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BackgroundAt least 77.0% of breast cancer patients will experience cancer-related fatigue. Hope level and resilience play as two important factors that have influence on cancer-related fatigue. Currently， most studies involve one single factor， either the level of hope or resilience， and explore its relationship with the cancer-related fatigue. Only limited studies explore the action mechanism behind with all three factors put together. ObjectiveTo investigate the mediating role of resilience between hope and cancer-related fatigue in patients with breast cancer， and to provide references for finding intervention targets for cancer-related fatigue in breast cancer patients. MethodsFrom March to October 2022， this study was conducted on the sample size of 324 hospitalized patients from three Grade-A tertiary hospitals in Shaanxi Province. These patients were over 18 years old and pathologically diagnosed as breast cancer. Hope level， resilience and cancer-related fatigue were assessed， respectively， using Adult Dispositional Hope Scale （ADHS）， Connor-Davidson Resilience Scale （CD-RISC-10） and Cancer Fatigue Scale （CFS）. Pearson Correlation Analysis was used to analyze the relationship between ADHS score， CD-RISC-10 score and CFS score. AMOS 22.0 was used to analyze the mediating effect of resilience between hope level and cancer-related fatigue in breast cancer patients. ResultsThe detection rate of cancer-related fatigue in patients with breast cancer was 88.58%. Scores of ADHS and CD-RISC-10 were negatively correlated with CFS score （r=-0.750， -0.809， P<0.01）. ADHS score was positively correlated with CD-RISC-10 score （r=0.901， P<0.01）. Resilience had a mediating effect between the hope level and cancer-related fatigue. The mediating effect value was -0.676（95% CI： -1.005~-0.347）， accounting for 81.90% of the total effect. ConclusionThe hope level of breast cancer patients can affect cancer-related fatigue directly as well as indirectly through resilience. Resilience plays a partial mediating role between hope level and cancer-related fatigue .
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Introduction- Breast cancer is abnormal growth of cells in the breast. Breast cancer affects all the domains of quality of life such as physical health, mental health, functioning due to emotional problems, financial problems and social problems. Symptoms of fatigue, insomnia, and pain have the most important infiuence on these domains. To evaluate quality of Aim of the studylife of breast cancer patient's post-surgery It is a cross-sectional study. Methodology- European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Caner 30 (EORTC QLQ C-30) and European Organization for Research and Treatment of Cancer Breast Specific -23 (EORTC BR-23) were used as study tool. The functional scale score of Results- the EORTC QLQ C-30 was the highest in radical mastectomy (80.56%) indicating a higher level of functioning. A lower level of functioning in breast reconstruction surgery (64.75%).The symptom scale of the EORTC QLQ C-30 was highest in breast reconstruction surgery (35.4 %) and least in radical mastectomy(19.63%). The quality of life was highest in breast reconstruction surgery ( 17.71 %) and lowest in radical mastectomy (9.9%). The quality of life Conclusionwas better in breast reconstruction surgery and was lowest in radical mastectomy.
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Postoperative adjuvant chemotherapy for breast cancers was one of the ways to decrease the tumor recurrencerate of patients and improve the overall survival.It reviewed related articles about cost-utility analysis of postoperative adjuvant chemotherapy regimens for breast cancers before 2016,which could provide references for selecting economic and effective treatment for clinicalpractice.
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Objective:To compare the therapeutic effects between immediate breast reconstruction (IBR) after skin-sparing mastecto-my and modified radical mastectomy (MRM) in young breast cancer patients (≤35 years), as well as to analyze the prognostic factors of IBR in these patients. Methods:The clinicopathological data of young breast cancer patients who had undergone IBR after skin-spar-ing mastectomy (60 cases) and MRM (68 cases) in Liuzhou People's Hospital from July 2008 to June 2014 were retrospectively ana-lyzed. Local recurrence, disease-free survival, and overall survival of the patients between the two groups were compared. The influ-encing factors for survival of the IBR group patients, such as age, tumor size, and nipple-areolar complex preservation, were analyzed. Results:All patients were followed-up for a period ranging from 15 to 88 months with a median of 51. In the IBR group, local recur-rence, distant metastasis, and death occurred in 3, 8, and 5 cases, respectively. The 3-and 5-year disease-free survival rates (DFSR) were 91.7%and 81.7%, respectively, whereas the overall survival rate (OSR) was 91.7%. In the MRM group, local recurrence, distant metastasis, and death occurred in 2, 9, and 5 cases, respectively. The 3-and 5-year DFSRs were 94.1%and 83.8%, respectively, where-as the OSR was 92.6%. No statistical difference was noted between the two groups (P>0.05). The analysis of prognostic correlation fac-tors in the IBR group patients shows that lymph node metastasis and estrogen and progesterone receptor-negative correlated with the tumor-free survival and overall survival rates (P<0.05). Conclusion:No apparent statistical difference in the comparison of the local re-currence and long-term survival rate was observed between the two groups' young breast cancer patients who underwent IBR after skin-sparing mastectomy and MRM. IBR after skin-sparing mastectomy is safe for young breast cancer patients with early-stage, and nipple-areolar complex preservation does not increase the risk of recurrence in the IBR group patients. Lymph node metastasis and es-trogen and progesterone receptor-negative are the major prognostic factors of IBR after skin-sparing mastectomy in young breast can-cer patients.
