Patient-reported cognitive impairments among women with breast cancer randomly assigned to hormonal therapy (HT) alone versus chemotherapy followed by hormonal therapy (C+HT): Results from the Trial Assigning Individualized Options for Treatment (TAILORx).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 9020-9020
Author(s):  
Lynne I. Wagner ◽  
Robert James Gray ◽  
George W. Sledge ◽  
Timothy Joseph Whelan ◽  
Daniel F. Hayes ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Hormonal Therapy ◽  
Cognitive Impairments ◽  
Menopausal Status ◽  
Recurrence Score ◽  
Well Being ◽  
Control Group ◽  
Breast Cancer Patients ◽  
Change Scores ◽  
Patient Reported

9020 Background: Cognitive impairment is a complication of chemotherapy. Perceived cognitive impairments (PCI) were prospectively assessed among TAILORx participants randomized to HT alone versus chemotherapy followed by HT (C+HT). Methods: TAILORx participants with an OncoType DX Recurrence Score 11-25 were randomly assigned to HT or C+HT. PCI, fatigue, endocrine symptoms and health-related quality of life (HRQL) were assessed at baseline, 3, 6, 12, 24, and 36 months, using the Functional Assessment of Cancer Therapy (FACT) in 455 patients enrolled after 1/15/10. PCI change scores > 4.5 from baseline were defined a priori as clinically meaningful. Linear regression (LR) was used to model PCI scores on baseline PCI, treatment and other factors. Results: PCI scores were significantly worse at 3, 6, and 12 months compared to baseline for both groups (Table). The decline was greater for C+HT than HT at 3 months, but scores were similar at 12 months. Tests of an interaction between menopausal status and treatment were non-significant. PCI correlated with fatigue (r = 0.57-0.64) but not FACT Emotional well-being (EWB; r = 0.28-0.38); controlling for EWB did not account for differences in PCI change scores between treatment arms. Conclusions: Our study is the first to examine PCI among breast cancer patients randomized to receive C+HT vs. HT alone. C+HT was associated with greater declines in PCI at 3 months, but at 12 months PCI was similar in the C+HT and HT groups. PCI was associated with fatigue but not EWB. Pre- and post-menopausal groups demonstrated the same pattern of change. Since this study did not include a control group of patients not treated with HT, further study is required to determine if and to what extent HT contributes to PCI. [Table: see text]

Randomized Controlled Trial of Yoga Among a Multiethnic Sample of Breast Cancer Patients: Effects on Quality of Life

2007 ◽  
Vol 25 (28) ◽  
pp. 4387-4395 ◽  
Author(s):  
Alyson B. Moadel ◽  
Chirag Shah ◽  
Judith Wylie-Rosett ◽  
Melanie S. Harris ◽  
Sapana R. Patel ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cancer Patients ◽  
Intervention Group ◽  
Well Being ◽  
Control Group ◽  
Breast Cancer Patients ◽  
Spiritual Well Being ◽  
Multiethnic Sample

Purpose This study examines the impact of yoga, including physical poses, breathing, and meditation exercises, on quality of life (QOL), fatigue, distressed mood, and spiritual well-being among a multiethnic sample of breast cancer patients. Patients and Methods One hundred twenty-eight patients (42% African American, 31% Hispanic) recruited from an urban cancer center were randomly assigned (2:1 ratio) to a 12-week yoga intervention (n = 84) or a 12-week waitlist control group (n = 44). Changes in QOL (eg, Functional Assessment of Cancer Therapy) from before random assignment (T1) to the 3-month follow-up (T3) were examined; predictors of adherence were also assessed. Nearly half of all patients were receiving medical treatment. Results Regression analyses indicated that the control group had a greater decrease in social well-being compared with the intervention group after controlling for baseline social well-being and covariates (P < .0001). Secondary analyses of 71 patients not receiving chemotherapy during the intervention period indicated favorable outcomes for the intervention group compared with the control group in overall QOL (P < .008), emotional well-being (P < .015), social well-being (P < .004), spiritual well-being (P < .009), and distressed mood (P < .031). Sixty-nine percent of intervention participants attended classes (mean number of classes attended by active class participants = 7.00 ± 3.80), with lower adherence associated with increased fatigue (P < .001), radiotherapy (P < .0001), younger age (P < .008), and no antiestrogen therapy (P < .02). Conclusion Despite limited adherence, this intent-to-treat analysis suggests that yoga is associated with beneficial effects on social functioning among a medically diverse sample of breast cancer survivors. Among patients not receiving chemotherapy, yoga appears to enhance emotional well-being and mood and may serve to buffer deterioration in both overall and specific domains of QOL.

