scholarly journals A Prospective Pilot Study to Evaluate Molecular Changes in the Hematopoietic System after Receipt of Chemotherapy or Radiotherapy and Its Clinical Implications Among Racially Diverse Breast Cancer Survivors: Breast Survivorchip Study

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 34-35
Author(s):  
Monica Peravali ◽  
Chidera Nosiri ◽  
Christopher S. Hourigan ◽  
Christopher Gallagher ◽  
Aarthi Shenoy
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Cancer Patients ◽  
Breast Cancer Survivors ◽  
Breast Cancer Patients ◽  
Racially Diverse ◽  
Advisory Committees ◽  
Treatment Delays ◽  
Clonal Hematopoiesis

Background: Clonal hematopoiesis (CH) increases in inflammatory states, and in retrospective epidemiological studies, has been associated with increased rates of atherosclerotic coronary artery disease, ischemic stroke, neurocognitive disorders, and hematologic malignancies.Previous data in non-cancer patients reported approximately 5% incidence of CH in patients aged 60-69. Next-generation sequencing (NGS) has demonstrated CH in 25% of predominantly white cancer survivors (21% in breast cancer patients) following chemotherapy and radiotherapy and 16% in a subset of patients prior to treatment suggesting a higher incidence of CH at baseline with malignancy and an increase in incidence following cancer treatment. The variance in CH rate among racially diverse cancer patients has not been well reported. The purpose of this prospective pilot investigator-initiated translational study is to characterize baseline profiles of existing CH, patterns of clonal evolution, and clinical implications of CH in a racially diverse population of breast cancer patients in a longitudinal fashion prior to and one year after receiving cancer directed therapy. This study will be performed at MedStar Washington Hospital Center (MWHC). MWHC is a not-for-profit, 912-bed, teaching and research hospital caring for a racially and socioeconomically diverse population in Washington, D.C. Study Design: Newly diagnosed breast cancer patients stages 0-III, who are candidates for surgery, chemotherapy and/or radiation, and/or endocrine therapy and/or Her2 directed therapy at WHC will be eligible. Baseline demographic data, comprehensive history, quality of life and cognitive assessments will be obtained at baseline and at 12 ± 1 months post initiation of therapy.Clinical data including blood counts, treatment delays, dose adjustments, and echocardiography results will be collected throughout treatment and entered into RedCap database. Blood will be collected in Paxgene tubes for each timepoint. Error-corrected NGS will be performed in a NIH laboratory on regions of genes known to be recurrently mutated in CH allowing for the sensitive and reproducible detection of low-level variants and accurate quantification of changes over time. Research sequencing results will not be returned to treating physicians or patients. Study Outcomes: The primary outcome of this study is to determine baseline rate of CH in a cohort of 100 breast cancer patients. We expect 50-60% of our patients to be black and therefore, can specifically evaluate CH in this group of patients compared to whites. Secondary outcome is to describe change in mutational profile after cancer-directed therapy. Descriptive analysis of the relationship of CH to treatment tolerance including prolonged myelosuppression or organ dysfunction leading to dose reductions and treatment delays as well as reduction in quality of life and cognition will be conducted as part of the exploratory analysis. Statistical methods: Descriptive statistics would be presented using frequency and proportions for categorical data and means and standard deviation for continuous data. Medians and quartiles will be presented for continuous data with non-normal distribution. Proportion of CH in breast cancer patients pre-treatment would be compared to proportion of CH post treatment using McNemar test for comparison of marginal proportions in paired data. Difference in baseline incidence of CH among different race categories would be evaluated using chi-squared test of independence. Effect of CH on delay in treatment would be evaluated using Kaplan Meier method for comparison of time to treatment between patients with CH and patients without CH. Clinical Significance: Life expectancy of breast cancer survivors is inferior to the general population and more so for black women. These differences may extend beyond psychosocial disparities and may have their foundation in genomic differences. Understanding clonal hematopoiesis in our racially diverse breast cancer patients will have significant implications both during the delivery of cancer directed therapy and in their long-term survivorship care. We currently have 25 patients enrolled in our study with their samples awaiting processing for NGS at NIH. Disclosures Gallagher: Seattle Genetics:Membership on an entity's Board of Directors or advisory committees;Daiichi Sankyo:Membership on an entity's Board of Directors or advisory committees.

