scholarly journals Persistent Breast Cancer Pain

2021 ◽  
Author(s):  
Sachin Sahni ◽  
James Khan
Keyword(s):  
Breast Cancer ◽  
Treatment Options ◽  
Pain Syndrome ◽  
Well Being ◽  
Pain Disorder ◽  
Breast Cancer Surgery ◽  
Negative Effects ◽  
Healthcare Expenditures ◽  
Surgical Incision ◽  
The Common

Fortunately, with advances in screening and management, the prognosis of breast cancer has substantially improved. However, as patients with breast cancer are living much longer, consequences of management are becoming increasingly apparent, particularly persistent pain after breast cancer surgery. This pain disorder, referred to as Post-Mastectomy Pain Syndrome (PMPS) is common and typically presents as pain with neuropathic features around the surgical incision. This pain disorder is associated with negative effects on the patient’s social and psychological well-being as well as increased healthcare expenditures. Despite the common occurrence of this disorder, it is vastly under-recognized with a lack of preventative and treatment options. This chapter aims to outline the management of persistent breast surgery pain. The pathophysiology and etiology will be reviewed, followed by tools that clinicians can implement in order to appropriately diagnose neuropathic pain. Pertinent risk factors that are commonly seen in practice will be outlined, followed by non-pharmacological, pharmacological, and interventional therapeutic options that can be offered.

scholarly journals Influence of false-positive mammography results on subsequent screening: do physician recommendations buffer negative effects?

2012 ◽  
Vol 19 (1) ◽  
pp. 35-41 ◽  
Author(s):  
Jessica T DeFrank ◽  
Barbara K Rimer ◽  
J Michael Bowling ◽  
Jo Anne Earp ◽  
Erica S Breslau ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
False Positive ◽  
Well Being ◽  
Negative Consequences ◽  
Cancer Worry ◽  
Negative Effects ◽  
Screening Guidelines ◽  
Regular Screening ◽  
Positive Results

Objective Cancer screening guidelines often include discussion about the unintended negative consequences of routine screening. This prospective study examined effects of false-positive mammography results on women's adherence to subsequent breast cancer screening and psychological well-being. We also assessed whether barriers to screening exacerbated the effects of false-positive results. Methods We conducted secondary analyses of data from telephone interviews and medical claims records for 2406 insured women. The primary outcome was adherence to screening guidelines, defined as adherent (10–14 months), delayed (15–34 months), or no subsequent mammogram on record. Results About 8% of women reported that their most recent screening mammograms produced false-positive results. In the absence of self-reported advice from their physicians to be screened, women were more likely to have no subsequent mammograms on record if they received false-positive results than if they received normal results (18% vs. 7%, OR = 3.17, 95% CI = 1.30, 7.70). Receipt of false-positive results was not associated with this outcome for women who said their physicians had advised regular screening in the past year (7% vs. 10%, OR = 0.74, 95% CI = 0.38, 1.45). False-positive results were associated with greater breast cancer worry ( P < .01), thinking more about the benefits of screening ( P < .001), and belief that abnormal test results do not mean women have cancer ( P < .01), regardless of physicians' screening recommendations. Conclusion False-positive mammography results, coupled with reports that women's physicians did not advise regular screening, could lead to non-adherence to future screening. Abnormal mammograms that do not result in cancer diagnoses are opportunities for physicians to stress the importance of regular screening.

Management of Neuropathic Postoperative Pain

2018 ◽  
Author(s):  
Ean Saberski ◽  
Lloyd Saberski
Keyword(s):  
Breast Cancer ◽  
Neuropathic Pain ◽  
High Risk ◽  
Postoperative Pain ◽  
Pain Syndrome ◽  
Breast Cancer Surgery ◽  
Chronic Postoperative Pain ◽  
Treatment Regimens ◽  
Postherniorrhaphy Pain ◽  
Deliberate Strategy

Pain following surgery is routine and unavoidable but expected to resolve with time. In some cases, postoperative pain persists as the result of a neuropathic process such as a neuroma or nerve entrapment. Postoperative neuropathic pain is physiologically distinct from acute pain, but the mechanisms by which pain is transduced, transmitted, decoded, and modulated are shared. Effective treatment regimens for postoperative neuropathic pain employ a deliberate strategy to disrupt the aberrant nociceptive signal. Some surgeries are high risk for chronic postoperative pain with postherniorrhaphy pain syndrome and persistent pain following breast cancer surgery existing as well described entities in the literature.

