Oncofertility Knowledge and Communication: Comparison Between Medical and Surgical Oncologists and Breast Cancer Patients in Academic Chinese Centers

Background: As cancer has become a major public health issue in China, fertility preservation remains limited despite the wide application of Assisted Reproductive Technology (ART) throughout the country.Objective: This study aimed to identify gaps in knowledge and communication as well as referrals in the previous year regarding oncofertility among medical and surgical oncologists and breast cancer patients (BCPs) in Chinese academic settings to target areas of needed improvement.Materials and Methods: A WeChat online questionnaire was designed, distributed, and compared between medical and surgical oncology specialists and reproductive age BCPs in academic teaching settings in Shanghai.Results: Sixty-one medical and surgical oncologists and 125 BCPs responded to the survey. 63.3% of oncologists were familiar with the term “oncofertility” compared to 25.6% of BCPs (p < 0.001). Oncologists were more likely to correctly know the costs associated with treatment (59.0 vs. 32.0%, p < 0.001); patient did not have to be married to undergo oncofertility treatment (50.8 vs. 24.8%, p < 0.001). Both oncologists and BCPs were similarly unlikely to know when patients could utilize cryopreserved tissue in the future (37.7 vs. 22.2%, p = 0.056). While oncologists reported they discussed all oncofertility options (41.0%) and offered psychological counseling (98.4%), significantly fewer BCPs reported receiving information on all options and offered counseling (3.2%, p < 0.001 and 85.6%, p < 0.01). Knowledge of oncofertility was the most important predictor for providing and receiving counseling from oncologists [OR = 6.44 (95% CI = 1.59–26.1, p = 0.009] and BCPs (OR = 3.73 95% CI: = 1.36–10.2, p = 0.011). Overall, 57.4% of oncologists referred <10 patients and none referred more than 25 patients in the past year.Conclusion: Data suggests a significant knowledge gap and ineffective communication/comprehension exists between academic Chinese oncologists and BCPs. Continued education and raised awareness are needed to optimize utilization of oncofertility services in China.

Download Full-text

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

Breast Care ◽

10.1159/000510380 ◽

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

Introduction: The aim of this study was to evaluate the accuracy and reliability of the Magseed magnetic marker in breast cancer surgery. Methods: 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. Results: 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. Conclusion: 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.

Download Full-text

Referral trends for reproductive-age patients with breast cancer to a reproductive endocrinology clinic for fertility preservation counseling between 2004 and 2012.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.26_suppl.129 ◽

2013 ◽

Vol 31 (26_suppl) ◽

pp. 129-129

Author(s):

Jonathan David Kort ◽

Kira Seiger ◽

Solomon Henry ◽

Lynn Westphal

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Fertility Preservation ◽

Reproductive Age ◽

Oocyte Cryopreservation ◽

Cancer Center ◽

Research Database ◽

Breast Cancer Patients ◽

Reproductive Endocrinology ◽

Patients Âgés

129 Background: As of October 2012, both embryo and oocyte cryopreservation are considered non-experimental fertility preservation (FP) options for cancer patients facing potentially gonadotoxic therapy. This study aims to assess the historical referral frequency of reproductive aged breast cancer patients from a major cancer center to an associated reproductive endocrinology and infertility (REI) clinic for counseling regarding FP and also assess how frequently these patients underwent FP after referral. Methods: Using the Stanford Cancer Center Research Database in conjunction with our EMR, a query was made for patients of reproductive age (13-45) who were seen at the Stanford Cancer Center for a new breast cancer diagnosis between 2004 and 2012. These patients’ records were then searched for referral encounters in the REI department. Those who were seen by REI were assessed for having undergone FP via embryo or oocyte cryopreservation prior to starting chemotherapy. Results: 420 women, ages 20 to 45, were seen at our cancer center for a new diagnosis of breast cancer between 2004 and 2012. Sixty (14.3%) of these patients, ages 20 to 42 at diagnosis, were referred to the REI department for FP counseling. Patients who were referred for FP counseling were 5.1 years younger at diagnosis than those who were not (p<.005). Of those referred, 33.3% underwent FP with embryo (77%) or oocyte cryopreservation (23%) under an experimental protocol. Among breast cancer patients ≤35 years old, 35% were referred to our REI department for FP counseling and 53.5% of those referred underwent FP. Conclusions: Despite advances in FP technology, the majority of reproductive aged breast cancer patients are still not referred for FP counseling by a reproductive endocrinologist. This trend was also seen among patients younger than 35—a subgroup who is more likely to undergo and benefit most from FP. This study does not reflect patients who decline this opportunity or seek FP elsewhere, however additional study and outreach is needed to improve referral rates, which are now a measure of the Quality Oncology Practice Initiative (QOPI).

