Implementation of distress screening for breast cancer patients.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 196-196
Author(s):  
Jill Bryant ◽  
Helen Colleen Silva ◽  
Greg Mapp ◽  
Daphne Terrell
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Screening Tool ◽  
Treatment Plan ◽  
Disease Process ◽  
Breast Cancer Patients ◽  
Distress Screening ◽  
Extreme Stress ◽  
Number Of Patients ◽  
Short Period

196 Background: Cancer is a complex disease process. Patients experience psychological, social, financial, and behavioral issues that can interfere with their treatment plan and adversely affect their outcomes. Distress should be measured as the 6th Vital Sign. Consequences of distress can cause deterioration of Quality of Life; produce higher levels of pain; longer rehabilitation; reduced adherence to treatment with less efficacy; and shorter survival expectancy. Methods: Problem exists with a lack of screening patients’ level of distress during breast cancer experience within their cancer care continuum. Goal was to improve the prevalence of distress screening of breast cancer patients from 0% to 50% within 3 months. Cause and effect analysis showed evidence of areas for improvement. Improvements and interventions included: education on stress and psychosocial assessment; developing a distress screening tool; and developing inclusion criteria for patient screening. Screenings were completed on first follow-up visit after diagnosis with continuation of assessment every three months for the first year. A distress screening tool with a thermometer illustration was provided to the patients for them to rate amount of distress experienced in the past week. Scoring was “0 = no distress to 10 = extreme stress.” The tool also included Yes/No questions. A value of 4 or greater on the thermometer or any question marked “Yes” on the questionnaire was considered a positive screen. Results: In addition to developing a tool, a template was implemented in the electronic medical record. Opportunities for assistance with distress were discovered based on patients’ responses where interventions and follow-ups with the patient were provided. Conclusions: A process was developed and implemented to integrate and monitor on-site psychosocial distress screening and referral for provision of psychosocial care. A small number of patients analyzed met criteria during a short period of time. The percentage of distress screenings completed improved from 0% to 92%. [Table: see text]

scholarly journals Application and Effect of the Gymnastic Exercise Mode during Chemotherapy for Breast Cancer Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Feifei Xie
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Incidence Rate ◽  
Evaluation System ◽  
Malignant Tumors ◽  
Treatment Plan ◽  
Breast Cancer Surgery ◽  
Breast Cancer Patients ◽  
Rehabilitation Training ◽  
Cancer Related Fatigue

Breast cancer is one of the most common malignant tumors in women, which seriously threatens the health of women. With the improvement of living standards, the incidence rate of breast cancer is also rising. In the past ten years, the incidence rate of breast cancer in China’s major cities has increased by 37%, far higher than that in Europe and America. At present, chemotherapy and radiotherapy are the main treatment methods for breast cancer, but many patients will have cancer-related fatigue after surgery. Some studies believe that appropriate sports can improve cancer-related fatigue, but there is no specific research in this area. In view of this problem, this paper puts forward a rehabilitation training method based on gymnastics for breast cancer surgery. This paper is divided into three parts. The first part is the basic theory and core concept of breast cancer and cancer-related fatigue. Through the in-depth study of the theory, this paper believes that breast cancer patients paying attention to rehabilitation training can effectively improve cancer-related fatigue and affect the final therapeutic effect. The second part is the rehabilitation training program based on the way of gymnastics. The corresponding experimental model is established by using real cases as samples. In order to ensure the quality of the experiment, this paper gives the treatment plan in detail and establishes a unified evaluation system. In the third part of this paper, the relevant experiments and results analysis are given, and through data analysis, this paper believes that gymnastics can effectively help breast cancer patients with postoperative rehabilitation and continuous recovery of the upper limb function and improve cancer-related fatigue and other issues.

Randomized, Controlled, Dose-Range Study of Ro 25-8315 Given Before and After a High-Dose Combination Chemotherapy Regimen in Patients With Metastatic or Recurrent Breast Cancer Patients

2002 ◽  
Vol 20 (1) ◽  
pp. 24-36 ◽  
Author(s):  
P. Viens ◽  
C. Chabannon ◽  
P. Pouillard ◽  
M. Janvier ◽  
W. Brugger ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Progenitor Cell ◽  
Chemotherapy Regimen ◽  
Single Injection ◽  
Optimal Dose ◽  
High Dose ◽  
Breast Cancer Patients ◽  
Number Of Patients ◽  
Cell Mobilization

