Mammography Adherence among High-Risk Women with Breast Cancer and Either a Non-Pathogenic Mutation Identified or Untested BRCA1/2 Genetic Status

2020 ◽  
Vol 1 (1) ◽  
pp. 29-42
Author(s):  
Alison Flehr ◽  
Fiona Judd ◽  
Geoffrey J. Lindeman ◽  
Maira Kentwell ◽  
Penny Gibson ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Illness Perceptions ◽  
Response Rate ◽  
Familial Cancer ◽  
Pathogenic Mutation ◽  
Self Report ◽  
Middle Income ◽  
Income Status ◽  
Emotional Representations ◽  
The Impact

Background: Little is known about the illness perceptions of women with a previous breast cancer diagnosis and either no access to a personal BRCA1/2 test or tested and a no pathogenic mutation identified result and how this might impact their mammography adherence. Objective: The aim of this study was to assess the impact of illness beliefs, specifically those relating to emotional representations and cure and control beliefs about breast cancer, and socio-economic status (SES) on mammography adherence of these women. The traditional health belief model (HBM) was compared to a modified model which allowed for the contribution of emotions in health surveillance decision-making. Method: Mailed self-report questionnaires were completed by 193 women recruited from an Australian Familial Cancer Centre. Step-wise logistic regression analyses were conducted on n=150 [aged 27-89 years (M=56.9)] for whom complete data were available. Results: The questionnaire response rate was 36%. Higher levels of emotional representations of breast cancer were associated with greater mammography adherence (OR = 1.18, 95% CI = 1.03-1.36, p =.019). Middle income was six times more likely to predict mammography adherence than lower income (OR = 6.39, 95% CI = 1.03 – 39.63, p =.047). The modified HBM was superior to the traditional HBM in predicting mammography adherence (X2 [15, N = 118] = 26.03, p =.038). Conclusions: Despite a modest response rate, our data show that emotional illness representations about breast cancer and middle income status were found to significantly predict mammography adherence. Therefore, providing surveillance services and delivering information considerate of financial status and constructed around emotional motivators may facilitate mammography adherence among women like those described in this study.

scholarly journals Monitoring women's experiences during three rounds of breast cancer screening: results from a longitudinal study

2002 ◽  
Vol 9 (4) ◽  
pp. 168-175 ◽  
Author(s):  
C.H.C. Drossaert ◽  
H. Boer ◽  
E.R. Seydel
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Response Rate ◽  
Drop Out ◽  
The Third ◽  
Experienced Pain ◽  
Cancer Screening Programme ◽  
Pain Experiences ◽  
The Impact

OBJECTIVES: (a) To monitor experiences of women during three successive rounds of breast screening; (b) to examine the impact of previous experiences (obtained either immediately after the latest mammogram or shortly before the subsequent one) on reattendance; and (c) to examine which factors are associated with the experience of pain and distress during screening. SETTING: The Dutch Breast Cancer Screening Programme METHODS: 2657 women completed a baseline measurement (response rate 67%) about 8 weeks after they had been invited for an initial mammogram (T1). Actual participation data of these women in the second and third rounds of screening were collected. Follow up questionnaires were sent to subgroups of the sample at different times: shortly before the second screening (T2; response rate 86%), shortly after the second screening (T3; response rate 85%), shortly before the third screening (T; response rate 80%), and shortly after the third screening (T5; response rate 78%). RESULTS: Most women were satisfied with the first screening round and remained positive about subsequent screens. Although pain and anxiety were not uncommon, only a few (10%–15%) experienced moderate or severe levels of distress or pain. Experiences were relatively stable: women who experienced pain in the first screen were more likely to experience pain in subsequent screens (r values from 0.39 to 0.50). Fear of breast cancer was associated with increased distress related to mammography and, to a lesser extent, with increased pain during the mammography. Evidence was found for a relief effect: women were more positive about their previous screen when asked shortly after this screen, than when asked just before the subsequent one. Previous experiences (obtained either proximally or distally) were only slightly predictive for future attendance. CONCLUSION: Experiences during mammography are fairly stable. Negative experiences were generally not a reason to drop out of the programme.