scholarly journals Changing goals in the management of breast carcinoma patients towards preservation of feminity and quality of life

2018 ◽  
Vol 4 (2) ◽  
pp. 96-98
Author(s):  
Soumi Pathak ◽  
Ajay Kumar Bhargava
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Health Care ◽  
Developing Countries ◽  
Breast Carcinoma ◽  
Cancer Patients ◽  
Breast Cancer Survivors ◽  
Breast Cancer Patients ◽  
Health Care Burden

Breast cancer is the commonest cancer in women worldwide. In the developing countries of Asia, the health care burden on account of breast cancer has been steadily mounting. Over 100,000 new breast cancer patients are estimated to be diagnosed annually in India.1 As per the ICMR-PBCR data, breast cancer is the commonest cancer among women in urban registries of Delhi, Mumbai, Ahmedabad, Calcutta, and Trivandrum where it constitutes > 30% of all cancers in females. Previous literature on mastectomy indicates that the operation may be perceived by the patient as a threat to her feminity. Breast cancer survivors have dissatisfaction with appearance, perceived loss of femininity and body integrity, self-consciousness about appearance, and dissatisfaction with surgical scars… Journal of Society of Anesthesiologists of NepalVol. 4, No. 2, 2017, Page: 96-98 

scholarly journals Breast Cancer Patients’ Treatment Choices and Outcomes in a Naturopathic Clinic

2017 ◽  
Vol 2 (1) ◽  
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Cancer Patients ◽  
Breast Cancer Survivors ◽  
Disease Status ◽  
Tumor Burden ◽  
Water Soluble ◽  
Breast Cancer Patients ◽  
Treatment Choices ◽  
History Of

In this study we gathered data in July 2016 by means of questionnaires from breast cancer survivors following initial consult in a naturopathic clinic. Most patients surveyed had previously or concurrently had total surgical resection of their tumor burden, followed by at least 36 treatments of intravenous nutrients, including water -soluble vitamins and minerals. We compare those having a history of surgery with those not having that history. We also compare outcomes among those having a history of radiation therapy and those without, as well as those having a history of chemotherapy and those without. Some of those in remission chose to return for follow-up intravenous nutrients once per month after achieving remission from their cancers. We compare the different cohorts, among the various stages of cancer, for treatment choices and disease status. 97 total cancer survivors responded fully and promptly to the questionnaires. 37 of those were breast cancer patients.

scholarly journals Sleep Quality and Fatigue among Breast Cancer Patients Undergoing Chemotherapy

2019 ◽  
Author(s):  
Mahrokh Imanian ◽  
Mahsa Imanian ◽  
Mahdi Karimyar
Keyword(s):  
Breast Cancer ◽  
Sleep Quality ◽  
Sleep Disorders ◽  
Cancer Patients ◽  
Breast Cancer Survivors ◽  
Breast Cancer Patients ◽  
Quality Of Sleep ◽  
The Mean ◽  
Cutting Point

Background: Breast cancer survivors make up a growing population facing treatment that poses long – standing adverse effects including chemotherapy- related sleep disorders and fatigue. There is limited knowledge of patients' lived experiences of chemotherapy- induced sleep disorders and fatigue. The aim of this study was to explore sleep quality and fatigue among breast cancer patients undergoing chemotherapy. Materials and Methods: One hundred fifteen patients were included in this census-based cross-sectional study. Data were collected through the Pittsburgh Sleep Quality Index and Brief Fatigue Inventory four days after the chemotherapy session. Statistical analysis was carried out using SPSS software version 13 and P<0.05 was considered statistically significant in all tests. Results: The mean hours of sleep were 5.6±1.83 in the range of 2 to 10 hours. The mean score of fatigue of participants was 5.59±1.67. Based on the cutting point, 57.4%, 20.9%, and 21.7% of participants had a moderate (4-6.9), mild (0.1-3.9), and severe (7-9.9) level of fatigue, respectively. The mean score of sleep quality among the participants was equal to 14.06±3.06, with a maximum and minimum of 7 and 21. The results of Spearman correlation coefficient showed that there is a significant relationship between fatigue and quality of sleep )0.210). Conclusion: Although the study findings revealed that patients with breast cancer undergoing chemotherapy experience different degrees of sleep disorders and fatigue, there is a need for more detailed studies to improve the quality of sleep and reduce fatigue in these patients due to the little attention paid to this issue in the medical field.

