Aesthetic outcome and patient’s quality of life in breast cancer patients undergoing mastectomy with or without immediate reconstruction.

e12587 Background: : Although post mastectomy Immediate breast reconstruction has shown to improve physical and psychosocial well-being of breast cancer patients, this is not a usual procedure in Pakistan due to limited resources and lack of awareness. The aim of our study is to evaluate patient’s satisfaction/ aesthetic outcomes between the patients undergoing mastectomy alone (Group A) and the ones undergoing mastectomy followed by immediate reconstruction (Group B). Methods: This is a prospective study conducted at Shaukat Khanum Hospital Pakistan comparing aesthetic outcome, patient’s satisfaction and Quality of life between two groups using Breast Q module. All patients undergoing mastectomy with and without reconstruction between April 2017 to July 2019 are included. Sample size of 84 was calculated (42 in each group). Results: The mean Q score of satisfaction with the breast in group B is 82.64 and in group A is 35.82 (P = 0.001). The mean Q score of Psychosocial well-being in group B is 89 vs 44.95 in group A (P = 0.001). The mean Q score of Physical well-being in group B is 98.23 vs 90.41 in group A (P = 0.002). The mean Q score of sexual well-being in group B is 81.93 vs 43 in Group A (P = 0.001). [Mean difference in score of 5-10 - little change, 10-20 - moderate change, > 20 - significant change].The mean difference between two groups in satisfaction with breast , psychosocial well-being and sexual well-being is more than 20 with a statistically significant p-value, while in physical well-being the mean difference is 7.8 which falls in little change group. Conclusions: Our study shows that reconstruction helps breast cancer patients in providing comprehensive care in a manner that they achieve a higher satisfaction with their appearance, psychological and sexual well-being without compromising oncological safety and this should be practiced more in our country. Also patients education about these procedures should be raised to help them fighting against this disease

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Effects of Different Exercise Interventions on Quality of Life in Breast Cancer Patients: A Randomized Controlled Trial

Integrative Cancer Therapies ◽

10.1177/1534735419880598 ◽

2019 ◽

Vol 18 ◽

pp. 153473541988059

Author(s):

Tetiana Odynets ◽

Yuriy Briskin ◽

Valentina Todorova

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Cancer Patients ◽

Well Being ◽

Breast Cancer Patients ◽

Exercise Interventions ◽

Water Exercise ◽

Group A ◽

Group B

Purpose: The aim of the present study was to evaluate the effects of different exercise interventions on quality of life parameters in breast cancer patients during 1 year of outpatient rehabilitation. Material and Methods: A total of 115 breast cancer patients met the eligibility criteria and completed the study. Participants were randomly allocated for the water exercise interventions (group A, n = 45), for the Pilates exercise interventions (group B, n = 40), and yoga exercise interventions (group C, n = 30). The 3 groups attended relevant programs for 1 year and received 144 rehabilitation sessions. Quality of life parameters were assessed using the Functional Assessment of Cancer Therapy questionnaire with a specific module for breast cancer patients (FACT-B). Quality of life data were recorded at baseline and after 6 and 12 months of exercise interventions. Results: A significant increase in quality of life indicators was observed in participants of all groups. Based on the results of the 12-month monitoring, patients of group A scored significantly more points for emotional well-being compared with group B and group C by 1.40 points ( P < .05) and 1.69 points ( P < .01), respectively, as well as by breast cancer subscale by 2.15 points ( P < .05) compared with group B. Patients in group C scored significantly better compared with group A in social/family well-being by 2.80 points ( P < .01). Conclusions: It was found that using water exercise intervention is more effective for improving emotional well-being and decreasing negative symptoms associated with breast cancer treatment compared with Pilates and yoga interventions, while yoga was more effective in improving social/family well-being. Further research on water interventions for different populations is warranted.

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Prospective study of hair recovery after (neo)adjuvant chemotherapy with scalp cooling in Japanese breast cancer patients

Supportive Care in Cancer ◽

10.1007/s00520-021-06168-y ◽

2021 ◽

Author(s):

Shozo Ohsumi ◽

Sachiko Kiyoto ◽

Mina Takahashi ◽

Seiki Takashima ◽

Kenjiro Aogi ◽

...