Inflammatory breast cancer and body mass index.

1998 ◽  
Vol 16 (12) ◽  
pp. 3731-3735 ◽  
Author(s):  
S Chang ◽  
A U Buzdar ◽  
S D Hursting
Keyword(s):  
Breast Cancer ◽  
Body Mass Index ◽  
Cancer Patients ◽  
Body Mass ◽  
Inflammatory Breast Cancer ◽  
Menopausal Status ◽  
Control Group ◽  
Breast Cancer Patients ◽  
Increased Risk ◽  
High Bmi

PURPOSE No studies have investigated the etiology of inflammatory breast cancer (IBC), the most lethal form of breast cancer. Because high body mass index (BMI) is associated with decreased risk of premenopausal breast cancer but increased risk of postmenopausal breast cancer, we evaluated whether high BMI was a risk factor for IBC. PATIENTS AND METHODS In a case-comparison study, we matched by ethnicity and registration date 68 IBC patients treated at The University of Texas M.D. Anderson Cancer Center from 1985 to 1996 with 143 patients with non-IBC and 134 patients with cancer at sites other than the breast or reproductive tract (non-breast cancer). The non-breast cancer group was used in lieu of a population-based, healthy control group, which was not available. RESULTS IBC patients were younger at menarche and the time of their first live birth than non-IBC and non-breast cancer patients. The proportion of premenopausal IBC patients was higher than the proportion of premenopausal women in the comparison groups, although differences were not significant. There were no differences in height, but IBC patients were heavier (77.6 kg) than non-IBC (70.0 kg) and non-breast cancer patients (68.0 kg). After adjusting for other factors, women in the highest BMI tertile (BMI > 26.65 kg/m2) relative to the lowest tertile (BMI < 22.27) had significantly increased IBC risk (IBC v non-IBC, odds ratio [OR] = 2.45, 95% confidence interval [CI] = 1.05 to 5.73; IBC v non-breast cancer, OR = 4.52, 95% CI = 1.85 to 11.04). This association was not significantly modified by menopausal status and was independent of age at menarche, family history of breast cancer, gravidity, smoking status, and alcohol use. CONCLUSION Our investigation showed that high BMI was significantly associated with an increased risk of IBC. This association did not vary by menopausal status, although IBC patients were more likely to be premenopausal. Confirming our findings and identifying other IBC risk factors may provide directions for future research on the aggressive nature of IBC.

scholarly journals Comprehensive Association Analysis of 21-Gene Recurrence Score and Obesity in Chinese Breast Cancer Patients

2021 ◽  
Vol 11 ◽  
Author(s):  
Yiwei Tong ◽  
Weiqi Gao ◽  
Jiayi Wu ◽  
Siji Zhu ◽  
Ou Huang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Gene Expression ◽  
Cancer Patients ◽  
Prognostic Value ◽  
Single Gene ◽  
Menopausal Status ◽  
Recurrence Score ◽  
Risk Category ◽  
Obese Patients ◽  
Breast Cancer Patients

PurposeA center-specific 21-gene recurrence score (RS) assay has been validated in Luminal-like, HER2-, pN0-1 Chinese breast cancer patients with both predictive and prognostic value. The association between RS and host factors such as obesity remains unclear. The objectives of the current study are to comprehensively analyze the distribution, single gene expression, and prognostic value of RS among non-overweight, overweight and obese patients.Patients and methodsLuminal-like patients between January 2009 and December 2018 were retrospectively reviewed. Association and subgroup analysis between BMI and RS were conducted. Single-gene expression in RS panel was compared according to BMI status. Disease-free survival (DFS) and overall survival (OS) were calculated according to risk category and BMI status.ResultsAmong 1876 patients included, 124 (6.6%), 896 (47.8%) and 856 (45.6%) had RS &lt; 11, RS 11-25, and RS ≥ 26, respectively. Risk category was significantly differently distributed by BMI status (P=0.033). Obese patients were more likely to have RS &lt; 11 (OR 2.45, 95% CI 1.38-4.35, P=0.002) compared with non-overweight patients. The effect of BMI on RS significantly varied according to menstruation (P&lt;0.05). Compared to non-overweight patients, obese ones presented significantly higher ER, PR, CEGP1, Ki67, CCNB1 and GSTM1 (all P&lt;0.05) mRNA expression, and such difference was mainly observed in postmenopausal population. After a median follow-up of 39.40 months (range 1.67-119.53), RS could significantly predict DFS in whole population (P=0.001). RS was associated with DFS in non-overweight (P=0.046), but not in overweight (P=0.558) or obese (P=0.114) population.ConclusionsRS was differently distributed among different BMI status, which interacted with menopausal status. Estrogen receptor and proliferation group genes were more expressed in obese patients, especially in postmenopausal population.

