Abstract B033: Breast cancer and other cause of death among adult women in rural Ethiopia: Presentation and duration of suffering using the direct sisterhood method

Cancer, responsible for about 1 death in 5 in Scotland, cost over £1 per head of population in 1965 and led to bed occupation of almost 2,000 bed years. Time lag (symptoms-doctor-hospital-treatment) is usuallv small. Age distribution is as in other European countries. Excluding accidents, cancer is the second most important cause of death in children. In relation to other countries Scotland's position is very poor and the lung cancer mortality in both sexes is the highest known. Lung cancer is the most important in males, breast cancer in females. Alimentary cancers come second in both sexes. In this century alimentary cancers increased till the thirties or forties and then declined. Cancers of pancreas, cervix uteri, ovary, prostate, kidney and bladder, together with leukaemia, have all increased. Cancer of the lung has increased elevenfold in women and fiftyfold in men. It now accounts for 9 to 12 per cent of all male deaths in cities and large towns

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Second primary cancer after female breast cancer: Familial risks and cause of death

Cancer Medicine ◽

10.1002/cam4.1899 ◽

2018 ◽

Vol 8 (1) ◽

pp. 400-407 ◽

Cited By ~ 3

Author(s):

Guoqiao Zheng ◽

Akseli Hemminki ◽

Asta Försti ◽

Jan Sundquist ◽

Kristina Sundquist ◽

...

Keyword(s):

Breast Cancer ◽

Cause Of Death ◽

Female Breast Cancer ◽

Second Primary ◽

Primary Cancer ◽

Second Primary Cancer ◽

Female Breast

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Metástasis duodenal de cáncer de mama. Presentación atípica y resolución quirúrgica no habitual

Acta gastroenterológica latinoamericana ◽

10.52787/vdru8702 ◽

2020 ◽

Vol 50 (2) ◽

Author(s):

Roberto Muñoz Jaramillo ◽

Sonia Ojeda ◽

Tomás Fumo ◽

Lucio Uranga ◽

Oscar Zerbo ◽

...

Keyword(s):

Breast Cancer ◽

Gastrointestinal Tract ◽

Adjuvant Chemotherapy ◽

Cause Of Death ◽

Malignant Tumor ◽

Cáncer De Mama ◽

History Of ◽

Metastatic Involvement

Breast cancer is the most frequent malignant tumor and the leading cause of death worldwide. The most frequent sites of metastatic involvement are the bone, liver and lung, and less than 1% compromise the gastrointestinal tract. The case of a patient with a history of breast cancer treated with chemotherapy and subsequent duodenal relapse is presented below. A cephalic duodenopancreatectomy (CDP) and adjuvant chemotherapy were performed with favorable evolution.

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Early-age breast cancer awareness and prevention by the formation of peer groups: 'GiRLs Can' (youth movement against cancer)

Community Empowerment ◽

10.31603/ce.4962 ◽

2021 ◽

Vol 6 (9) ◽

pp. 1577-1584

Author(s):

Kurnia Wijayanti ◽

Fitria Endah Janitra ◽

Indah Sri Wahyuningsih

Keyword(s):

Breast Cancer ◽

Peer Group ◽

Health Condition ◽

Cancer Type ◽

Adult Women ◽

Cancer Awareness ◽

Youth Movement ◽

Breast Cancer Awareness ◽

Detection And Diagnosis ◽

Self Examination

The rate of new breast cancer cases is globally on the rise. This health condition is the most common cancer type suffered by adult women and adolescents in Indonesia. There is also a widespread concern of an increasing risk in subsequent generations. Therefore, the need to provide extensive awareness and prevention efforts appears very paramount, particularly in a premature stage. Early detection and diagnosis have been proved effective in breast cancer reduction and treatment. The peer group 'GiRLs Can' was formed to enhance the knowledge, skills and abilities related to active breast cancer prevention. This initiative also involved peer education in the form of training, demonstration, practice and re-training. The results showed 90% of the ‘GiRLs Can’ members were well-informed on the basic concepts of breast cancer, and demonstrated accurate self-examination processes, meanwhile 89% were able to invite other peers to partake in the self-examination. Furthermore, the service team recommended the formation of similar groups in other locations.