Predictors of Sexual Health in Women After a Breast Cancer Diagnosis

1999 ◽  
Vol 17 (8) ◽  
pp. 2371-2371 ◽  
Author(s):  
Patricia A. Ganz ◽  
Katherine A. Desmond ◽  
Thomas R. Belin ◽  
Beth E. Meyerowitz ◽  
Julia H. Rowland
Keyword(s):  
Breast Cancer ◽  
Body Image ◽  
Sexual Health ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Sexual Interest ◽  
Well Being ◽  
Two Samples ◽  
The Common

PURPOSE: To identify variables that might be predictive of sexual health (interest, dysfunction, and satisfaction) in a large sample of breast cancer survivors, with a validation conducted in a second, independent sample. PATIENTS AND METHODS: On the basis of a conceptual framework of sexual health in breast cancer survivors, we performed multivariable regression analyses to estimate sexual interest, dysfunction, and satisfaction in both samples. Additional analyses were performed using stepwise regression and recursive partitioning to explore in each sample the relative contributions of the independent variables toward predicting the outcome measures. RESULTS: The models for sexual interest accounted for at least 33% of the variance, and the significant predictors common to the two samples were having a new partner since the diagnosis of breast cancer, mental health score, and body image score. For sexual dysfunction, the models in the two samples explained at least 33% of the variance, and the common significant predictors were vaginal dryness, past chemotherapy use, and having a new partner since diagnosis. The sexual satisfaction models explained at least 27% of the variance, with the common significant predictors being the quality of the partnered relationship and sexual problems in the partner. CONCLUSION: Among the predictors of sexual health, several are mutable (vaginal dryness, emotional well-being, body image, the quality of the partnered relationship, and sexual problems in the partner), and these should be considered for future interventions to address the sexual health and well-being of breast cancer survivors.

scholarly journals Association of Breast Cancer Surgery With Quality of Life and Psychosocial Well-being in Young Breast Cancer Survivors

JAMA Surgery ◽  
2020 ◽  
Vol 155 (11) ◽  
pp. 1035
Author(s):  
Shoshana M. Rosenberg ◽  
Laura S. Dominici ◽  
Shari Gelber ◽  
Philip D. Poorvu ◽  
Kathryn J. Ruddy ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Well Being ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Young Breast Cancer

13. A Navigated Intelligent Knife for Breast Cancer Surgery

2018 ◽  
Author(s):  
Mark Asselin
Keyword(s):  
Breast Cancer ◽  
Tracking System ◽  
Treatment Options ◽  
Three Dimensional ◽  
Positive Margin ◽  
Breast Conserving Surgery ◽  
Breast Cancer Surgery ◽  
Feasibility Trial ◽  
Clinical Safety ◽  
Surgical Smoke

When a woman is diagnosed with breast cancer, several treatment options are considered including breast conserving surgery. In this type of surgery, the goal is to completely remove the cancer while leaving as much healthy breast tissue as possible. This is a clinical judgement of high consequence since resecting less tissue is cosmetically appealing but increases the chances of leaving cancer cells behind, known as a positive margin. Conventionally, this operation is performed with an electrocautery – imagine it as an electronic knife – which seals tissue as it cuts and produces small amounts of surgical smoke in the process. In most operating rooms today this smoke is treated as a by product, and it is discarded with no further consideration. But this smoke is rich with useful information; it contains traces of the molecules the knife passed through when the smoke was generated. The intelligent knife (iKnife) analyzes this smoke to determine the pathology of tissue the surgeon’s knife has passed through – whether the tissue is cancerous or not. We have coupled the iKnife with an electromagnetic position tracking system to create a three dimensional spatially resolved malignancy map showing where the surgeon’s knife has encountered cancerous tissue. We have developed a functional prototype and have approval for a first clinical safety and feasibility trial. We hope the spatial map will help surgeons to successfully remove the entire malignancy with the smallest amount of healthy tissue while maintaining negative margins – a successful surgical outcome for the patient.

scholarly journals Linguistic and Psychometric Validity of the Malay BREAST-Q in Women Undergoing Breast Cancer Surgery in Malaysia

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 115s-115s
Author(s):  
B. Shunnmugam ◽  
S. Sinnadurai ◽  
S.H. Chua ◽  
T. Islam ◽  
M.H. See ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Intraclass Correlation ◽  
Well Being ◽  
Cancer Surgery ◽  
Psychometric Validation ◽  
Breast Cancer Surgery ◽  
Breast Cancer Patients ◽  
Patient Reported ◽  
The Impact

