scholarly journals A longitudinal cohort study on benefit finding evolution in Chinese women breast cancer survivals

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Weiyun Bi ◽  
Huaning Wang ◽  
Guitao Yang ◽  
Cailin Zhu

AbstractEven though the prevalence of benefit finding (BF) has been empirically shown to exist among breast cancer (BC) survivals, how does benefit finding evolve over time remains inadequately investigated. The objective of this cohort study is to examine how BF evolves over time among Chinese breast cancer survivals and determine the demographic, medical and psychosocial factors that can sustain BF increase over time. Participants were 486 women with different stages of breast cancer (stages I, II and III) followed from completion of primary treatment. Analysis were performed on the data collected during 2014–2019. During the assessment, each participant completed self-report questionnaires of characteristics and benefit finding at six time points with the interval of 6 months since BC diagnosis. The relationships between demographic, medical and psychosocial characteristics and benefit finding evolution over time were examined using mixed models. Participants reported mixed results on the evolving patterns of benefit finding: 28% reported an upward trend in BF scoring over time, 49% instead reported an downward trend, and the remaining 23% reported no obvious change. Our study has shown that some well-known covariates of benefit finding, e.g. education, income, and social support, are not associated with BF trends. In comparison, levels of spirituality and disease coping at diagnosis can more reliably predict BF evolution over time. Identifying the sustaining factors of benefit finding in the experience of breast cancer is the key to design effective psycho clinical solutions for patients’ long-term post-traumatic growth. As time goes by, breast cancer patients may experience less benefit finding. Our results strongly indicate that benefit finding can be sustained and increased by encouraging attempts at meaning-making and active disease coping during breast cancer treatment. To the best of our knowledge, this study is among the first to examine the evolution trends of benefit finding over time on breast cancer survivals and determine their psychosocial predictors in developing countries.

2021 ◽  
Author(s):  
Weiyun Bi ◽  
Huaning Wang ◽  
Guitao Yang ◽  
Cailin Zhu

Abstract Objective: Even though the prevalence of benefit finding (BF) has been empirically shown to exist among breast cancer (BC) survivals, how does benefit finding evolve over time remains inadequately investigated. This objective of this study is to examine how BF evolves over time among Chinese breast cancer survivals and determine the demographic, medical and psychosocial factors that can sustain BF increase over time, thus bring about higher level of long-term post-traumatic growth among breast cancer survivals. Methods: Participants were 486 women with different stages of breast cancer (stages I, II and III) followed from completion of primary treatment. Analysis were performed on the data collected at the 3-year assessment during 2014-2019. Participants completed self-report questionnaires of characteristics and benefit finding at six time points with the interval of six months since BC diagnosis. The relationships between demographic, medical and psychosocial characteristics and benefit finding evolution over time were examined using mixed models. Results: Participants reported mixed results on the evolving patterns of benefit finding: 28% reported an upward trend in BF scoring over time, 49% instead reported an downward trend, and the remaining 23% reported no obvious change. Our study has shown that some well-known covariates of benefit finding, e.g. education, income, and social support, are not associated with BF trends. In comparison, levels of spirituality and disease coping at diagnosis can more reliably predict BF evolution over time. Our results strongly indicate that benefit finding can be sustained and increased by encouraging attempts at meaning-making and active disease coping during breast cancer treatment. To our knowledge, this study is among the first to examine trends of benefit finding evolution over time on breast cancer survivals and determine their psychosocial predictors in developing countries. Conclusion: Identifying the sustaining factors of benefit finding in the experience of breast cancer is the key to design psycho clinical solutions for patients’ long-term post-traumatic growth. As time goes by, cancer patients may experience less benefit finding. However, active disease coping and meaning-making by patients can effectively counter this undesired trend and boost their higher long-term post-traumatic growth.


