Women with newly diagnosed breast cancer and their perceptions of needs in a health-care context.

The Commission on Cancer’s standard 3.3 represents a paradigm shift in the care of cancer survivors, recommending that survivors receive a treatment summary and survivorship care plan (SCPs). A focus on older breast cancer survivors is needed, as they are the majority of the breast cancer population and their experiences and perspectives of SCPs is limited in the literature. This pilot study utilized a mixed methods approach (focus groups and self-report questionnaire data) to gather information on older (≥65 years) breast cancer survivors’ perspectives of their SCPs, cancer survivorship, and communication with their health-care providers. The questionnaire was completed individually by the participants prior to the focus group and contained items on basic demographics and their health status following cancer treatment. The focus groups indicated that only a minority of women actually developed a SCP. Those who developed a SCP in collaboration with their providers valued the personal care and attention received. However, some participants reported poor communication with their providers and within their health-care team, resulting in frustration and confusion. Participants’ suggestions for ideal SCPs included better education and personalization, particularly in appropriate nutrition and exercise, and managing side effects and comorbidities. Lastly, the women believed that additional long-term care resources, such as health coaches, were important in improving their survivorship. These findings provide insight into enhancing the content, communication, and application of SCPs to improve the survivorship experience of older breast cancer survivors.

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Learning from and Leveraging Multi-Level Changes in Responses to the COVID 19 Pandemic to Facilitate Breast Cancer Prevention Efforts

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18136999 ◽

2021 ◽

Vol 18 (13) ◽

pp. 6999

Author(s):

Deborah J. Bowen ◽

Kelly E. Rentscher ◽

Amy Wu ◽

Gwen Darien ◽

Helen Ghirmai Haile ◽

...

Keyword(s):

Breast Cancer ◽

Health Care ◽

Cancer Prevention ◽

Care Delivery ◽

Breast Cancer Prevention ◽

Health Care Use ◽

Economic Life ◽

Future Research ◽

Multi Level ◽

And Shifts

The coronavirus pandemic (COVID-19) has had multilevel effects on non-COVID-19 health and health care, including deferral of routine cancer prevention and screening and delays in surgical and other procedures. Health and health care use has also been affected by pandemic-related loss of employer-based health insurance, food and housing disruptions, and heightened stress, sleep disruptions and social isolation. These disruptions are projected to contribute to excess non-COVID-19 deaths over the coming decades. At the same time municipalities, health systems and individuals are making changes in response to the pandemic, including modifications in the environmental to promote health, implementation of telehealth platforms, and shifts towards greater self-care and using remote platforms to maintain social connections. We used a multi-level biopsychosocial model to examine the available literature on the relationship between COVID-19-related changes and breast cancer prevention to identify current gaps in knowledge and identify potential opportunities for future research. We found that COVID-19 has impacted several aspects of social and economic life, through a variety of mechanisms, including unemployment, changes in health care delivery, changes in eating and activity, and changes in mental health. Some of these changes should be reduced, while others should be explored and enhanced.

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Recommendation and Acceptance of Counselling for Familial Cancer Risk in Newly Diagnosed Breast Cancer Cases

Breast Care ◽

10.1159/000517021 ◽

2021 ◽

pp. 1-6

Author(s):

Karin Kast ◽

Julia Häfner ◽

Evelin Schröck ◽

Arne Jahn ◽

Carmen Werner ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Risk ◽

Genetic Counselling ◽

Primary Breast Cancer ◽

Ductal Carcinoma ◽

Familial Cancer ◽

University Hospital ◽

Tumor Board ◽

Newly Diagnosed ◽

Familial Cancer Risk

Background: In clinical routine, not every patient who is offered genetic counselling and diagnostics in order to investigate a familial cancer risk predisposition opts for it. Little is known about acceptance of counselling and testing in newly diagnosed breast cancer cases in Germany. Methods: All primary breast cancer cases and patients with DCIS (ductal carcinoma in situ) treated at the University Hospital of Dresden between 2016 and 2019 were included. The number of tumor board recommendations for genetic counselling on the basis of the GC-HBOC risk criteria was recorded. Acceptance was analyzed by number of cases with counselling in the GC-HBOC-Center Dresden. Results: Of 996 primary breast cancer and DCIS cases, 262 (26.3%) were eligible for genetic counselling. Recommendation for genetic counselling was accepted by 64.1% (168/262). Of these 90.5% (152/168) opted for molecular genetic analysis. The acceptance rate for counselling increased between 2016 and 2019 from 58.3 to 72.6%. Altogether, 20.4% (31/152) patients were found to carry a pathogenic variant in the breast cancer genes BRCA1 or BRCA2. Conclusion: Acceptance of recommendation is increasing as clinical consequences augment. Optimization in providing information about hereditary cancer risk and in accessibility of counselling and testing is required to further improve acceptance of recommendation.