Download Full-text

Autologous Lipotransfer - Daily Therapeutic Practice in Breast Cancer: An Intergroup Analysis Encompassing NOGGO, WSG, GBG, AWO Gyn and DGPRÄC

Breast Care ◽

10.1159/000490040 ◽

2018 ◽

Vol 14 (3) ◽

pp. 165-169

Author(s):

Aylin Kümmel ◽

Sherko Kümmel ◽

Jens-Uwe Blohmer ◽

Andree Faridi ◽

Ulrike Nitz ◽

...

Keyword(s):

Breast Cancer ◽

Breast Reconstruction ◽

Cancer Patients ◽

Daily Practice ◽

Primary Data ◽

Breast Cancer Patients ◽

Online Questionnaire ◽

Autologous Fat Transfer ◽

Risk Patients ◽

Breast Reconstructive Surgery

Background: Autologous fat transfer in breast reconstruction has become increasingly important in breast reconstructive surgery. Although the indication to obtain fat, the various operative procedures, and the risks for the patient have been addressed in a large number of studies, detailed information on the everyday use of autologous lipotransfer in breast units in Germany is still lacking. Methods: The objective of the study was to obtain primary data on the use of autologous lipotransfer to treat breast cancer patients in Germany and to determine measures for quality assurance in the daily practice. An online questionnaire concerning breast cancer and lipofilling was sent to specialists in gynecology and plastic surgery. Results: Two-thirds of the specialists who responded to the questionnaire use autologous lipotransfer for breast reconstruction and did not report an increase of local recurrence following lipotransfer. There were only small differences between gynecologists and plastic surgeons regarding the procedure and indication for lipotransfer. The method is highly accepted by patients and physicians, and both gynecologists and plastic surgeons rated the improvement achieved through lipofilling as ‘high'. Conclusions: The lack of randomized controlled data, especially in high-risk patients, demonstrates the necessity for a registry study on this topic. Our survey describes, in detail, the indications for lipofilling as well as its appropriate application in breast cancer patients in Germany and may thereby reduce the present therapeutic uncertainties.

Download Full-text

Reducing breast cancer chemotherapy treatment delays by improving the transition from surgical to medical oncology.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.31_suppl.51 ◽

2013 ◽

Vol 31 (31_suppl) ◽

pp. 51-51

Author(s):

Katya Losk ◽

Sarah Kadish ◽

Mehra Golshan ◽

Nancy Lin ◽

Judith Hirshfield-Bartek ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Medical Oncology ◽

Surgical Oncology ◽

Transitions Of Care ◽

Administrative Staff ◽

Breast Cancer Patients ◽

Breast Cancer Chemotherapy ◽

Definitive Surgery

51 Background: Delayed chemotherapy is associated with adverse clinical outcomes for breast cancer patients. Few studies have examined the processes of care within administrative staff and providers’ control that might affect the timeliness of breast cancer care. Coordinating transitions of care from surgical to medical oncology to eliminate variation is essential in ensuring timely chemotherapy for patients after surgery. This study evaluated the time of transition from surgery to medical oncology when administrative change of practice was implemented. Methods: We studied 192 consecutive breast cancer patients who received adjuvant chemotherapy. The interval between last definitive surgery and initiation of chemotherapy was calculated by integrating billing and scheduling data. Using process improvement methods a multidisciplinary team identified the opportunity to reduce delays in care coordination by scheduling the surgery, surgical post-op appointment, and medical oncology follow-up appointments simultaneously. Furthermore, responsibility for scheduling the medical oncology follow-up appointment was shifted and standardized from medical to surgical oncology administrative staff. Criteria for acceptable timeliness of appointments and escalation pathways for when provider availability was limited were established. The intervention targeted patients whose initial consultation with a breast surgeon and medical oncologist occurred on the same day, the standard practice at our institution. Results: Implementation of the interventions decreased the time from surgery to chemotherapy by six days. The standard deviation also declined, suggesting that the intervention reduced process variability. Conclusions: Standardizing administrative practices between breast surgery and medical oncology has led to a significant decrease in the time from last definitive surgery to initiation of chemotherapy and in the variability of that delay. [Table: see text]