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Background and purpose:The young breast cancer patients were treated with goserelin without individualized regimen, and lack of available clinical marker. The aim of this study was to investigate the role of anti-Müllerian hormone (AMH) in evaluation of individualized treatment of ovarian function suppression in the young breast cancer patients.Methods:Forty-one young patients with estrogen receptor (ER) and progesterone receptor (PR) positive breast cancer from May 2012 to Jan. 2014 were randomly divided into 2 groups to undergo radical resection of breast cancer. According to postoperative treatment, one group was treated with goserelin + chemotherapy (n=20), and the other group received chemotherapy alone (n=21). Thirty female patients in the same age group were selected as normal control group. The time of menopause and menstrual recovery after the goserelin + chemotherapy or chemotherapy alone were observed in 2 groups. In early follicular phase (day 3-5) of the cycle preceding the operation and 3, 6 courses after the goserelin + chemotherapy treatment or chemotherapy treatment, serum levels of AMH, FSH and E2 were measured in 2 groups. Accordingly, serum levels of AMH, FSH and E2 were evaluated as well in normal control group.Results:There were no signiifcant differences in preoperative general conditions and preoperative serum FSH and E2 levels among the 3 groups (P>0.05). Compared with normal control group, the preoperative serum AMH levels of young breast cancer patients were decreased signiifcantly (P=0.04). The menopause time and menstrual recovery time in 2 chemotherapy groups were signiifcantly shorter than that in normal control group (P=0.00). Compared with normal control group and preoperative measurement, the differences in serum FSH and E2 levels were not statistically significant in goserelin + chemotherapy group or chemotherapy alone group (P<0.05). The serum AMH levels measured at different time points of the goserelin + chemotherapy group and chemotherapy alone group were decreased signiifcantly (P<0.05). Compared with the chemotherapy group, the serum AMH levels of the goserelin + chemotherapy group after 6 courses were signiifcantly decreased, and then signiifcantly increased 6 months after menstrual recovery (P<0.05).Conclusion:This study demonstrated that the serum AMH levels were obviously decreased after the ovarian function suppression treatment and increased after the menstrual recovery compared with evaluation of other ovarian reserve index. The serum AMH level could suggest ovarian reserve damage even after ovarian function has recovered to the noticeable level. Thus, AMH could be used clinically to evaluate the ovarian reserve of breast cancer patients as a potential marker for the individualized ovarian function suppression treatment in young breast cancer patients.
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Objective To explore the effect of gemcitabine combined with cisplatin on ER , MMP-9 and estrogen in patients with stage III breast cancer.Methods 93 patients with breast cancer were collected and randomly divided into control group and experimental group.Two groups were all under breast cancer surgery, control group was treated with cisplatin chemotherapy,1st day of intravenous infusion of cisplatin 90 mg/m2 , 21 days for a course of treatment, continuous treatment of 6 courses.Experimental group were treated with cisplatin combined with gemcitabine chemotherapy , 1st and 8th days of intravenous infusion of 1000 mg/m2 gemcitabine, 3 ~5d, intravenous drip of cisplatin 90 mg/m2 , every 28 days a cycle, continuous administration of 2 cycles,After treatment, the clinical efficacy of the two groups, the level of ER, MMP-9, estrogen and the incidence of adverse reactions were compared.Results Compared with before treatment,the levels of serum MMP-9,E1, E2, ER were decreased (P<0.05), and the level of LH and FSH were increased (P<0.05) of two group post-treatment.Compared with control group post-treatment, the levels of serum ER, MMP-9, E1, E2 were lower in experimental group (P<0.05), and the LH and FSH levels were higher (P <0.05).The incidence of adverse reactions of experimental group was 6.38%, and control group was 15.22%, the incidence of adverse reactions in the two groups was no significant difference . Conclusion Gemcitabine combined with cisplatin in the treatment of patients with breast cancer has a significant effect, and can improve the clinical symptoms, reduce the serum ER, E1, MMP-9, E2 levels, improve FSH, LH level.
