scholarly journals The Mode of Detection Is Not Associated with Quality of Life in Women with Breast Cancer

Breast Care ◽  
2019 ◽  
Vol 15 (5) ◽  
pp. 498-505
Author(s):  
Bettina Braun ◽  
Marc-André Kurosinski ◽  
Laura Khil ◽  
Joke Tio ◽  
Barbara Krause-Bergmann ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Tumor Stage ◽  
Screening Mammography ◽  
Influential Factors ◽  
Breast Cancers ◽  
Interval Cancers ◽  
Screening Programs ◽  
Mode Of Detection

Introduction: Apart from saving lives, mammography screening programs (MSP) are expected to reduce negative side effects of treatment by detecting cancer earlier, when it is more responsive to less aggressive treatment. This study compared quality of life (QoL) among women with breast cancers that were detected either by screening mammography, as interval cancers, or clinically among women not participating in the MSP. Methods: Retrospective study of first-ever invasive breast cancers detected among MSP-eligible women aged 50–69 years between 2006 and 2012 in Münster, Germany. EORTC QLQ-C30 and -BR23 questionnaires were mailed to 1,399 cases still alive in 2015 (response rate 64.1%). Results: Women’s responses were obtained on average 6.1 years after diagnosis. Mean crude and age-adjusted scores for overall QoL, breast and body image (BBI), and five functional scales (FS) were comparable between groups of detection mode. Clearly lower adjusted means for most scores were observed in women with interval cancers, if time since diagnosis was less than 5 years. Cases younger than 60 years showed lower values for some FS, particularly among interval and screen-detected cases. Discussion/Conclusion: In summary, cases with breast cancer showed health-related score values that were similar to the general population of the same age. There was also no indication that mode of detection markedly influenced these scores. However, after adjusting for tumor stage and other influential factors, screening participants appeared more susceptible to score declines after a diagnosis of cancer than non-participants.

Considerations on the Use of Aromatase Inhibitors in Postmenopausal Women With Breast Cancer

2020 ◽  
pp. 385-400
Author(s):  
Jeffrey D. Blaustein
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cognitive Function ◽  
Adverse Effects ◽  
Develop Breast Cancer ◽  
Laboratory Animals ◽  
Breast Cancers ◽  
The Brain

About 1 of every 8 women will develop breast cancer during her lifetime, and approximately 250,000 new cancer cases are expected annually as of 2017. Of those breast cancers, approximately 60% to 75% will express estrogen receptors, suggesting that estrogens are likely to promote growth of those tumors. Because the use of inhibitors of the synthesis of estrogens is the adjuvant treatment of choice for many women, it is essential that we understand the potential adverse effects on quality of life of those treatments. This review addresses the role of estrogens locally synthesized in the brain in laboratory animals and women, the effects of estrogens on cognitive function, the effects of synthesis blockers on cognitive function, and the limitations in performing experiments that will give us strong confidence in the results and conclusions.

Does the extent of therapy differ between breast cancers detected by screening mammogram and non-screening methods?

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 1544-1544
Author(s):  
Wendie-Lou D. Den Brok ◽  
Caroline Speers ◽  
Lovedeep Gondara ◽  
Alan Nichol ◽  
Christine Wilson ◽  
...  
Keyword(s):  
Breast Cancer ◽  
British Columbia ◽  
Overall Survival ◽  
Screening Mammography ◽  
Screening Methods ◽  
Breast Cancers ◽  
Screening Programs ◽  
Lower Stage ◽  
Cancer Agency ◽  
Overall Survival Benefit

1544 Background: There is ongoing debate about the role of screening mammography and its impact on overall survival in breast cancer. We hypothesized that women with screen-detected breast cancers (SDBC) receive less surgery, regional radiotherapy (RRT), and chemotherapy (CH) than women with non-screen-detected breast cancers (NSDBC). Less therapy equates to less personal and societal burden, including less time away from work, fewer side effects, lower health care and disability costs, and reduced psychosocial distress. These may be adequate justification for screening programs even in the absence of an overall survival benefit. Methods: Women aged 40-79 years with stage 0-III breast cancers diagnosed between 2007-2012 and referred to the British Columbia Cancer Agency were identified using the Breast Cancer Outcomes Unit database. Clinical and tumor characteristics and type/extent of treatment were extracted. Linkage with the Screening Mammography Program of British Columbia segregated cases into SDBCs and NSDBCs. Interval breast cancers arising in regularly screened women (minimum 2-year interval) were excluded. Results: We identified 12,393 women; 7807 with SDBC and 4586 with NSDBC. Compared with NSDBCs, SDBCs were lower stage, less often treated with mastectomy and CH, and occurred in slightly older women (Table 1). SDBC received more radiation than NSDBC. Conclusions: Women with NSDBC are more likely to present with higher stage breast cancer. Rates of mastectomy and CH were 20% higher in NSDBC whereas SDBC had a modest 5% higher rate of RRT. These findings suggest that screening mammography decreases the extent of local and systemic treatment for breast cancer. [Table: see text]

