• Title, Summary, Keyword: breast cancer care

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The impact of continuous positive airway pressure on radiation dose to heart and lung during left-sided postmastectomy radiotherapy when deep inspiration breath hold technique is not applicable: a case report

  • Kil, Whoon Jong;Pham, Tabitha;Hossain, Sabbir;Casaigne, Juan;Jones, Kellie;Khalil, Mohammad
    • Radiation Oncology Journal
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    • v.36 no.1
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    • pp.79-84
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    • 2018
  • Deep inspiration breathing hold (DIBH) compared to free-breathing (FB) during radiotherapy (RT) has significantly decreased radiation dose to heart and has been one of the techniques adopted for patients with breast cancer. However, patients who are unable to make suitable deep inspiration breath may not be eligible for DIBH, yet still need to spare the heart and lung during breast cancer RT (left-sided RT in particular). Continuous positive airway pressure (CPAP) is a positive airway pressure ventilator, which keeps the airways continuously open and subsequently inflates the thorax resembling thoracic changes from DIBH. In this report, authors applied CPAP instead of FB during left-sided breast cancer RT including internal mammary node in a patient who was unable to tolerate DIBH, and substantially decreased radiation dose the heart and lung with CPAP compared to FB.

Statistical Analysis of Quality Improvement in Health Care Services Using National Cancer Registration and Statistics of Five-Year Relative Survival Data (국가 암 등록통계 자료의 암 상대생존율을 기반으로 한 의료서비스 품질 수준 분석)

  • Chun, Nami
    • Journal of the Korea Management Engineers Society
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    • v.22 no.2
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    • pp.71-80
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    • 2017
  • Population-based relative cancer survival rate is an important outcome indicator to measure the overall effectiveness of cancer management in a population. Data for female breast cancer patients in Korea between 1994 and 2014 were analyzed to project the incidence rate and relative survival rate by using Minitab. Projected number of new female breast cancer patients in year 2022 were 25,287 per 100,000 general population. Projected five year relative survival rate of female breast cancer patients were 94.8 in year 2022. Results indicates trends of the quality improvement in health care services. This statistical model could be utilized to measure a quantitative outcome of the quality improvement in the various area of health care services.

Breast and Colorectal Cancer Screening and Associated Correlates among Chinese Older Women

  • Leung, Doris Y.P.;Leung, Angela Y.M.;Chi, Iris
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.1
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    • pp.283-287
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    • 2012
  • Objective: To explore the participation rates for breast and colorectal cancer screening and identify associated correlates among elderly women. Methods: Logistic regressions were conducted using data collected in 2006 from 1,533 elderly women aged 60 years or above who had completed a screening instrument, the Minimum Data Set-Home Care, while applying for long-term care services at the first time in Hong Kong. Results: The participation rates for breast and colorectal cancer screening among frail older Chinese women were 3.7% and 10.8% respectively. Cognitive status was inversely associated with the likelihood of participation in screening (breast: OR = 0.66, 95%CI = 0.47-0.94; colon: OR = 0.81, 95%CI = 0.66-0.99), as was educational level with the likelihood of participation in breast cancer screening (no formal education: OR = 0.20, 95%CI = 0.06-0.61, some primary education: OR = 0.31, 95%CI = 0.10-1.00). Conclusion: The delivery of cancer preventive health services to frail older women is less than ideal. Cognitive status and educational level were important factors in cancer screening behaviour. Tailor-made strategic promotion programmes targeting older women with low cognitive status and educational levels are needed to enhance awareness and acceptance within this vulnerable group.

Evaluation of BreastLight as a Tool for Early Detection of Breast Lesions among Females Attending National Cancer Institute, Cairo University

  • Labib, Nargis Albert;Ghobashi, Maha Mohamed;Moneer, Manar Mohamed;Helal, Maha Hesien;Abdalgaleel, Shaimaa Abdalaleem
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.8
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    • pp.4647-4650
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    • 2013
  • Background: Breast illumination was suggested as a simple method for breast cancer screening. BreastLight is a simple apparatus for this purpose. Objective: To evaluate the diagnostic performance of BreastLight as a screening tool of breast cancer in comparison to mammography and histopathology. Materials and Methods: This hospital-based cross sectional study was conducted in the mammography unit of the radiodiagnosis department at National Cancer Institute, Cairo University. All participants were subjected to breast examination with the BreastLight tool, mammography and ultrasonography. Suspicious cases were biopsied for histopathological examination which is considered as a gold standard. Results: The mean age of the participants was $46.3{\pm}12.4$ years. Breast illumination method had sensitivity, specificity, positive predictive value, negative predictive value and total accuracy of 93.0%, 73.7%, 91.4%, 77.8% and 88.2%, respectively in detection of breast cancer. Conclusions: Breast illumination method with BreastLight apparatus is a promising easy-to-use tool to screen for breast cancer suitable for primary health care physician or at-home use. It needs further evaluation especially in asymptomatic women.

