ABSTRACT
OBJECTIVES: To describe the Quality of Life (QOL) of breast-cancer patients diagnosed with COVID-19 and analyse its evolution, compare the QOL of these patients according to the COVID-19 wave in which they were diagnosed, and examine the clinical and demographic determinants of QOL. METHODS: A total of 260 patients with breast cancer (90.8% I-III stages) and COVID-19 (85% light/moderate) were included (February-September 2021) in this study. Most patients were receiving anticancer treatment (mainly hormonotherapy). Patients were grouped according to the date of COVID-19 diagnosis: first wave (March-May 2020, 85 patients), second wave (June-December 2020, 107 patients) and third wave (January-September 2021, 68 patients). Quality of Life was assessed 10 months, 7 months, and 2 weeks after these dates, respectively. Patients completed QLQ-C30, QLQ-BR45, and Oslo COVID-19 QLQ-PW80 twice over four months. Patients ≥65 also completed QLQ-ELD14. The QOL of each group and changes in QOL for the whole sample were compared (non-parametric tests). Multivariate logistic regression identified patient characteristics related to (1) low global QOL and (2) changes in Global QOL between assessments. RESULTS: Moderate limitations (>30 points) appeared in the first assessment in Global QOL, sexual scales, three QLQ-ELD14 scales, and 13 symptoms and emotional COVID-19 areas. Differences between the COVID-19 groups appeared in two QLQ-C30 areas and four QLQ-BR45 areas. Quality of Life improvements between assessments appeared in six QLQ-C30, four QLQ-BR45 and 18 COVID-19 questionnaire areas. The best multivariate model to explain global QOL combined emotional functioning, fatigue, endocrine treatment, gastrointestinal symptoms, and targeted therapy (R2 = 0.393). The best model to explain changes in global QOL combined physical and emotional functioning, malaise, and sore eyes (R2 = 0.575). CONCLUSIONS: Patients with breast cancer and COVID-19 adapted well to illness. The few differences between wave-based groups (differences in follow-up notwithstanding) may have arisen because the second and third waves saw fewer COVID restrictions, more positive COVID information, and more vaccinated patients.
Subject(s)
Breast Neoplasms , COVID-19 , Humans , Female , Quality of Life/psychology , COVID-19/epidemiology , Breast Neoplasms/therapy , Breast Neoplasms/drug therapy , Surveys and Questionnaires , Logistic ModelsABSTRACT
PURPOSE: There is a debate on the role of adjuvant Radiotherapy (RT) in elderly breast cancer patients. The aim is to study Quality of Life (QL) throughout the treatment and follow-up periods in early stages breast cancer patients who have started radiotherapy, and to compare the QL of axillary surgery groups. METHODS: 173 patients, ≥65 years completed the EORTC QLQ-C30 and QLQ-BR23, and the Interview for Deterioration in Daily Living Activities in Dementia(IDDD) questionnaires three times throughout treatment and follow-up periods. Linear mixed effect models were used to evaluate longitudinal changes in QL, and whether these changes differed among axillary surgery groups. RESULTS: QL scores were high (>70/100 points) in most QL areas, with moderate limitations (>30) in sexual functioning and enjoyment, future perspective and global QL. In six areas there was a decline at the RT sessions end, that after 6 weeks was recovered. For three areas, there was an improvement in the follow-up measurement compared to the previous assessments. Changes in seven areas were <5 points. Axillary node dissection patients had a body image decrease (6 points) in the follow up period. The lymphadenectomy group had more fatigue (10 points, p = 0.078) than the other two axillary surgery groups. CONCLUSIONS: Results orientate towards good patients' adaptation to their disease and treatments, and to administering RT in early stages breast cancer patients. QL differences between the axillary surgery groups and in their evolutions were few but have appeared in key QL areas.
Subject(s)
Breast Neoplasms/radiotherapy , Quality of Life , Age Factors , Aged , Aged, 80 and over , Breast Neoplasms/psychology , Breast Neoplasms/surgery , Female , Follow-Up Studies , Humans , Linear Models , Prospective Studies , Radiotherapy, Adjuvant , Surveys and QuestionnairesABSTRACT
En diciembre de 2014 hemos tenido la oportunidad de ampliar nuestro conocimiento en el Simposio Internacional de Cáncer de Mama, celebrado en San Antonio, resaltando: 1) en el escenario básico, la adquisición de mutaciones durante el proceso de carcinogénesis y metástasis, aumentando la clonalidad y heterogeneidad tumoral, el papel pronóstico de los neoantígenos y los linfocitos infiltrantes en el residuo tumoral tras la neoadyuvancia, así como el mayor conocimiento de alteraciones en el receptor de estrógeno asociadas a hormonorresistencia; 2) en el translacional, el empleo de xenoinjertos derivados de tumores de pacientes en modelos murinos para evitar las resistencias terapéuticas, y los biomarcadores líquidos para descartar enfermedad mínima residual en cáncer de mama precoz; y 3) en clínica los resultados tanto en prevención como en adyuvancia con hormonoterapia, la quimioterapia en triples negativos y las novedades en inmunoterapia (AU)
The 37th San Antonio Breast Cancer Symposium, held in December 2014, provided an opportunity to gain greater knowledge. Notable contributions were the following: 1) in basic research, the acquisition of mutations in carcinogenesis and metastasis, which increase with clonality and heterogeneity; the prognostic role of neoantigens and infiltrating lymphocytes in the residual tumor after neoadjuvant chemotherapy; and an increased knowledge of molecular mutations in the estrogen receptor, which explain hormonal resistance; 2) in the translational arena, the role of patient-derived xenografts to avoid therapeutic resistance; and the role of liquid biomarkers to detect minimal residual disease in early breast cancer; and 3) in the clinical scenario, advances in prevention and hormone therapy, and news on triple-negative tumors and immunotherapy (AU)
Subject(s)
Humans , Breast Neoplasms , Congresses as Topic , Immunotherapy , Translational Research, Biomedical , Hormones/therapeutic useABSTRACT
La autora sostiene que el próximo dictamen de la Ley de Organización de las Comunas, último peldaño en el camino de la descentralización del Gobierno de la Ciudad de Buenos Aires, marcará un antes y un después en relación a la gestión política y administrativa del espacio público. Que por lo tanto se hace imperioso aprovechar esta última oportunidad para llevar la gestión de los espacios verdes urbanos a su máxima excelencia, tanto desde el punto de vista de sus aspectos conceptuales, como de los actores encargados de llevarlos a la práctica
Subject(s)
CitiesABSTRACT
La autora sostiene que el próximo dictamen de la Ley de Organización de las Comunas, último peldaño en el camino de la descentralización del Gobierno de la Ciudad de Buenos Aires, marcará un antes y un después en relación a la gestión política y administrativa del espacio público. Que por lo tanto se hace imperioso aprovechar esta última oportunidad para llevar la gestión de los espacios verdes urbanos a su máxima excelencia, tanto desde el punto de vista de sus aspectos conceptuales, como de los actores encargados de llevarlos a la práctica