Does a better grade of tumour occurring in women under hormone replacement therapy compensate for their lower probability of detection by screening mammography

2002 ◽  
Vol 9 (2) ◽  
pp. 70-73 ◽  
Author(s):  
J. Estève ◽  
B. Séradour ◽  
J. Jacquemier ◽  
L. Remontet
Keyword(s):  
Breast Cancer ◽  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Hormone Replacement ◽  
Screening Mammography ◽  
Probability Of Detection ◽  
Lower Probability ◽  
Lower Grade ◽  
Breast Cancers ◽  
Mode Of Detection

OBJECTIVE: To compare the prognostic factor of breast cancer survival between breast cancer diagnosed in subjects receiving hormone replacement therapy (HRT) before diagnosis to those without such a therapy. Subjects and methods: All breast cancers diagnosed between 1993 and 2000 within the breast cancer screening programme in Bouches du Rhône (France) were analysed for size, node status, and grade according to use, or not, of HRT. Univariate and multivariate analyses were carried out taking into account age, density of the breast, and mode of detection. RESULTS: The breast tumours diagnosed among HRT users had a lower grade whatever the mode of detection. The proportion of node positive tumours was identical in the two groups after adjustment for age. The smaller size of the tumours among HRT users is partly explained by the lower grade of these tumours Conclusion: Although tumours occurring in HRT users have a lower chance of being detected by screening, their prognostic factors, especially the grade of the tumour, are better than in non-users. More work is needed to find which part of this advantage is attributable to better surveillance of women treated with HRT

Treatments for Breast Cancer That Affect Cognitive Function in Postmenopausal Women

2017 ◽  
Vol 4 (2) ◽  
pp. 170-177 ◽  
Author(s):  
Jeffrey D. Blaustein
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cognitive Function ◽  
Develop Breast Cancer ◽  
Laboratory Animals ◽  
Breast Cancers ◽  
Estrogen Synthesis ◽  
The Brain

About one of every eight women will develop breast cancer during her lifetime. Approximately a quarter of a million new cancer cases are expected in 2017. Of those breast cancers, 60% to 75% will have characteristics suggesting that estrogens are likely to promote growth of those tumors. Consequently, inhibiting estrogen synthesis is one of the main treatments of choice. Therefore, women must understand the potential adverse effects of those treatments on quality of life. This review discusses (a) the role of estrogens locally synthesized in the brain in laboratory animals and women, (b) the effects of estrogens and blockers of estrogen synthesis on cognitive function, and (c) the limitations in experiments on women taking inhibitors. This article aims to provide women and oncologists with information that will encourage them to consider side effects of aromatase inhibitors (AIs) treatment on the brain.

scholarly journals Characteristics of Screen-Detected Breast Cancer of Turkish Bahcesehir (Istanbul) Screening Project

2018 ◽  
Vol 4 (Supplement 3) ◽  
pp. 9s-9s
Author(s):  
Neslihan Cabıoğlu ◽  
Sibel Ozkan-Gurdal ◽  
Arda Kayhan ◽  
Ayse Nilufer Ozaydın ◽  
Cennet Şahin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Research Funding ◽  
Conflicts Of Interest ◽  
Statistical Significance ◽  
Interval Cancer ◽  
Multivariable Logistic Regression Analysis ◽  
Breast Cancers ◽  
Interval Cancers ◽  
Ki 67 ◽  
Screening Programs

