Impact of a Peer-Delivered Telephone Intervention for Women Experiencing a Breast Cancer Recurrence

2007 ◽  
Vol 25 (15) ◽  
pp. 2093-2099 ◽  
Author(s):  
Carolyn Cook Gotay ◽  
Carol M. Moinpour ◽  
Joseph M. Unger ◽  
Caroline S. Jiang ◽  
Dorothy Coleman ◽  
...  

Purpose A first breast cancer recurrence creates considerable distress, yet few psychosocial interventions directed at this population have been reported. The Southwest Oncology Group conducted a phase III randomized trial to evaluate the effectiveness of a brief telephone intervention. Patients and Methods Three hundred five women experiencing a first recurrence of breast cancer were randomly assigned to standard care or intervention. The intervention consisted of four to eight telephone calls delivered over a 1-month period. The calls were conducted by trained peer counselors at a breast cancer advocacy organization, the Y-ME National Breast Cancer Organization, and followed a standard curriculum. Psychosocial distress (Cancer Rehabilitation Evaluation System–Short Form [CARES-SF]) and depressive symptoms (Center for Epidemiologic Studies Depression Scale [CES-D]) outcomes were assessed at baseline and 3 and 6 months. The 3-month assessment was the primary end point and is the focus of this article. Results Analysis revealed no differences in distress or depressive symptoms at 3 months between the intervention and control groups; at 3 months, 70% of control patients and 66% of intervention patients reported psychosocial distress, and 40% of control patients and 47% of intervention patients exhibited depressive symptoms. Conclusion Telephone peer counseling did not lead to better psychosocial outcomes. The persistent distress in these women supports the urgent need for the development and testing of more intensive or different supportive interventions for this group of patients.

2014 ◽  
Vol 22 (2) ◽  
pp. 14E-28E ◽  
Author(s):  
Mirjam P.J. Bogaarts ◽  
Brenda L. Den Oudsten ◽  
Jan A. Roukema ◽  
Johanna M.G.H. Van Riel ◽  
Laurens V. Beerepoot ◽  
...  

Background and Purpose: To evaluate the psychometric properties of the Psychosocial Distress Questionnaire-Breast Cancer (PDQ-BC) and to compare its referrals with the Distress Thermometer (DT). Methods: Group 1 (N = 54) and Group 2 (N = 80) completed the PDQ-BC. Group 2 also completed the DT, the Hospital Anxiety and Depression Scale (HADS), and World Health Organization Quality of Life instrument-100 (WHOQOL-100; n = 55). Results: Moderate to high correlations (r ≥ .44, p < .001) were found between related facets of the PDQ-BC, WHOQOL-100, and DT. The subscales state anxiety and depressive symptoms (PDQ-BC) have a sensitivity of 87.5% and 78.6%, respectively, and a specificity of 81.1% and 73.0%, respectively, compared to the HADS. Conclusions: The PDQ-BC shows good construct validity, test–retest reliability, and sensitivity to change. The PDQ-BC has a satisfactory sensitivity and specificity of the subscales state anxiety and depressive symptoms.


2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 1553-1553
Author(s):  
Andrea De Censi ◽  
Harriet Ann Johansson ◽  
Thomas Helland ◽  
Matteo Puntoni ◽  
Tania Buttiron Webber ◽  
...  

1553 Background: Low dose tamoxifen (T, 5 mg/d) given for 3 years halved recurrence in 500 women with non-invasive disease (DeCensi et al. JCO 2019). Retrospective studies with 20 mg/d have shown an association between low levels of endoxifen (9-16 nM) or Z-4OHtam (3.26 nM) and recurrence, but recent prospective studies have not confirmed these findings. We measured CYP2D6 genotype and 8 metabolite levels to determine their associations with adverse events, tumor biomarkers (IGF-I, SHBG, C-reactive protein, CRP) and breast cancer recurrence. Methods: CYP2D6 genotyping was performed in the T arm (n = 183) as previously described (Johansson H et al. BCRT 2016). T and metabolites were measured at 1 (n = 169) and 3 y (n = 152) as previously described (Helland T et al. BCR 2017). We tested linear relationships between metabolite levels and biomarkers, adjusting for age, BMI, treatment compliance and baseline biomarker levels. Cumulative incidence of recurrence according to endoxifen levels was calculated by the Cox model. Results: Endoxifen concentrations were associated to CYP2D6 metabolizer status (p < 0.001). Median (IQR) endoxifen levels were 8.4 (5.2-11.3) and 8.8 (5.8-11.5) at 1 and 3 y, with only 42% and 47% of subjects reaching 9 nM. Median endoxifen levels were related to pill count (5.5, 7.1 and 9.0 nM/L for medication possession rate < 83.3%, 83.4-99.9%, 100%, respectively). There was no difference in metabolite levels and menopausal symptoms. There was an inverse relationship between endoxifen and endometrial thickness at 3 y (p = 0.04), and between endoxifen or tamoxifen levels and IGF-I levels at 3 y (p = 0.001). T levels were positively associated with SHBG levels in postmenopausal women (p-interaction = 0.04). Endoxifen, T and 4OHtam decreased CRP, with a greater effect in premenopausal women (p-interaction = 0.02). An increase in CRP after 3 years was associated with a HR of 4.37 (95% CI, 1.14-16.73, P = 0.03) of recurrence compared to women with no increase of CRP. Median (IQR) endoxifen levels at year 1 were 8.4 (5.3-11.4) in patients who recurred vs 7.5 (5.1-10.2) in those who did not recur (p = 0.6), although this comparison was underpowered. Conclusions: T levels themselves may contribute to clinical activity by decreasing IGF-I and increasing SHBG. Elevated CRP is a predictive factor for recurrence which is down-regulated by T and metabolites. Endoxifen is below 9 nM in the majority of subjects treated with 5 mg/day, although this threshold was obtained in studies up to 20 years. Clinical trial information: NCT01357772.


2019 ◽  
Vol 25 (14) ◽  
pp. 4248-4254 ◽  
Author(s):  
Elizabeth A. Mittendorf ◽  
Biao Lu ◽  
Michelle Melisko ◽  
Julie Price Hiller ◽  
Igor Bondarenko ◽  
...  

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