Keyword(s):

Breast Cancer ◽

Adjuvant Chemotherapy ◽

Prospective Study ◽

Cancer Patients ◽

Scalp Cooling ◽

Breast Cancer Patients ◽

Chemotherapy Infusion ◽

Group A ◽

Neo Adjuvant Chemotherapy ◽

Group B

Abstract Purpose Scalp cooling during chemotherapy infusion to mitigate alopecia for breast cancer patients is becoming widespread; however, studies regarding hair recovery after chemotherapy with scalp cooling are limited. We conducted a prospective study of hair recovery after chemotherapy with scalp cooling. Patients and methods One hundred and seventeen Japanese female breast cancer patients who completed planned (neo)adjuvant chemotherapy using the Paxman Scalp Cooling System for alopecia prevention were evaluated for alopecia prevention in our prospective study. We evaluated their hair recovery 1, 4, 7, 10, and 13 months after chemotherapy. Primary outcomes were grades of alopecia judged by two investigators (objective grades) and patients’ answers to the questionnaire regarding the use of a wig or hat (subjective grades). Results Of 117 patients, 75 completed scalp cooling during the planned chemotherapy cycles (Group A), but 42 discontinued it mostly after the first cycle (Group B). Objective and subjective grades were significantly better in Group A than in Group B throughout 1 year, and at 4 and 7 months after chemotherapy. When we restricted patients to those with objective Grade 3 (hair loss of > 50%) at 1 month, Group A exhibited slightly faster hair recovery based on the objective grades than Group B. There was less persistent alopecia in Group A than in Group B. Conclusions Scalp cooling during chemotherapy infusion for Japanese breast cancer patients increased the rate of hair recovery and had preventive effects against persistent alopecia.

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Impact of Different Modules of 21-Gene Assay in Early Breast Cancer Patients

10.21203/rs.3.rs-652397/v1 ◽

2021 ◽

Author(s):

Mengdi Chen ◽

Deyue Liu ◽

Weilin Chen ◽

Weiguo Chen ◽

Kunwei Shen ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Young Patients ◽

Breast Cancer Patients ◽

Old Patients ◽

Gene Assay ◽

Risk Patients ◽

Group A ◽

Group B ◽

The Impact

Abstract Background: Young patients were under-evaluated in the construction and validation of the 21-gene Assay Recurrence Score (RS). Previous evidence suggested that RS performed differently according the ages of patients. Our study aimed to explore the molecular driving patterns in patients of different ages.Methods: A total of 1,078 estrogen receptor (ER)-positive breast cancer patients between Jan 2009 and Mar 2017 from Shanghai Jiao Tong University Breast Cancer Data Base were divided into three subgroups: Group A, ≤40y and premenopausal (n=97); Group B, >40y and premenopausal (n=284); Group C, postmenopausal (n=697). The correlation of RS and its modules and the variance of RS modules was explored.Results: Estrogen module had a stronger correlation with RS in patients >40y (ρ = -0.76 in Group B and -0.79 in Group C) compared with patients ≤40y (ρ = -0.64). Contrarily, the correlation between RS and invasion group was weaker in patients >40y (ρ = 0.29 in Group B and 0.25 in Group C) than in patients ≤40y (ρ = 0.44). The proliferation module contributed most to the variance in young patients (37.3%) while ER module contributed most in old patients (54.1% in Group B and 53.4% in Group C). For RS >25, proliferation module was the leading driver in all three subgroups (ρ = 0.38, 0.53 and 0.52 in Group A, B and C) while estrogen module had a weaker association with RS. The negative impact of ER related features on RS was stronger in clinical low-risk patients while the positive effect of proliferation module was stronger in clinical high-risk patients.Conclusions: RS was primarily driven by estrogen module in patients regardless of age, but the proliferation module had a stronger impact on RS in patients ≤40y than in those >40y. The impact of modules varied in patients with different genetic and clinical risk.