Purpose The Turkish Bahcesehir Breast Cancer Screening Project is a 10-year organized population-based screening program carried out in one of the largest counties of Istanbul, Turkey. The aim of the current study was to examine the biologic features of screen-detected and interval breast cancers for the first 9-year study period. Methods Between January 2009 and January 2018, 26,040 mammographies were performed with 2-year intervals for 8,408 women age 40 to 69 years. Clinicopathologic and biologic tumor characteristics—estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2-neu, and protein encoded by the MKI67 gene (Ki-67) —were analyzed for those patients who were diagnosed with breast cancer. Interval cancer was defined as symptomatic cancer diagnosed within 24 months of a negative screening. Ki-67 level > 20% was considered a high score. Results Median age was 52.5 years, and 37% were younger than age 50 years. Of 8,408 women, 113 breast cancers (1.3%) were detected. There were 14 ductal carcinoma in situ (12.4%) and 99 invasive cancers (87.6%). The majority of patients with invasive cancer had stage 1 (49.1%) or stage 2 (31.8%) disease. The majority of patients underwent breast-conserving therapy (83%) with sentinel lymph node biopsy alone (74.1%). Interval cancers (n = 11) were more likely to have multifocality or multicentricity ( P = .002) and high Ki-67 score ( P = .05). Furthermore, diagnosis with interval cancer was associated with more advanced disease, including stage II to IV disease and axillary positivity, and patients were more likely to have nonluminal cancers or tumors with lymphovascular invasion. However, these associations did not reach statistical significance. Multivariable logistic regression analysis identified multifocality or multicentricity as the only significant factor to be associated with interval cancers (odds ratio, 5.94; 95% CI, 1.4 to 25.4; P = .016). Conclusion Our findings suggest that the majority of screen-detected breast cancers exhibit either luminal A or B subtype with low Ki-67 scores and unifocal tumors. However, interval cancers were more likely to have aggressive biology and multicentricity that was less likely to be detected by mammographic screening programs and that required more aggressive surgical and systemic therapies. 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 . Neslihan Cabioğlu Research Funding: Roche (Inst) Travel, Accommodations, Expenses: Genomic Health Sibel Ozkan-Gurdal Research Funding: Roche (Inst) Arda Kayhan Research Funding: Roche (Inst) Ayse Nilufer Ozaydin Research Funding: Roche (Inst) Cennet Şahin Research Funding: Roche (Inst) Beyza Ozcinar Research Funding: Roche (Inst) Erkin Aribal Employment: Nutricia – Danone and TRPharm (I) Leadership: Nutricia – Danone and TRPharm (I) Stock or Other Ownership: Roche (I) Honoraria: GE Healthcare, Fuji, Roche Travel, Accommodations, Expenses: Bayer Vahit Ozmen Honoraria: Pfizer, Roche Research Funding: Roche (Inst), Genekor, Roche Travel, Accommodations, Expenses: Pfizer

scholarly journals FACTORS THAT RELEVANT TO THE QUALITY OF LIFE OF BREAST CANCER PATIENTS

2018 ◽  
Vol 1 (2) ◽  
Author(s):  
Haris H ◽  
Laili Rahayuwati ◽  
Ahmad Yamin
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cancer Patients ◽  
Linear Regression Analysis ◽  
Life Quality ◽  
Breast Cancers ◽  
Breast Cancer Patients ◽  
National Breast ◽  
Age Factor

Breast cancer is a health problem since so many years ago especially to women. In 2013, Basic Health Research (Riskesdas) showed that the number of national breast cancer prevalence was the second most numerous patients in the world especially attacked women in Indonesia. The common problems experienced by breast cancers patients is the decrease of life quality of the patients. The purpose of this research was to identify factors related to the life quality of the breast cancers patients in Bandung city. This research used cross sectional method. The determination of life quality based on Quality of Life Cancer Survivor Version (QOL-CSV). Accidental sampling was used to choose samples. This research was taken place in four rumah singgah (shelters) of breast cancer located in Bandung city. There were 30 women involved in this study. Inclusive criterion in this research was the patients of breast cancers who are undergoing medications such as surgery, chemotherapy, or radiotherapy, who are willing to be the respondents voluntary. Result of normality test included age factor, marital age and firts time pregnance. Multivariate test used in this research was the linear regression analysis. Based on the result of bivariate analysis, age factor and frequency of pregnancy had positive correlated (p<0.05) to the life quality of breast cancer patients, while menarche had a negative correlated. Regression linear result was determined to life quality factor (p<0,05) including age factor, marital age and  pathology anatomy result. Half of the result of coefficient correlation showed a strong relationship in the quality of life of breast cancer patients. This Research showed that some of the reproduction factors related to the quality of life. Some factors are contributed to the quality of life of breast cancer patients such as age of the patient, marital age and result of pathology anatomy (cancer stage). This research needs more in-depths studies toward the quality of life of breast cancers patients as well as efforts of intervention to increase the quality of life of breast cancers patients.Keywords: breast cancer, quality of life, reproductive factors

pTNM Stage Distribution in Breast Cancer: A Population-Based Survey in Northern Italy

