Precision Medicine: Technological Impact into Breast Cancer Diagnosis, Treatment and Decision Making

Breast cancer is the most common cancer in women, impacting 2.1 million women each year. The number of publications on BC is much higher than for any other type of tumor, as well as the number of clinical trials. One of the consequences of all this information is reflected in the number of approved drugs. This review aims to discuss the impact of technological advances in the diagnosis, treatment and decision making of breast cancer and the prospects for the next 10 years. Currently, the literature has described personalized medicine, but what will the treatment be called for in the coming years?

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The Impact of COVID-19 Outbreak on Emotional and Cognitive Vulnerability in Iranian Women With Breast Cancer

Frontiers in Psychology ◽

10.3389/fpsyg.2021.663310 ◽

2021 ◽

Vol 12 ◽

Author(s):

Mohammad H. Choobin ◽

Vida Mirabolfathi ◽

Bethany Chapman ◽

Ali Reza Moradi ◽

Elizabeth A. Grunfeld ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Diagnosis ◽

Cognitive Vulnerability ◽

Emotional Health ◽

Breast Cancer Diagnosis ◽

Well Being ◽

Emotional Impact ◽

Targeted Interventions ◽

Emotional Vulnerability ◽

The Impact

The psychological cost on emotional well-being due to the collateral damage brought about by COVID-19 in accessing oncological services for breast cancer diagnosis and treatment has been documented by recent studies in the United Kingdom. The current study set out to examine the effect of delays to scheduled oncology services on emotional and cognitive vulnerability in women with a breast cancer diagnosis in Iran, one of the very first countries to be heavily impacted by COVID-19. One hundred thirty-nine women with a diagnosis of primary breast cancer answered a series of online questionnaires to assess the current state of rumination, worry, and cognitive vulnerability as well as the emotional impact of COVID-19 on their mental health. Results indicated that delays in accessing oncology services significantly increased COVID related emotional vulnerability. Regression analyses revealed that after controlling for the effects of sociodemographic and clinical variables, women’s COVID related emotional vulnerability explained higher levels of ruminative response and chronic worry as well as poorer cognitive function. This study is the first in Iran to demonstrate that the effects of COVID-19 on emotional health amongst women affected by breast cancer can exaggerate anxiety and depressive related symptoms increasing risks for clinical levels of these disorders. Our findings call for an urgent need to address these risks using targeted interventions exercising resilience.

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In the Moment: Women Speak About Surgical Treatment Decision Making Days After a Breast Cancer Diagnosis

Oncology Nursing Forum ◽

10.1188/09.onf.e257-e265 ◽

2009 ◽

Vol 36 (5) ◽

pp. E257-E265 ◽

Cited By ~ 20

Author(s):

Robin M. Lally

Keyword(s):

Breast Cancer ◽

Decision Making ◽

Surgical Treatment ◽

Cancer Diagnosis ◽

Treatment Decision ◽

Breast Cancer Diagnosis ◽

Treatment Decision Making ◽

The Moment

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Divorce after breast cancer diagnosis and its impact on quality of life

Palliative & Supportive Care ◽

10.1017/s1478951521001711 ◽

2021 ◽

pp. 1-6

Author(s):

Danbee Kang ◽

Nayeon Kim ◽

Gayeon Han ◽

Sooyeon Kim ◽

Hoyoung Kim ◽

...

