scholarly journals What Really Matters for Returning to Work After Breast Cancer? A 6-month Longitudinal Study and a Multidimensional Approach

2022 ◽  
Author(s):  
Elena Fiabane ◽  
Paola Dordoni ◽  
Cecilia Perrone ◽  
Antonio Bernardo ◽  
Fabio Corsi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Return To Work ◽  
Psychological Resilience ◽  
Related Data ◽  
Work Related ◽  
Returning To Work ◽  
Baseline Factors

Abstract Purpose. Return to work (RTW) after breast cancer (BC) may easily impact on women recovery and quality of life. Literature on RTW hightlighed several factors associated to RTW after BC, and there is still some concern for exploring the main sociodemographic, clinical, psychological and work-related predictors of RTW after BC treatments especially when considering the first 6 months. The present study aims to explore which baseline factors are associated with RTW at 6-month after BC surgery. Methods. A 6-month follow-up study was performed among patients recruited from a Hospital in Northern Italy after their cancer-related surgery. Partecipants filled in a battery of questionnaires at baseline and at 6-month follow-up. Measurements were on job stress, work engagement, quality of life, anxiety, depression and resilience. Moreover, sociodemographic, clinical and work-related data were collected. Univariate and multivariate analyses were performed. Results. We recruited a sample of 149 patients, whose 73.9% returned to work after surgery. The women who returned to work were more likely to be not in a relationship, nor to have children. Also, they were not treated by chemiotherapy, and had higher scores in expectations of job changes after illness, RTW expectations, perception of physical quality of life and psychological resilience. In the multivariate model, chemiotherapy and women’s RTW expectations resulted as significant predictors of RTW at 6-month after BC surgery. Conclusion Most patients returned to work within first 6 months from breast surgery. Return to work was influenced by chemiotherapy and RTW expectations at baseline. A carefully individual screening of risk factors at baseline can prevent from occupational disability and long sickness absence.

scholarly journals Breast reconstruction after breast cancer surgery – persistent pain and quality of life 1–8 years after breast reconstruction

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Nina Honkanen ◽  
Laura Mustonen ◽  
Eija Kalso ◽  
Tuomo Meretoja ◽  
Hanna Harno
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Breast Reconstruction ◽  
Perforator Flap ◽  
Persistent Pain ◽  
Rectus Abdominis ◽  
Preoperative Pain ◽  
Significant Difference

Abstract Objectives To assess the long-term outcome of breast reconstructions with special focus on chronic postsurgical pain (CPSP) in a larger cohort of breast cancer survivors. Methods A cross-sectional study on 121 women with mastectomy and breast reconstruction after mean 2 years 4 months follow up. The mean time from breast reconstruction to the follow-up visit was 4 years 2 months. We studied surveys on pain (Brief Pain Inventory, BPI and Douleur Neuropathique 4, DN4), quality of life (RAND-36 health survey), sleep (insomnia severity questionnaire, ISI), mood (Beck’s Depression Index, BDI; Hospital Anxiety and Depression Scale, HADS), and a detailed clinical sensory status. Patients were divided into three groups: abdominal flap (Deep inferior epigastric perforator flap, DIEP; Free transverse rectus abdominis flap, fTRAM, and Pedicled transverse rectus abdominis flap, pTRAM), dorsal flap (Latissimus dorsi flap, LD and Thoracodorsal artery perforator flap, TDAP), and other (Transverse myocutaneous gracilis flap, TMG; implant). Clinically meaningful pain was defined ≥ 4/10 on a numeric rating scale (NRS). We used patients’ pain drawings to localize the pain. We assessed preoperative pain NRS from previous data. Results 106 (87.6%) of the patients did not have clinically meaningful persistent pain. We found no statistically significant difference between different reconstruction types with regards to persistent pain (p=0.40), mood (BDI-II, p=0.41 and HADS A, p=0.54) or sleep (p=0.14), respectively. Preoperative pain prior to breast reconstruction surgery correlated strongly with moderate or severe CPSP. Conclusions Moderate to severe CPSP intensity was present in 14% of patients. We found no significant difference in the prevalence of pain across different reconstruction types. Preoperative pain associated significantly with postoperative persistent pain.