1994 ◽  
Vol 80 (4) ◽  
pp. 263-268
Author(s):  
Stefania Rodella ◽  
Monica Turazza ◽  
Cosimo Picoco ◽  
Franco Stanziai ◽  
Franco Bonetti ◽  
...  
Keyword(s):  
Breast Cancer ◽  
International Comparisons ◽  
Population Based ◽  
Northern Italy ◽  
Breast Cancers ◽  
Nodal Involvement ◽  
Screening Programs ◽  
Incident Cases ◽  
Population Based Survey

Aims and background The role of distribution by stage at diagnosis in breast cancer has been considered in many studies, with particular regard to evaluation of prognosis, impact of screening programs and quality of care. Nevertheless, international comparisons of descriptive data can be hampered by lack of homogeneity in staging methods. The TNM is presently the most common staging system used all over the world, although some criticism have been raised recently against its pragmatic value. The present study reports a population-based survey of pathologic TNM distribution in incident cases of female breast cancer in the Verona province, a geographical area of northern Italy covered by cancer registration. Methods All histologically proven incident cases of breast cancer were identified in the study period 1988-1990 and classified as for tumor size and nodal involvement according to the pathological TNM criteria. The type of surgical treatment was also registered for all cases diagnosed in 1990. Results one thousand two hundreds and fifty-four invasive and in situ breast cancers were observed and pT1 cases accounted for 44.4%. Nodal involvement was present in 41.5% of invasive cancers. A surgical treatment was performed in 1213 patients (96.7%). Axillary dissection was reported in 1080 cases, 820 of them (76.6%) having 10 or more lymph nodes examined. Radical mastectomy accounted for 74% of the 458 breast cancers diagnosed in 1990 and 31.6% of the eligible cases were conservatively treated. Conclusions Cancer registries should be encouraged to report data on stage distribution in breast cancer (and in other malignancies). This practice could improve international comparisons and give an essential contribution to studies on survival, screening programs and quality of care.

scholarly journals Breast Density and Risk of Interval Cancers: The Effect of Annual Versus Biennial Screening Mammography Policies in Canada

2021 ◽  
pp. 084653712110279
Author(s):  
Jean Morag Seely ◽  
Susan Elizabeth Peddle ◽  
Huiming Yang ◽  
Anna M. Chiarelli ◽  
Megan McCallum ◽  
...  
Keyword(s):  
Screening Program ◽  
Breast Cancer Mortality ◽  
Interval Cancer ◽  
Screening Mammography ◽  
Dense Breast ◽  
Breast Cancers ◽  
Interval Cancers ◽  
Screening Programs ◽  
Dense Breasts ◽  
Cancer Rates

Regular screening mammography reduces breast cancer mortality. However, in women with dense breasts, the performance of screening mammography is reduced, which is reflected in higher interval cancer rates (ICR). In Canada, population-based screening mammography programs generally screen women biennially; however, some provinces and territories offer annual mammography for women with dense breast tissue routinely and/or on recommendation of the radiologist. This study compared the ICRs in those breast screening programs with a policy of annual vs. those with biennial screening for women with dense breasts. Among 148,575 women with dense breasts screened between 2008 to 2010, there were 288 invasive interval breast cancers; screening programs with policies offering annual screening for women with dense breasts had fewer interval cancers 63/70,814 (ICR 0.89/1000, 95% CI: 0.67-1.11) compared with those with policies of usual biennial screening 225/77,761 (ICR 1.45 /1000 (annualized), 95% CI: 1.19-1.72) i.e. 63% higher (p = 0.0016). In screening programs where radiologists’ screening recommendations were able to be analyzed, a total of 76,103 women were screened, with 87 interval cancers; the ICR was lower for recommended annual (65/69,650, ICR 0.93/1000, 95% CI: 0.71, 1.16) versus recommended biennial screening (22/6,453, ICR 1.70/1000 (annualized), 95%CI: 0.70, 2.71)(p = 0.0605). Screening program policies of annual as compared with biennial screening in women with dense breasts had the greatest impact on reducing interval cancer rates. We review our results in the context of current dense breast notification in Canada.