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Cancer Survivors ◽

Cancer Diagnosis ◽

Breast Cancer Survivors ◽

Breast Cancer Diagnosis ◽

Factors Associated ◽

After Cancer ◽

The Impact

Abstract Objective This study aims to identify factors associated with divorce following breast cancer diagnosis and measures the impact of divorce on the quality of life (QoL) of patients. Methods We used cross-sectional survey data collected at breast cancer outpatient clinics in South Korea from November 2018 to April 2019. Adult breast cancer survivors who completed active treatment without any cancer recurrence at the time of the survey (N = 4,366) were included. The participants were classified into two groups: “maintaining marriage” and “being divorced,” between at the survey and at the cancer diagnosis. We performed logistic regression and linear regression to identify the factors associated with divorce after cancer diagnosis and to compare the QoL of divorced and nondivorced survivors. Results Approximately 11.1/1,000 of married breast cancer survivors experienced divorce after cancer diagnosis. Younger age, lower education, and being employed at diagnosis were associated with divorce. Being divorced survivors had significantly lower QoL (Coefficient [Coef] = −7.50; 95% CI = −13.63, −1.36), social functioning (Coef = −9.47; 95% CI = −16.36, −2.57), and body image (Coef = −8.34; 95% CI = −6.29, −0.39) than survivors who remained married. They also experienced more symptoms including pain, insomnia, financial difficulties, and distress due to hair loss. Conclusion Identifying risk factors of divorce will ultimately help ascertain the resources necessary for early intervention.

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Non-Invasive Biomarkers for Early Detection of Breast Cancer

Cancers ◽

10.3390/cancers12102767 ◽

2020 ◽

Vol 12 (10) ◽

pp. 2767

Author(s):

Jiawei Li ◽

Xin Guan ◽

Zhimin Fan ◽

Lai-Ming Ching ◽

Yan Li ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Diagnosis ◽

Early Stage ◽

False Negative ◽

Breast Cancer Diagnosis ◽

Diagnostic Biomarkers ◽

Circulating Micrornas ◽

Non Invasive ◽

Common Cancer ◽

Volatile Organic

Breast cancer is the most common cancer in women worldwide. Accurate early diagnosis of breast cancer is critical in the management of the disease. Although mammogram screening has been widely used for breast cancer screening, high false-positive and false-negative rates and radiation from mammography have always been a concern. Over the last 20 years, the emergence of “omics” strategies has resulted in significant advances in the search for non-invasive biomarkers for breast cancer diagnosis at an early stage. Circulating carcinoma antigens, circulating tumor cells, circulating cell-free tumor nucleic acids (DNA or RNA), circulating microRNAs, and circulating extracellular vesicles in the peripheral blood, nipple aspirate fluid, sweat, urine, and tears, as well as volatile organic compounds in the breath, have emerged as potential non-invasive diagnostic biomarkers to supplement current clinical approaches to earlier detection of breast cancer. In this review, we summarize the current progress of research in these areas.

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How do women with secondary breast cancer experience telling their adolescent children about their diagnosis?

Journal of Health Psychology ◽

10.1177/1359105316648484 ◽

2016 ◽

Vol 23 (9) ◽

pp. 1223-1233 ◽

Cited By ~ 1

Author(s):

Leonie Lalayiannis ◽

Nicky Asbury ◽

Graham Dyson ◽

Amanda Walshe

Keyword(s):

Breast Cancer ◽

Cancer Diagnosis ◽

Interpretative Phenomenological Analysis ◽

Breast Cancer Diagnosis ◽

Phenomenological Analysis ◽

Primary Cancer ◽

Structured Interviews ◽

Cancer Experience ◽

Secondary Breast Cancer ◽

The Impact

This study investigated how women with secondary breast cancer experience telling their adolescent children. Semi-structured interviews were conducted with women who had been diagnosed with secondary breast cancer at least 1 year prior to the interview. Seven women, who had at least one child between 12 and 19 years old living at home at the time of diagnosis, were interviewed. The interviews were analysed using interpretative phenomenological analysis for an in-depth understanding of women’s experiences. Women found that it was easier to tell their children of their secondary breast cancer diagnosis compared to their primary cancer. However, they talked about the impact the diagnosis had on their family.

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The impact of a breast cancer diagnosis on women’s work status.