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Psychosocial Aspects of Immediate versus Delayed Breast Reconstruction

Breast Care ◽

10.1159/000485234 ◽

2017 ◽

Vol 12 (6) ◽

pp. 374-377 ◽

Cited By ~ 7

Author(s):

Anne-Sophie Heimes ◽

Kathrin Stewen ◽

Annette Hasenburg

Keyword(s):

Breast Cancer ◽

Breast Reconstruction ◽

Cancer Patients ◽

Well Being ◽

Psychological Outcomes ◽

Psychosocial Aspects ◽

Breast Cancer Patients ◽

Immediate Reconstruction ◽

Delayed Breast Reconstruction ◽

Delayed Reconstruction

Background: Only little is known about the psychosocial aspects of breast cancer patients after mastectomy with immediate versus delayed breast reconstruction. Methods: We systematically screened PubMed using the following key words: mastectomy, immediate vs. delayed reconstruction, psychosocial aspects and quality of life. To highlight different psychological outcomes, studies were categorized into those describing: anxiety, depression, body image and satisfaction with the surgical outcome. We also compared patients after mastectomy alone with those undergoing immediate or delayed reconstruction. Results: Methodologies and psychological outcomes varied among the identified studies, making it difficult to compare results. There are contradictory outcomes concerning the psychosocial aspects of breast cancer patients after mastectomy alone compared with those who underwent an immediate or delayed reconstruction following mastectomy. Some studies show that immediate reconstruction after mastectomy had a positive impact on patients' psychological well-being. In contrast, other studies indicated that in the long-term view the compared patient groups were very similar concerning psychosocial aspects. Conclusion: Analyzing different aspects of psychosocial well-being after breast cancer surgery, there might be an advantage in choosing immediate reconstruction, if oncological safety allows it.

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Correlation between Spiritual Well-Being and Level of Fatigue among Patients Suﬀering from Breast Cancer

Jurnal Keperawatan Padjadjaran ◽

10.24198/jkp.v9i1.1592 ◽

2021 ◽

Vol 9 (1) ◽

pp. 52

Author(s):

Maria Komariah ◽

Mohd Khairul Zul Hasymi Firdaus ◽

Kalpana Paudel Aryal ◽

Md Abdul Latif

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Well Being ◽

Breast Cancer Patients ◽

Fatigue Score ◽

Cancer Related Fatigue ◽

Correlational Design ◽

Chronic Illness Therapy ◽

Spiritual Well Being ◽

The Mean

Cancer-related fatigue has been shown to be a signifcant side eﬀect that inﬂuences a person’s wellbeing, duringtreatment, and after treatment. It is recorded that cancer patients have also been shown experiencing spiritualdistress. The study aims to determine the connection between spiritual well-being and cancer-related fatigueamong patients suﬀering from breast cancer during chemotherapy treatment. 112 patients who were undergoingchemotherapy treatment were recruited in this study using a correlational design. The instruments used inassessing spiritual well-being and fatigue are Functional Assessment of Chronic Illness Therapy - Spirituality(FACIT-Sp) and FACIT-Fatigue Scales. Data were analyzed using the Spearman Correlation analysis. Meanspiritual well-being score was 35.91 (SD = 6.89), and the mean fatigue score was 33.04 (SD = 9.58). Therewere a moderate and signifcant correlation between fatigue scores and spiritual well-being (r = .364, p < 0.001).Breast cancer patients who had higher spiritual well-being that means they would alleviate fatigue symptoms.Therefore, nurses should consider that increasing spiritual well-being would reduce fatigue and vice versa.

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Mitomycin C in combination with capecitabine (Mi-Cap) as chemotherapy in breast cancer patients with extensive liver metastases and impaired hepatic function: A non-randomized multicentre phase II study

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.19597 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 19597-19597

Author(s):

S. Loibl ◽

M. Schmidt ◽

F. Marquardt ◽

J. Huober ◽

J. Bischoff ◽

...