Unkindness Experience of Health Care Provider in Patients with Breast Cancer (유방암 환자의 의료인 관련 불친절 경험)

  • Sohn, Sue-Kyung;Kim, Ick-Jee;Kim, Mi-Sun;Shin, Kyeong-Hee;Lee, Min-Suk;Lee, Eun-Mee
    • Journal of East-West Nursing Research
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    • v.22 no.1
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    • pp.51-59
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    • 2016
  • Purpose: This phenomenological study aimed to identify breast cancer patients' experience of unkindness of healthcare providers. Methods: Ten participants who were diagnosed with breast cancer were recruited to participate in the study and asked to share their experience related to healthcare providers. Data were analyzed using the phenomenological method of Colaizzi. In-depth interviews were conducted from November, 2014 to March, 2015. Results: Seven consistent categories and fourteen theme clusters emerged from collected data. The seven themes were 'being treated thoughtlessly', 'not giving special services for breast cancer patients', 'cold and authoritative manner', 'incomplete explanation', 'not accepting an appeal', 'being sorry for having short consultation hours', and 'unskilled and careless treatment'. Conclusions: It is needed to develop health care services in the view of beneficiaries. This may reduce the patients' experience of unkindness of the healthcare providers and improve the satisfaction of health care service.

A Novel Prognostic Nomogram for Predicting Risks of Distant Failure in Patients with Invasive Breast Cancer Following Postoperative Adjuvant Radiotherapy

  • Lim, Yu Jin;Lee, Sea-Won;Choi, Noorie;Kwon, Jeanny;Eom, Keun-Yong;Kang, Eunyoung;Kim, Eun-Kyu;Kim, Jee Hyun;Kim, Yu Jung;Kim, Se Hyun;Park, So Yeon;Kim, In Ah
    • Cancer Research and Treatment
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    • v.50 no.4
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    • pp.1140-1148
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    • 2018
  • Purpose This study aimed to identify predictors for distant metastatic behavior and build a related prognostic nomogram in breast cancer. Materials and Methods A total of 1,181 patients with non-metastatic breast cancer between 2003 and 2011 were analyzed. To predict the probability of distant metastasis, a nomogram was constructed based on prognostic factors identified using a Cox proportional hazards model. Results The 7-year overall survival and 5-year post-progression survival of locoregional versus distant recurrence groups were 67.6% versus 39.1% (p=0.027) and 54.2% versus 33.5% (p=0.043), respectively. Patients who developed distant metastasis showed early and late mortality risk peaks within 3 and after 5 years of follow-up, respectively, but a broad and low risk increment was observed in other patients with locoregional relapse. In multivariate analysis of distant metastasis-free interval, age (${\geq}45years$ vs. < 45 years), molecular subtypes (luminal A vs. luminal B, human epidermal growth receptor 2, and triple negative), T category (T1 vs. T2-3 and T4), and N category (N0 vs. N1 and N2-3) were independently associated (p < 0.05 for all). Regarding the significant factors, a well-validated nomogram was established (concordance index, 0.812). The risk score level of patients with initial brain failure was higher than those of non-brain sites (p=0.029). Conclusion The nomogram could be useful for predicting the individual probability of distant recurrence in breast cancer. In high-risk patients based on the risk scores, more aggressive systemic therapy and closer surveillance for metastatic failure should be considered.

A Model for Community Participation in Breast Cancer Prevention in Iran

  • Ahmadian, Maryam;Samah, Asnarulkhadi Abu
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.5
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    • pp.2419-2423
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    • 2012
  • Context: Genuine community participation does not denote taking part in an action planned by health care professionals in a medical or top-down approach. Further, community participation and health education on breast cancer prevention are not similar to other activities incorporated in primary health care services in Iran. Objective: To propose a model that provides a methodological tool to increase women's participation in the decision making process towards breast cancer prevention. To address this, an evaluation framework was developed that includes a typology of community participation approaches (models) in health, as well as five levels of participation in health programs proposed by Rifkin (1985&1991). Method: This model explains the community participation approaches in breast cancer prevention in Iran. In a 'medical approach', participation occurs in the form of women's adherence to mammography recommendations. As a 'health services approach', women get the benefits of a health project or participate in the available program activities related to breast cancer prevention. The model provides the five levels of participation in health programs along with the 'health services approach' and explains how to implement those levels for women's participation in available breast cancer prevention programs at the local level. Conclusion: It is hoped that a focus on the 'medical approach' (top-down) and the 'health services approach' (top-down) will bring sustainable changes in breast cancer prevention and will consequently produce the 'community development approach' (bottom-up). This could be achieved using a comprehensive approach to breast cancer prevention by combining the individual and community strategies in designing an intervention program for breast cancer prevention.