2021 ◽  
Author(s):  
Weiyun Bi ◽  
Huaning Wang ◽  
Guitao Yang ◽  
Cailin Zhu

Abstract Objective: Even though the prevalence of benefit finding (BF) has been empirically shown to exist among breast cancer (BC) survivals, how does benefit finding evolve over time remains inadequately investigated. This objective of this study is to examine how BF evolves over time among Chinese breast cancer survivals and determine the demographic, medical and psychosocial factors that can sustain BF increase over time, thus bring about higher level of long-term post-traumatic growth among breast cancer survivals. Methods: Participants were 486 women with different stages of breast cancer (stages I, II and III) followed from completion of primary treatment. Analysis were performed on the data collected at the 3-year assessment during 2014-2019. Participants completed self-report questionnaires of characteristics and benefit finding at six time points with the interval of six months since BC diagnosis. The relationships between demographic, medical and psychosocial characteristics and benefit finding evolution over time were examined using mixed models. Results: Participants reported mixed results on the evolving patterns of benefit finding: 28% reported an upward trend in BF scoring over time, 49% instead reported an downward trend, and the remaining 23% reported no obvious change. Our study has shown that some well-known covariates of benefit finding, e.g. education, income, and social support, are not associated with BF trends. In comparison, levels of spirituality and disease coping at diagnosis can more reliably predict BF evolution over time. Our results strongly indicate that benefit finding can be sustained and increased by encouraging attempts at meaning-making and active disease coping during breast cancer treatment. To our knowledge, this study is among the first to examine trends of benefit finding evolution over time on breast cancer survivals and determine their psychosocial predictors in developing countries. Conclusion: Identifying the sustaining factors of benefit finding in the experience of breast cancer is the key to design psycho clinical solutions for patients’ long-term post-traumatic growth. As time goes by, cancer patients may experience less benefit finding. However, active disease coping and meaning-making by patients can effectively counter this undesired trend and boost their higher long-term post-traumatic growth.


2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e24121-e24121
Author(s):  
Yuanyuan Lei ◽  
Winnie Yeo ◽  
Suzanne C. Ho ◽  
Ashley Chi Kin Cheng ◽  
Carol Kwok

e24121 Background: The diagnosis of cancer can motivate patients to change their physical activity habits. No data has reported level of physical activity before and after breast cancer diagnosis in Chinese women. Methods: In an on-going prospective cohort study which involved 1462 Chinese women with early-stage breast cancer, a validated modified Chinese Baecke questionnaire was used to assess physical activity at baseline, 18-, 36- and 60-month after diagnosis. At baseline, patients recalled their habitual physical activity in the preceding 12 months before cancer diagnosis. At 18-, 36- and 60-month follow-up, patients reported their habitual physical activity over the previous 12 months. The level of physical activity at post-diagnosis was defined as the average value assessed at 18-, 36- and 60-month follow-up. Results: Breast cancer patients significantly increased level of physical activity, with median value of 0.6, 5.3, 4.4 and 3.9 MET-hours/week at baseline, 18-, 36- and 60-month follow-up. The average level of physical activity at post-diagnosis was also significantly higher than that at pre-diagnosis ( P < 0.001), with median value of 5.8 MET-hours/week. However, there was no significant difference between any two follow-ups at post-diagnosis. The proportions of participant who met the exercise recommendation (according to WCRF/AICR, 10 MET-hours/week) were low at pre- and post-diagnosis, being 20.7% and 35.1%, respectively. Compared to pre-diagnosis, most of the patients improved or had no change on level of recreational physical activity at post-diagnosis, with the respective proportion being 48.2% and 43.8%. Multivariate analysis showed that higher increase in physical activity after cancer diagnosis was observed among breast cancer patients who were married or cohabitation, unemployed (compared to full time) and had no comorbidity (compared to patients who had one comorbidity). Conclusions: Chinese breast cancer patients reported significant and long-term changes in physical activity after cancer diagnosis, which was in line with current recommendation. However, the proportion of patients who met the exercise recommendation for cancer survivors was still low. Empowering patients on the importance of durable high level of physical activity in breast cancer survivorship is warranted.


Breast Cancer ◽  
2021 ◽  
Author(s):  
Takamichi Yokoe ◽  
Sasagu Kurozumi ◽  
Kazuki Nozawa ◽  
Yukinori Ozaki ◽  
Tetsuyo Maeda ◽  
...  

Abstract Background Trastuzumab emtansine (T-DM1) treatment for human epidermal growth factor receptor-2 (HER2)-positive metastatic breast cancer after taxane with trastuzumab and pertuzumab is standard therapy. However, treatment strategies beyond T-DM1 are still in development with insufficient evidence of their effectiveness. Here, we aimed to evaluate real-world treatment choice and efficacy of treatments after T-DM1 for HER2-positive metastatic breast cancer. Methods In this multi-centre retrospective cohort study involving 17 hospitals, 325 female HER2-positive metastatic breast cancer patients whose post-T-DM1 treatment began between April 15, 2014 and December 31, 2018 were enrolled. The primary end point was the objective response rate (ORR) of post-T-DM1 treatments. Secondary end points included disease control rate (DCR), progression-free survival (PFS), time to treatment failure (TTF), and overall survival (OS). Results The median number of prior treatments of post-T-DM1 treatment was four. The types of post-T-DM1 treatments included (1) chemotherapy in combination with trastuzumab and pertuzumab (n = 102; 31.4%), (2) chemotherapy concomitant with trastuzumab (n = 78; 24.0%), (3), lapatinib with capecitabine (n = 63; 19.4%), and (4) others (n = 82; 25.2%). ORR was 22.8% [95% confidence interval (CI): 18.1–28.0], DCR = 66.6% (95% CI 60.8–72.0), median PFS = 6.1 months (95% CI 5.3–6.7), median TTF = 5.1 months (95% CI 4.4–5.6), and median OS = 23.7 months (95% CI 20.7–27.4). Conclusion The benefits of treatments after T-DM1 are limited. Further investigation of new treatment strategies beyond T-DM1 is awaited for HER2-positive metastatic breast cancer patients.


BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Daniel C. Beachler ◽  
Cynthia de Luise ◽  
Aziza Jamal-Allial ◽  
Ruihua Yin ◽  
Devon H. Taylor ◽  
...  

Abstract Background There is limited real-world safety information on palbociclib for treatment of advanced stage HR+/HER2- breast cancer. Methods We conducted a cohort study of breast cancer patients initiating palbociclib and fulvestrant from February 2015 to September 2017 using the HealthCore Integrated Research Database (HIRD), a longitudinal claims database of commercial health plan members in the United States. The historical comparator cohort comprised patients initiating fulvestrant monotherapy from January 2011 to January 2015. Propensity score matching and Cox regression were used to estimate hazard ratios for various safety events. For acute liver injury (ALI), additional analyses and medical record validation were conducted. Results There were 2445 patients who initiated palbociclib including 566 new users of palbociclib-fulvestrant, and 2316 historical new users of fulvestrant monotherapy. Compared to these historical new users of fulvestrant monotherapy, new users of palbociclib-fulvestrant had a greater than 2-fold elevated risk for neutropenia, leukopenia, thrombocytopenia, stomatitis and mucositis, and ALI. Incidence of anemia and QT prolongation were more weakly associated, and incidences of serious infections and pulmonary embolism were similar between groups after propensity score matching. After adjustment for additional ALI risk factors, the elevated risk of ALI in new users of palbociclib-fulvestrant persisted (e.g. primary ALI algorithm hazard ratio (HR) = 3.0, 95% confidence interval (CI) = 1.1–8.4). Conclusions This real-world study found increased risks of several adverse events identified in clinical trials, including neutropenia, leukopenia, and thrombocytopenia, but no increased risk of serious infections or pulmonary embolism when comparing new users of palbociclib-fulvestrant to fulvestrant monotherapy. We observed an increased risk of ALI, extending clinical trial findings of significant imbalances in grade 3/4 elevations of alanine aminotransferase (ALT).


2014 ◽  
Vol 29 (1) ◽  
pp. e1-e7 ◽  
Author(s):  
Yanzhi Zhang ◽  
Peng Wang ◽  
Mumu Shi ◽  
Hironobu Sasano ◽  
Monica S.M. Chan ◽  
...  

Background Disparities of biomarkers’ expression in breast cancer across different races and ethnicities have been well documented. Proline, glutamic acid, and leucine-rich protein 1 (PELP1), a novel ER coregulator, has been considered as a promising biomarker of breast cancer prognosis; however, the pattern of PELP1 expression in Chinese women with breast cancer has never been investigated. This study aims to provide useful reference on possible racial or ethnic differences of PELP1 expression in breast cancer by exploring the pattern of PELP1 expression in Chinese women with primary breast cancer. Methods The expression of PELP1 in primary breast cancer samples from 130 Chinese female patients was detected by immunohistochemistry and correlated to other clinicopathological parameters; for comparison, the expression of PELP1 in 26 benign breast fibroadenomas was also examined. Results The overall value of the PELP1 H-score in breast cancer was significantly higher than that in breast fibroadenoma (p<0.001). In our breast cancer patients, the ER/HER-2-positive group had significantly higher PELP1 H-scores than their negative counterparts (p=0.003 for ER and p=0.022 for HER-2); the Ki-67-high group also showed significantly higher PELP1 H-scores than the Ki-67-low group (p=0.008). No significant association between PELP1 H-scores and other clinicopathological parameters was found. Finally, the PELP1 H-score in breast cancers of the luminal B subtype was significantly higher than that in the triple negative subtype (p=0.002). Conclusion Overexpression of PELP1 in Chinese women with primary breast cancer appears to be associated with biomarkers of poor outcome; these results are similar to other reports based on Western populations.


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