Keyword(s):

Breast Cancer ◽

Liver Metastases ◽

Cancer Patients ◽

Mitomycin C ◽

Metastatic Disease ◽

Liver Enzymes ◽

Breast Cancer Patients ◽

Elevated Liver Enzymes ◽

Group A ◽

Group B

19597 Background: Breast cancer patients with an impaired liver function due to liver metastases have very limited, evidence based treatment options. Based on our experience with mitomycin C, 5Fu and folinate (Loibl et al. 2004), we wanted to improve this schedule by including the oral antimetabolite capecitabine. Methods: Breast cancer patients (pts) with liver metastases and elevated liver enzymes defined as AST/ALT = 3×UNL (group A) or liver enzymes = 1.5×UNL and AP = 3×UNL (group B) were enrolled. Further inclusion criteria were as follows: bidimensionally measurable disease, normal hematological values (WBCs = 3×109/L; platelets = 100×109/L; hemoglobin = 10 g/dL), normal renal function. A three weekly cycle with Mitomycin C 8 mg/m2 i.v. on day 1, capecitabine 2,000 mg/m2 day 1–14 and prednison 5 mg day 1–5 orally was given. Primary endpoint is the progression free survival (PFS) measured from the planned 44 eligible patients who received at least one cycle of Mi-Cap. Results: Between April 2004 and December 2006, 35 patients with a median age of 57.1 years (range, 39–76) were enrolled. 29 pts. received an adjuvant or neoadjuvant chemotherapy of whom 20 received anthracyclines and 6 a taxane containing regimen. 9 pts. had no chemotherapy for metastatic disease and 9 pts. had 3 or more chemotherapies for metastatic disease. At the start of chemotherapy 24 pts belonged to group A and 11 to group B and 12 pts had hyperbilirubinemia. 20 pts had liver involvement only. So far 109 cycles had been given. 29 pts. received more than one cycle, 6 pts. received the 6 preplanned cycles so far. Myelosuppression and hand foot syndrome are the most frequent toxicities. 4 patients had a documented partial remission, 18 patients had stable disease or are still under treatment, and 13 patients progressed during treatment. The median time to progression is 6.4 months in all patients who received at least one cycle. The median overall survival for the total population was 8.3 months. Conclusion: Mi-Cap can be safely given. Initial observations show that pts with a decrease in liver enzymes or bilirubin in the first two cycles had a longer PFS. No significant financial relationships to disclose.

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The Effect of Metformin When Combined With Neoadjuvant Chemotherapy in Breast Cancer Patients

10.21203/rs.3.rs-857423/v1 ◽

2021 ◽

Author(s):

Shaimaa El-Khayat ◽

Mohamed Abouegylah ◽

Dina Abdallah ◽

Ahmed Gaber Geweil ◽

A.M. Elenbaby ◽

...

Keyword(s):

Breast Cancer ◽

Neoadjuvant Chemotherapy ◽

Cancer Patients ◽

Pathological Response ◽

Phase Iii ◽

P Value ◽

Base Line ◽

Breast Cancer Patients ◽

Group A ◽

Group B

Abstract BackgroundMetformin has been used to treat type 2 Diabetes Mellitus since long time. It has two proposed anti-neoplastic mechanisms, direct (insulin-independent) and indirect (insulin-dependent) actions. PurposeTo assess the effect of Metformin on pathological response when combined with neoadjuvant chemotherapy in breast cancer. Material and MethodsA prospective study included stage II, III non-diabetic breast cancer patients who received neoadjuvant chemotherapy in our center during the period from May 2017 to March 2019. 59 patients met our inclusion criteria and completed the study, 27 patients received 850mg Metformin every 12 hrs with chemotherapy (group A), 32 patients received chemotherapy without Metformin (group B). Pathological response was assessed by Chevallier classification and residual cancer burden score (RCB). ResultsBoth groups were well balanced regarding base line characteristics. The results of our study showed that the rate of pathological complete response (pCR) was 14.8% in group (A) vs. 6.3% in group (B) with a P-value of 0.39. RCB class 3 was 40.7% in group (A) Vs. 68.8% in group (B) which was statistically significant with a (P-value of 0.031). Patients with triple-positive histology who had RCB class 3 were only (14.3%) in group (A) versus (60%) in group B. Patients with body mass index (BMI) ≥25 who had RCB 3 were 40% and 66.7% in group (A) and (B) respectively. ConclusionMetformin may increase the pCR especially in patients with BMI≥25 and patients with triple-positive histology, a larger phase III study is needed to confirm this finding.

