Estimating the weighted prevalence of anxiety disorders in breast cancer patients using a Two-stage approach

Background: A two-stage survey is useful when the actual diagnostic interview is time-consuming and expensive to administer on the general population. Objective: To compare Schedule for Clinical Assessment in Neuropsychiatry (SCAN) with Hospital Anxiety and Depression Scale (HADS) in the determination of the prevalence of anxiety disorder in patients with breast cancer. Methods: A cross-sectional study of 200 female patients diagnosed with breast cancer attending the Oncology Out-Patients Clinic of the Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria was done. The instruments used for the survey included a socio-demographic questionnaire, the HADS and the SCAN. Results: The mean age of the subjects was 49.6 ± 11.2 years. Majority of the subjects (76.5%) were married. Using HADS with a threshold score of ≥ 8, 53 (26.5%) met the criteria for probable anxiety disorders (herein called ‘cases’). Of the 68 patients (all 53 ‘cases’ plus 15 randomly selected 10% of the non-cases) interviewed with the SCAN instrument, only 38 met the criteria for diagnosis of anxiety disorder. Conclusions: The prevalence of anxiety disorders can be determined with greater precision using the two-stage design approach. Diagnostic tools like SCAN should therefore be incorporated in the assessment protocols for patients with breast cancer and other illnesses.

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Evaluation of BRCA1 and BRCA2 Protein Dysfunction in Breast Cancer Cells among Women in Osun State, Southwest Nigeria

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqaa161.259 ◽

2020 ◽

Vol 154 (Supplement_1) ◽

pp. S118-S119

Author(s):

S Iyiola ◽

A Komolafe ◽

A Samuel ◽

J A Onifade ◽

I Enweani ◽

...

Keyword(s):

Breast Cancer ◽

University Teaching ◽

Teaching Hospitals ◽

Breast Cancers ◽

Breast Cancer Patients ◽

Brca1 And Brca2 ◽

Cross Sectional ◽

Brca2 Protein ◽

Brca 1 ◽

Brca 2

Abstract Introduction/Objective Breast cancer among Nigeria women had been found to occur at a much younger age compared with their Caucasian age groups. BRCA1 and BRCA2 were suspected to responsible for breast cancers at a young age, therefore this work examined the BRCA1 and BRCA2 dysfunction among women suffering from breast cancer in Osun State, Nigeria. Methods This cross-sectional study was carried out at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife and Ladoke Akintola University Teaching Hospital, Osogbo, Nigeria. The request cards and tissue blocks were sorted from the year 2014 to 2017. The breast tissue blocks were sectioned, stained with H&E. A representative tissue block was selected for each patient. Sections obtained from the blocks were stained with BRCA 1 and BRCA 2 antibody using a diaminobenzidine horseradish peroxidase technique. The cells were semi-quantitatively scored as percentage of tumour cells stained brown. Score 0-5% were taken as negative as proposed by Karuna et al., 2013. The value obtained was tabulated against the age of the patient. Results Out of 240 breast cancer patients sampled 16(6.7%), 32(13.3%), 85(35.4%), 43(17.9%), 64(26.7%) patients were between ages 21-30, 31-40, 41-50, 51-60 and 60+ years respectively. 54(22.5%) showed loss of BRCA 1 staining with only 1(0.4%) patient between age 21-40 years while 18(7.5%), 16(6.67), 19(7.9) patients between age 41-50, 51-60 and 60+ years respectively. 82(34.2%) showed loss of BRCA 2 staining; 7(2.9%), 12(5%), 31(12.9%), 15(6.25%),17(5.8%) patients for age between 21-30, 31-40, 41-50, 51-60 and 60+ years respectively. Among women aged 50 years and below, BRCA 1 and BRCA 2 dysfunctions were responsible for 14.3% and 37.6% of breast cancers respectively. Conclusion Increase in age increases the rate of BRCA 1 dysfunction while BRCA 2 dysfunction is not more associated to with any age. BRCA1 and BRCA2 are responsible for more than thirty percent of breast cancers among women less than 50 years of age in Osun state.

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Trajectory of cognitive impairment during breast cancer treatment: A prospective analysis

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.8500 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 8500-8500 ◽

Cited By ~ 5

Author(s):

L. I. Wagner ◽

J. J. Sweet ◽

Z. Butt ◽

J. Beaumont ◽

K. A. Havlin ◽

...