Background: BREAST-Q is a PROMs used to measure and assess patient satisfaction and quality of life before and after breast cancer surgery. BREAST-Q composed of 5 different modules and each module comprised of multiple scales. Each module has preoperative and postoperative versions to assess the impact of surgery. Four subscales with common items from the 5 modules: “satisfaction with the breast”, psychosocial, sexual and physical well-being were subjected to testing. Two other subscales, “satisfaction with overall outcomes” and “satisfaction with the care” were only validated linguistically. Currently, the BREAST-Q has already been translated into 25 languages. Linguistic and psychometric validation of BREAST-Q has not been performed in Malaysia. Aim: To translate the BREAST-Q into Malay language and perform psychometric validation. Methods: Translation of the English BREAST-Q to Malay language was done based on linguistic validation protocol provided by MAPI Research Trust. Content and face validation were performed to determine contextual accuracy, acceptability and understanding of the items. The finalised Malay BREAST-Q then underwent psychometric testing. Breast cancer patients (n=186) who were planned for breast cancer surgery were conveniently sampled at the breast clinic of UMMC between June 2015 to June 2016. Consented participants completed the questionnaire in the same visit following their diagnosis. Retest was done 2-3 weeks after the first questionnaire administration in 62 patients who were admitted for their surgery. Data were analyzed using SPSS and AMOS software. Results: Content experts (4 breast surgeons) agreed the items in BREAST-Q comprehensively measured the concept of interest and I-CVI for each item was 1.0. Participants agreed the questionnaire was comprehensive and easy to understand. The average time taken to complete the questionnaire was 15.3 minutes. Test–retest analysis showed good reproducibility with intraclass correlation coefficient (ICC) value of 0.71-0.98. Internal consistencies were good for all items in each subscale with Cronbach's alpha values of 0.83-0.95. The highest interitem correlation for each item with at least one other item in the construct ranged from 0.47 to 0.90. The lowest corrected item-total correlation (CITC) values ranged from 0.47 to 0.72. In exploratory factor analysis, the KMO values were excellent in all 4 subscales (0.76, 0.92, 0.91, and 0.86). Single factor was extracted in 3 subscales that explained more than 50% of the variance and 3 factors (breast pain, general pain, and discomfort) were extracted in “physical well-being” subscale that cumulatively explained more than 50% of the variance. Conclusion: The Malay BREAST-Q demonstrated good reliability, content and face validity, and excellent psychometric properties. Hence, we propose the use of the Malay BREAST-Q to measure patient reported outcomes among breast cancer patients in Malaysia undergoing breast cancer surgery.

Breast Cancer: A Review of Risk Factors and New Insights into Treatment

2021 ◽  
Vol 17 ◽  
Author(s):  
Kimia Karami Dolisgan ◽  
Khatereh Anbari
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Cancer Treatment ◽  
Breast Cancer Surgery ◽  
The Common ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing ◽  
Biomedical Investigation ◽  
Surgical Treatments ◽  
Chemotherapy Agents

Abstract: Today, in spite of significant advances in cancer treatment has been made, however, breast cancer is still remains as one of the main health problem and considered as a top biomedical investigation urgency. The present study reviewed the common conventional chemotherapy agents and also some alternative and complementary approaches such as oncolytic virotherapy, bacteriotherapy, nanotherapy, immunotherapy, and natural products which are recommended for breast cancer treatment. In addition to current surgery approaches such as mastectomy, in recent years a number of novel techniques such as robotic mastectomies, nipple-sparing mastectomy, skin-sparing mastectomy, day-case mastectomy were used in breast cancer surgery. In this review, we summarize new insights risk factors, surgical and non-surgical treatments for breast cancer.

scholarly journals A randomized trial of exercise on well-being and function following breast cancer surgery: the RESTORE trial

2011 ◽  
Vol 6 (2) ◽  
pp. 172-181 ◽  
Author(s):  
Roger T. Anderson ◽  
Gretchen G. Kimmick ◽  
Thomas P. McCoy ◽  
Judith Hopkins ◽  
Edward Levine ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Randomized Trial ◽  
Well Being ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
And Function

scholarly journals The impact of age on patient-reported outcomes after oncoplastic versus conventional breast cancer surgery