Significance of patient-reported outcomes for occupational resumption and quality of life after cardiac rehabilitation

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Salzwedel ◽  
I Koran ◽  
E Langheim ◽  
A Schlitt ◽  
J Nothroff ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Performance ◽  
Well Being ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Funding Source ◽  
Patient Reported ◽  
Returning To Work

Abstract Introduction Comprehensive cardiac rehabilitation (CR) programs based on the bio-psycho-social approach of the international classification of functioning and disease are carried out to achieve improved prognosis, superior health-related quality of life (HRQL) and social integration. We aimed to identify predictors of returning to work (RTW) and HRQL among cardiovascular risk factors and physical performance as well as patient-reported outcome measures (PROMs) modifiable during CR. Methods We designed a prospective observational multi-center study and enrolled 1,586 patients (2017/18) in 12 German rehabilitation centers regardless of their primary allocation diagnoses (e.g. acute myocardial infarction (AMI), coronary artery bypass grafting (CABG), coronary artery disease (CAD), valvular disease). Besides general data (e.g. age, gender, diagnoses), parameters of risk factor management (e.g. smoking, lipid profile, hypertension, lifestyle change motivation), physical performance (e.g. maximum exercise capacity, endurance training load, 6-min walking distance), and PROMs (e.g. depression, heart-focused anxiety, HRQL, subjective well-being, somatic and mental health, pain, general self-efficacy, pension desire as well as self-assessment of occupational prognosis using several questionnaires) were documented at CR admission and discharge. 6 months after discharge, status of RTW and HRQL (SF-12) were captured by a follow-up (FU) survey and analyzed in multivariable regression models with multiple imputation of missing values. Results Out of the study participants, 1,262 patients (54±7 years, 77% men) responded to the follow-up survey and could be analyzed regarding the outcome parameters. Most of them were assigned to CR primarily due to AMI (40%) or CAD without myocardial infarction (18%), followed by heart valve diseases in 12% of patients and CABG (8%). 864 patients (69%) returned to work within the follow-up period. Pension desire, negative self-assessed occupational prognosis, heart-focussed anxiety, major life events, smoking and heart failure were negatively associated with RTW, while higher endurance training load, HRQL and work stress were positively associated (Figure 1). HRQL after 6 months was determined more by PROMs (e.g. pension desire, heart-focused anxiety, physical/mental HRQL in SF-12, physical/mental health in indicators of rehab-status questionnaire (IRES-24), stress, well-being in the World Health Organization well-being index and self-efficacy expectations) than by clinical parameters or physical performance. Conclusions Patient-reported outcome measures predominantly influenced RTW and HRQL in heart-disease patients, whereas patients' pension desire and heart-focussed anxiety had a dominant impact on all investigated endpoints. Therefore, the multi-component CR approach focussing on psychosocial support is crucial for subjective health prognosis and occupational resumption. Figure 1. Predictors of returning to work Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): German pension insurance

scholarly journals The impact of hyperbaric oxygen therapy on late radiation toxicity and quality of life in breast cancer patients

2021 ◽  
Author(s):  
Marilot C. T. Batenburg ◽  
Wies Maarse ◽  
Femke van der Leij ◽  
Inge O. Baas ◽  
Onno Boonstra ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Side Effects ◽  
Cancer Patients ◽  
Oxygen Therapy ◽  
Radiation Toxicity ◽  
Breast Pain ◽  
Breast Cancer Patients

Abstract Purpose To evaluate symptoms of late radiation toxicity, side effects, and quality of life in breast cancer patients treated with hyperbaric oxygen therapy (HBOT). Methods For this cohort study breast cancer patients treated with HBOT in 5 Dutch facilities were eligible for inclusion. Breast cancer patients with late radiation toxicity treated with ≥ 20 HBOT sessions from 2015 to 2019 were included. Breast and arm symptoms, pain, and quality of life were assessed by means of the EORTC QLQ-C30 and -BR23 before, immediately after, and 3 months after HBOT on a scale of 0–100. Determinants associated with persistent breast pain after HBOT were assessed. Results 1005/1280 patients were included for analysis. Pain scores decreased significantly from 43.4 before HBOT to 29.7 after 3 months (p < 0.001). Breast symptoms decreased significantly from 44.6 at baseline to 28.9 at 3 months follow-up (p < 0.001) and arm symptoms decreased significantly from 38.2 at baseline to 27.4 at 3 months follow-up (p < 0.001). All quality of life domains improved at the end of HBOT and after 3 months follow-up in comparison to baseline scores. Most prevalent side effects of HBOT were myopia (any grade, n = 576, 57.3%) and mild barotrauma (n = 179, 17.8%). Moderate/severe side effects were reported in 3.2% (n = 32) of the patients. Active smoking during HBOT and shorter time (i.e., median 17.5 vs. 22.0 months) since radiotherapy were associated with persistent breast pain after HBOT. Conclusion Breast cancer patients with late radiation toxicity reported reduced pain, breast and arm symptoms, and improved quality of life following treatment with HBOT.

