A study of lifestyle factors associated with breast cancer patients in Iran

Background: Several environmental and lifestyle factors have a significant role in the incidence of various types of cancer. Lifestyle factors are important elements in the development of cancer, and correction of them can lead to prevention. Given that the underlying cause of cancer is unclear, comparing the lifestyle of two groups of women can explain some of the breast cancer risk factors. Objective: The present study was conducted to compare the lifestyle dimensions in women with and without breast cancer. Methods: This cross-sectional study was carried out to compare two groups of 546 women (273 healthy individuals and 273 cancer patients). The lifestyle sub-scales were collected using a lifestyle questionnaire (LSQ). The differences between the scores of the eight sub-scales in the two groups were analyzed using independent ttest and Mann-Whitney test. Results: The mean age of the participants in both groups of this study was 44.51 ± 11.28. Although the lifestyle scores of the healthy individuals were higher than the patient group, in terms of all eight dimensions of lifestyle, a significant difference was found between the two groups in terms of four dimensions (P<0.05). Also, there was a positive and significant correlation between the socioeconomic status and the lifestyle of women with breast cancer (P=0.49). Conclusions: Regarding the difference between the lifestyle score of the two groups, it seems to be necessary for authorities and healthcare providers to plan for educational programs of lifestyle practices, and healthy behaviors. Besides, conducting longitudinal studies are recommended to find the causal relationship between the two variables

The accuracy of midwives' clinical breast examination in detection of breast lumps.

BACKGROUND: Screen-detected breast cancers are usually diagnosed at earlier stages. Therefore, countries with limited resources are recommended to implement clinical breast examination (CBE) as a screening method in conjunction with mammography. Since there are so many limitations to performance of CBE by surgeons in the health system and CBE by midwives is more feasible, this study was conducted to test the agreement of CBE by midwives and surgeons. METHODS: One thousand and twenty seven patients with no personal history of breast cancer received breast physical examination by both a midwife and a surgeon and designed forms including patients' general information, cause of referral and abnormal physical findings were completed for each patient. RESULTS: The inter-observer agreement (kappa) for mass detection was 36 % (95% CI= 31% to 41%), indicating a "fair" agreement exists between the midwife's and the surgeon's physical examination. Sensitivity, specificity, positive and negative predictive values of "midwife's physical examination" to detect abnormal breast masses in comparison to "surgeon's physical examination" as the gold standard were 75, 67, 48, and 87 percent respectively. CONCLUSIONS: The results of this study do not justify the replacement of general surgeons by midwives in the health care system as the first examiner for clinical breast screening. Decisions about this issue need more comprehensive studies considering cost-effectiveness and training procedures.

The role of depression in the development of breast cancer: analysis of registry data from a single institute.

Although controversial, the belief that developing breast cancer may be associated with psychological distress is not uncommon. The present study examined the role of psychological variables in the development of breast cancer in women attending a breast clinic for medical examination in Tehran, Iran. During a three-year period (1997-1999) a trained female nurse interviewed all women attending the Iranian Center for Breast Cancer (ICBC) before a confirmed diagnosis was made (N = 3000). Data were collected on demographic variables (age, education and marital status), known risk factors (age at menarche, age at first time full term pregnancy, family history of breast cancer, menopausal status, and oral contraceptive use), psychological variables, including history of psychiatric medications, depression (depressed mood, hopelessness, and loss of interests and pleasures), anxiety (mental and somatic signs) and two single measures of overall health and quality of life. In all, 243 patients were diagnosed as having breast cancer. A total of 486 patients with benign disease were randomly selected from the original cohort as controls. Univariate and multivariate logistic regression analyses were performed to determine the predictive effect of each factor on the risk of breast cancer. There were no significant differences between cases and controls except for age at menarche (P = 0.007) and family history of breast cancer (P<0.001). With regard to psychological variables studied, the results showed that there were significant differences between cases and controls regarding depression (depressed mood P<0.0001, hopelessness P = 0.001, and loss of interest and pleasures P = 0.001), and anxiety (mental signs P = 0.006). Finally, after performing multiple logistic regression analysis in addition to family history and age at menarche, depressed mood and hopelessness showed significant results (odds ratios of 1.90, and 1.63 respectively). The findings of the present study suggest that in addition to the known risk factors, psychological determinants such as depressed mood may play an important role in etiology of breast cancer and deserve further investigation, especially in different populations.