Download Full-text

Our act on fertility preservation for young breast cancer patients in our single institute.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.3_suppl.109 ◽

2016 ◽

Vol 34 (3_suppl) ◽

pp. 109-109 ◽

Cited By ~ 1

Author(s):

Yasuyuki Kojima ◽

Kyoko Tsuchiya ◽

Chie Nishijima ◽

Nao Suzuki ◽

Koichiro Tsugawa

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Fertility Preservation ◽

Reproductive Age ◽

Ovarian Tissue Cryopreservation ◽

Embryo Cryopreservation ◽

Newly Diagnosed ◽

Breast Cancer Patients ◽

Er Positive ◽

Young Breast Cancer

109 Background: Along with increasing number of newly diagnosed Japanese breast cancer patients, the number of breast cancer survivors in reproductive age is also increasing. Among newly diagnosed Japanese breast cancer patients, 3182(6.6%) are under age 40 in 2011, which was 1610 in 2006. In our institute, we have been cooperating with gynecologists and providing fertility preservation program since 2010. Our aim is to access our team management, clinical impact and outcome of fertility preservation among young breast cancer patients in our institute. Methods: A patient, 1)without distant metastasis, 2)systemic chemotherapy and/or hormonal therapy planned, 3)within reproductive age and 4)willing to preserve fertility, will be referred to oncofertility clinic. Chart review was done retrospectively. Results: Ninety-five patients had consultation to the oncofertility clinic between April 2010 and April 2015. The average age at consultation was 34.1(range 22-44). Almost all patient had invasive cancer; cStage0:4%, cStageI:31%, cStageII:53%, cStageIII:11%. Fifty-five percent had estrogen receptor (ER) positive/HER2 negative, 31% had ER positive/HER2positive, 2% had ER negative/HER2 positive and 12% had ER negative/HER2 negative breast cancer. Forty-five had counseling without any procedure, 22 underwent ovarian tissue cryopreservation, 17 underwent embryo cryopreservation and 8 underwent oocyte cryopreservation. Because observation period is still short, we haven’t had any case that got pregnant or delivered, yet. Conclusions: The number of patient who choose to underwent fertility preservation is increasing. We have actually started facing proposition, when we shall lay aside adjuvant therapy and let them plan to be conceived. Taking risk into account, we are now evaluating the safety of cancer treatment and outcome of each procedure which undergone multidisciplinary deliberate decision-making process.

Download Full-text

The relationship of osteoporosis with severity of pain dirung the treatment of breast cancer patients of childbearing age

Russian Journal of Oncology ◽

10.18821/1028-9984-2015-21-3-122-125 ◽

2016 ◽

Vol 21 (3) ◽

pp. 122-125

Author(s):

Nataliya. Yu Tretyakova ◽

E. V Kotljarov

Keyword(s):

Breast Cancer ◽

Hormone Therapy ◽

Cancer Patients ◽

Comparison Group ◽

Specific Treatment ◽

Reproductive Age ◽

Breast Cancer Patients ◽

Childbearing Age ◽

Relationship Of ◽

The Relationship

Aim. The analysis of the relationship of osteoporosis with severity of pain and the improvement of the diagnosis of osteoporosis in breast cancer (BC) patients of the reproductive age. Methods. There were examined 60 women, including 30 BC patients at the age from 30 to 50 years and 30 women of similar age as comparison group. The examination included a blood test for osteocalcin, calcitonin, alkaline phosphatase, parathyroid hormone, thyroid stimulating hormone, calcium and phosphorus. The degree ofpain in BC patients was evaluated according to the McGill Pain Questionnaire and classification of pain. Osteodensitometry was made in all BC patients and cases from the comparison group. These 30 BC patients were examined prior to the appointment of specific treatment and a half year after the performed treatment Results. In the analysis of 30 breast cancer patients of childbearing age in 26 patients the onset of artificial menopause occurred. Pain syndrome prior to the treatment of the underlying disease was determined in 20% of cases. 6 months after treatment of BC pain breast cancer was detected in 70% of patients. Artificial menopause is associated with the delivery of chemotherapy and shutdown of ovarian function. Hormone therapy with tamoxifen was prescribed to 16 BC patients, 5 of them were transferred to second-line hormone therapy due to side effects of antiestrogens. At that the menopause is the basic condition for the appointment of aromatase inhibitors. In the examination of the whole group ofpatients in 63,3% of cases were revealed to have osteopenia and osteoporosis. Conclusion The prevalence rate of osteoporosis in BC patients of reproductive age is directly related to the performed specific treatment when the appointment of the therapy of osteoporosis it is necessary in complex treatment of cancer patients for the its prevention