Psychoeducational Approach to Distress Management of Newly Diagnosed Patients with Breast Cancer (진단 직후 유방암환자의 디스트레스 관리를 위한 심리교육프로그램의 효과)

  • Park, Jin-Hee;Chun, Mison;Jung, Yong Sik;Bae, Sun Hyoung;Jung, Young-Mi
    • Journal of Korean Academy of Nursing
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    • v.48 no.6
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    • pp.669-678
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    • 2018
  • Purpose: The purpose of this study was to examine the effects of integrated psychoeducational program for distress management of newly diagnosed patients with breast cancer. Methods: A quasi-experimental trial was conducted. The participants consisted of 47 female patients with breast cancer assigned to an intervention group (n=25) and control group (n=22). The intervention group participated in integrated psychoeducational program, consisting of individual face-to-face education and telephone-delivered health-coaching sessions. Data were collected at three time points: pre-intervention (T1), post-intervention (T2), and 6-month follow-up (T3). Study instruments were Distress thermometer, Supportive Care Needs Survey Short Form 34 and Functional Assessment of Cancer Therapy-Breast. Results: Compared with the control group, breast cancer patients in the intervention group reported lower distress and supportive care needs than the control group. The intervention group reported higher quality of life (QOL) overall and higher emotional well-being than the control group. Conclusion: These findings indicate that the integrated psychoeducational program is an effective intervention for reducing distress and supportive care needs and increasing QOL of newly diagnosed patients with breast cancer. Oncology nurses need to provide psychoeducational intervention to support patients with breast cancer in managing their distress and helping them adjust to their life.

Effect of Comprehensive Breast Care on Breast Cancer Outcomes: A Community Hospital Based Study from Mumbai, India

  • Gadgil, Anita;Roy, Nobhojit;Sankaranarayanan, Rengaswamy;Muwonge, Richard;Sauvaget, Catherine
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.4
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    • pp.1105-1109
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    • 2012
  • Breast cancer is the second most common cancer in women in India and the disease burden is increasing annually. The lack of awareness initiatives, structured screening, and affordable treatment facilities continue to result in poor survival. We present a breast cancer survival scenario, in urban population in India, where standardised care is distributed equitably and free of charge through an employees' healthcare scheme. We studied 99 patients who were treated at our hospital during the period 2005 to 2010 and our follow-up rates were 95.95%. Patients received evidence-based standardised care in line with the tertiary cancer centre in Mumbai. One-, three- and five-year survival rates were calculated using Kaplan-Meier method. Socio-demographic, reproductive and tumor factors, relevant to survival, were analysed. Mortality hazard ratios (HR) were calculated using Cox proportional hazard method. Survival in this series was compared to that in registries across India and discrepancies were discussed. Patients mean age was 56 years, mean tumor size was 3.2 cms, 85% of the tumors belonged to T1 and T2 stages, and 45% of the patients belonged to the composite stages I and IIA. Overall 5-year survival was 74.9%. Patients who presented with large-sized tumors (HR 3.06; 95% CI 0.4-9.0), higher composite stage (HR 1.91; 0.55-6.58) and undergone mastectomy (HR 2.94; 0.63-13.62) had a higher risk of mortality than women who had higher levels of education (HR 0.25; 0.05-1.16), although none of these results reached the significant statistical level. We observed 25% better survival compared to other Indian populations. Our results are comparable to those from the European Union and North America, owing to early presentation, equitable access to standardised free healthcare and complete follow-up ensured under the scheme. This emphasises that equitable and affordable delivery of standardised healthcare can translate into early presentation and better survival in India.

The Lymphotoxin-α 252 A>G Polymorphism and Breast Cancer: A Meta-analysis

  • Zhou, Ping;Huang, Wei;Chu, Xing;Du, Liang-Feng;Li, Jian-Ping;Zhang, Chun
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.5
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    • pp.1949-1952
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    • 2012
  • Objective: The aim of this meta-analysis is to evaluate associations between LTA-252 A>G and breast cancer (BC). Methods: Electronic searches of several databases were conducted for all online publications. A total of 7 studies involving 4,625 BC patients and 4,373 controls were identified. Results: This meta-analysis showed no significant association between the LTA-252 A>G polymorphism and BC in overall or Caucasian populations. However, a positive association was found limited to Asian populations. Conclusion: Although there was no significant association found between the LTA-252 A>G polymorphism and BC overall, a positive association was found in Asian populations.