Keyword(s):

Breast Cancer ◽

Working Memory ◽

Cognitive Impairment ◽

Cancer Patients ◽

Depression Scale ◽

Attention Problems ◽

Breast Cancer Patients ◽

Cross Sectional ◽

Scale Scores

8500 Background: Several studies havedocumented cognitive impairment in cancer patients; however these reports are primarily based on cross-sectional comparisons. Prospective evaluation would better elucidate the onset and course of cognitive dysfunction related to chemotherapy. Methods: Of 72 breast cancer patients enrolled, 51 completed a comprehensive neuropsychological battery before chemotherapy (T1), on Day 1 of Cycle 4 (T2), and at 6-month follow-up (T3). Participants scoring ≥ 1 SD below the normative mean on ≥ 3 neuropsychological tests OR ≥ 2 SD below on 1 test were classified as impaired. Reliable change indices (RCI) conservatively estimated significant change over time. Results: Participants were White (70.6%) females (96.1%) with a mean of 15.9 ± 2.3 years of education. Mean age was 51.6 ± 8.6 years and most had Stage II (78%) or Stage III (16%) disease. Hospital Anxiety and Depression Scale scores were in the normal range at all assessments and were unrelated to T1 cognitive impairment. Consistent with previous research, 9 (17.6%) of patients met criteria for cognitive impairment at T1. By T2, 14 (27.4%) were cognitively impaired; however, at T3 follow up only 5 (9.8%) were impaired. As noted in the table, most impairment occurs during chemotherapy. Among patients not impaired before chemotherapy it was uncommon for impairment at T2 to persist at follow-up. Conclusions: Some breast cancer patients indeed develop cognitive impairment during treatment, much of which appears to resolve at 6 months. Domains most affected include attention, visuospatial skills, and working memory. Attention problems resolved by 6 months, while working memory and visuospatial deficits persisted. [Table: see text] No significant financial relationships to disclose.

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Delusion-like experiences in older people with anxiety disorders

International Psychogeriatrics ◽

10.1017/s1041610215000113 ◽

2015 ◽

Vol 27 (7) ◽

pp. 1191-1196 ◽

Cited By ~ 2

Author(s):

Gerard J. Byrne ◽

Sarah J. Steele ◽

Nancy A. Pachana

Keyword(s):

Logistic Regression ◽

Anxiety Disorder ◽

Anxiety Disorders ◽

Older People ◽

Composite International Diagnostic Interview ◽

Well Being ◽

Cross Sectional Study ◽

Diagnostic Interview ◽

Cross Sectional ◽

National Probability Sample

ABSTRACTBackground:Little is known about the occurrence of psychotic or quasi-psychotic experiences in older people with anxiety disorders.Methods:We used a cross-sectional national probability sample of community-residing individuals to investigate the prevalence and correlates of delusion-like experiences in older people with DSM-IV anxiety disorders. The 2007 Australian National Survey of Mental Health and Well-being (NSMHWB) included 1,905 persons between the ages of 65 and 85 years. Anxiety disorder diagnoses were established using the Composite International Diagnostic Interview (CIDI v3). Participants were asked about three types of delusion-like experiences: thought control or interference, special meaning, and special powers. We used multivariate logistic regression to examine the relationship between a 12-month history of any anxiety disorder and the presence of these delusion-like experiences, adjusting for several potential confounders.Results:Eighty-two of 1,905 (4.3%) older people met criteria for an anxiety disorder over the previous 12 months. Of these, six reported delusion-like experiences, whereas the prevalence of these experiences among older people without anxiety disorder was 26/1,822 (7.3% vs. 1.4%; χ2 = 16.5; p = 0.000). In a logistic regression model, male gender (OR 0.38; p = 0.019), separated marital status (OR 4.86; p = 0.017), and the presence of anxiety disorder (OR 5.33; p = 0.001) were independently associated with delusion-like experiences, whereas MMSE (Mini-Mental State Examination) score, general medical conditions and affective disorder were not.Conclusions:In this cross-sectional study, self-reported delusion-like experiences occurred at increased prevalence among community-residing older persons with anxiety disorder. More work is needed to clarify the nature and significance of these findings.

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(Ex-)breast cancer patients with (pre-existing) symptoms of anxiety and/or depression experience higher barriers to contact health care providers during the COVID-19 pandemic

Breast Cancer Research and Treatment ◽

10.1007/s10549-021-06112-y ◽

2021 ◽

Author(s):

Dieuwke R. Mink van der Molen ◽

◽

Claudia A. Bargon ◽

Marilot C. T. Batenburg ◽

Roxanne Gal ◽

...