scholarly journals Breast Cancer Support Group at Ocean Road Cancer Institute in Dar es Salaam

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 178s-178s
Author(s):  
S. Nyagabona ◽  
F. Rubagumya ◽  
A. Longombe ◽  
A. Manirakiza ◽  
T. Maniragaba ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Cancer Patients ◽  
Support Group ◽  
Breast Cancer Survivors ◽  
Psychosocial Support ◽  
Cancer Education ◽  
Developed Countries ◽  
Breast Cancer Patients ◽  
Cancer Support

Background and context: Breast cancer is a common type of cancer among women worldwide, with about 2 million new cases diagnosed in the yearly. It is the second common cancer and leading cause of cancer mortality among women in Tanzania, after cervical cancer. More than 70% of breast cancer patients in developed countries are diagnosed at early stages, whereas in low and middle-income countries, only 20%–60% of patients are diagnosed early. Physician in developed countries consults on average 15-20 breast cancer patients daily, while in developing countries the number triples. This high load does not allow a treating physician to spend ample time with patients explaining hence leaving patients not informed about their diagnosis, side effects of treatments and even living with the physical, emotional and psychological challenges of their disease. Residents at the Ocean Road Cancer Institute (ORCI), initiated a patient support group targeting breast cancer patients for feasibility. Aim: Provide forum for patients with same diagnosis to share common challenges Provide peer emotional, psychosocial support and cancer education Organize activities that will help to spread awareness to the community Initiate projects to improve socioeconomic status of breast cancer survivors in Tanzania Strategy/Tactics: Involved the ORCI administration from the beginning Involved the academic and research unit of ORCI Residents prepared session curriculum and teaching materials Sessions took place once a month Sessions were two hours long divided into three components, where the first is introduction of participants, then survivors led discussions or lectures prepared by an expert in the topic and lastly closing remarks by a physician Breakfast was provided Program/Policy process: Open membership for all breast cancer patients Physician lead face to face peer discussions Institutional acknowledgment of the support group Provision of primary registry of patients for follow-up Provision of a link to other social organizations Outcomes: Increase knowledge of cancer in general and breast cancer in particular A total of seven sessions were held to date For each session, participation ranged from 30-50 breast cancer survivors, and on average attendance was 4 sessions out of 7 Topics covered over a period of seven months included Coping with a cancer diagnosis and treatment Living with cancer and its changes to daily life Exercise Nutrition Breast cancer general knowledge Collaboration with other stake holders including IST secondary school students who initiated breast prosthesis knitting club What was learned: A need to reach out and give psycho-social support to ORCI patients Through education we can improve treatment adherence Possible partners are available if we reach out Exist a need to address misconceptions in the community so as to avoid stigma to patients.

Feasibility of group follow-up visit for breast cancer survivors

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 19603-19603
Author(s):  
C. O. Ruud ◽  
K. Francis ◽  
C. Stephens ◽  
M. H. Rajab
Keyword(s):  
Breast Cancer ◽  
Patient Satisfaction ◽  
Cancer Survivors ◽  
Cancer Patients ◽  
Social Worker ◽  
Breast Cancer Survivors ◽  
Breast Cancer Patients ◽  
Group Visit ◽  
Follow Up Care

19603 Background: The ASCO 2006 guidelines specify that regularly scheduled follow-up care of breast cancer survivors should be the standard. Follow up care is a “teachable moment” to train survivors in positive habits. A group visit model at the Cleveland Clinic proved feasible and improved patient satisfaction for other diseases. Our objectives include assessing the feasibility of an adapted group follow-up visit for the care of breast cancer patients and patient satisfaction. Methods: A feasibility study targeting breast cancer patients who completed primary therapy and were scheduled for a routine appointment. We mailed letters inviting patients to a follow-up group visit. Patients were divided into 3 groups, each scheduled for a separate (90–120 minute). During the first half of the visit, participants were divided into three groups; 5-minute physician exam, nurse review of medications and vital signs, and instruction by a social worker. Groups were rotated. During the second half the doctor, nurse, and social worker met with all participants in one room starting with an educational presentation about fatigue and exercise. Each participant was subsequently interviewed by the physician in the presence of their peers. Shared complaints were investigated first. Patients rated their satisfaction with the different parts of the visit on a scale of 1–5. Participants were surveyed pre- and post- education session and asked if they would participate again. Participants were allowed to bring a family member or friend. Results: 29 (29.6 %) out of 98 consented and 22 (22.5%) attended;10 in first visit, 5 in second visit and 7 in last visit. Average age 61±8, ranged from 46–72 years. Most participants were satisfied with all parts of the group visit, except two in the first group were less satisfied with the check in process and moving between rooms. Comparing the pre- vs. post- educational session surveys showed an improved understanding of the importance of fatigue or exercise. 17 (77%) out of 22 participants agreed to participate in another group visit. Conclusion: Group visit format is feasible and provides patient satisfaction. No significant financial relationships to disclose.