2021 ◽  
Author(s):  
M. Ritter ◽  
B. M. Ling ◽  
I. Oberhauser ◽  
G. Montagna ◽  
L. Zehnpfennig ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Patient Reported Outcomes ◽  
Breast Surgery ◽  
Perforator Flap ◽  
Well Being ◽  
Breast Cancer Surgery ◽  
Oncoplastic Breast Surgery ◽  
Age Related ◽  
Patient Reported ◽  
The Impact

Abstract Purpose Some studies have indicated age-specific differences in quality of life (QoL) among breast cancer (BC) patients. The aim of this study was to compare patient-reported outcomes after conventional and oncoplastic breast surgery in two distinct age groups. Methods Patients who underwent oncoplastic and conventional breast surgery for stage I-III BC, between 6/2011–3/2019, were identified from a prospectively maintained database. QoL was prospectively evaluated using the Breast-Q questionnaire. Comparisons were made between women < 60 and ≥ 60 years. Results One hundred thirty-three patients were included. Seventy-three of them were ≥ 60 years old. 15 (20.5%) of them received a round-block technique (RB) / oncoplastic breast-conserving surgeries (OBCS), 10 (13.7%) underwent nipple-sparing mastectomies (NSM) with deep inferior epigastric perforator flap (DIEP) reconstruction, 23 (31.5%) underwent conventional breast-conserving surgeries (CBCS), and 25 (34.2%) received total mastectomy (TM). Sixty patients were younger than 60 years, 15 (25%) thereof received RB/OBCS, 22 (36.7%) NSM/DIEP, 17 (28.3%) CBCS, and 6 (10%) TM. Physical well-being chest and psychosocial well-being scores were significantly higher in older women compared to younger patients (88.05 vs 75.10; p < 0.001 and 90.46 vs 80.71; p = 0.002, respectively). In multivariate linear regression, longer time intervals had a significantly positive effect on the scales Physical Well-being Chest (p = 0.014) and Satisfaction with Breasts (p = 0.004). No significant results were found concerning different types of surgery. Conclusion Our findings indicate that age does have a relevant impact on postoperative QoL. Patient counseling should include age-related considerations, however, age itself cannot be regarded as a contraindication for oncoplastic surgery.

scholarly journals Role of physiotherapy in supporting recovery from breast cancer treatment: a qualitative study embedded within the UK PROSPER trial

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e040116
Author(s):  
Sophie Rees ◽  
Bruno Mazuquin ◽  
Helen Richmond ◽  
Esther Williamson ◽  
Julie Bruce
Keyword(s):  
Breast Cancer ◽  
Cancer Treatment ◽  
Exercise Intervention ◽  
Well Being ◽  
Breast Cancer Treatment ◽  
Breast Cancer Surgery ◽  
Sense Of Control ◽  
Post Surgery ◽  
The Uk ◽  
Behavioural Strategies

ObjectivesTo explore the experiences of women with breast cancer taking part in an early physiotherapy-led exercise intervention compared with the experiences of those receiving usual care. To understand physiotherapists’ experience of delivering the trial intervention. To explore acceptability of the intervention and issues related to the implementation of the Prevention Of Shoulder Problems (PROSPER) programme from participant and physiotherapist perspective.DesignQualitative semistructured interviews with thematic analysis.SettingUK National Health Service.ParticipantsTwenty participants at high risk of shoulder problems after breast cancer surgery recruited to the UK PROSPER trial (10 each from the intervention arm and control arm), and 11 physiotherapists who delivered the intervention. Trial participants were sampled using convenience sampling. Physiotherapists were purposively sampled from high and low recruiting sites.ResultsParticipants described that the PROSPER exercise intervention helped them feel confident in what their body could do and helped them regain a sense of control in the context of cancer treatment, which was largely disempowering. Control arm participants expressed less of a sense of control over their well-being. Physiotherapists found the exercise intervention enjoyable to deliver and felt it was valuable to their patients. The extra time allocated for appointments during intervention delivery made physiotherapists feel they were providing optimal care, being the ‘perfect physio’. Lessons were learnt about the implementation of a complex exercise intervention for women with breast cancer, and the issues raised will inform the development of a future implementation strategy.ConclusionsA physiotherapist-delivered early supported exercise intervention with integrated behavioural strategies helped women at risk of shoulder problems following breast cancer treatment to feel more confident in their ability to mobilise their arm post-surgery. A physiotherapist-delivered early supported exercise intervention with integrated behavioural strategies may address the sense of powerlessness that many women experience during breast cancer treatment.Trial registration numberISRCTN35358984.

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