Keyword(s):

Breast Cancer ◽

Health Care ◽

Cancer Patients ◽

Health Care Providers ◽

Access To Health Care ◽

Depression Scale ◽

Current Treatment ◽

Care Providers ◽

Breast Cancer Patients ◽

Cross Sectional

Abstract Purpose To identify factors associated with (perceived) access to health care among (ex-)breast cancer patients during the COVID-19 pandemic. Methods Cross-sectional study within a large prospective, multicenter cohort of (ex-)breast cancer patients, i.e., UMBRELLA. All participants enrolled in the UMBRELLA cohort between October 2013 and April 2020 were sent a COVID-19-specific survey, including the Hospital Anxiety and Depression Scale (HADS) questionnaire. Results In total, 1051 (66.0%) participants completed the survey. During COVID-19, 284 (27.0%) participants reported clinically relevant increased levels of anxiety and/or depression, i.e., total HADS score ≥ 12. Participants with anxiety and/or depression reported statistically significant higher barriers to contact their general practitioner (47.5% vs. 25.0%, resp.) and breast cancer physicians (26.8% vs. 11.2%, resp.) compared to participants without these symptoms. In addition, a higher proportion of participants with anxiety and/or depression reported that their current treatment or (after)care was affected by COVID-19 compared to those without these symptoms (32.7% vs. 20.5%, resp.). Factors independently associated with symptoms of anxiety and/or depression during COVID-19 were pre-existent anxiety (OR 6.1, 95% CI 4.1–9.2) or depression (OR 6.0, 95% CI 3.5–10.2). Conclusion During the COVID-19 pandemic, (ex-)breast cancer patients with symptoms of anxiety and/or depression experience higher barriers to contact health care providers. Also, they more often report that their health care was affected by COVID-19. Risk factors for anxiety and/or depression during COVID-19 are pre-existent symptoms of anxiety or depression. Extra attention—including mental health support—is needed for this group.

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Hair Loss Prevention by a Scalp Cooling Device in Early Breast Cancer Patients: The Poliambulanza Preliminary Experience

Reviews on Recent Clinical Trials ◽

10.2174/1574887113666181120111104 ◽

2019 ◽

Vol 14 (1) ◽

pp. 66-71 ◽

Cited By ~ 2

Author(s):

Tiziana Prochilo ◽

Alessandra Huscher ◽

Federica Andreis ◽

Mara Mirandola ◽

Elisabetta Zaina ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Hair Loss ◽

Depression Scale ◽

Hair Follicles ◽

Common Side Effect ◽

Scalp Cooling ◽

Breast Cancer Patients ◽

Cooling Device ◽

End Of Treatment

Background: The most effective agents in the treatment of breast cancer have a common side effect, the hair loss. Some studies reported a reduction of hair loss with the use of the scalp cooling device. Indeed, it decreases the drug accumulation in the hair follicles. We report our preliminary experience with a scalp cooling device in reducing chemotherapy-induced alopecia and related distress in breast cancer patients undergoing adjuvant chemotherapy. </P><P> Methods: Hair loss grading and treatment tolerability were evaluated during chemotherapy every 21 days and 3 weeks after the last cycle of chemotherapy via Dean’s scale by patients and operators and a comfort analogic scale by patients. We administered the Hospital Anxiety and Depression Scale questionnaire at the baseline and at the end of treatment to assess the distress related to chemotherapy- induced alopecia. Results: Among the 46 patients identified, 27 accepted the device. The eligible chemotherapy regimens included docetaxel+cyclophosphamide (TC), doxorubicin+cyclophosphamide (AC) and paclitaxel (P) weekly+trastuzumab (T). 24 pts (89%) completed the treatment; 3 pts (11%) treated with AC prematurely interrupted use of the scalp-cooling device due to inefficacy. After the last cycle of chemotherapy, the number of patient who perceived a HL < grade 2 was 16 (59%). The hair retention reported by operators has been higher (78%). 81.5% of patients well tolerated the treatment. Conclusion: In our study, the scalp-cooling device reduced chemotherapy-induced alopecia in taxane- based chemotherapy. Furthermore, it suggests a discordance in hair loss perception between patients and operators.

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Association of CYP2D6*10 (c. 100 C>T) Genotype with Z-END Concentration in Patients with Breast Cancer Receiving Tamoxifen Therapy in Indonesian Population

Endocrine Metabolic & Immune Disorders - Drug Targets ◽

10.2174/1871530319666190306094617 ◽

2019 ◽

Vol 19 (8) ◽

pp. 1198-1206 ◽

Cited By ~ 2

Author(s):

Yenny ◽

Sonar S. Panigoro ◽

Denni J. Purwanto ◽

Adi Hidayat ◽

Melva Louisa ◽

...