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Lack of effect of pegfilgrastim on anemia in breast cancer patients treated with dose-dense chemotherapy

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.11071 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 11071-11071

Author(s):

M. Manzoni ◽

K. Bencardino ◽

B. Rovati ◽

S. Mariucci ◽

F. Cappuzzo ◽

...

Keyword(s):

Breast Cancer ◽

Locally Advanced ◽

Dose Intensity ◽

Breast Cancer Patients ◽

Adjuvant Setting ◽

Group A ◽

The Mean ◽

Dose Dense ◽

Group B ◽

The Impact

11071 Background: A greater risk of anemia has been evidenced among breast cancer (BC) pts receiving dose-dense CT. A recent report showed that filgrastim may play a role in worsening anemia in BC pts receiving intensified Epirubicin (E) + Cyclophosphamide (CTX), by inducing stem cells to differentiate into more committed hematopoietic progenitors (Papaldo P. JCO, 2006). No data are available about the impact of pegfilgrastim-induced leucocytosis on Hb levels without prophylactic erythropoietic support. Methods: We have focused on this point in 36 BC pts. 14 N+ pts received 4 cycles of E 90 mg/sqm + CTX 600 mg/sqm every 14 days in adjuvant setting. 22 pts with locally advanced disease received 4 cycles of E 75 mg/sqm + Docetaxel 80 mg/sqm every 14 days as primary CT. All pts received prophylactic pegfilgrastim 6 mg s.c, after CT. Three groups were defined on the basis of WBC: A = <10 x 103/mL; B = between 10 and 20 x 103/mL and C = > 20 x 103/mL. WBC and Hb levels at the beginning of treatment were normal in all pts and were subsequently determined on day 1 of each treatment cycle. Results: All pts received the planned CT dose intensity. Only 3 pts developed G2 anemia and were excluded from the analysis, because of receiving darbepoietin alpha support. Among the 14 pts treated in adjuvant setting, 5 dropped in group A, 6 in group B and 3 in group C. The mean Hb decrease from the baseline to the last CT course was - 1.5 g/dL; -1.4, -1.8 and -1.4 in group A, B and C, respectively. In the primary setting, 4 pts dropped in group A, 12 in group B and 4 in group C. The mean Hb decrease was -1.5 g/dL; -1.3, -1.4 and -1.8 in group A, B and C respectively. No statistically significant correlation was found between the Hb levels and the degree of leukocytosis. Conclusions: Pegfilgrastim does not worsen anemia in BC pts treated with dose- dense CT, even when its use is related to some degree of leucocytosis. No significant financial relationships to disclose.

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Breast Cancer With Synchronous Metastases: Survival Impact of Exclusive Locoregional Radiotherapy

Journal of Clinical Oncology ◽

10.1200/jco.2008.19.5396 ◽

2009 ◽

Vol 27 (9) ◽

pp. 1375-1381 ◽

Cited By ~ 100

Author(s):

Romuald Le Scodan ◽

Denise Stevens ◽

Etienne Brain ◽

Jean Louis Floiras ◽

Christine Cohen-Solal ◽

...

Keyword(s):

