Real world patterns of care in HER2-overexpressing breast cancer: Results of a survey of TEACH clinical trial investigators in 2011.

BACKGROUND: HER2-overexpressing breast cancer (BC) is common among young patients and poses a public health burden. Adjuvant anti-HER2/neu therapy with trastuzumab reduces the risk of recurrence and improves survival. METHODS: A web-based survey was sent to 386 physicians of the "TEACH" trial in 2011 to determine access to HER2/neu testing and treatment patterns for HER2-overexpressing BC. RESULTS: There were 151 responders (39%) from 28 countries. Ninety-seven percent reported HER2/neu expression is routinely measured in their institutions by immunohistochemistry (85%), FISH (80%) and other methods (16%). Twenty percent of responders from Asia reported that the test was not routinely available. Forty-eight percent of participants reported instances when adjuvant HER2-directed therapy was recommended to a patient who eventually did not receive it. Reasons for not receiving trastuzumab was cost (73%, p < 0.0001) in low- and middle-income countries and co-morbidities in high-income countries (43%, p = 0.003). CONCLUSIONS: This survey reflects the availability of HER2/neu testing and anti-HER2/neu therapy among physicians who participated in TEACH. A high proportion of women with HER2-overexpressing BC may not receive standard adjuvant therapy due to unavailability of the test and cost of therapy. Despite having some limitations, such as a possible selection bias of participating physicians, variable definitions of access to healthcare among respondents, and changes in trastuzumab availability since 2011, our results demonstrate that access to care and region of practice impact the implementation of cancer treatments.

The relationship between peer status and depressive symptoms in children and adolescents.

The purpose of this study was to examine the relationship between specific symptoms of depression and particular styles of peer difficulties. Participants were 1687 students in fourth, sixth, seventh, eighth, ninth, and eleventh grades from a midsized Midwestern city. Based on previous studies, it was hypothesized that rejected and neglected youths would report greater depressive symptomatology than other peers. In addition, aggressive-rejected youth were predicted to report more Interpersonal Problems while submissive-rejected youths were expected to report more Anhedonia. There were no sociometric group differences on global scores of depression as measured by the Children's Depression Inventory; however, the aggressive- and submissive-rejected youths did report specific differences. Aggressive-rejected youths reported more Interpersonal Problems and feelings of Ineffectiveness, while the neglected and submissive-rejected youths reported more Anhedonia. Taken together, such differences provide support for differentiating among types of rejected students and suggest that different interventions may be necessary to address the needs of these youths.

The role of social anxiety in adolescent peer relations: differences among sociometric status groups and rejected subgroups.

Examined the relation between sociometric nominations and social anxiety in adolescence. Participants were 973 students (473 boys and 500 girls) in Grades 6, 7, 8, and 9. Students completed the Social Anxiety Scale for Adolescents and a sociometric nomination task that included the following behavioral descriptors: liked most, liked least, starts fights the most, best sense of humor, class leader, easiest to push around, and most cooperative. Sociometric nominations were used to classify students into standard sociometric status groups (i.e., popular, average, rejected, neglected, and controversial) as well as into rejected subgroups (aggressive rejected and submissive rejected). Results indicated that students classified as rejected and neglected reported more social anxiety than those classified as average, popular, or controversial. In addition, submissive rejected students reported significantly more social anxiety than did aggressive rejected or average students. Implications of these results for assessment and treatment of adolescents with peer problems are discussed.