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Improving Access and Adherence to Endocrine Therapy With Nurse-Based Intervention

Journal of Global Oncology ◽

10.1200/jgo.18.10170 ◽

2018 ◽

Vol 4 (Supplement 3) ◽

pp. 15s-15s

Author(s):

Sefonias Getachew ◽

Adamu Addisse ◽

Lesley Taylor ◽

Eva J. Kantelhardt

Keyword(s):

Breast Cancer ◽

Endocrine Therapy ◽

Hormone Receptor ◽

Nursing Intervention ◽

Tamoxifen Therapy ◽

Rural Ethiopia ◽

Long Term Treatment ◽

Nurse Navigator ◽

The Impact

Purpose The majority of women with breast cancer from low-income countries, including Ethiopia, present with advanced clinical stage disease, which results in limited and difficult therapeutic options and high mortality rates. In Ethiopia, breast cancer is the most common cancer. We found that 70% of breast cancer cases in Ethiopia are hormone receptor positive. Endocrine therapy is one of the treatment options recommended for breast cancer but that is highly underutilized in the country. Recommendations on interventions to improve uptake and adherence to therapy exist, but studies that have assessed the feasibility of implementing these are limited. Our study (n = 107) in rural Ethiopia revealed an estimated 53% 2-year survival rate in patients who underwent surgery only. In our pilot study, of 51 eligible patients 26 initiated therapy and one half of those adhered after 1 year. Our study aims to evaluate the effectiveness of using a trained breast nurse navigator to improve patient adherence to tamoxifen therapy among patients with breast cancer in rural Ethiopia. Methods A cluster randomized intervention trial is being carried out in rural hospitals in southwestern Ethiopia from February 2018 to June 2019. We use hospitals in clusters as the units of randomization. The sample size includes four per intervention arm and control arm, with each cluster comprised of approximately 15 patients. Before intervention, all patients in the hospitals will receive tamoxifen therapy free of charge. Hormone receptor status of the breast cancer specimen will be determined before the initiation of therapy or throughout the course of therapy. The primary outcome of this trial is adherence to endocrine therapy on the basis of objective and subjective measures. Data will be collected with a prospective repeated measures approach. Analysis will be based on an intention-to-treat principle. Results The trial aims to provide evidence on the effectiveness of the breast nurse intervention to improve adherence to long-term endocrine therapy and answer the following research question: does the nursing intervention improve long-term treatment adherence by patients to endocrine therapy compared with those who receive usual care services? Conclusion These data are essential to maximize the impact of trained nurse-based interventions on adherence to endocrine (tamoxifen) therapy among patients with breast cancer on follow-up. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . Eva J. Kantelhardt Travel, Accommodations, Expenses: Daiichi Sankyo Oncology Europe

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Competing risks of death in NCIC CTG MA.27 adjuvant exemestane versus anastrozole.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.564 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. 564-564

Author(s):

Judy-Anne W. Chapman ◽

Lois E. Shepherd ◽

James N. Ingle ◽

Hyman Bernard Muss ◽

Kathleen I. Pritchard ◽

...

Keyword(s):