PURPOSE: To evaluate the safety, pharmacokinetics, and efficacy of three different dose levels of pegylated granulocyte colony-stimulating factor (Ro 25-8315) on progenitor cell mobilization and hematologic recovery in cancer patients. PATIENTS AND METHODS: Breast cancer patients (n = 36) were randomly assigned to receive before (part I) and after (part II) chemotherapy either a single-dose injection of Ro 25-8315 (20 μg/kg, n = 9; 60 μg/kg, n = 9; 100 μg/kg, n = 10) or a standard daily dose of filgrastim (part I, 10 μg/kg/d; part II, 5 μg/kg/d) (control group, n = 8). RESULTS: Overall, Ro 25-8315 was well tolerated. In part I, more progenitor cell mobilization was observed with Ro 25-8315 100 μg/kg. The peak of circulating CD34+ cells was obtained at day +5 in the four groups, and the absolute neutrophil count (ANC) returned to less than 20 × 109/L by day +15. In part II, high levels of circulating CD34+ cells (> 20 cells/μL) were obtained in all four groups. The chemotherapy-induced neutropenia (< 1 × 109/L) was similar in the four groups. Ro 25-8315 100 μg/kg was more effective than filgrastim in reducing the number of patients with an ANC less than 0.5 × 109/L on day +12 after chemotherapy. CONCLUSION: A single injection of Ro 25-8315 100 μg/kg might be the optimal dose for steady-state peripheral-blood progenitor cell mobilization. A single injection of 20, 60, or 100 μg/kg could be as efficient as daily administration of filgrastim to correct chemotherapy-induced cytopenia. The optimal dose of Ro 25-8315 should be determined according to the planned chemotherapy regimen.

The G8 frailty screening tool and the decision‐making process in older breast cancer patients

2020 ◽  
Author(s):  
Ellen R. M. Scheepers ◽  
Loes F. Molen ◽  
Frederiek Bos ◽  
Josephine P. Burgmans ◽  
Lieke H. Huis‐Tanja ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Cancer Patients ◽  
Screening Tool ◽  
Decision Making Process ◽  
Breast Cancer Patients

FDG PET-CT in breast cancer: A single institution experience from India.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11027-e11027
Author(s):  
Nalini K Rao ◽  
Basavalinga S Ajaikumar ◽  
Kumar G Kallur ◽  
P S Sridhar ◽  
Bhattacharjee Somorat ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Fdg Pet ◽  
Treatment Plan ◽  
Whole Body ◽  
Breast Cancer Patients ◽  
Term Survival ◽  
New Findings ◽  
Pet Ct ◽  
Fdg Pet Ct

e11027 Background: Whole body FDG PET CT is a useful tool in diagnosis, staging and prognosis; and its timely use is critical for early intervention and achieving long term survival in patients with early and advanced breast cancer. Methods: In this observational retrospective study, we report FDG PET CT findings of all breast cancer patients enrolled in our hospital based cancer registry between the years 2008 to 2011. Results: One thousand and fifty three women underwent a total of 1638 scans. Two hundred and forty five scans (14.96%) were done for staging /restaging/diagnosis, 1208 (73.75%) were for response evaluation to chemotherapy and 185 (11.29%) were for surveillance. The median age at diagnosis was 53 years. We identified a possible synchronous breast primary in 28 (2.66%) women and a probable new or existing second non-breast primary in 21(1.99%) women. Internal nodal metastasis was identified in 76 (7.21%) women at diagnosis. There were 26 (2.47%) patients with multicentric tumors. There was an increased uptake in the thyroid gland in 49(2.99%) and in the adrenal in 41 (2.50%) women. There were other random ‘Incidental findings of concern’ in 7 (0.37%) of women, diagnosed either on the CT or PET-CT component. Findings on PET-CT, including- upstaging of the breast primary and unexpected new findings, unrelated to the breast primary, changed the treatment plan in approximately 7% -10% of the patients. We did find that PET-CT did not impact early tumors; however, it did contribute in, 1) the assessment of internal mammary nodes, 2) prognostication based on tumor burden and, 3) aggressive management of oligometastases. Conclusions: Whole body FDG PET CT is a useful tool for staging and prognostication in breast cancer patients. However, the timing of such scans for surveillance needs to be defined for early detection of progression to have an impact on survival.

Identifying treatment options for triple negative breast cancer patients using RNA-sequencing.

