scholarly journals Developing a Decision-Aid Website for Breast Cancer Surgery: An Action Research Approach (Preprint)

2018 ◽  
Author(s):  
Yu-Ting Hung ◽  
Ching-Fang Wu ◽  
Te-Hsin Liang ◽  
Shin-Shang Chou ◽  
Guan-Liang Chen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Action Research ◽  
Cancer Patients ◽  
Medical Information ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Research Approach ◽  
Breast Cancer Patients ◽  
Action Research Approach

BACKGROUND Patients with early-stage breast cancer have numerous options when choosing the type of breast surgery method to be applied. Each of these options lead to a similar long-term survival rate, but result in significant differences in appearance, function, cost, recurrence rate, and various other relevant considerations. However, the time available for detailed communication with each patient is often limited in clinics, which puts these women under great psychological stress and can hinder their surgery-related decision making. OBJECTIVE The objective of this study was to develop a multipurpose surgery decision-making website providing medical information, psychological support, and decision-related simulation for women during breast cancer surgery-related decision making. METHODS Using the 4 steps of action research, which involve multigroup teamwork via regular team meetings, the following were performed: (1) Planning: searching, analyzing, and evaluating health websites to consensually decide the major infrastructure; (2) Action: work was performed simultaneously in 4 groups, which consisted of medical information collection and editing, patient interviews and data extraction, webpage content design, and programming to create or host the website; (3) Evaluation: the website was tested by clinical experts and focus groups of former breast cancer patients to assess its effectiveness and pinpoint appropriate improvements; and (4) Reflection: constant dialogue was conducted between the various participants at each step, which was used as the foundation and motivation of next plan-action-evaluation-reflection circle. RESULTS Using the action research approach, we completed the development of our website, which includes the following: (1) “Woman’s Voice”—an animated comic depicting the story of a female breast cancer patient with interspersed questions for the users that will help them better empathize with the experience; (2) “Cancer Information Treasure House”—providing breast cancer surgery-related information through text, tables, pictures and a presentation video; (3) “Decision-making Simulator”—helping patients think through and check the pros and cons of the different surgical options via visual-based interactions including “Stairs Climbing” and “Fruit of Hope”; and (4) “Recommended Links”—providing reliable websites for further reference. Additionally, we have further improved the website based on the feedback received from postsurgery breast cancer patients and clinicians. We hope to continue improving to better meet both the patients’ and health providers’ needs and become a practical decision-making aid for patients undergoing breast cancer surgery. CONCLUSIONS We have created the first breast cancer surgery decision-making assistance tool in Taiwan using a “Web-based” and multifunctional website design. This site aims to provide health care knowledge, psychological healing, and emotional support functions, as well as decision-making capability enhancement simulations. We look forward to assisting breast cancer patients in their decision-making process and expect our website to increase patient’s autonomy and improve their communication with clinicians.

scholarly journals Developing a Decision-Aid Website for Breast Cancer Surgery: An Action Research Approach

10.2196/10404 ◽  
2019 ◽  
Vol 21 (2) ◽  
pp. e10404 ◽  
Author(s):  
Yu-Ting Hung ◽  
Ching-Fang Wu ◽  
Te-Hsin Liang ◽  
Shin-Shang Chou ◽  
Guan-Liang Chen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Action Research ◽  
Decision Aid ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Research Approach ◽  
Action Research Approach

scholarly journals Magnetic Seed (Magseed) Localisation in Breast Cancer Surgery: A Multicentre Clinical Trial

Breast Care ◽  
2020 ◽  
pp. 1-6
Author(s):  
Jan Žatecký ◽  
Otakar Kubala ◽  
Oldřich Coufal ◽  
Markéta Kepičová ◽  
Adéla Faridová ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Surgical Oncology ◽  
Breast Tumour ◽  
Axillary Node ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Breast Cancer Patients ◽  
Magnetic Marker ◽  
Magnetic Seeds