Breast Cancer ◽

Adjuvant Chemotherapy ◽

Cause Of Death ◽

Performance Status ◽

Postmenopausal Breast Cancer ◽

Prior Treatment ◽

Phase Iii ◽

Lymph Node Status ◽

Tumor Characteristics ◽

All Cause Mortality

564 Background: Our group previously examined if baseline patient/tumor characteristics, or prior treatment affected cause of death in MA.17, a placebo controlled extended adjuvant trial of the aromatase inhibitor (AI) letrozole. We now examine factor effects on all cause mortality in MA.27. Methods: MA.27 was an adjuvant phase III superiority trial of 5 yrs of exemestane vs anastrozole, in ER+ postmenopausal breast cancer accrued between 2003 and 2008; event free survival was similar. We examined by intention-to-treat, the multivariate time-to-breast cancer-specific (BrCa), cardiovascular (Cardio), and other causes (OT) of death with log-normal survival analysis adjusted by treatment and stratification factors (lymph node status, adjuvant chemotherapy, celecoxib, aspirin, and trastuzumab). We tested whether factors were associated with 1) all cause mortality, and if so, 2) cause-specific mortality. We also fit step-wise forward cause-specific adjusted models. Results: 7,576 women (median age 64.1 years; 5417 (71.5%) <70 yrs and 2159 (28.5%) >70 yrs) were enrolled and followed for a median of 4.1 yrs. The 432 deaths comprised: 187 (43.3%) BrCa, 66 (15.3%) Cardiovascular, and 179 (41.4%) OT MA.27 therapy was not associated with mortality (p=0.84). Five baseline factors were differentially associated with cause of death. Older age was associated with greater BrCa (p=0.03), Cardio (p<0.001), and OT (p<0.001) mortality. Pre-existing cardiovascular history led to worse Cardio mortality (p<0.001). Worse ECOG performance status led to worse OT death (p<0.001). T1 tumors were associated with less BrCa mortality (p<0.001). PgR+ tumors were also associated with less BrCa mortality (p<0.001). There were fewer BrCa deaths with Node –ve disease (p<0.001), ER+ tumors (p=0.001) and without adjuvant chemotherapy (p=0.005); there was worse Cardio mortality (p=0.01) with receipt of trastuzumab; worse OT (p=0.03) for non-whites, and without adjuvant radiotherapy (p=0.003). Conclusions: 56.7% of deaths in MA.27 patients were non-breast cancer related. We showed baseline patient and tumor characteristics, and prior treatment differentially affected cause of death. Clinical trial information: NCT00066573.

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Evidence for persistent radiation-related injury to the immune system in patients with local breast cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e15189 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e15189-e15189

Author(s):

Janhavi Athale ◽

Kristen Broderick ◽

Xiaojun Wu ◽

Stuart A. Grossman

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Lymph Nodes ◽

Control Group ◽

Diep Flap ◽

Adult Women ◽

Node Density ◽

Abdominal Lymph Node ◽

Lymph Node Density ◽

Tumor Stages

e15189 Background: Clinical data in multiple tumors has demonstrated that the inadvertent radiation of circulating lymphocytes causes grade III-IV lymphopenia which is associated with worse outcomes in cancer patients and failure to respond to immunologic interventions. Murine data from our lab demonstrated that radiation to the brain results in striking changes in the anatomy and cellularity of distant unirradiated lymph nodes. This study was designed to understand the relationship between local radiation and the depletion of distant unirradiated lymph nodes in humans which has not been previously studied. Methods: Adult women with breast cancer who had undergone prior mastectomy with pathology, labs, and radiation data available at our institution were enrolled at the time of their deep inferior epigastric perforator artery (DIEP) flap reconstruction. During reconstruction, a single abdominal lymph node was extracted, and subsequently formalin fixed. The pre- and post-treatment lymph nodes of radiated and non-radiated patients were presented in a blinded manner to the hematopathologist. The pathologist described each lymph node and graded the lymph node density as (1) low, (2) low-normal, (3) normal, or (4) high. Results: Seven women have been enrolled (median age 50; range 31-55) with AJCC tumor stages from 1a – 3b (five are hormone positive, and two are triple negative). The reconstruction was completed on average 488.71 + 224.57 days after initial mastectomy. Three of the women received neoadjuvant chemotherapy, and five received adjuvant chemotherapy. Five of the seven women had received radiation (mean 50.9 + 5.6 Gy). The baseline median LN density score in all patients was 4 (range 1-4), with a post mean LN density of 1.2 + 0.4 in the radiation group compared to a mean score of 3 + 1.4 in the control group. Conclusions: Systemic lymphocyte counts remain relatively stable but lymph node density is markedly lower than baseline in 80% of patients who received chest wall irradiation consistent with data from animal model studies. It is important to note that this effect on the nodes is seen long after the radiation has been completed. [Table: see text]

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Breast Cancer Screening Among Adult Women in China, 2010

Preventing Chronic Disease ◽

10.5888/pcd10.130136 ◽

2013 ◽

Vol 10 ◽

Cited By ~ 27

Author(s):

Baohua Wang ◽

Minfu He ◽

Limin Wang ◽

Michael M. Engelgau ◽

Wenhua Zhao ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Screening ◽

Breast Cancer Screening ◽

Adult Women

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Healthcare Resource Use and Expenditures among Metastatic Breast Cancer Patients Treated with HER2-Targeted Agents

International Journal of Breast Cancer ◽

10.1155/2014/475171 ◽

2014 ◽

Vol 2014 ◽

pp. 1-12 ◽

Cited By ~ 5

Author(s):

Nicole Meyer ◽

Yanni Hao ◽

Xue Song ◽

Nianwen Shi ◽

William Johnson ◽

...