scholarly journals Linguistic and Psychometric Validity of the Malay BREAST-Q in Women Undergoing Breast Cancer Surgery in Malaysia

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 115s-115s
Author(s):  
B. Shunnmugam ◽  
S. Sinnadurai ◽  
S.H. Chua ◽  
T. Islam ◽  
M.H. See ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Intraclass Correlation ◽  
Well Being ◽  
Cancer Surgery ◽  
Psychometric Validation ◽  
Breast Cancer Surgery ◽  
Breast Cancer Patients ◽  
Patient Reported ◽  
The Impact

Background: BREAST-Q is a PROMs used to measure and assess patient satisfaction and quality of life before and after breast cancer surgery. BREAST-Q composed of 5 different modules and each module comprised of multiple scales. Each module has preoperative and postoperative versions to assess the impact of surgery. Four subscales with common items from the 5 modules: “satisfaction with the breast”, psychosocial, sexual and physical well-being were subjected to testing. Two other subscales, “satisfaction with overall outcomes” and “satisfaction with the care” were only validated linguistically. Currently, the BREAST-Q has already been translated into 25 languages. Linguistic and psychometric validation of BREAST-Q has not been performed in Malaysia. Aim: To translate the BREAST-Q into Malay language and perform psychometric validation. Methods: Translation of the English BREAST-Q to Malay language was done based on linguistic validation protocol provided by MAPI Research Trust. Content and face validation were performed to determine contextual accuracy, acceptability and understanding of the items. The finalised Malay BREAST-Q then underwent psychometric testing. Breast cancer patients (n=186) who were planned for breast cancer surgery were conveniently sampled at the breast clinic of UMMC between June 2015 to June 2016. Consented participants completed the questionnaire in the same visit following their diagnosis. Retest was done 2-3 weeks after the first questionnaire administration in 62 patients who were admitted for their surgery. Data were analyzed using SPSS and AMOS software. Results: Content experts (4 breast surgeons) agreed the items in BREAST-Q comprehensively measured the concept of interest and I-CVI for each item was 1.0. Participants agreed the questionnaire was comprehensive and easy to understand. The average time taken to complete the questionnaire was 15.3 minutes. Test–retest analysis showed good reproducibility with intraclass correlation coefficient (ICC) value of 0.71-0.98. Internal consistencies were good for all items in each subscale with Cronbach's alpha values of 0.83-0.95. The highest interitem correlation for each item with at least one other item in the construct ranged from 0.47 to 0.90. The lowest corrected item-total correlation (CITC) values ranged from 0.47 to 0.72. In exploratory factor analysis, the KMO values were excellent in all 4 subscales (0.76, 0.92, 0.91, and 0.86). Single factor was extracted in 3 subscales that explained more than 50% of the variance and 3 factors (breast pain, general pain, and discomfort) were extracted in “physical well-being” subscale that cumulatively explained more than 50% of the variance. Conclusion: The Malay BREAST-Q demonstrated good reliability, content and face validity, and excellent psychometric properties. Hence, we propose the use of the Malay BREAST-Q to measure patient reported outcomes among breast cancer patients in Malaysia undergoing breast cancer surgery.

scholarly journals Comparison between the american joint committee on cancer (ajcc) anatomic and prognostic stages for breast cancer

Mastology ◽  
2020 ◽  
Vol 30 (Suppl 1) ◽  
Author(s):  
Mariana Soares Cardoso ◽  
Marcelo Antonini Matheus de Paula Solino
Keyword(s):  
Breast Cancer ◽  
Surgical Treatment ◽  
Hormone Receptors ◽  
Histological Grade ◽  
Menopausal Status ◽  
Recurrence Score ◽  
Clinical Staging ◽  
Molecular Profile ◽  
Breast Cancer Patients ◽  
Genomic Test