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.7_suppl.23 ◽

2018 ◽

Vol 36 (7_suppl) ◽

pp. 23-23

Author(s):

Lucinda Barry ◽

Leanne Storer ◽

Meron Pitcher

Keyword(s):

Breast Cancer ◽

Cancer Diagnosis ◽

Financial Stress ◽

Breast Cancer Diagnosis ◽

Work Status ◽

Paid Employment ◽

The Mean ◽

Woman's Work ◽

One Year ◽

The Impact

23 Background: The diagnosis and treatment of cancer often causes financial stress, partly by impacting on the ability to continue in paid employment. Our aim was to identify changes in work status 12 months after a diagnosis of breast cancer. Methods: An audit of the medical records of women who presented to the Western Health (Victoria, Australia) nurse led breast cancer Survivorship Clinic (SC) between October 2015 and October 2016 was performed to identify employment status at diagnosis and at their review at SC 12 months later. Results: 111 records were reviewed. The mean age was 55 (range 28-82yrs). 84 of these women (76%) were 65 years of younger at the time of diagnosis. 46 of the 84 women ≤65 years were in paid employment at diagnosis (55%), and 38 (83%) were still working in some capacity at review in the SC. Of the 38 still working, 28 were working in the same capacity, 8 were working reduced hours, and 2 were working increased hours. Women who had axillary dissections were most likely to have changed work status. Financial stress was reported by 8/19 of women who stopped working or had changed work hours, including 9 no longer in paid employment and 10 with changed hours. 2/28 women working in the same capacity reported financial stress. 65% of those who reported financial stress (11/17) had chemotherapy as part of their treatment. Conclusions: A breast cancer diagnosis has the ability to influence a woman's work status one year after diagnosis. Health professionals should appreciate the potential work concerns and financial stresses continuing to affect their patients.

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Outcomes associated with rapid genetic testing for BRCA1 and BRCA2 at time of breast cancer diagnosis.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.1577 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. 1577-1577

Author(s):

Kelly A. Metcalfe ◽

Aletta Poll ◽

Andrea Eisen ◽

Jordan Lerner-Ellis ◽

Steven Narod

Keyword(s):

Breast Cancer ◽

Decision Making ◽

Genetic Testing ◽

Cancer Diagnosis ◽

Psychosocial Functioning ◽

Genetic Test ◽

Brca Mutation ◽

Breast Cancer Diagnosis ◽

Bilateral Mastectomy ◽

Rapid Genetic Testing

1577 Background: Bilateral mastectomy improves survival for women with BRCA-associated breast cancer. Most women do not know their BRCA status at the time of BC diagnosis when making surgical decisions. Rapid genetic testing (RGT) allows a woman to have genetic test results prior to treatment decision making, but it is unclear if RGT has an impact on treatment choices. It is also unclear if there are psychosocial implications associated with genetic testing at the time of breast cancer diagnosis. The objective of the current study was to assess the impact of RGT at the time of BC diagnosis on surgical decision-making and psychosocial functioning. Methods: Eligible women were referred from participating surgeons at BC diagnosis. Women completed baseline questionnaires assessing treatment preferences, cancer related distress, anxiety, and depression. All participants received in-person pre-test genetic counselling and genetic test results were given within 10 days. Participants completed surveys at 1 week and 1 year post-genetic testing to assess treatments and psychosocial functioning. Results: 1010 women consented to participate and 60 (5.9%) were identified with a BRCA mutation. 15% of those identified with a BRCA mutation did not meet provincial eligibility criteria for genetic testing, and 20% were eligible prior to a breast cancer diagnosis but had not received testing. Mean levels of cancer-related distress, anxiety and depression declined significantly from baseline to 1 year for all women (all p < .05), and there were no differences at any time point between those with and without a BRCA mutation. Of those identified with a BRCA mutation, 67.3% reported that their surgery choice changed. 73.7% of BRCA carriers had a bilateral mastectomy, compared to 20.2% of BRCA negative (p < 0.001). Most women used genetic testing results for surgical decision making (96.1% of BRCA positive and 86.4% for negative). Conclusions: Rapid genetic testing for BRCA1 and BRCA2 at the time of BC diagnosis does not have a negative impact on psychosocial functioning. There are no differences in cancer-related distress, anxiety or depression between women who receive a positive result compare to a negative genetic test result. Furthermore, surgical choice changed for many women identified with a BRCA mutation, with the majority electing for bilateral mastectomy.

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