Nutritional status of breast cancer patients and the related factors at Vietnam National Cancer hospital in 2019-2020

2021 ◽  
Vol 30 (4) ◽  
pp. 42-51
Author(s):  
Hoang Ha Linh ◽  
Le Xuan Hung ◽  
Pham Quang Thai ◽  
Hoang Thi Hai Van ◽  
Do Thi Thanh Toan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Nutritional Status ◽  
Cancer Survivors ◽  
Cancer Patients ◽  
Breast Cancer Survivors ◽  
Low Frequency ◽  
Overweight And Obesity ◽  
Breast Cancer Patients ◽  
Related Factors ◽  
Cancer Hospital

A cross-sectional study on 170 breast cancer patients to describe nutritional status of breast cancer patients and the related factors at Vietnam National Cancer hospital in 2019-2020. The results revealed that overweight and obesity were the most common problem among breast cancer survivors. Up to 38% of studied patients are diagnosed as overweight or obesity using BMI classification; 84.71% are overweight while 80% of the studied subjects had central obesity. Alcohol abuse and surgery treatment were the factors worsening the risk of malnutrition of the study subjects (OR = 8.2 and 13.6, respectively). Low frequency of meat consumption (<1-3 times/week) has a higher risk of malnutrition than those who used meat daily (OR = 88.6). In addition, the age group, physical activities, chemotherapy and menopausal status affected the overweight and obesity status of breast cancer survivors (OR= 2.5, 10.7, 20.3 and 4.1, respectively). Low frequency consumption of vegetables increased the risk of overweight (OR=3.2). It is necessary to assess and screen the nutritional status for hospitalized patients immediately before treatment. Food intake and nutritional status of patients should also be paid attention in order to improve general health status and treatment outcome of breastcancer patients.

scholarly journals Metabolic comorbidities and the association with risks of recurrent metastatic disease in breast cancer survivors

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sumadi Lukman Anwar ◽  
Roby Cahyono ◽  
Dayat Prabowo ◽  
Widya Surya Avanti ◽  
Lina Choridah ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Cancer Patients ◽  
Glucose Intolerance ◽  
Metastatic Disease ◽  
Breast Cancer Survivors ◽  
Metastatic Breast ◽  
Breast Cancer Patients ◽  
Post Menopausal ◽  
Metabolic Comorbidities

Abstract Background Obesity and other metabolic comorbidities affect over 10% of patients with breast cancer and are closely related with adverse outcomes. Although metabolic comorbidities among breast cancer patients in low- and middle-income countries are suggested to be lower, only a few studies are currently available. Effective management of metabolic comorbidities in cancer patients has been associated with better outcomes. Methods Non-metastatic breast cancer patients (N = 1081) treated in our department (2014–2018) were monitored for the presence of high Body Mass Index (BMI), diabetes or glucose intolerance, dyslipidemia, and hypertension and the development of recurrent metastatic diseases during a median follow-up of 3.9 years. Results Glucose intolerance, hypertension, dyslipidemia, and BMI ≥ 27.7 kg/m2 considered at risk for metabolic comorbidities were found in 26.5, 42.6, 27.7, and 23.3% of breast cancer patients, respectively. Diabetes or glucose intolerance and having both glucose intolerance and dyslipidemia were associated with the risk of recurrent metastatic disease (OR = 1.442, 95%CI = 1.071–1.943, p = 0.016 and OR = 1.495, 95%CI = 1.090–2.049, p = 0.010; respectively). Having three or more metabolic comorbidities was significantly associated with the risk of recurrent metastatic disease (OR = 1.647, 95%CI = 1.139–2.382, p = 0.008) compared to patients without any comorbidity. The metabolic comorbidities were distributed unevenly among breast cancer subtypes. A significant association with recurrent metastatic disease was found in the Luminal B-like subtype. In post-menopausal patients, having more than three comorbidities was associated with a higher risk of recurrent metastatic disease compared to those without any comorbidity (OR = 2.000, 95%CI = 1.035–3.067, p = 0.001). The risks of having three or more metabolic comorbidities were significantly higher in breast cancer survivors who were obese, lived in an urban area, and received hormonal therapy of aromatase inhibitors. Conclusion Metabolic comorbidities were frequently found in breast cancer patients and were associated with higher risks to develop recurrent metastatic disease, particularly in post-menopausal women. Subsequent larger studies are needed to better understand the association of metabolic comorbidities with patients’ quality of life and prognosis, and to explore the potential combination of clinical intervention and lifestyle modification in breast cancer survivors to treat as well as reduce their impact.