Introduction: The knowledge regarding the biology of breast cancer has grown substantially and resulted in the identification of different breast cancer subtypes based on their molecular profile, which led to an important change in treatment, from a standardized therapy to a personalized one. A panel of experts and AJCC representatives were responsible for preparing the most recent Cancer Staging Manual. The panel recognized the clinical usefulness of biological factors such as histological grade, expression of hormone receptors (HR; estrogen and progesterone) and overexpression and/or amplification of the human epidermal growth factor receptor 2 (HER2) in predicting patient survival7 and incorporated data regarding these biomarkers in the new staging system. In addition, for eligible cases, the ‘Recurrence score’ was also incorporated, generated by the analysis of OncotypeDx (genomic test). The new manual, therefore, started to use 3 stagings. Anatomical staging – based on the classic TNM; clinical prognostic staging and pathological prognosis – association of TNM with prognostic biomarkers (using clinical data in the first and data after surgical treatment in the second). Objective: To verify the agreement between anatomical staging from the 7th edition of the AJCC manual and the prognosis from its 8th edition in a cohort of breast cancer patients at the Hospital do Servidor Público Estadual de São Paulo. Methodology: Observational and cross-sectional study, which evaluated patients undergoing surgical treatment at Hospital do Servidor Público Estadual from March, 2014 to March, 2019. Information was collected regarding age, menopausal status, tumor characteristics, anatomical and clinical staging, neoadjuvant chemotherapy, adjuvant chemotherapy and radiotherapy, and type of surgery performed. Patients were staged using the digital platform “TNM8 Breast Cancer Calculator”. Results: 805 patients were included in the analysis. All patients were females aged between 29 and 97 years, mostly in the post-menopausal period (78.88%). 74.04% of cases were positive for ER, 66.21% PR-positive, and 88.07% HER2-negative. Prognostic staging downgraded a total of 285 out of 805 patients (35.4%). Almost all of the cases that decreased in staging were ER and/or PR+ (283 of 285). Most of those who went up were Triple Negatives (100 out of 111). Conclusion: Prognostic Staging changes the staging in almost half of the cases and there was a greater number of decreased staging in total and an association of increased staging with tumors considered to have a worse prognosis, which is in agreement with several studies already carried out since the new manual came out.

scholarly journals Menopausal status and adjuvant hormonal therapy for breast cancer patients: A practical guideline

2012 ◽  
Vol 84 (2) ◽  
pp. 252-260 ◽  
Author(s):  
F.Y.F.L. De Vos ◽  
H.W.M. van Laarhoven ◽  
J.S.E. Laven ◽  
A.P.N. Themmen ◽  
L.V.A.M. Beex ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Hormonal Therapy ◽  
Menopausal Status ◽  
Adjuvant Hormonal Therapy ◽  
Breast Cancer Patients ◽  
Practical Guideline

scholarly journals Effectiveness of Existential-Humanity based Therapy on Psychological Well-Being and Post-¬Traumatic Growth in Women with Breast Cancer

2021 ◽  
Author(s):  
Safoora Mavaeeyan ◽  
Fazlolah Mirderikvand ◽  
Masoud Sadecghi
Keyword(s):  
Breast Cancer ◽  
Repeated Measures ◽  
Well Being ◽  
Control Group ◽  
Breast Cancer Patients ◽  
Psychological Well Being ◽  
Repeated Measures Anova ◽  
Post Traumatic Growth ◽  
Post Test ◽  
Post Traumatic

Introduction: Breast cancer is one of the most common cancers among Iranian women. The aim of this study was to evaluate the effectiveness of existential-humanity based therapy on psychological well-being and post-traumatic growth in women with breast cancer. Methods: This was a quasi-experimental study with a pre-test, post-test and follow-up design with a control group. The population of  this study insisted all the patients with breast cancer that referred to Khorramabad Shahid Rahimi Hospital in 2020. 30 patients selected randomly and assigned in two groups (15 experimental and 15 evidence), and it was asked them to answer to the Reef psychological well-being scale and post-traumatic growth questionnaire by Tedachi et al. Afterwards, the experimental group was intervened in 8 sessions of 90 minutes. After the intervention, post-test was taken from both groups and both groups were followed up again after two months. The data were analyzed by repeated measures ANOVA and SPSS version 16 software. Results: The results of analysis of repeated measures ANOVA showed that the interaction between group and time was significant. Therefore, psychological well-being variable increased significantly (F=77.98, P<0/01) and post-­trauma growth variable increased significantly (F=27.46, P<0/01). Conclusion: According to the results of the study, existential-humanity based therapy has a significant effect on psychological well-being and post-traumatic growth in breast cancer patients. It would be beneficial to offer, along with medication, psychological treatments, including existential-humanity based therapy to these patients should be considered.