<b><i>Introduction:</i></b> The aim of this study was to evaluate the accuracy and reliability of the Magseed magnetic marker in breast cancer surgery. <b><i>Methods:</i></b> Thirty-nine patients with 41 implanted Magseeds undergoing surgical treatment in 3 surgical oncology departments were included in the retrospective trial to study pilot use of the Magseed magnetic marker in the Czech Republic for localisation of breast tumours or pathological axillary nodes in breast cancer patients. <b><i>Results:</i></b> Thirty-four breast cancer and 7 pathological lymph node localisations were performed by Magseed implantation. No placement failures, or perioperative detection failures of Magseeds were observed (0/41, 0.0%), but one case of Magseed migration was present (1/41, 2.4%). All magnetic seeds were successfully retrieved (41/41, 100.0%). Negative margins were achieved in 29 of 34 (85.3%) breast tumour localisations by Magseed. <b><i>Conclusion:</i></b> Magseed is a reliable marker for breast tumour and pathological axillary node localisation in breast cancer patients. Magseed is comparable to conventional localisation methods in terms of oncosurgical radicality and safety.

scholarly journals Developing a Web-Based Comic for Newly Diagnosed Women With Breast Cancer: An Action Research Approach (Preprint)

2018 ◽  
Author(s):  
Tzu-I Lee ◽  
Shuh-Jen Sheu ◽  
Hsueh-Chin Chang ◽  
Yu-Ting Hung ◽  
Ling-Ming Tseng ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Action Research ◽  
Cancer Treatment ◽  
Diagnostic Process ◽  
Research Approach ◽  
Newly Diagnosed ◽  
Web Based ◽  
Action Research Approach ◽  
The Web

BACKGROUND Personal narratives have been seen as a useful way of communicating about cancer treatment options and providing recovery information. Many printed versions of such material are available, including comics that explore the individual memories of patients who have gone through cancer treatment. These studies have been used to orientate patients, patients’ relatives, and physicians. However, only a few Web-based comics have been specifically designed for patients with breast cancer and used as aids to decision making. OBJECTIVE We aimed to describe the developmental process of creating an animated comic as a Web-based surgery decision-making tool; the comic was aimed at illustrating the feelings, thoughts, and meanings when a patient suffers from breast cancer. This was done by recounting the symptoms, diagnostic process, treatments, and treatment effects of such women from the diagnosis stage onward. METHODS Using cycles of planning, action, evaluation, and reflection, which involved collaborative work, action research was conducted to develop a Web-based animated comic. The stages of action research consisted of (1) semistructured and in-depth interviews to collect experiences of women with breast cancer; (2) construction of an animated comic by editors, graphics designers, dubbers, and information technology engineers; (3) redrawing of pictures of the comic after gathering feedback from a breast surgeon; and (4) evaluation of the Web-based animated comic using 6 patient focus groups. RESULTS The comic was produced and showcased on the website “The Network of Making-decision Aids for Breast Cancer Surgery”; the comic was accompanied by soft music and audio explanations. The comic functions as a personal statement that describes experiencing breast cancer. The animated comic consists of 8 chapters, based on the 8 themes deducted from the findings obtained during the analysis of relevant interviews. The 8 chapters include (1) the appearance of a lump; (2) confirmation by medical diagnosis; (3) the uncertainty of waiting (4) fear of life-threatening disease; (5) choosing life over despair; (6) being brave and deciding to undergo treatment; (7) choosing the type of surgery; and (8) being reborn. CONCLUSIONS Using action research, this study illustrated that the comic that sheds light on issues of feelings, emotions, and thoughts that are present when a woman is diagnosed with breast cancer and provides a communication medium to explain the steps in the process. Meanwhile, it implies that hope will be able to overcome the challenges that will be faced. Within the Web-based decision aid for patients with breast cancer, the animated comic acts as an information resource and is aimed at patients’ understanding of impacts of emotions arising when suffering from breast cancer. It is potentially applicable as a therapeutic tool that facilitates self-reflection and self-healing among newly diagnosed patients with breast cancer.

scholarly journals Resection or Preservation? A Tough Surgical Decision for Chinese Breast Cancer Patients Who Are in Line with Breast Conserving

2021 ◽  
Author(s):  
Pingting Zhu ◽  
Qiaoying Ji ◽  
Xinyi Liu ◽  
Ting Xu ◽  
Qiwei Wu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Cancer Patients ◽  
Chinese Culture ◽  
Breast Conservation ◽  
Breast Cancer Surgery ◽  
Oncologic Outcomes ◽  
Breast Cancer Patients ◽  
Surgical Decision ◽  
Colaizzi's Method