scholarly journals Police and sniffer dogs in psychiatric settings

2008 ◽  
Vol 32 (7) ◽  
pp. 253-256 ◽  
Author(s):  
Najat Khalifa ◽  
Simon Gibbon ◽  
Conor Duggan
Keyword(s):  
Illicit Drugs ◽  
Illicit Drug ◽  
Response Rate ◽  
The Other ◽  
Self Report ◽  
Clinical Implications ◽  
Patient Response ◽  
Secure Unit ◽  
The Individual ◽  
The Impact

Aims and MethodTo study the views of staff and patients on the use of sniffer dogs to detect illicit drugs and the prosecution of in-patients suspected of taking illicit drugs. A 15-item self-report questionnaire was given to all in-patients and staff who had any contact with patients in a medium-secure unit. Responses to the individual statements were measured on a five-point Likert scale and staff and patients' responses were compared.ResultsWe achieved a response rate of 63% (patient response rate, 71.6%; staff response rate, 60.7%). Overall there were fewer differences than anticipated, although, as expected, staff viewed the impact of illicit drugs more negatively than patients, and on the other hand, patients viewed the use of sniffer dogs and police involvement more negatively than the staff did.Clinical ImplicationsNotice ought to be taken of the discordance between staff and patients' views (particularly in relation to consent and confidentiality) when attempting to detect and manage illicit drug use among psychiatric in-patients.

scholarly journals Patterns and Correlates of Adjuvant Radiotherapy Receipt After Lumpectomy and After Mastectomy for Breast Cancer

2010 ◽  
Vol 28 (14) ◽  
pp. 2396-2403 ◽  
Author(s):  
Reshma Jagsi ◽  
Paul Abrahamse ◽  
Monica Morrow ◽  
Sarah T. Hawley ◽  
Jennifer J. Griggs ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Los Angeles ◽  
Adjuvant Radiotherapy ◽  
Strong Influence ◽  
Response Rate ◽  
Breast Conserving Surgery ◽  
Self Report ◽  
Seer Data ◽  
Survey Responses ◽  
Positive Lymph Nodes

Purpose To use patient self-report to provide more valid estimates of whether radiotherapy (RT) is underutilized than possible with registry data, as well as to evaluate for disparities and the influence of preferences and provider interactions. Methods We considered 2,260 survey respondents who had nonmetastatic breast cancer, were age 20 to 79 years, were diagnosed between July 2005 and February 2007 in Detroit and Los Angeles, and reported to Surveillance, Epidemiology and End Results (SEER) registries (72% response rate). Survey responses were merged with SEER data. We assessed rates and correlates of RT receipt among all patients with invasive cancer receiving breast-conserving surgery (BCS) and among patients undergoing mastectomy with indications for RT (ie, positive lymph nodes or T3-4 tumors). Results Among 904 patients undergoing BCS with strong indications for RT, 95.4% received RT, and 77.6% received RT among the 135 patients undergoing mastectomy with strong indications (P < .001). Among 114 patients undergoing BCS with weaker indications (ie, elderly) for RT, 80.0% received treatment, and 47.5% received RT among the 164 patients undergoing mastectomy with weaker indications (T1N1, T2N1, or T3N0 disease; P < .001). On multivariate analysis, surgery type (P < .001), indication strength (P < .001), age (P = .005), comorbidity (P < .001), income (P = .03), patient desire to avoid RT (P < .001), level of surgeon involvement in decision to have radiation (P < .001), and SEER site (P < .001) were significantly associated with likelihood of RT receipt. Conclusion RT receipt was consistently high across sociodemographic subgroups after BCS but was lower after mastectomy, even among patients with strong indications for treatment, in whom clinical benefit is similar. Surgeon involvement had a strong influence on RT receipt.

