The clinical impact of ASCO “choosing wisely” recommendations on staging imaging for early stage breast cancers: An interrupted time-series analysis utilizing SEER-Medicare data.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 2078-2078
Author(s):  
Alan Baltz ◽  
Issam Makhoul ◽  
Eric R Siegel
Keyword(s):  
Breast Cancer ◽  
Cancer Diagnosis ◽  
Negative Binomial ◽  
Early Stage ◽  
Breast Cancer Diagnosis ◽  
Choosing Wisely ◽  
Breast Cancers ◽  
Interrupted Time Series Analysis ◽  
Medicare Data ◽  
The Impact

2078 Background: The “Choosing Wisely” (CW) list, released by the American Society for Clinical Oncology (ASCO), highlights low-value procedures. In 2012, the CW recommendations advised against the use of staging imaging, including Positron Emission Tomography (PET), Computerized Tomography (CT) and radionuclide bone scans, for the staging of early breast cancer at low risk for metastasis. The objective of this study was therefore to assess the impact of the ASCO CW recommendations on staging imaging among early stage breast cancers. Methods: Women above the age of 66 with an early stage incident breast cancer diagnoses between 2010 and 2015 were identified within the linked SEER-Medicare data. The primary outcome of interest was the proportion of patients with a claim for staging imaging in the six months following the breast cancer diagnosis. Negative binomial regression, adjusting for pre-recommendation trends, was performed to estimate the changes in the rate of imaging staging within each year following the release of the recommendation. Results: A total of 50,004 women were identified during the study period. Prior to the release of the recommendations in 2012, the staging imaging rates among women newly diagnosed with early stage breast cancers were 5% greater in 2010 (p<.01) and 4% greater in 2011 (p<.01). Following the release of the recommendations, staging imaging rates did not decrease significantly in 2013 (2%;p=0.18). Imaging rates did, however, significantly decrease by 13% in 2014 (p<0.01) and by 16% in 2015 (p<0.01). Conclusions: The CW recommendation was associated with a significant decrease in unadvised staging imaging among incident early stage breast cancer diagnosis in the second and third year following its release. These findings demonstrate an improvement in the proportion of potentially inappropriate staging imaging in early stage breast cancers. The creation and dissemination of resources, such as the CW recommendations, serves as a powerful tool to improve clinical practice, quality of care, and patient safety from secondary malignancies, anxiety, and overdiagnosis.

scholarly journals The COVID-19 pandemic and impact on breast cancer diagnoses: what happened in England in the first half of 2020

2020 ◽  
Author(s):  
Toral Gathani ◽  
Gill Clayton ◽  
Emma MacInnes ◽  
Kieran Horgan
Keyword(s):  
Breast Cancer ◽  
Cancer Diagnosis ◽  
Waiting Time ◽  
Breast Cancer Diagnosis ◽  
Breast Cancers ◽  
Time Data ◽  
Breast Cancer Outcomes ◽  
Time Period ◽  
Number Of Patients ◽  
The Impact

AbstractDelays in cancer diagnosis and treatment due to the COVID-19 pandemic is a widespread source of concern, but the scale of the challenge for different tumour sites is not known. Routinely collected NHS England Cancer Waiting Time data were analysed to compare activity for breast cancer in the first 6 months of 2020 compared to the same time period in 2019. The number of referrals for suspected breast cancer was 28% lower (N = 231,765 versus N = 322,994), and the number of patients who received their first treatment for a breast cancer diagnosis was 16% lower (N = 19,965 versus N = 23,881). These data suggest that the number of breast cancers diagnosed during the first half of 2020 is not as low as initially feared, and a substantial proportion of the shortfall can be explained by the suspension of routine screening in March 2020. Further work is needed to examine in detail the impact of measures to manage the COVID-19 pandemic on breast cancer outcomes.