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Prospective comparison of the diagnostic accuracy of 18F-FDG PET/MRI, MRI, CT, and bone scintigraphy for the detection of bone metastases in the initial staging of primary breast cancer patients

European Radiology ◽

10.1007/s00330-021-07956-0 ◽

2021 ◽

Author(s):

Nils Martin Bruckmann ◽

Julian Kirchner ◽

Lale Umutlu ◽

Wolfgang Peter Fendler ◽

Robert Seifert ◽

...

Keyword(s):

Breast Cancer ◽

Bone Metastases ◽

Cancer Patients ◽

Bone Scintigraphy ◽

Fdg Pet ◽

Primary Breast Cancer ◽

Whole Body ◽

Newly Diagnosed ◽

Breast Cancer Patients ◽

Initial Staging

Abstract Objectives To compare the diagnostic performance of [18F]FDG PET/MRI, MRI, CT, and bone scintigraphy for the detection of bone metastases in the initial staging of primary breast cancer patients. Material and methods A cohort of 154 therapy-naive patients with newly diagnosed, histopathologically proven breast cancer was enrolled in this study prospectively. All patients underwent a whole-body [18F]FDG PET/MRI, computed tomography (CT) scan, and a bone scintigraphy prior to therapy. All datasets were evaluated regarding the presence of bone metastases. McNemar χ2 test was performed to compare sensitivity and specificity between the modalities. Results Forty-one bone metastases were present in 7/154 patients (4.5%). Both [18F]FDG PET/MRI and MRI alone were able to detect all of the patients with histopathologically proven bone metastases (sensitivity 100%; specificity 100%) and did not miss any of the 41 malignant lesions (sensitivity 100%). CT detected 5/7 patients (sensitivity 71.4%; specificity 98.6%) and 23/41 lesions (sensitivity 56.1%). Bone scintigraphy detected only 2/7 patients (sensitivity 28.6%) and 15/41 lesions (sensitivity 36.6%). Furthermore, CT and scintigraphy led to false-positive findings of bone metastases in 2 patients and in 1 patient, respectively. The sensitivity of PET/MRI and MRI alone was significantly better compared with CT (p < 0.01, difference 43.9%) and bone scintigraphy (p < 0.01, difference 63.4%). Conclusion [18F]FDG PET/MRI and MRI are significantly better than CT or bone scintigraphy for the detection of bone metastases in patients with newly diagnosed breast cancer. Both CT and bone scintigraphy show a substantially limited sensitivity in detection of bone metastases. Key Points • [18F]FDG PET/MRI and MRI alone are significantly superior to CT and bone scintigraphy for the detection of bone metastases in patients with newly diagnosed breast cancer. • Radiation-free whole-body MRI might serve as modality of choice in detection of bone metastases in breast cancer patients.

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Motivation, Education, and Expectations: Experiences of Philippine Immigrant Nurses

SAGE Open ◽

10.1177/21582440211016554 ◽

2021 ◽

Vol 11 (2) ◽

pp. 215824402110165

Author(s):

Kari Dahl ◽

Ann Kristin Bjørnnes ◽

Vibeke Lohne ◽

Line Nortvedt

Keyword(s):

Health Care ◽

Elderly Care ◽

Qualitative Interviews ◽

Educational Experience ◽

Nursing Curriculum ◽

Host Countries ◽

Filipino Nurses ◽

Health Care Context ◽

Immigrant Nurses ◽

Empirical Material

Globally, Philippine-educated nurses have made vital contributions to health care; however, there is a lack of in-depth knowledge about emigrating nurses’ initial motives to become nurses, their educational experience and their transition in the host country’s health care context. This research aimed to explore Philippine-educated nurses’ educational experience in their home country and their expectations of competence in Norway. The study utilized an explorative design consisting of qualitative interviews with 10 Filipino nurses. A hermeneutic approach was used to analyze and interpret the empirical material. The findings and interpretations underline that Philippine-educated nurses mainly are externally motivated; their educational program is very demanding, but their level of competence does not meet the competence expected in the host country. Although these nurses lack training in elderly care, the Philippine nursing curriculum emphasizes patient care and mastery of basic nursing skills, which are qualities that should be valued and utilized in host countries.

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