scholarly journals The Feasibility and Performance of the Patient Navigation Programme in Improving Breast Cancer Care in Malaysia

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 95s-95s
Author(s):  
M. Jaganathan ◽  
N.H. Zainal ◽  
N. Rajaram ◽  
T. Soo Hwang ◽  
M.Y. Abdul Wahab
Keyword(s):  
Breast Cancer ◽  
Cancer Care ◽  
Patient Navigation ◽  
Poor Adherence ◽  
Adherence To Treatment ◽  
Breast Cancer Care ◽  
Middle Income ◽  
Treatment Delays ◽  
And Performance ◽  
The Impact

Background: Breast cancer is the most common cancer in Malaysia and it is anticipated that incidence will increase by 49% from 2012 to 2025. Unfortunately, survival remains poor because of late presentation and poor adherence to evidence-based medicine. Barriers to early presentation include inadequate knowledge about the disease, financial issues, negative influence of relatives and perceived poor quality of care and services in state-run hospitals. Poor adherence to treatment is also a common struggle, and is further exacerbated by the use of traditional, alternative healing methods. While patient navigation (PN) programs have been shown to improve breast cancer outcomes in the US, its implementation and performance in low and middle income countries is not well studied. Aim: We sought to determine the impact of a PN program in reducing treatment delays and improving adherence to treatment and patient satisfaction, as well as to evaluate the barriers faced by women seeking breast cancer care in Malaysia. Methods: We established a nurse-led patient navigation center at a secondary government hospital in Klang. This clinical team involved the surgery, pathology, radiology and nursing departments and provided patient-centered care, including patient tracking and call reminder systems, family counseling, health education and decision aids. The community team involved a Patient Navigator Program Coordinator and a Community Navigator. We compared treatment delays and adherence to treatment between navigated patients and patients registered in the year prior to the PN program. We used Student t-tests and Pearson χ2 or Fisher's Exact tests to compare timeliness between navigated patients and patients registered in the year prior. Results: Of the 136 Malaysian women enrolled in the PNP in 2015, 48.9% were diagnosed with advanced disease (stage 3 or 4). Women with advance disease had a lower median monthly household income compared with women with early disease (USD $350 vs $540, P = 0.023). Women with advance disease were also less likely to have personal transportation to the hospital (36.4% vs 56.5%, P = 0.048). Compared with the year before PN, more navigated patients underwent mammography within 7 days of their first visit (96.4% vs 74.4%, P < 0.001) and received their diagnosis within 14 days of their first visit (80.0% vs 58.5%, P < 0.001). The proportion of women who met timeliness to treatment initiation was similar for navigated patients and patients in the year prior. The proportion of defaulters were marginally lesser among navigated patients compared with the year prior (4.4% vs 11.5%, P = 0.048). Conclusion: We found that integrating PN within a breast clinic of a middle income country is feasible, and in the long run, could improve outcomes for breast cancer patients. Long-term follow-up is needed to assess the impact of the PN program on improving treatment completion and survival.

scholarly journals Correlation of the pathological response rate with the global disease and survival of patients with sub type her2 breast cancer submitted to neoadjuvant chemotherapy at hospital de câncer de Pernambuco

Mastology ◽  
2020 ◽  
Vol 30 (Suppl 1) ◽  
Author(s):  
Juliana Beatriz de Oliveira Ferreira ◽  
Jose Peixoto ◽  
Carolina de Souza Vasconcelos ◽  
Tainan de Morais Bispo
Keyword(s):  
Breast Cancer ◽  
Response Rate ◽  
Statistical Significance ◽  
Pathological Response ◽  
Time Data ◽  
Recurrence Rates ◽  
Logrank Test ◽  
Her2 Breast Cancer ◽  
Significant Difference ◽  
The Impact