Keyword(s):

Breast Cancer ◽

Steady State ◽

Ultra Performance Liquid Chromatography ◽

Cross Sectional Study ◽

Threshold Concentration ◽

Breast Cancer Patients ◽

Cross Sectional ◽

Significant Difference ◽

Pcr Rflp ◽

Liquid Chromatography Tandem Mass

Background: Tamoxifen (TAM) is a frequently used hormonal prodrug for patients with breast cancer that needs to be activated by cytochrome P450 2D6 (CYP2D6) into Zusammen-endoxifen (Z-END). Objective: The purpose of the study was to determine the association between CYP2D6*10 (c.100C>T) genotype and attainment of the plasma steady-state Z-END minimal threshold concentration (MTC) in Indonesian women with breast cancer. Methods: A cross-sectional study was performed in 125 ambulatory patients with breast cancer consuming TAM at 20 mg/day for at least 4 months. The frequency distribution of CYP2D6*10 (c.100C>T) genotypes (C/C: wild type; C/T: heterozygous mutant; T/T: homozygous mutant) was detected using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), the results of which were subsequently confirmed by sequencing. The genotypes were categorized into plasma Z- END concentrations of <5.9 ng/mL and ≥5.9 ng/mL, which were measured using ultra performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS). Results: Percentages of C/C, CT, and T/T genotypes were 22.4%, 29.6%, and 48.8%, respectively. Median (25-75%) Z-END concentrations in C/C, C/T, and T/T genotypes were 9.58 (0.7-6.0), 9.86 (0.7-26.6), and 3.76 (0.9-26.6) ng/mL, respectively. Statistical analysis showed a significant difference in median Z-END concentration between patients with T/T genotype and those with C/C or C/T genotypes (p<0.001). There was a significant association between CYP2D6*10 (c.100C>T) genotypes and attainment of plasma steady-state Z-END MTC (p<0.001). Conclusion: There was a significant association between CYP2D6*10 (c.100C>T) and attainment of plasma steady-state Z-END MTC in Indonesian breast cancer patients receiving TAM at a dose of 20 mg/day.

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Mental health crisis in healthcare providers in the COVID-19 pandemic: a cross-sectional facility-based survey

BMJ Open ◽

10.1136/bmjopen-2021-052184 ◽

2021 ◽

Vol 11 (7) ◽

pp. e052184

Author(s):

Chih-Wei Sung ◽

Chi-Hsin Chen ◽

Cheng-Yi Fan ◽

Jia-How Chang ◽

Chia Chun Hung ◽

...

Keyword(s):

Anxiety Disorder ◽

Depressive Disorder ◽

Acute Stress ◽

Healthcare Providers ◽

Depression Scale ◽

Epidemiologic Studies ◽

Mental Health Crisis ◽

Cross Sectional ◽

Health Crisis ◽

Levels Of Care

ObjectivesDuring a pandemic, healthcare providers experience increased mental and physical burden. Burnout can lead to treatment errors, patient mortality, increased suicidal ideation and substance abuse as well as medical malpractice suits among medical staff. This study aimed to investigate the occurrence of burnout, acute stress disorder, anxiety disorder and depressive disorder among healthcare providers at the third month of the COVID-19 pandemic.DesignA cross-sectional facility-based survey.SettingHospitals around the country with different levels of care.ParticipantsA total of 1795 respondents, including 360 men and 1435 women who participated in the survey.Primary outcome measuresBurnout was assessed using the Physician Work Life Study. A score of ≥3 implied burnout.ResultsOf the 1795 respondents, 723 (40.3%) reported burnout, and 669 (37.3%) cared for patients with COVID-19. Anxiety levels were mild in 185 (10.3%) respondents, moderate in 209 (11.6%) and severe in 1401 (78.1%). The mean Center for Epidemiologic Studies Depression Scale-10 score was 9.5±6.3, and 817 (45.5%) respondents were classified as having depression. Factors associated with burnout were working in acute and critical care (ACC) divisions (adjusted OR (aOR)=1.84, 95% CI 1.20 to 3.39, p=0.019), caring for patients with COVID-19 (aOR=3.90, 95% CI 1.14 to 13.37, p=0.031) and having depressive disorder (aOR=9.44, 95% CI 7.44 to 11.97, p<0.001).ConclusionsPhysicians and nurses are vulnerable to burnout during a pandemic, especially those working in ACC divisions. Anxiety disorder, depressive disorder and care of patients with COVID-19 may be factors that influence the occurrence of burnout among healthcare providers.