Simple and fast isolation of circulating exosomes with chitosan modified shuttle flow microchip towards breast cancer diagnosis

Lab on a Chip ◽  
2021 ◽  
Author(s):  
Wenwen Chen ◽  
Rongkai Cao ◽  
Wentao Su ◽  
xu zhang ◽  
Yuhai Xu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Medical Treatment ◽  
Cancer Diagnosis ◽  
Biological Samples ◽  
Early Stage ◽  
Breast Cancer Diagnosis ◽  
Early Stage Cancer ◽  
Tumor Prognosis ◽  
Huge Challenge

Tumor-derived exosomes have been recognized as promising biomarkers for early-stage cancer diagnosis, tumor prognosis monitoring and individual medical treatment. However, separating exosomes from trace biological samples is a huge challenge...

Breast cancer ER, PR, and HER2 expression variance by germline cancer predisposition genes.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 10526-10526
Author(s):  
Grace Wei ◽  
Marilin Rosa ◽  
Maxine Chang ◽  
Brian J. Czerniecki ◽  
Xia Wang
Keyword(s):  
Breast Cancer ◽  
Cancer Diagnosis ◽  
Breast Cancer Diagnosis ◽  
Cancer Predisposition ◽  
Tumor Evolution ◽  
Breast Cancers ◽  
Her2 Expression ◽  
Expression Levels ◽  
Genetic Test Results ◽  
Predisposition Genes

10526 Background: The association between breast cancer characteristics and survival with estrogen receptor (ER) and progesterone receptor (PR) expression has been primarily studied via binomial categories, ER-positive and ER-negative. In order to better characterize germline genetic influences on these markers, we investigated their IHC expression semi-quantitatively in cancer predisposition germline pathogenic variant (PV) carriers of the following genes: BRCA1, BRCA2, PALB2, TP53, PTEN, CDH1, ATM, CHEK2, and Lynch syndrome genes. The HER2 expression was also analyzed. Methods: We conducted a retrospective chart review of patients with germline panel genetic testing for cancer predisposition genes at Moffitt Cancer Center’s GeneHome clinic. Inclusion criteria included 1) women ≥18 years old, 2) breast cancer diagnosis, 3) cancer predisposition germline panel genetic test results, 4) available ER and PR expression levels, and 5) available HER expression and/or amplification status. ER, PR, and HER2 status were compared between PV carriers and non-PV carriers via Mann-Whitney U at p>0.05. Results: A total of 847 cases were reviewed for the study. Among 658 patients with a breast cancer diagnosis and complete ER PR data, 365 cases (55.5%) were non-PV carriers and 293 cases (44.5%) carried a PV in at least one of the genes listed above. Among 635 cases with available HER2 expression/amplification status, 355 (55.9%) cases were non-PV carriers and 288 (45.4%) cases were PV-carriers. When compared with non-PV carrier controls, BRCA1 PV carriers’ breast tumors had significantly lower ER and/or PR expression. Further, BRCA2 and TP53 PV tumors also displayed moderately lower ER expression. Contrarily, CHEK2 tumors displayed higher ER and PR expression compared to controls. Further, BRCA1 and BRCA2 PV carriers were more likely to have HER2- breast cancers. Conclusions: Differences in ER, PR, HER2 expression levels were observed in germline PV carrier breast cancers, signaling differential impacts by germline PVs on the tumor evolution process. It is likely that tumor differences in PV carriers influence responses to therapies, including hormone therapy, anti-HER2 therapy, and subsequent survival.[Table: see text]

scholarly journals The Impact of COVID-19 Outbreak on Emotional and Cognitive Vulnerability in Iranian Women With Breast Cancer

2021 ◽  
Vol 12 ◽  
Author(s):  
Mohammad H. Choobin ◽  
Vida Mirabolfathi ◽  
Bethany Chapman ◽  
Ali Reza Moradi ◽  
Elizabeth A. Grunfeld ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Diagnosis ◽  
Cognitive Vulnerability ◽  
Emotional Health ◽  
Breast Cancer Diagnosis ◽  
Well Being ◽  
Emotional Impact ◽  
Targeted Interventions ◽  
Emotional Vulnerability ◽  
The Impact