Download Full-text

Hubungan Dukungan Keluarga dengan Self Esteem pada Pasien Kanker Payudara di Poliklinik Bedah Onkologi RSUP Sanglah Denpasar

Jurnal Akademika Baiturrahim Jambi ◽

10.36565/jab.v9i2.210 ◽

2020 ◽

Vol 9 (2) ◽

pp. 181

Author(s):

Ni luh Putu Mahayani ◽

Ni Komang Sukraandini ◽

Ni Wayan Suniyadewi

Keyword(s):

Breast Cancer ◽

Family Support ◽

Cancer Patients ◽

Surgical Oncology ◽

Self Esteem ◽

P Value ◽

Breast Cancer Patients ◽

Cross Sectional ◽

Cross Sectional Design ◽

The Relationship

AbstractBreast cancer sufferers have a tendency to experience a decrease of self esteem that make patients shall showing symptoms such as blaming themself for what they experienced. One way to increase self esteem in cancer patients is by increasing family participation through family support. The aim of this study is to determine the relationship between family support and self esteem in breast cancer patients. This study was using cross sectional design. The study was taken place at the Surgical Oncology Polyclinic, found samples of 188 respondents which was selected with a purposive sampling technique.The results showed that the majority of respondents were in the category of moderate self-esteem were 98 respondents (52.1%) and the category of moderate family support were 96 respondents (51.1%). The Rank Spearmen test results shows p value 0,000 (p <ɑ), means there is a relationship between self-esteem and family support in breast cancer patients with r value of 0.566 (positive relationship). It is expected that the family will always support the patient in every process of treatment, whether in the form of physical, psychological or financial support that could increase the patient's self esteem

Download Full-text

Changes in eating habits in breast cancer patients

Slovenian Journal of Public Health ◽

10.2478/sjph-2021-0010 ◽

2020 ◽

Vol 60 (1) ◽

pp. 65-71

Author(s):

Karmen Grašič Lunar ◽

Nada Rotovnik Kozjek ◽

Milena Blaž Kovač

Keyword(s):

Breast Cancer ◽

Dietary Supplements ◽

Cancer Patients ◽

Cancer Diagnosis ◽

Vegetable Intake ◽

Eating Habits ◽

Activity Level ◽

Breast Cancer Patients ◽

Online Questionnaire ◽

Wide Range

AbstractIntroductionReceiving a cancer diagnosis is an important moment in anyone’s life. Consequently, many patients are prepared to change their everyday habits and begin to look for advice from a wide range of sources. Women with breast cancer are particularly motivated and committed to making changes to their lifestyle and diet. The purpose of this study was to elucidate the changes in nutritional and other lifestyle habits following breast cancer diagnosis in Slovenia. A further goal was to estimate the proportion of breast cancer patients using dietary supplements and alternative diets or ascertain their desire to attend a consultation with a dietician.MethodsA link to an online questionnaire was sent to the email addresses of members of Europa Donna and posted on their website (www.europadonna-zdruzenje.si) and Facebook page.ResultsA total of 102 patients were included in the study. We found that a majority of breast cancer patients changed their eating habits (68.6%) and/or physical activity level (53.9%) following diagnosis. On average, they increased their fruit and vegetable intake and reduced their intake of sugar, red meat and fat. Alternative diets were used by 29.4% of patients, with a high proportion of patients (75.5%) consuming dietary supplements. More than a half of the patients (69.6%) expressed a desire for a consultation with a dietician.ConclusionsNutritional support during cancer treatment is part of medical treatment and has an important role to play in secondary and tertiary cancer prevention activities. More dieticians should therefore be incorporated into the health system.