Abstract Purpose Breast cancer patients who are in line with breast conserving are faced more challenges in making surgery decision, because breast conservation and mastectomy have equivalent oncologic outcomes. The purpose of this study is to analyze the surgical decision-making process for breast cancer patients and further explore the reasons why do Chinese women who are in line with breast conserving are more likely to choose mastectomy. Methods A qualitative study was conducted. With the sample saturation principle, data collected by semi-structured interviews with 14 breast cancer patients who are in line with breast conserving. Colaizzi’s method of phenomenology was used for data analysis. Results Three major themes emerged from the data. The themes were the following: (1) lack of significant decision-making support (stereotyping of breast cancer surgery, Inferior quality of interaction with health professions, and without the help of decision aids); (2) can’t mull under the strike (immediacy of the decision, breasts are out of deliberating, and escape); and (3) edified by the Chinese culture (deep family values, hiding concerns about femininity, and conservative character). Conclusions Our findings explore the reasons why more Chinese breast cancer patients with breast conserving conditions choose mastectomy, and help patients to choose knowledge-based treatment options which are concordant with their needs, values, and preferences.

Breast cancer surgery during pregnancy.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 1127-1127
Author(s):  
Rakesh Surapaneni ◽  
Jolanta Jozefara ◽  
Karen Hendershott ◽  
Krystal Hunter ◽  
Elyce Cardonick
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Breast Conserving Surgery ◽  
Lymph Node Biopsy ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Breast Cancer Patients ◽  
Node Biopsy ◽  
Significant Difference ◽  
Mastectomy Group

1127 Background: There is limited literature on breast surgery during pregnancy. We present prospective registry data on 88 breast cancer patients who underwent breast cancer surgery during pregnancy. Methods: The Cancer and Pregnancy Registry is a voluntary international registry that prospectively collects the clinical course, treatment, and disease outcome of women diagnosed with cancer during pregnancy and the perinatal and neonatal outcomes of their children. Results: We identified 88 patients who were diagnosed with breast cancer and had surgery while pregnant. 59 patients (67%) underwent Mastectomy while29 patients (32%) underwent breast conserving surgery (BCS). Out of 43 patients who underwent BCS as their first surgery 13 patients (30.23%) required subsequent mastectomy during pregnancy. 15 patients (34.88%) from the BCS group and 4 patients (8.69%) from the Mastectomy group had positive margins. There was no significant difference between patients who underwent mastectomy vs BCS based on Age (34.67 vs 34.72 P: 0.97), gestational age at surgery (14.05 vs 16.06 P: 0.23) or ER positivity (47.5% vs 46.4% P: 0.93). 2 patients had neo-adjuvant chemotherapy. 17 patients (19.31%) had sentinel lymph node biopsy. 37 patients (42%) had a pregnancy complication. There was no difference in the rate of complication based on mastectomy vs BCS(45.8% vs 34.5% P: 0.31). There was only 1 patient (from mastectomy group) that delivered within 2 weeks of surgery. Of the 17 patients (19.3%) with spontaneous preterm delivery, there was no difference between Mastectomy and BCS group (22% vs 13.2% P: 0.41). Of the 25 patients (28.4%) with birth complications, there was no significant difference between mastectomy vs BCS (30.5% vs 24.1% P: 0.53). There was also no difference in mean birth weight between the groups (2598 grams vs 2672.3 grams P: 0.57). Conclusions: The data supports the safety of breast cancer surgery during pregnancy. In addition, there were no identified adverse effects in patients who underwent BCS as opposed to mastectomy. Of note, only 19% of patients underwent sentinel node biopsy which is considered the standard of care in early breast cancer patients regardless of pregnancy status.

Genetic variability of tramadol pharmacokinetic genes and pain treatment outcome after breast cancer surgery.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e23133-e23133
Author(s):  
Nikola Besic ◽  
Katja Goricar ◽  
Jakob Jeriha ◽  
Vita Dolzan ◽  
Branka Strazisar
Keyword(s):  
Breast Cancer ◽  
Genetic Variability ◽  
Cancer Patients ◽  
Pain Treatment ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
Node Dissection ◽  
One Year