The psychological cost on emotional well-being due to the collateral damage brought about by COVID-19 in accessing oncological services for breast cancer diagnosis and treatment has been documented by recent studies in the United Kingdom. The current study set out to examine the effect of delays to scheduled oncology services on emotional and cognitive vulnerability in women with a breast cancer diagnosis in Iran, one of the very first countries to be heavily impacted by COVID-19. One hundred thirty-nine women with a diagnosis of primary breast cancer answered a series of online questionnaires to assess the current state of rumination, worry, and cognitive vulnerability as well as the emotional impact of COVID-19 on their mental health. Results indicated that delays in accessing oncology services significantly increased COVID related emotional vulnerability. Regression analyses revealed that after controlling for the effects of sociodemographic and clinical variables, women’s COVID related emotional vulnerability explained higher levels of ruminative response and chronic worry as well as poorer cognitive function. This study is the first in Iran to demonstrate that the effects of COVID-19 on emotional health amongst women affected by breast cancer can exaggerate anxiety and depressive related symptoms increasing risks for clinical levels of these disorders. Our findings call for an urgent need to address these risks using targeted interventions exercising resilience.

Divorce after breast cancer diagnosis and its impact on quality of life

2021 ◽  
pp. 1-6
Author(s):  
Danbee Kang ◽  
Nayeon Kim ◽  
Gayeon Han ◽  
Sooyeon Kim ◽  
Hoyoung Kim ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cancer Survivors ◽  
Cancer Diagnosis ◽  
Breast Cancer Survivors ◽  
Breast Cancer Diagnosis ◽  
Factors Associated ◽  
After Cancer ◽  
The Impact

Abstract Objective This study aims to identify factors associated with divorce following breast cancer diagnosis and measures the impact of divorce on the quality of life (QoL) of patients. Methods We used cross-sectional survey data collected at breast cancer outpatient clinics in South Korea from November 2018 to April 2019. Adult breast cancer survivors who completed active treatment without any cancer recurrence at the time of the survey (N = 4,366) were included. The participants were classified into two groups: “maintaining marriage” and “being divorced,” between at the survey and at the cancer diagnosis. We performed logistic regression and linear regression to identify the factors associated with divorce after cancer diagnosis and to compare the QoL of divorced and nondivorced survivors. Results Approximately 11.1/1,000 of married breast cancer survivors experienced divorce after cancer diagnosis. Younger age, lower education, and being employed at diagnosis were associated with divorce. Being divorced survivors had significantly lower QoL (Coefficient [Coef] = −7.50; 95% CI = −13.63, −1.36), social functioning (Coef = −9.47; 95% CI = −16.36, −2.57), and body image (Coef = −8.34; 95% CI = −6.29, −0.39) than survivors who remained married. They also experienced more symptoms including pain, insomnia, financial difficulties, and distress due to hair loss. Conclusion Identifying risk factors of divorce will ultimately help ascertain the resources necessary for early intervention.

scholarly journals A Technical Review of Convolutional Neural Network-Based Mammographic Breast Cancer Diagnosis

2019 ◽  
Vol 2019 ◽  
pp. 1-16 ◽  
Author(s):  
Lian Zou ◽  
Shaode Yu ◽  
Tiebao Meng ◽  
Zhicheng Zhang ◽  
Xiaokun Liang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neural Network ◽  
Convolutional Neural Network ◽  
Cancer Diagnosis ◽  
Early Stage ◽  
Breast Cancer Diagnosis ◽  
Fine Tuning ◽  
Learning Tools ◽  
Pros And Cons ◽  
Future Work