Download Full-text

Predictive factors of adjuvant therapy-related amenorrhea for patients with breast cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2011.29.27_suppl.217 ◽

2011 ◽

Vol 29 (27_suppl) ◽

pp. 217-217

Author(s):

N. Tamura ◽

T. Kato ◽

C. Shimizu ◽

T. Kinoshita ◽

Y. Fujiwara

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Intrinsic Subtype ◽

Reproductive Age ◽

Breast Cancer Patients ◽

Patient Age ◽

Logistic Analysis ◽

Patient Âgé ◽

Number Of Patients ◽

The Mean

217 Background: Reproductive age breast cancer patients often experience therapy-related amenorrhea so preserving fertility after treatment is a major concern. Anti-mullerian hormone (AMH) values have been reported useful in predicting menopause for infertility treatment patients, but published information is limited regarding breast cancer patients. If amenorrhea can be predicted before treatment, breast cancer patients hoping to have children in the future can consider this information in choosing treatment. Our aim was to predict patient fertility using AMH values. Methods: Forty breast cancer patients, 25-45 years of age (median, 35.5), who received adjuvant chemotherapy (CT) or endocrine therapy (ET), had AMH values retrospectively assayed from frozen serum before and after treatment. AMH values were then analyzed in relation to clinicopathological factors using logistic analysis. Of 19 adjuvant CT patients whose AMH values could be assayed, Cox’s proportional hazard model indicated a correlation in terms of amenorrhea and time to menses resumption between clinicolpathological factors and AMH values. Results: The mean pretreatment AMH value for all 40 patients was 21.4pM (range, 3-78) and a correlation was demonstrated with patient age, but not breast cancer intrinsic subtype or stage. AMH values decreased to the lower limit after treatment for all CT patients regardless of age, but there was a difference in degree depending on patient age for ET patients. Of the 19 CT patients, the mean AMH value was 25.6pM (3-78). These patients all underwent a regimen of anthracycline with 11 (58%) also receiving a regimen of taxiane. After starting CT, 17 patients (89%) experienced amenorrhea, but 11 (59%) resumed menstruation within one year of finishing CT and 15 (78%) resumed within two years. There were no significant differences among CT patients in age, pretreatment AMH value, intrinsic subtype or stage, but patients receiving taxiane demonstrated a noteworthy trend. Conclusions: Although we were unable to predict menopause directly using AMH values given the small number of patients in this study, we could estimate the risk of menopause as being either low or high for CT patients based on age and type of regimen.

Download Full-text

Anti-Müllerian hormone: determination of ovarian reserve in early breast cancer patients

Endocrine Related Cancer ◽

10.1530/erc-13-0335 ◽

2013 ◽

Vol 21 (1) ◽

pp. R51-R65 ◽

Cited By ~ 20

Author(s):

Claudia Bozza ◽

Fabio Puglisi ◽

Matteo Lambertini ◽

Etin-Osa Osa ◽

Massimo Manno ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Young Women ◽

Ovarian Reserve ◽

Menopausal Status ◽

Poor Response ◽

Reproductive Age ◽

Endocrine Treatment ◽

Breast Cancer Patients ◽

Potential Marker

Breast cancer is the most common invasive cancer in women of reproductive age. In young women, chemotherapy may induce amenorrhea: it is still uncertain how to assess menopausal status in these patients despite the importance of its definition for choosing appropriate endocrine treatment. In the development of sensitive biomarkers for fertility and ovarian reserve, anti-Müllerian hormone (AMH) is considered a promising marker of ovarian reserve. The clearest data regarding a clinical use of AMH are related to the measurement of the ovarian pool in women who undergo IVF: the available data, also in breast cancer patients, seem to suggest that AMH measurement, before gonadotropin administration, can be a useful marker for the prediction of women at risk for poor-response or no response to ovarian stimulation. The utility of AMH as a potential marker of chemotherapy-induced ovarian follicular depletion and an early plasma marker of chemotherapy-induced gonadal damage has been evaluated both in young women after treatment for cancer in childhood and in young survivors of hematological malignancies and solid tumors. Several studies have demonstrated a potential utility of AMH, inhibin, or follicle-stimulating factor as biomarkers predicting infertility risk in breast cancer patients, but the studies conducted so far are not conclusive. Further studies are needed in order to define the regimen-specific action of chemotherapy on AMH levels, the percentage of post-treatment recovery of plasma levels of the hormone, and the relationship between menopausal status and AMH.

Download Full-text