, type and measures of social relationships (functional and structural), and the association between social relationships and affective-cognitive symptoms. Results: Of sixty-five included studies, none of them focused on cognitive symptoms of breast cancer patients; thus, in this review, we focused on only the affective symptoms of breast cancer patients and their association with patients’ both aspects of social relationships. Conclusion: Our findings reveal that positive social relationships benefit in mitigating affective symptoms of women with breast cancer. Thus, health care providers need to educate patients about the importance of building solid social relationships and encourage them to participate in a supportive network of friends and family members.

Download Full-text

Experiences of Patients Diagnosed and Living With Metastatic Breast Cancer in Kumasi, Ghana: A Lesion to Learn From Low-Middle Income Country

Journal of Global Oncology ◽

10.1200/jgo.18.40600 ◽

2018 ◽

Vol 4 (Supplement 2) ◽

pp. 8s-8s

Author(s):

C. Asoogo ◽

M. Hoyte-Williams ◽

B. Dwobeng ◽

D. Sam ◽

E. Amankwa-Frimpong

Keyword(s):

Breast Cancer ◽

Health Care ◽

Metastatic Breast Cancer ◽

Cancer Patients ◽

Support Groups ◽

Metastatic Breast ◽

Care Providers ◽

Breast Cancer Patients ◽

Financial Changes ◽

Fear And Anxiety

Background: Breast cancer is a leading cause of death among women in Ghana. About 50% of cases seen at the oncology directorate are breast cancer-related, and 85% of these cases present in advanced stage with very poor prognosis and high mortality. Objectives: To explore and describe the experiences of patients diagnosed and living with metastatic breast cancer. Methods: A cross sectional descriptive study design was used to involved breast cancer patients at Komfo Anokye Teaching Hospital who comes from various social and ethnic groups as well as geographically distinct areas from the vast territory of the Ashanti region and the Northern part of Ghana. Convenient sampling was used to select 120 participants for the study using semistructured questionnaire. Data of their social and demographic background and experiences living with metastatic breast cancer were obtained after seeking informed consent. Results: The study revealed that 12% of participants diagnosed and living with metastatic breast cancer experience loneliness and devastated, 22% experience fear and anxiety, while 35% experience stigma from both family and the society. Moreover, feeling of anger and hopelessness also account for 15%, 11% experience financial changes, while 5% of participants experience both physical and emotional pain with their diagnosis and treatment. Recommendations were made for policy makers, health care professionals, and other researchers. These include the need for intensified metastatic breast cancer awareness campaigns, educating health care providers on the need for professional counseling on metastatic breast cancer and the need to organized support groups, so that patients could contact each other. Emphasis should be placed on training of nurses to deal with issues relating to metastatic breast cancer. Conclusion: Generally, fear and anxiety, stigma, feeling of loneliness, devastated, anger and hopelessness, emotional and physical pain and financial changes are the variables that explain the experiences of women diagnosed and living with metastatic breast cancer. Some support groups has shown an improvement, therefore efforts to raise public awareness of metastatic breast cancer should be continued. The current study became imperative to fill this identified gap and improve health interventions and health outcomes for metastatic breast cancer patients in future.

Download Full-text

Inquiry and computer program Onko-Online: 25 years of clinical registry for breast cancer at the University Medical Centre Maribor

Radiology and Oncology ◽

10.2478/raon-2019-0043 ◽

2019 ◽

Vol 53 (3) ◽

pp. 348-356

Author(s):

Darja Arko ◽

Iztok Takac

Keyword(s):

Breast Cancer ◽

Computer Program ◽

Cancer Patients ◽

Health Care Providers ◽

Cancer Registries ◽

International Standards ◽

Care Providers ◽

Breast Cancer Patients ◽

Clinical Registry

Abstract Background High-quality routine care data collected in the clinical registry play a significant role in improving the management of cancer patients. Clinical cancer registries record important data in the course of cancer diagnosis, treatment, follow-up and survival. Analyses of such comprehensive data pool make it possible to improve the quality of patients care and compare with other health care providers. Methods The first inquiry at the Department of Gynaecologic and Breast Oncology of the then General Hospital Maribor to follow breast cancer patients has been introduced in 1994. Based on our experience and new approaches in breast cancer treatment, the context of inquiry has been changed and extended to the present form, which served as a model for developing a relevant computer programme named Onko-Online in 2014. Results During the 25-year period, we collected data from about 3,600 breast cancer patients. The computer program Onko-Online allowed for quick and reliable collection, processing and analysis of 167 different data of breast cancer patients including general information, medical history, diagnostics, treatment, and follow-up. Conclusions The clinical registry for breast cancer Onko-Online provides data that help us to improve diagnostics and treatment of breast cancer patients, organize the daily practice and to compare the results of our treatment to the national and international standards. A limitation of the registry is the potentially incomplete or incorrect data input by different healthcare providers, involved in the treatment of breast cancer patients.

Download Full-text