2017 ◽  
Vol 35 (7_suppl) ◽  
pp. 31-31
Author(s):  
Gitte Pedersen
Keyword(s):  
Breast Cancer ◽  
Dna Repair ◽  
Cancer Patients ◽  
Messenger Rna ◽  
Dna Analysis ◽  
Triple Negative ◽  
Tumor Antigens ◽  
Standard Of Care ◽  
Breast Cancer Patients ◽  
Number Of Patients

31 Background: In the context of diagnostics, RNA is proxy for proteins and proteins are typically targets for drugs; e.g. breast cancer is typically driven by over-expression of various hormone receptors and Her2. In the current standard-of-care setting there is no measurement of mutations. Furthermore, all the markers for response to the new immune therapies are expressed as mRNA. Approximately 15% of the breast cancer patients are triple negative. Due to the poor outcome of chemo, standard-of-care guidelines (NCCN) suggests doctors encourage the patient to enroll in clinical trials. However, with more than 2000 ongoing trials in breast, which trial could potentially benefit the patient? Methods: Using the RNA-seq data from the TCGA study, we analyzed more than 120 triple negative datasets. Results: We found at least one over-expressed checkpoint inhibitor target in almost all the patients, suggesting that if you analyzed for all of the checkpoint targets, it would be possible to find a clinical study for these patients. Furthermore, when we analyzed over-expressed tumor antigens, we realized that it would be possible to design sophisticated combination trials with this information. In addition, we identified patients that were BRCAwt with an impaired DNA repair pathway; e.g. some had BRCA silencing and could potentially benefit from PARP inhibitors. Finally, a small number of patients overexpressed the androgen receptor for which there is a drug approved for prostate cancer. Conclusions: Compared to DNA analysis, tumor RNA profiling has the potential to guide a much broader set of drugs and treatment approaches including immunotherapy and chemotherapy. Messenger RNA (mRNA) analysis can reveal tumor antigens and drug targets expressed by cancer cells, as well as the vital status of the tumor microenvironment including immune response, the integrity of DNA repair mechanisms, and the engagement of angiogenesis and other cancer-related pathways.

scholarly journals The Optimal Treatment Plan to Avoid Axillary Lymph Node Dissection in Early-Stage Breast Cancer Patients Differs by Surgical Strategy and Tumor Subtype

2017 ◽  
Vol 24 (12) ◽  
pp. 3527-3533 ◽  
Author(s):  
Melissa Pilewskie ◽  
Emily C. Zabor ◽  
Anita Mamtani ◽  
Andrea V. Barrio ◽  
Michelle Stempel ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Cancer Patients ◽  
Axillary Lymph Node ◽  
Early Stage ◽  
Treatment Plan ◽  
Axillary Lymph ◽  
Tumor Subtype ◽  
Breast Cancer Patients ◽  
Node Dissection

scholarly journals Breast cancer during pregnancy: retrospective institutional case series

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Erika Matos ◽  
Tanja Ovcaricek
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
De Novo ◽  
Treatment Plan ◽  
Case Series ◽  
Blue Dye ◽  
Breast Cancer Patients ◽  
Her2 Positive ◽  
Tertiary Institution ◽  
International Guidelines

Abstract Background Pregnancy associated breast cancer is a rare disease. It presents a unique entity of breast cancer with aggressive phenotype. The main aim was to evaluate how the international guidelines were followed in daily practice. Patients and methods Data concerning patients’ and tumours’ characteristics, management, delivery and maternal outcome were recorded from institutional electronic database. In this paper a case series of pregnant breast cancer patients treated at single tertiary institution between 2007 and 2019 are presented and the key recommendations on managing such patients are summarized. Results Fourteen patients met the search criteria. The majority of tumours were high grade, triple negative or HER2 positive, two patients were de novo metastatic. Treatment plan was made for each patient by multidisciplinary team. Eight patients were treated with systemic chemotherapy with no excess toxicity or severe maternal/fetal adverse effects. In all but two patients, delivery was on term and without major complications. Only one event, which was not in whole accordance with international guidelines, was identified. It was the use of blue dye in one patient. Conclusions Women with pregnancy associated breast cancer should be managed like non-pregnant breast cancer patients and should expect a similar outcome, without causing harm to the unborn child. To achieve a good outcome in pregnancy associated breast cancer, a multidisciplinary approach is mandatory.

scholarly journals The Effect of External Radiotherapy to the Left Ventricle Systolic Function in Locally Advanced Breast Cancer Patients