This study reviews the technique of convolutional neural network (CNN) applied in a specific field of mammographic breast cancer diagnosis (MBCD). It aims to provide several clues on how to use CNN for related tasks. MBCD is a long-standing problem, and massive computer-aided diagnosis models have been proposed. The models of CNN-based MBCD can be broadly categorized into three groups. One is to design shallow or to modify existing models to decrease the time cost as well as the number of instances for training; another is to make the best use of a pretrained CNN by transfer learning and fine-tuning; the third is to take advantage of CNN models for feature extraction, and the differentiation of malignant lesions from benign ones is fulfilled by using machine learning classifiers. This study enrolls peer-reviewed journal publications and presents technical details and pros and cons of each model. Furthermore, the findings, challenges and limitations are summarized and some clues on the future work are also given. Conclusively, CNN-based MBCD is at its early stage, and there is still a long way ahead in achieving the ultimate goal of using deep learning tools to facilitate clinical practice. This review benefits scientific researchers, industrial engineers, and those who are devoted to intelligent cancer diagnosis.

scholarly journals Non-Invasive Biomarkers for Early Detection of Breast Cancer

Cancers ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 2767
Author(s):  
Jiawei Li ◽  
Xin Guan ◽  
Zhimin Fan ◽  
Lai-Ming Ching ◽  
Yan Li ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Diagnosis ◽  
Early Stage ◽  
False Negative ◽  
Breast Cancer Diagnosis ◽  
Diagnostic Biomarkers ◽  
Circulating Micrornas ◽  
Non Invasive ◽  
Common Cancer ◽  
Volatile Organic

Breast cancer is the most common cancer in women worldwide. Accurate early diagnosis of breast cancer is critical in the management of the disease. Although mammogram screening has been widely used for breast cancer screening, high false-positive and false-negative rates and radiation from mammography have always been a concern. Over the last 20 years, the emergence of “omics” strategies has resulted in significant advances in the search for non-invasive biomarkers for breast cancer diagnosis at an early stage. Circulating carcinoma antigens, circulating tumor cells, circulating cell-free tumor nucleic acids (DNA or RNA), circulating microRNAs, and circulating extracellular vesicles in the peripheral blood, nipple aspirate fluid, sweat, urine, and tears, as well as volatile organic compounds in the breath, have emerged as potential non-invasive diagnostic biomarkers to supplement current clinical approaches to earlier detection of breast cancer. In this review, we summarize the current progress of research in these areas.

How do women with secondary breast cancer experience telling their adolescent children about their diagnosis?

2016 ◽  
Vol 23 (9) ◽  
pp. 1223-1233 ◽  
Author(s):  
Leonie Lalayiannis ◽  
Nicky Asbury ◽  
Graham Dyson ◽  
Amanda Walshe
Keyword(s):  
Breast Cancer ◽  
Cancer Diagnosis ◽  
Interpretative Phenomenological Analysis ◽  
Breast Cancer Diagnosis ◽  
Phenomenological Analysis ◽  
Primary Cancer ◽  
Structured Interviews ◽  
Cancer Experience ◽  
Secondary Breast Cancer ◽  
The Impact

This study investigated how women with secondary breast cancer experience telling their adolescent children. Semi-structured interviews were conducted with women who had been diagnosed with secondary breast cancer at least 1 year prior to the interview. Seven women, who had at least one child between 12 and 19 years old living at home at the time of diagnosis, were interviewed. The interviews were analysed using interpretative phenomenological analysis for an in-depth understanding of women’s experiences. Women found that it was easier to tell their children of their secondary breast cancer diagnosis compared to their primary cancer. However, they talked about the impact the diagnosis had on their family.