Keyword(s):

Breast Cancer ◽

Metastatic Breast Cancer ◽

De Novo ◽

Metastatic Breast ◽

Adult Women ◽

Targeted Agents ◽

Newly Diagnosed ◽

Breast Cancer Patients ◽

Office Visits ◽

Outpatient Services

Objective. To compare healthcare utilization (HCU) and costs of women newly diagnosed with metastatic breast cancer (mBC) by receipt of HER2-targeted agents (H2T) and among H2T subgroups.Methods. Adult women newly diagnosed with mBC (index date) during 2008–2012 were followed until enrollment end or inpatient death. Study cohorts were antineoplastic ± H2Ts, and no treatment; and subgroups of H2T patients stratified by receipt of hormonal therapy (HT+/HT−), byde novoversus recurrent disease status, and by age group. All-cause (ALL) and breast cancer related (BCR) HCU and costs (in 2012 dollars) were estimated using a generalized linear model.Results. Of 18,059 women, 14.6% were H2T users 71.1% nonusers, and 14.3% untreated. No treatment patients had the highest ALL and BCR inpatient HCU, and ALL emergency room HCU. H2Ts users had the highest ALL and BCR office visits, lab and diagnostic radiology, radiation treatments, other outpatient services, and prescription antineoplastics. Adjusted ALL and BCR costs were the highest for H2T users and, in H2T subgroups, higher for HT—versus HT+ andde novoversus recurrent, and declined with older age.Conclusions. Receipt of H2Ts was associated with greater levels of ALL and BCR HCU and costs. H2T subgroups ofHT-,de novo, and younger age had higher HCU and costs, possibly indicating more aggressive treatments.

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An Overview of the Swedish Randomised Mammography Trials: Total Mortality Pattern and the Representivity of the Study Cohorts

Journal of Medical Screening ◽

10.1177/096914139600300208 ◽

1996 ◽

Vol 3 (2) ◽

pp. 85-87 ◽

Cited By ~ 40

Author(s):

Lennarth Nyström ◽

Lars-Gunnar Larsson ◽

Stig Wall ◽

Lars Erik Rutqvist ◽

Ingvar Andersson ◽

...

Keyword(s):

Breast Cancer ◽

Cause Of Death ◽

Mammography Screening ◽

Breast Cancer Mortality ◽

Total Mortality ◽

Control Group ◽

Control Groups ◽

Mortality Pattern ◽

And Control ◽

Screening Trials

Objectives –To analyse the cause of death pattern in the cohorts of women included in the Swedish randomised mammography screening trials by comparing the groups of invited and control women both with each other and with the general population of Swedish women. Setting –Since 1977 four randomised trials of mammography screening have been performed in Sweden: Malmö, Kopparberg and ÖOstergötland (the two county trial), Stockholm, and Gothenburg. Design –Overview of four randomised mammography screening trials. Results –The total numbers of deaths in the invited and control groups respectively were 15 695 and 11 887 corresponding to a relative risk (RR) of 1.00. There were no significant differences between the invited and control groups for cause-specific mortality, except for breast cancer. When the total mortality in the invited and the control groups was compared with that for Swedish women in general the standardised mortality ratio was close to 100. Conclusions –The cause of death pattern in the invited group was, except for breast cancer, very similar to that in the control group, showing that the groups were comparable. Similarly, the total mortality including breast cancer mortality in the control group was almost identical to that in Swedish women in general. The same was true, with the exception of breast cancer, for the invited group. These observations confirm that the trial cohorts are representative of Swedish women and indicate that the quantitative results from these trials may safely be generalised to the Swedish population.

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