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Complementary and Alternative Medicine Use in Breast Cancer Patients at a Medical Center in Taiwan: A Cross-Sectional Study

Integrative Cancer Therapies ◽

10.1177/1534735420983910 ◽

2020 ◽

Vol 19 ◽

pp. 153473542098391

Author(s):

Chieh-Ying Chin ◽

Yung-Hsiang Chen ◽

Shin-Chung Wu ◽

Chien-Ting Liu ◽

Yun-Fang Lee ◽

...

Keyword(s):

Breast Cancer ◽

Alternative Medicine ◽

Complementary And Alternative Medicine ◽

Cancer Patients ◽

Medical Center ◽

Cancer Center ◽

Breast Cancer Patients ◽

Cross Sectional ◽

Cam Use ◽

Complementary And Alternative

Background Complementary and alternative medicine (CAM) is becoming more common in medical practice, but little is known about the concurrent use of CAM and conventional treatment. Therefore, the aim was to investigate the types of CAM used and their prevalence in a regional patient cohort with breast cancer (BC). Methods BC patients were interviewed with a structured questionnaire survey on the use of CAM in southern Taiwan at an Integrative Breast Cancer Center (IBCC). The National Centre for Complementary and Integrative Health (NCCIH) classification was used to group responses. Over a period of 8 months, all patients receiving treatment for cancer at the IBCC were approached. Results A total of 106 BC patients completed the survey (response rate: 79.7%). The prevalence of CAM use was 82.4%. Patients who were employed, were receiving radiotherapy and hormone therapy, and had cancer for a longer duration were more likely to use CAM ( P < .05). Multivariate analysis identified employment as an independent predictor of CAM use (OR = 6.92; 95% CI = 1.33-36.15). Dietary supplementation (n = 69, 82.1%) was the type of CAM most frequently used, followed by exercise (n = 48, 57.1%) and traditional Chinese medicine (n = 29, 34.5%). The main reason for using CAM was to ameliorate the side effects of conventional therapies. Almost half (46.4%) of these CAM users did not disclose that they were using it in medical consultations with their physicians. Most chose to use CAM due to recommendations from family and friends. Conclusion A large portion of BC patients at the IBCC undergoing anti-cancer treatment courses used CAM, but less than half discussed it with their physicians. Given the high prevalence of CAM, it would be justifiable to direct further resources toward this service so that cancer patients can benefit from a holistic approach to their treatment.

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Subsequent endometrial carcinoma with adjuvant tamoxifen treatment in Japanese breast cancer patients

International Journal of Gynecological Cancer ◽

10.1136/ijgc-00009577-200107000-00003 ◽

2001 ◽

Vol 11 (4) ◽

pp. 272-276 ◽

Cited By ~ 1

Author(s):

N. Nishimura ◽

T. Hachisuga ◽

T. Saito ◽

T. Kawarabayashi

Keyword(s):

Breast Cancer ◽

Endometrial Carcinoma ◽

Cancer Patients ◽

Myometrial Invasion ◽

Tamoxifen Treatment ◽

Adjuvant Tamoxifen ◽

Serous Carcinoma ◽

Breast Cancer Patients ◽

Two Stage ◽

Endometrial Carcinomas

Abstract.Nishimura N, Hachisuga T, Saito T, Kawarabayashi T. Subsequent endometrial carcinoma with adjuvant tamoxifen treatment in Japanese breast cancer patients.This study aimed to detail the clinicopathologic features of endometrial carcinomas that developed in Japanese patients receiving adjuvant tamoxifen treatment for breast cancer patients. Ten endometrial carcinomas in tamoxifen-treated breast cancer patients were collected from two medical centers. The endometrial carcinomas included two stage Ia, four stage Ib, two stage Ic and two stage IIIc. Three tumors were Grade 1, six were Grade 2, and one was Grade 3. The tumor was limited to the endometrium in two cases. Myometrial invasion was limited to the inner half of the myometrium in five cases and involved the outer half in three. A mild degree of lymphovascular space invasion was identified in five cases. Deep cervical invasion was recognized in one case. The cell types comprised nine endometrioid adenocarcinomas and one serous carcinoma. Five of eight postmenopausal endometrial carcinomas were associated with polypoid endometrial lesions composed of cystically dilated atrophic and proliferative glands widely separated by fibrotic stroma. Two patients with retroperitoneal lymph node metastases died of endometrial cancer. One patient developed a contralateral breast cancer during tamoxifen treatment. No patient died of breast cancer. We did not demonstrate a higher frequency of either high-grade tumors or unfavorable histologic subtypes in tamoxifen-treated Japanese breast cancer patients.

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