Obesity at diagnosis and breast cancer (BC) recurrence risk based on the 21-gene assay recurrence score (RS).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 555-555 ◽  
Author(s):  
Kimberly Ridolfi ◽  
Chong Zhang ◽  
Adedayo A. Onitilo ◽  
Wendy M. Ledesma ◽  
Molly Andreason ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Univariate Analysis ◽  
Menopausal Status ◽  
Tumor Biology ◽  
Recurrence Score ◽  
Her2 Status ◽  
Breast Cancer Patients ◽  
Significance Level ◽  
Wilcoxon Rank Sum Test ◽  
Gene Assay

555 Background: Obesity at diagnosis has been associated with poorer overall survival in BC patients. The Oncotype Dx 21-gene assay RS has been shown to predict the risk of distant recurrence in estrogen receptor (ER) positive BC. This study aimed to evaluate if an association exists between body mass index (BMI) and RS. Methods: Retrospective chart review of patients (pts) with BC diagnosed 2005-2010 and a 21-gene assay was performed. Risk factors including BMI, hormone use, and menopausal status were collected as well as tumor characteristics such as ER/PR/HER2 status, stage, and grade. Univariate analysis of the association between BMI level (<30 vs ≥30), and RS (≤18 vs >18), stage (I vs II), and grade (1 vs 2 vs 3) was conducted using Chi square test. Correlation of BMI with RS (0-100) was also assessed via Spearman’s correlation. All tests were at a two sided significance level of 0.05. Results: Of 495 pts with a RS value, 482 had a BMI within 6 months of diagnosis. Median BMI was 27.7 kg/m2 (range 17-63). BMI for pts presenting with stage 2 disease is significantly higher (30±6.9) than those with stage 1 (29±7.8), p=0.04 (Wilcoxon rank sum test). No association was found between BMI level and stage, grade or RS. See Table. Mean RS was 18.8 vs 18.2 (BMI <30 vs ≥30), p=0.79 (Wilcoxon rank sum test). Conclusions: This is the largest study of the association between BMI and the RS. Obesity (BMI≥30) has been associated with increased recurrence and death from BC. However, we found no association between BMI and RS. This suggests that poorer outcomes among obese ER+ breast cancer patients may not be due to intrinsic tumor biology (as reflected in the RS), but to other non-tumor factors, whether higher circulating estrogen levels, reduced efficacy of aromatase inhibitors, other comorbidities, difficulty with chemotherapy or other unidentified factors. Further study is warranted. [Table: see text]

Clinical utility and therapeutic implications of oncotype analysis in patients with breast cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11084-e11084
Author(s):  
Stephanie A. Williams ◽  
Talar Tatarian ◽  
Christine B. Teal ◽  
Anita P. McSwain ◽  
Robert S. Siegel ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Hormone Therapy ◽  
Cancer Patients ◽  
Hormonal Therapy ◽  
Recurrence Score ◽  
Oncotype Dx ◽  
Breast Cancer Patients ◽  
Radiation Oncologists ◽  
Medical Oncologists ◽  
Gene Assay

e11084 Background: Oncotype DX is a 21-gene assay developed for early stage, hormone receptor positive breast cancer that generates a Recurrence Score which estimates response to chemotherapy and the likelihood of systemic recurrence at 10 years. It differentiates between patients who would benefit from chemotherapy plus hormonal therapy versus hormonal therapy alone. This study’s goal was to determine if the Recurrence Score affected clinical management at our institution and physicians’ accuracy at predicting Recurrence Scores. Methods: A retrospective review was conducted of 116 breast cancer patients treated over a 7 year period. Clinic notes, pathology reports, and additional relevant information were presented to breast surgeons, oncologists, radiation oncologists, and surgical pathologists. Individual physicians estimated recurrence risks and recommended treatment based on those estimates. The Recurrence Score was revealed and changes in therapeutic recommendations were recorded. Results: Treatment recommendations changed in 43% of patients. 29% had a change from chemotherapy followed by hormone therapy to hormone therapy alone due to a low recurrence score, while 14% initially recommended hormonal therapy were changed to chemotherapy plus hormonal therapy due to an intermediate range score. Surgical oncologists accurately predicted Recurrence Scores 52% of the time, medical oncologists 46%, radiation oncologists 45%, and surgical pathologists 15%. A nested mixed model showed that pathologists were statistically significantly worse at predicting recurrence scores than surgical oncologists, medical oncologists, and radiation oncologists. Conclusions: The Oncotype DX assay changes management of breast cancer patients at our institution, frequently downgrading the intensity of systemic therapy. Clinicians were able to accurately estimate recurrence categories about 50% of the time. We recommend the use of Oncotype DX assay along with assessment of clinicopathologic features of an individual’s disease in eligible patients to enhance the selection of appropriate adjuvant therapy.

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