2021 ◽  
Vol 8 (11) ◽  
pp. 350-356
Author(s):  
Helmy Fahada ◽  
Desak Agung Suprabawati ◽  
Dyah Erawati
Keyword(s):  
Breast Cancer ◽  
Advanced Breast Cancer ◽  
Cancer Patients ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Left Ventricular ◽  
Advanced Breast ◽  
External Radiation ◽  
Breast Cancer Patients ◽  
Number Of Patients

Background: Locoregional management in breast cancer patients includes surgery and radiation. Radiation increases the risk of the decreasing of cardiac ventricular performance and known as cardiotoxicity. This study aims to analyze the relationship between radiation exposure in locally advanced breast cancer patients with the left ventricular systolic function. Methods: The subjects in this study were patients with locally advanced breast cancer who underwent external radiation therapy after surgery procedure at Dr. Soetomo General Hospital in January 2021 – April 2021. Examination of left ventricular performance parameters was carried out using an invasive method, the transthoracic echocardiography. The performance parameters examined were left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS). Results: A total of 45 patients were recruited in this study. Twenty-two patients (22/45; 48.9%) underwent radiation therapy from the left side and 23 patients (23/45; 51.1%) from the right side. After external radiation, the number of patients with left ventricular dilatation were increased. On the left side, there were 6 patients (6/22; 27.6%) who experienced dilatation compared to before radiation (3 patients), while on the right side of the body there were 8 patients (8/22; 34.8%) who experienced dilatation compared to before radiation (6 patients). There was an increase in the number of patients who experienced a decrease in EFT and EFB after radiation, although the association was not significant. Almost all patients experienced a decrease in GLS values ​​after radiation (44/45; 97.8%). Conclusion: There was an increase in the number of patients with left ventricular dilatation and decrease in EFT and EFB values after external radiation. Decreased GLS values ​​were found in almost all patients who underwent external radiation in this study. Keywords: Radiation, locally advanced breast cancer, LVID, ejection fraction, GLS.

scholarly journals Understanding the Breast Cancer Experience of Women in East Africa: A Qualitative Study

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 120s-120s ◽  
Author(s):  
M. Mutebi ◽  
O. Olasehinde ◽  
P. Kingham ◽  
C. Boutin-Foster ◽  
A. Pusic
Keyword(s):  
Breast Cancer ◽  
Alternative Medicine ◽  
East Africa ◽  
Cancer Patients ◽  
Breast Cancer Patients ◽  
Related Factors ◽  
Access To Treatment ◽  
Inappropriate Treatment ◽  
Number Of Patients ◽  
Initial Care

Background: Breast cancer is one of the leading causes of premature death in women in East Africa. The majority of patients are diagnosed with advanced cancers (stage III and IV) which results in more cancer deaths. Even after a diagnosis of breast cancer, many patients do not complete their treatment. The reasons why delays in diagnosis and treatment occur are multilevel, involving a combination of both patient related factors, such as sociocultural reasons like stigma or fatalism, or the use of alternative medicine. Financial factors play a big role as many patients have to pay out of pocket for their health expenditure. System related factors such as a lack of resources for the diagnosis or treatment, lack of health worker knowledge leading to misdiagnosis with inappropriate treatment and poor referral pathways, also contribute to delays in care. Aim: To understand the experience of breast cancer patients in East Africa, to determine the facilitators and barriers to diagnosis, treatment and follow-up of breast cancer. Methods: 28 patients in Kenya and Tanzania who had completed at least a year of initial treatment were invited to participate in the study. A qualitative exploratory study was done using semistructured, in-depth interviews. Grounded theory was then used to analyze and develop themes that emerged from these narratives. Results: For these patients who had completed at least a year of treatment, the cost of treatment and expenses incurred was a major concern. Family disintegration emerged as a significant theme following cancer diagnosis. There was a prevalence of stigma around breast cancer and patients would not disclose their status to others in the community for fear of being ridiculed, pitied or isolated. A number of patients used alternative medicine resulting in delays in treatment. Family support, support groups and spirituality played a major role in facilitating the completion of initial care and in reducing psychological morbidity. System factors such as poor referral pathways, and inappropriate treatment emerged as minor themes. Conclusion: The sociocultural aspects of breast cancer need to be addressed to ensure comprehensive management of breast cancer patients and completion of treatment. As programs in the region, mainly run by governments, aim to improve the financial access to treatment, it would be critical to include efforts aimed at stigma reduction and interventions focusing on the sociocultural reintegration of these patients.

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