Introduction: QT NEO starts from the premise of tumor downstaging, enabling excision of previously unresectable tumors, reducing surgical extension and, consequently, enabling higher rates of conservative surgery. It also allows an in vivo assessment of the neoplastic response to systemic therapy. PCR is a powerful indicator of the benefit of QT NEO and is associated with better outcomes for relapse, DFS and OS. Objectives: This study aimed to evaluate the pathological response rate of patients with CM HER2 who underwent QT NEO, treated at HCP in the years 2014-2016 and to correlate with the recurrence rates, DFS and OS, observing whether the data are in agreement with those reported in the literature. Methods: The study evaluated patients with BC HER2, confirmed by IHC and/or FISH, who underwent QT NEO followed by surgery from 2014 to 2016, treated at the HCP. It is a retrospective, observational, and descriptive study. The information collected comes from a questionnaire formulated by the researcher with the relevant points to be analyzed in the project. The data were stored and analyzed using SPSS, version 20.0. The Kolmogorov-Smirnov test, χ2 test or Fisher’s exact test were used to assess the variables. The DFS and OS time data were represented by the Kapplan-Meier curves and the Logrank test was used to verify a significant difference between the categories with or nPRC. A significance level of 5% was assigned to it. Results: The medical records of 58 patients with BC subtype HER 2 who received QT NEO followed by surgery were analyzed. During a mean follow-up of 35 months, 5 (8.6%) local recurrences and 20 (34.5%) distant ones and 18 deaths from breast cancer (31%) were observed. A result of 50% of PRC was achieved, with no correlation of statistical significance between age, histological type, nuclear grade, staging prior to QT NEO and chemotherapy regimen used. The PRC group achieved lower recurrence rates (20.68 vs. 51.72%) with statistical significance. DFS in the PRC group is 75.9% and in the nPRC group it is 44.82%. OS of the group with PRC is 82.7 vs. 48.2% in the nPRC group. Patients with HR- and PRC were the ones that most benefited from obtaining PRC in the recurrence and DFS outcomes, reaching recurrence rates of 22% and DFS of 77.8% compared to the HR group – without PRC, which had recurrence rates of 72% and DFS of 27.3%. Conclusion: This study found significant data with lower recurrence rates and better rates of DFS and OS in patients who achieved PRC, thus evidencing the impact that PRC has on long-term outcomes, especially in the HR- subgroup of patients.

scholarly journals Increase of internalized mental health symptoms among adolescents during the last three decades

2019 ◽  
Vol 29 (5) ◽  
pp. 925-931 ◽  
Author(s):  
Ida Blomqvist ◽  
Eva Henje Blom ◽  
Bruno Hägglöf ◽  
Anne Hammarström
Keyword(s):  
Mental Health ◽  
Conduct Problems ◽  
Internalizing Symptoms ◽  
Response Rate ◽  
Self Report ◽  
Mental Health Symptoms ◽  
Cross Sectional ◽  
Health Symptoms ◽  
Significant Difference ◽  
The Impact

Abstract Background Previous studies suggest an overall increase of adolescent mental health symptoms globally since the 1980s until today, especially an increase of internalizing symptoms in girls. Due to methodological limitations of these studies, further studies are warranted to obtain a more solid knowledgebase. Methods This study was cross-sectional and compared two separate but geographically identical groups of adolescents in a middle-sized industrial municipality in Northern Sweden at two time-points [(i) 1981, n = 1083, (505 girls, 577 boys), response rate 99.7%; (ii) 2014, n = 682, (338 girls, 344 boys), response rate 98.3%]. All students in their last year of compulsory school were included. The same self-report questionnaire, consisting of four sub-scales (functional somatic-, anxiety-, depressive symptoms and conduct problems), was used at both occasions. Data were analyzed with descriptive statistics, two-way ANOVA and general linear model. Results Symptoms of anxiety and depression and functional somatic symptoms, increased among both boys and girls from 1981 until 2014 (P < 0.001 for all subscales), and the increase of these symptoms was higher in girls. Conduct problems were significantly higher in boys in 1981 and decreased over time so that in 2014 there was no longer a significant difference between boys and girls regarding conduct problems (P = 0.286). Conclusion In this population-based study spanning over 30 years, both girls and boys showed increasing internalizing problems, while conduct problems decreased. To halt this trend, we need a deeper understanding of the impact of the major societal changes that have occurred during the last three decades.