Mammography use in breast cancer survivors: An administrative claims study.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 6531-6531 ◽  
Author(s):  
Kathryn Jean Ruddy ◽  
Lindsey R. Sangaralingham ◽  
Heather B. Neuman ◽  
Caprice Christian Greenberg ◽  
Rachel A. Freedman ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Cancer Diagnosis ◽  
Breast Cancer Survivors ◽  
Breast Tissue ◽  
Early Stage ◽  
Breast Cancer Diagnosis ◽  
First Year ◽  
Administrative Claims ◽  
Mammography Use

6531 Background: Annual mammography is recommended to screen residual breast tissue for new cancers and recurrent disease after treatment for early stage breast cancer. This study aimed to assess mammography rates over time in breast cancer survivors. Methods: We used administrative claims data from a large U.S. commercial insurance database, OptumLabs, to retrospectively identify privately- and Medicare Advantage-insured women with operable breast cancer who had residual breast tissue after definitive breast surgery between 2006 and 2015. We required coverage for at least 13 months following surgery. For each subsequent 13-month time period, we only included women without a loss of coverage, bilateral mastectomy, metastatic breast cancer diagnosis, or non-breast cancer diagnosis. We calculated the proportion of patients who had a mammogram during each 13-month period following breast surgery. We used multivariable logistic regression to test for factors associated with mammography in the first 13 months. Results: The cohort included 26,011 women followed for a median of 2.9 years (IQR 1.9-4.6) after surgery; 63.1% were less than 65 years of age, and 74.4% were white. In their first year of follow-up, 86% underwent mammography, but by year 7, this decreased to 73%. Fewer than 1% underwent MRI instead of mammography. In multivariable analysis, mammograms were less likely during the first year after surgery among women aged < 50 years (odds ratio [OR], 0.7; 95% confidence interval [CI], 0.6 to 0.8), African Americans (OR, 0.7; 95% CI, 0.7 to 0.8), patients who underwent mastectomy (OR, 0.7; 95% CI, 0.6 to 0.7), and patients residing in the Western part of the country (OR, 0.9; 95% CI, 0.7 to 0.9). Those with 1-2 comorbidities were more likely (OR, 1.1; 95% CI 1.1-1.2) than those with none to have a mammogram during that period. Mammography use did not differ significantly by year of diagnosis (2006-2015). Conclusions: Even in an insured cohort, a substantial proportion of breast cancer survivors do not undergo annual surveillance mammography. Mammography use falls as the time from the early stage breast cancer diagnosis increases. Understanding factors associated with lack of mammographic screening may help improve survivorship care.

The impact of a breast cancer diagnosis on women’s work status.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 23-23
Author(s):  
Lucinda Barry ◽  
Leanne Storer ◽  
Meron Pitcher
Keyword(s):  
Breast Cancer ◽  
Cancer Diagnosis ◽  
Financial Stress ◽  
Breast Cancer Diagnosis ◽  
Work Status ◽  
Paid Employment ◽  
The Mean ◽  
Woman's Work ◽  
One Year ◽  
The Impact

23 Background: The diagnosis and treatment of cancer often causes financial stress, partly by impacting on the ability to continue in paid employment. Our aim was to identify changes in work status 12 months after a diagnosis of breast cancer. Methods: An audit of the medical records of women who presented to the Western Health (Victoria, Australia) nurse led breast cancer Survivorship Clinic (SC) between October 2015 and October 2016 was performed to identify employment status at diagnosis and at their review at SC 12 months later. Results: 111 records were reviewed. The mean age was 55 (range 28-82yrs). 84 of these women (76%) were 65 years of younger at the time of diagnosis. 46 of the 84 women ≤65 years were in paid employment at diagnosis (55%), and 38 (83%) were still working in some capacity at review in the SC. Of the 38 still working, 28 were working in the same capacity, 8 were working reduced hours, and 2 were working increased hours. Women who had axillary dissections were most likely to have changed work status. Financial stress was reported by 8/19 of women who stopped working or had changed work hours, including 9 no longer in paid employment and 10 with changed hours. 2/28 women working in the same capacity reported financial stress. 65% of those who reported financial stress (11/17) had chemotherapy as part of their treatment. Conclusions: A breast cancer diagnosis has the ability to influence a woman's work status one year after diagnosis. Health professionals should appreciate the potential work concerns and financial stresses continuing to affect their patients.

Sign in / Sign up

Export Citation Format

Share Document