e23133 Background: Tramadol is a treatment of choice for pain management after axillary lymph node dissection in breast cancer patients. Tramadol is metabolized via CYP2D6 and UGT2B7, while ABCB1, ABCC2 and SLC22A1 are involved in transport of tramadol metabolites. Genetic variability of metabolizing enzymes or drug transporters may therefore affect efficacy and adverse effects of tramadol. The aim of this study was to evaluate the association of genetic variability in tramadol pharmacokinetics pathway on long-term outcome of tramadol pain treatment after breast cancer surgery. Methods: The study included 102 breast cancer patients treated with either 75 or 37.5 mg of tramadol for pain relief after breast cancer surgery including axillary lymph node dissection as part of a randomized clinical trial KCT 04/2015-DORETAonko/si at Institute of Oncology Ljubljana. All patients were genotyped for 14 polymorphisms in ABCB1, ABCC2, CYP2D6, SLC22A1 and UGT2B7 genes, as well as for CYP2D6 duplication and deletion. CYP2D6 phenotype was predicted from the genotype data and patients were categorized as poor (PM), intermediate, extensive or ultrarapid metabolizers. The association of genetic factors with pain one year after treatment was evaluated using logistic regression and Mann-Whitney test. Results: One year after treatment, 21 (20.8%) patients were still experiencing chronic and 25 (24.8%) neuropathic pain. CYP2D6 PMs were significantly more likely to experience chronic and neuropathic pain after tramadol treatment (OR = 5.96, 95% CI = 1.22-29.13, p = 0.027 and OR = 9.31, 95% CI = 1.65-50.59, p = 0.011, respectively), even after adjustment for tramadol dose (p = 0.032 and p = 0.016, respectively). PMs also had higher average pain intensity compared to others regardless of tramadol dose (p = 0.042). In patients receiving lower tramadol dose, ABCB1 rs1128503, rs2032582 and rs1045642 were associated with more chronic pain in the dominant model (p = 0.004, p = 0.004 and p = 0.047, respectively). Conclusions: Genetic variability in tramadol pharmacokinetics pathway may be associated with pain treatment outcome in breast cancer patients, therefore pharmacogenetic testing could enable more effective tramadol treatment. Clinical trial information: EudraCT 2015-000992-28.

scholarly journals Surgical Site Infections in Breast Cancer Patients Undergoing Surgery During the Covid-19 Pandemic. Preliminary Data from an Italian Oncologic Hub.

2021 ◽  
Author(s):  
Sonia Cappelli ◽  
Fabio Pelle ◽  
Marco Clementi ◽  
Maddalena Barba ◽  
Patrizia Vici ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Median Time ◽  
Breast Surgery ◽  
Surgical Site Infections ◽  
Final Analysis ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Breast Cancer Patients ◽  
Intrinsic Nature

Abstract Background: Over the Covid-19 pandemic, the compelling need of containing the virus spread while providing diseased people with adequate assistance has inevitably reflected on treatment priorities, which have been sometimes radically revised according to the intrinsic nature of the institution considered and its role and action within the pandemic context. We report on the experience matured at the Regina Elena National Cancer Institute concerning the effects of the restriction measures adopted during the pandemic on the outcomes of surgical site infections (SSIs) in breast cancer patients (BC-pts) undergoing non-deferrable breast cancer surgery. Methods: Within the frame of an observational study, we compared evidence from two cohorts, namely, the lockdown cohort (LDC) and non-lockdown cohort (NLDC). Patients from the LDC underwent breast cancer surgery between the 15th March 2020 and the 4th May 2020. Breast surgery was performed by the same team and postsurgical controls were performed regularly for a minimum of 12-months. SSIs were defined according to the criteria established by the Center for Disease Control and Prevention. Results: The LDC originally included 79 breast cancer patients, of whom 62 provided data to the final analysis. In the LDC, initially 64 breast cancer patients, only 52 were finally considered. No relevant differences emerged between LDC and NLDC by general characteristics. We observed significant evidence of lower SSIs in the subgroups of patients having undergone skin reducing mastectomy compared with the remaining subgroups (p=0.003). The overall number of surgical site infections was 10 (8.7%), and the median time to their occurrence17.1 days (7- 42). In the NLDC, 7 (13.5) SSIs were identified, with a median time to occurrence of 18.2 days (7-42). In the LDC, 3 (4.8%) SSIs occurred, with a median time to occurrence of 14.3 days (7 to 21). None of these patients was in need of re-hospitalization and there were no delays in adjuvant treatment starting. Conclusions: The restrictive measures issued during the lockdown period seemed to lower the SSI rates in breast cancer patients undergoing non-deferrable breast surgery, although, caution is needed due to the limited sample size.

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