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<b>Background/Purpose</b>: The purpose of this study is to clarify the effectiveness of interventions for breast cancer patients with psychological distress by a clinical psychologist on the basis of the contents of the interventions and counseling. <b>Methods</b>: The participants were 20 inpatient and outpatient women aged from 33 to 73 years who had been diagnosed with breast cancer. The interventions were conducted on the basis of patients' complaints about anxiety and/or depression or by a medical doctor's request. The interventions employed unstructured, one-on-one interviews. Each interview usually lasted no more than 60 minutes. <b>Results</b>: The 20 cases were classified into the following categories: (1) 15 general (nonpsychiatric) cases, consisting of (1-1) 9 cases at the cancer-notification and progressive-therapeutic stages and (1-2) 6 cases at the progressive-relapse stage; and (2) 5 specific (psychiatric) cases, consisting of (2-1) 3 cases at the cancer-notification and progressive-therapeutic stages and (2-2) 2 cases at the progressive-relapsestage. As for the general cases, interventions were found to be effective in all 9 cases at the cancer-notification and progressive-therapeutic stages but in only 2 of 6 cases at the progressive-relapse stage. In specific cases, effective interventions were found at the cancer-notification, the progressive-therapeutic, and the progressive-relapsestages. <b>Conclusion</b>: This study suggested that interventions for breast cancer patients by a clinical psychologist are effective. The psychological interventions had two roles: to assess the patients properly and to interview the patients as purposefully as a medical team member would.
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By analyzing the data of 459 patients who completed the Supportive Care Needs Survey (SCNS), the prevalence, medical and non-medical predictors of unmet needs were investigated. Breast cancer patients in Korea experienced high levels of unmet needs across the needs domains, particularly in the health system and information domain (56.9%). Various medical and non-medical variables were identified as significant predictors of unmet needs in each domain. By multivariate analyses, several predictors were identified across the domains including; less education ( 2cm) and younger age in the health system and information, and more education (> or = 13 years) in the care and support domain. The results of this study suggest medical professional should consider the complexity and dynamics of meeting patients' needs in providing supportive care services.
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Middle Aged , Humans , Female , Aged, 80 and over , Aged , Adult , Social Support , Perception , Needs Assessment , Multivariate Analysis , Korea , Health Services Needs and Demand , Health Services Accessibility , Breast Neoplasms/diagnosis , Attitude to HealthABSTRACT
PURPOSE: The objective of this study was to assess the supportive needs of breast cancer patients and determine the socio-demographic and clinicopathological predictors of those unmet needs. METHODS: Of 302 eligible breast cancer patients, attending Yonsei University Severance Hospital, 250 completed the surveys. The supportive care needs were assessed by administering a Supportive Care Needs Survey. RESULTS: Of the ten highest perceived needs items, 7 items were related to the health system and information domain and 2 to the psychological domain. The univariate analysis in each domain showed education (P=0.083) and chemotherapy (P=0.042) were significant predictors in the psychological domain; education (0=0.000), time since surgery (P=0.009), node metastasis (0.022), chemotherapy (P=0.001) and radiation therapy (P=0.003) in the physical and daily living domain; age (P=0, 009) and duration of marriage (P= 0.004) for sexuality; node metastasis (P=0.048), TNM stage (P=0.036), and recurrence (P=0.010) in the health system and information domain and religion (P=0.016) in the care and support domain. A multivariate analysis showed age (P=0.0253) and chemotherapy (P=0.0517) as significant independent predictors in the sexuality domain; education (P=0.0010), chemotherapy (P=0.0011), radiation therapy (P= 0.0133) and time since surgery (P=0.036) in the physical and daily living domain; recurrence (P=0.0324) in the health system and information; domain and education (P=0.0134) and chemotherapy (P=0.0207) in psychological domain. CONCLUSION: Breast cancer patients experience high levels of unmet supportive needs across each domain, but especially in the health systems and information domain. Also, the types of needs varied according to the patient subgroups. This study suggests considerable improvements be made in terms of supportive care of breast cancer patients.
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Humans , Breast Neoplasms , Breast , Drug Therapy , Education , Marriage , Multivariate Analysis , Neoplasm Metastasis , Recurrence , SexualityABSTRACT
Purpose:To find out the clinical biology value of p53 overexpression on Chinese breast cancer by Meta analysis. Methods:Reviewed all the published studies during the recent 10 years regarding p53 and breast cancer, and used standard techniques of Meta-analysis to combine the results of these studies to produce a more precise estimate of the prognostic significance of p53 mutations.Results:the mean of p53 positive express was 45%,95% confidence interval (43-47)%:, p53 positive was related with node metastasis, recurrence after surgery, over survival, tumor size and nuclear grade, but not related with age and pathology type, p53 was a special and sensitive prognostic factor for breast cancer.Conclusions:p53 can be an independent molecular marker to definitive prognostic of breast cancer, and possibly can be a reliable marker for choice of standard and individulized therapy.
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Twenty-three patients with cancer of the breast were referred to the Department of Radiology, Siriraj Hospital, for breast irradiation. The arm and body fixator Siriraj B-34 was used both during the treatment planning and the radiation treatment. Complications were 4 cases of radiation pneumonitis, 1 of radiation lung fibrosis and 3 of lymphedema of arms. But after supportive and symptomatic treatment these conditions were resolved. After 2-years of follwed-up, one patient had a local recurrence and distant metastasis, and two patients had distant metastases. We conclude that the arm and body fixator Siriraj B-34 is an acceptable & safe aid in the radiation treatment of breast cancer patients.