Variation among Local Health Units in Follow-Up Care of Breast Cancer Patients in Emilia-Romagna, Italy

2013 ◽  
Vol 99 (1) ◽  
pp. 30-34 ◽  
Author(s):  
Maurizio Leoni ◽  
Radha Sadacharan ◽  
Daniel Louis ◽  
Fabio Falcini ◽  
Carol Rabinowitz ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Cancer Patients ◽  
Breast Cancer Survivors ◽  
Local Health ◽  
X Rays ◽  
Breast Cancer Patients ◽  
Follow Up Care ◽  
Bone Scans

Aims and background This study examines the patterns of follow-up care for breast cancer survivors in one region in Italy. Methods and study design This retrospective analysis included 10,024 surgically treated women, with incident cases of breast cancer in the years 2002–2005 who were alive 18 months after their incidence date. Rates of use of follow-up mammograms, abdominal echogram, bone scans and chest x-rays were estimated from administrative data and compared by Local Health Unit (LHU) of residence. Logistic regression analyses were performed to assess possible “overuse”, accounting for patient age, cancer stage, type of surgery and LHU of residence. Results A total of 7168 (72.1%) women received a mammogram within 18 months of their incidence date, while 6432 (64.2%) had an abdominal echogram, 3852 (38.4%) had a bone scan and 5231 (52.2%) had a chest x-ray. The rates of use of abdominal echograms, bone scans and chest x-rays were substantially higher in the population of breast cancer survivors than in the general female population. Taking account of patient age, cancer stage at diagnosis and type of surgery, multivariate analyses demonstrated significant variation in the use of these tests by LHU of residence. Conclusions The observed variation in the use of abdominal echograms, bone scans and chest x-rays supports the conclusion that there is substantial misuse of these tests in the population of postsurgical breast cancer patients in the Emilia-Romagna region in Italy. In the absence of a documented survival benefit, overtesting has both a human and financial cost. We recommend additional review of the methods of follow-up care in breast cancer patients in the LHUs of Emilia-Romagna, with the aim of developing, disseminating and evaluating the implementation of specific guidelines targeting primary care physicians and oncologists providing care to breast cancer survivors. Patient education materials may also help to reduce unnecessary testing.

scholarly journals Short Communication...Therapeutic Values of Yoga and Qigong – Are These Exercises Suitable for Breast Cancer Survivors?

2014 ◽  
Vol 20 (1) ◽  
pp. 58-60
Author(s):  
Shirley S.M. FONG ◽  
Shamay S.M. NG ◽  
W. S. LUK ◽  
Ada W.W. MA
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Well Being ◽  
Breast Cancer Patients ◽  
Cancer Treatments ◽  
Shoulder Dysfunction ◽  
Health And Well Being

Breast cancer is one of the most common malignant diseases in women. The mortality rate of breast cancer patients is rather low and the survival rate continues to increase worldwide (Siegel, Naishadham, & Jernal, 2012). However, conventional breast cancer treatments (e.g., mastectomy and radiotherapy) often lead to long-term physical impairments such as lymphedema and shoulder dysfunction (Cheville & Tchou, 2007). These side-effects may diminish the psychological well-being and quality of life of breast cancer survivors (Fong et al., 2013a). Promoting the health and well-being of this growing population has, therefore, become a major concern for healthcare professionals. (Abstract taken from first paragraph of document)

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