Breast Cancer ◽

Multivariate Analysis ◽

Cancer Patients ◽

Primary Tumor ◽

Alternative Form ◽

Breast Cancer Patients ◽

Group A ◽

Synchronous Metastases ◽

Group B ◽

The Impact

Purpose Several studies suggest that surgical excision of the primary tumor improves survival among patients with stage IV breast cancer at diagnosis. Exclusive locoregional radiotherapy (LRR) is an alternative form of locoregional treatment (LRT) in this setting. We retrospectively studied the impact of LRT on the survival of breast cancer patients with synchronous metastases. Patients and Methods Among 18,753 breast cancer patients treated in our institution between 1980 and 2004, 598 patients (3.2%) had synchronous metastasis at diagnosis. Demographic data, tumor characteristics, metastatic sites, and treatments were prospectively recorded. The impact of LRT on overall survival (OS) was evaluated by multivariate analysis including known prognostic factors. Results Among 581 eligible patients, 320 received LRT (group A), and 261 received no LRT (group B). LRT consisted of exclusive LRR in 249 patients (78%), surgery of the primary tumor with adjuvant LRR in 41 patients (13%), and surgery alone in 30 patients (9%). With a median follow-up time of 39 months, the 3-year OS rates were 43.4% and 26.7% in group A and group B (P =.00002), respectively. The association between LRT and improved survival was particularly marked in women with visceral metastases. LRT was an independent prognostic factor in multivariate analysis (hazard ratio [HR] = 0.70; 95% CI, 0.58 to 0.85; P = .0002). The adjusted HR for late death (≥ 1 year) was 0.76 (95% CI, 0.61 to 0.96; P = .02). Conclusion In our experience, LRT, consisting mainly of exclusive LRR, was associated with improved survival in breast cancer patients with synchronous metastases. Exclusive LRR may thus represent an active alternative to surgery.

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Cyclic variation of integrated backscatter detects radiotherapy-induced changes better than global longitudinal strain, a three-year follow-up study in early-stage breast cancer patients

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jeaa356.112 ◽

2021 ◽

Vol 22 (Supplement_1) ◽

Author(s):

S Tuohinen ◽

T Skytta ◽

V Virtanen ◽

P-L Kellokumpu-Lehtinen ◽

P Raatikainen

Keyword(s):

Breast Cancer ◽

Longitudinal Strain ◽

Global Longitudinal Strain ◽

Posterior Wall ◽

Cyclic Variation ◽

Breast Cancer Patients ◽

Group A ◽

The Mean ◽

Group B ◽

Induced Changes

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): Paavo and Eila Salonen Legacy The Finnish Foundation for Cardiovascular Research onbehalf - Aims To characterize the early phases of radiotherapy-induced changes in myocardial deformation echocardiography. Methods Ninety-nine breast cancer patients were studied prior adjuvant treatment, after chemotherapy (CT), after radiotherapy (RT) and three years after RT (3Y). Nineteen patients with left-sided breast cancer received adjuvant CTand RT (Group A). Sixty patients with left-sided (Group B) and 20 patients with right-sided breast cancer (Group C) were treated with RT only. Echocardiography with the analysis of cyclic variation of the integrated backscatter of the septum (sCV) and the posterior wall (pCV) and global longitudinal strain (GLS) were performed. Results Group A patients had a sCV decline from baseline to after CT, after RT and at 3Y by 1.2 ± 3.4 dB (p = 0.146), 2.6 ± 3.9 dB (p = 0.010) and 4.1 ± 5.4 dB (p = 0.011), and GLS decline by 0.9 ± 1.7 % (p = 0.027), 0.1 ± 2.4 % (p = 0.848), and 0.9 ± 2.9 % (p = 0.124), respectively. Group B displayed sCV changes after RT by 1.4 ± 3.5 dB (p = 0.007) and at 3Y by 2.4 ± 3.2 dB (p < 0.001) and the respective GLS changes were 1.1 ± 2.7 % (p = 0.003) and 1.7 ± 3.5 % (p = 0.001). sCV changes in Group C were 1.3 ± 3.9 dB (p = 0.159) after RT and 2.0 ± 4.1 dB (p = 0.049) at 3Y whereas GLS remained stable. A late decline in pCV was observed in all groups. In the whole patient population, sCV decline was independently associated with the mean LAD dose (p = 0.023, β= -0.251), CT (p = 0.044, β= -0.240) and with the use of aromatase inhibitor (AI) (p = 0.027, β=0.251). GLS impairment was independently associated with AI (p = 0.017, β= -0.281). Conclusions Radiation-exposed septal areas displayed a significant decline early after RT in Group A and B patients in contrast to posterior wall and patients with right-sided breast cancer. In addition, the changes were independently associated with the mean LAD radiation dose. GLS had no independent association with radiation dose . CV appears to be a more sensitive marker of radiotherapy-induced changes of the myocardial contractility than GLS.

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