Predictors of patient-reported toxicities from endocrine therapy: Importance of illness perceptions, treatment beliefs, and fear of recurrence.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 542-542
Author(s):  
Xinni Song ◽  
Susan Faye Dent ◽  
Shailendra Verma ◽  
Mark J. Clemons ◽  
Nadine A. Graham ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Side Effects ◽  
Adverse Effects ◽  
Endocrine Therapy ◽  
Symptom Management ◽  
Self Report ◽  
Fear Of Cancer Recurrence ◽  
Management Interventions ◽  
Patient Reported ◽  
The Impact

542 Background: Numerous studies have documented the toxicities of endocrine therapy (ET) for early breast cancer (EBC) and their deleterious impact on quality of life and adherence. However, little is known about the factors that underlie patient's susceptibility to report toxicities. The identification of risk factors for toxicities from ET is important as it would allow early targeting of symptom management interventions for women more vulnerable to adverse effects of ET. This prospective study aims to examine the impact of pre-treatment perceptions of EBC, ET beliefs and fear of breast cancer (BC) recurrence (FBCR) on toxicities reported after 6 months of ET. Methods: Women diagnosed with EBC completed a survey prior to initiating endocrine therapy, then at 3, 6 and 12 months. Standardized self-report instruments were used to assess EBC perceptions, ET beliefs, FBCR and toxicities. Clinical and treatment variables were also evaluated. Univariate analyses and mulitivariate regression were conducted to identify factors associated (p<0.1) with side effects at 6 months. Results: Since 9/2010, 173 patients have consented and 84 (mean age = 60 y) have completed the questionnaires at baseline and after 6 months of ET. Controlling for age, none of the clinical or treatment variables (stage of disease, type of surgery, receipt of chemotherapy and radiation therapy) were significant univariate predictors of toxicities. In multiple regression, stronger perceptions that BC has serious consequences on their lives (β=0.218, p<0.05), greater concerns about the adverse effects of ET (β=0.215, p<0.05) and higher levels of FBCR (β=0.316, p<0.01) at baseline were associated with higher levels of reported toxicities. Conclusions: Baseline psychological factors predicted level of patient-reported toxicities to a larger extent than clinical/treatment factors. How patients perceived their illness, their beliefs about ET side effects and their fear of cancer recurrence are strongly associated with side effects experienced after 6 months of ET. These results could facilitate the identification of a subgroup of patients for early interventions to improve symptom management.

scholarly journals The potential role of aid in escaping the middle-income trap

2020 ◽  
Vol 42 (4) ◽  
pp. 420-441
Author(s):  
Timothy Yaw Acheampong ◽  
Beáta Udvari
Keyword(s):  
Economic Growth ◽  
Latin American ◽  
Income Group ◽  
Annual Growth Rate ◽  
Middle Income ◽  
Middle Income Countries ◽  
Income Status ◽  
Middle Income Group ◽  
Middle Income Trap ◽  
The Impact

AbstractRecently, the middle-income trap (MIT) has gained considerable attention – besides European countries, several African, Asian, and Latin-American developing countries are also affected. Many countries have remained in the middle-income bracket for decades, whilst only a few have advanced to high-income status. Felipe et al. in 2012 showed that an annual growth rate of at least 3.5 and 4.7% sustained for a period of 14 and 28 years is required respectively for upper-middle-income and lower-middle-income countries to escape the MIT. Economic growth is influenced by several factors including foreign aid received. Thus, in this study, we aim to answer the question of how aid affects economic growth in middle-income countries and whether aid may contribute to escaping the MIT. Focusing on the countries that have remained in the middle-income group between 1990 and 2017, our analysis confirms that aid contributes to economic growth; however, the impact is positive in the upper-middle-income countries and negative in the lower-middle-income countries. Aid is therefore, likely to be more effective in helping the upper-middle income countries to escape the MIT but not the lower-middle income countries.