scholarly journals Determination of the Influence of Peripheral Neuropathy Symptoms on Quality of Life in Breast Cancer Patients Receiving Paclitaxel: Prospective Cross Sectional Study With Four Follow-ups

2021 ◽  
Author(s):  
BERNA KURT ◽  
ZEYNEP SİPAHİ KARSLI ◽  
BERNA ÖMÜR ÇAKMAK ÖKSÜZOĞLU ◽  
EMİNE ÖZTÜRK ◽  
NESLİHAN DEMİRÖRS ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Peripheral Neuropathy ◽  
Assessment Tool ◽  
Life Questionnaire ◽  
Breast Cancer Patients ◽  
Cross Sectional ◽  
Quality Of Life Questionnaire

Abstract Background The objective of this study is to evaluate the impact of peripheral neuropathy on the quality of life of breast cancer patients throughout with monthly follow-up during 4 months of paclitaxel treatment.Material and methods The research was conducted with a prospective cross sectional with four follow-ups descriptive design. The study population consisted of female patients with breast cancer at Ankara Oncology Training and Research Hospital between August 2018 and January 2019. Data were collected the ‘’Patient Information Form’’,‘’EORTC C30 Cancer Quality Of Life Questionnaire’’ and ‘’Chemotherapy-Induced Peripheral Neuropathy Assessment Tool’’. The study was undertaken in accordance with the STROBE checklist for cross-sectional studies. Results Of 79 patients included in the Chemotherapy-Induced Peripheral Neuropathy Assessment Tool except for the general activity subdimension were statistically significant in the ratings of 2nd, compared to 1st; 3rd compared to 1st and 2nd; 4th compared to 1st, 2nd, and 3rd follow-up periods. The overall mean of EORTC C30 Cancer Quality of Life Questionnaire, functional subdimension, symptom severity, and general well-being in the evaluations of 2nd, compared with 1st; 3rd compared with 1st and 2nd; 4th compared with 1st, 2nd, and 3rd follow-up periods it was found that the mean values of symptom that decreased gradually were statistically significant.Conclusion The neuropathy scale was found to be higher in 2nd, 3rd, 4th follow-up periods than in 1st follow-up. Also, EORTC C30 Cancer QLQ subdimensions were high initially but gradually decreased after the fourth cycle. Thus, it was found that the increase in neuropathy symptoms negatively affects the quality of life.

scholarly journals Is quality of life after mastectomy comparable to that after breast conservation surgery? A 5-year follow up study from Mumbai, India

2019 ◽  
Vol 29 (3) ◽  
pp. 683-692
Author(s):  
K. V. Deepa ◽  
A. Gadgil ◽  
Jenny Löfgren ◽  
S. Mehare ◽  
Prashant Bhandarkar ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Breast Conservation ◽  
Radical Mastectomy ◽  
Breast Conservation Surgery ◽  
Breast Cancer Surgery ◽  
Significant Difference ◽  
Domain Scores

Abstract Purpose Breast cancer is the commonest cancer in women worldwide. Surgery is a central part of the treatment. Modified radical mastectomy (MRM) is often replaced by breast conserving therapy (BCT) in high-income countries. MRM is still the standard choice, in low- and middle-income countries (LMICs) as radiotherapy, a mandatory component of BCT is not widely available. It is important to understand whether quality of life (QOL) after MRM is comparable to that after BCT. This has not been studied well in LMICs. We present, 5-year follow-up of QOL scores in breast cancer patients from India. Methods We interviewed women undergoing breast cancer surgery preoperatively, at 6 months after surgery, and at 1 year and 5 years, postoperatively. QOL scores were evaluated using FACT B questionnaire. Average QOL scores of women undergoing BCT were compared with those undergoing MRM. Total scores, domain scores and trends of scores over time were analyzed. Results We interviewed 54 women with a mean age of 53 years (SD 9 ± years). QOL scores in all the women, dipped during the treatment period, in all subscales but improved thereafter and even surpassed the baseline in physical, emotional and breast-specific domains (p < 0.05) at 5 years. At the end of 5 years, there was no statistically significant difference between the MRM and BCT groups in any of the total or domain scores. Conclusion QOL scores in Indian women did not differ significantly between MRM and BCT in the long term. Both options are acceptable in the study setting.

Quality of life, fatigue and changes therein as predictors of return to work during breast cancer treatment

2019 ◽  
Vol 33 (2) ◽  
pp. 467-477 ◽  
Author(s):  
Bertrand Porro ◽  
Aude Michel ◽  
Cécile Zinzindohoué ◽  
Pierre Bertrand ◽  
Emilie Monrigal ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Return To Work ◽  
Cancer Treatment ◽  
Breast Cancer Treatment
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