scholarly journals An Underestimated Toxicity Radiation-Induced Hypothyroidism in Patients Multimodally Treated for Breast Cancer

2021 ◽  
Vol 10 (23) ◽  
pp. 5503
Author(s):  
Camil Ciprian Mireștean ◽  
Roxana Irina Iancu ◽  
Dragoș Petru Teodor Iancu
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Radiation Therapy ◽  
Thyroid Gland ◽  
Radical Mastectomy ◽  
Primary Hypothyroidism ◽  
Cervical Region ◽  
Breast Cancers ◽  
Free T4

Radiation therapy is part of the therapeutic arsenal for breast cancer, whether it is adjuvant treatment after lumpectomy or radical mastectomy, or it is used as a palliative option in the case of metastatic or recurrent disease. Significant advances in diagnostic and therapeutic stratification of breast cancers have significantly prolonged survival, even in the metastatic stage. Exposure of patients during the course of the disease in a multidisciplinary therapeutic approach including chemotherapy, hormone therapy, targeted anti-HER therapies or CDK4/6 inhibitors had led to improved survival but with the price of additional toxicity. Among them, hypothyroidism is a well-known consequence of external radiation therapy, especially in the case of cervical region irradiation, including supraclavicular and infra-clavicular nodal levels. In this situation, the thyroid gland is considered as an organ at risk (OAR) and receives a significant dose of radiation. Subclinical hypothyroidism is a common endocrine disorder characterized by elevated TSH levels with normal levels of FT4 (free T4) and FT3 (free T3), and as a late effect, primary hypothyroidism is one of the late effects that significantly affects the quality of life for patients with breast cancer receiving multimodal treatment. Hypothyroidism has a significant impact on quality of life, most often occurring as late clinical toxicity, secondary to thyroid irradiation at doses between 30 and 70 Gy. Dose-volume parameters of irradiation, gland function at the beginning of the treatment and associated systemic therapies may be factors that alter thyroid radio-sensitivity and affect thyroid gland tolerance. In the case of head and neck tumor pathology, in which doses of >50 Gy are routinely used, the thyroid gland is generally considered as an OAR, the rate of radio-induced hypothyroidism being estimated at rates of between 20% and 52%. For breast cancer, the thyroid is often neglected in terms of dosimetry protection, the rate of late dysfunction being 6–21%.

scholarly journals Overcoming Overdiagnosis: Women´s Preferences for Improving Breast Cancer Screening

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 38s-38s
Author(s):  
H.L. Bromley ◽  
T.E. Roberts ◽  
D. Petrie ◽  
B.G. Mann ◽  
D. Rea ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Ductal Carcinoma ◽  
Low Risk ◽  
Breast Cancers ◽  
Active Monitoring ◽  
The Impact

Background: Breast cancer screening is effective in reducing breast cancer mortality, but there is increasing concern that it may also lead to overdiagnosis; the detection and treatment of a cancer that would never have presented symptomatically during the woman's lifetime. Conservative management of low-risk breast cancer may reduce the harm of overdiagnosis resulting from mammographic screening programs, yet little is known about how such strategies might impact upon quality of life. Aim: To quantify women's preferences for managing low risk breast cancers identified by breast cancer screening. Methods: Utilities (measures of preference) were obtained from women with and without a history of breast cancer for seven health states reflecting low risk screen detected ductal carcinoma in situ (DCIS) using standard gambles. Demographics and a history of prior screening participation or breast cancer diagnosis were examined as predictors of screening and treatment pathway preferences. Results: Utilities were lower for breast cancers treated with mastectomy or invasive adjuvant treatment. The impact of active monitoring on quality of life was comparable to breast conserving surgery, although women in both patient and general population groups rated active monitoring more favorably as the risk of disease spread was decreased. There was some variation in ratings across patients suggesting that individual risk aversion does affect preferences for the type of conservative management valued. Conclusion: Overdiagnosis remains a challenge for improving the current breast cancer screening program. Active monitoring of low risk ductal carcinoma in situ may provide an acceptable solution for reducing the impact of overdiagnosis and overtreatment resulting from breast cancer screening on quality of life.

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