scholarly journals Improving Breast Cancer Control via the Use of Community Health Workers in South Africa: A Critical Review

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Brianna M. Wadler ◽  
Christine M. Judge ◽  
Marianne Prout ◽  
Jennifer D. Allen ◽  
Alan C. Geller
Keyword(s):  
Breast Cancer ◽  
South Africa ◽  
Community Health ◽  
Health Workers ◽  
Cancer Control ◽  
Middle Income ◽  
Patient Navigators ◽  
Income Status ◽  
Breast Cancer Outcomes ◽  
Clinical Breast

Breast cancer is a growing concern in low- and middle-income countries (LMCs). We explore community health worker (CHW) programs and describe their potential use in LMCs. We use South Africa as an example of how CHWs could improve access to breast health care because of its middle-income status, existing cancer centers, and history of CHW programs. CHWs could assume three main roles along the cancer control continuum: health education, screening, and patient navigation. By raising awareness about breast cancer through education, women are more likely to undergo screening. Many more women can be screened resulting in earlier-stage disease if CHWs are trained to perform clinical breast exams. As patient navigators, CHWs can guide women through the screening and treatment process. It is suggested that these roles be combined within existing CHW programs to maximize resources and improve breast cancer outcomes in LMCs.

Exploring the association between diabetes and breast cancer outcomes among Latinas.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 221-221
Author(s):  
Kimlin Tan Ashing ◽  
Raynald Samoa ◽  
Lily L. Lai ◽  
Arti Hurria ◽  
Mayra Serrano ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Chronic Conditions ◽  
Breast Cancer Survivors ◽  
Cancer Registries ◽  
Self Report ◽  
Multiple Chronic Conditions ◽  
Coordinated Care ◽  
Patient Centered ◽  
The Impact

221 Background: In cancer patients, diabetes increases the risk for poor overall health and cancer-specific outcomes even death. Moreover, both breast cancer (BC) and diabetes are amongst the most common illnesses in Latinas, who have documented poorer outcomes for both diseases. This study examined the impact of co-occurring diabetes on patient outcomes in a sample of Latina breast cancer survivors (BCS). Methods: 137 Latina BCS were recruited from the California Cancer Registry, hospital cancer registries, and community agencies. BCS completed a self-report questionnaire consisting of items related to demographic and medical characteristics, including diagnoses of cancer and diabetes, and physical and functional outcomes. Results: Thirty nine (28%) BCS reported a co-occurring diagnosis of diabetes; this is over twice the rate in the general population. Diabetes was most prevalent among BCS 65 years and older with 43% reporting co-occuring diabetes. BCS with diabetes, controlling for age, were more likely to report advanced BC staging at diagnosis ( p= 0.036) and more severe lymphedema symptoms than BCS without diabetes ( p= 0.038). BCS with diabetes also endorsed lower general health and greater social functioning limitations and physical role limitations than BCS without diabetes ( p= 0.048). Conclusions: This investigation sheds new light on emerging evidence documenting the negative associations of co-occurring chronic conditions, such as diabetes, on cancer patients’ outcomes. Our findings highlight the urgent need for additional inquiry examining multiple chronic conditions, particularly in the face of cancer. Early integrative and coordinated care that attends to multiple chronic conditions, especially among elderly and ethnic minority patients, may serve as a critical target for addressing disparate cancer risk and outcomes to improve quality, patient-centered care and patients’ outcomes. Clinical trial information: NCT00932997.

Sign in / Sign up

Export Citation Format

Share Document