• Title, Summary, Keyword: breast cancer care

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Quality of Breast Cancer Early Detection Services Conducted by Well Woman Clinics in the District of Gampaha, Sri Lanka

  • Vithana, Palatiyana Vithanage Sajeewanie Chiranthika;Ariyaratne, M.A.Y.;Jayawardana, P.L.
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.1
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    • pp.75-80
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    • 2013
  • Background: Breast cancer is the most common cancer diagnosed in females in Sri Lanka and early detection can lead to reduction in morbidity and mortality. Aim: To evaluate selected aspects of breast cancer early detection services implemented through well woman clinics (WWCs) in the Gampaha District. Methods: The study consisted of two components. A retrospective descriptive arm assessed clinical breast examination (CBE) coverage of target age group women (TGW) of 35-59 years in all the WWCs in Gampaha district over 2003-2007. A cross sectional descriptive study additionally assessed quality of breast cancer early detection services. The Lot Quality Assurance Sampling (LQAS) technique was used to decide on the lot size and threshold values, which were computed as twenty and six clinics. Checklists were employed in assessing coverage, physical facilities and clinic activities. Client satisfaction on WWC services was assessed among 200 TGW attending 20 WWCs using an interviewer-administered questionnaire. Results: CBE coverage in the Gampaha district increased only from 1.1-2.2% over 2003-2007. With regard to physical facilities, the number of clinics that were rated substandard varied between 7-18 (35-90%). The items that were lacking included dust bins, notice boards, stationary, furniture and linen, and cleanliness of outside premises and toilets. With regard to clinic activities, punctuality of staff, late commencement of clinics, provision of health education, supervision, CBE and breast self-examination (BSE) were substandard in 7-20 clinics (35-100%). Client satisfaction for WWC services was 45.2% (IQR: 38.7-54.8%) and only 11% had a score of ${\geq}70%$, the cut off set for satisfaction. Conclusions: Breast cancer early detection service coverage in the Gampaha district remained low (2.2%) in 2007, 11 years after commencing WWCs. All 20 clinics were substandard for overall CBE and BSE.

Topical Use of Recombinant Human Epidermal Growth Factor (EGF)-Based Cream to Prevent Radiation Dermatitis in Breast Cancer Patients: a Single-Blind Randomized Preliminary Study

  • Kong, Moonkyoo;Hong, Seong Eon
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.8
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    • pp.4859-4864
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    • 2013
  • Background: The purpose of this study was to assess the effectiveness of a recombinant human epidermal growth factor (EGF)-based cream for the prevention of acute radiation dermatitis in breast cancer patients receiving radiotherapy (RT). Materials and Methods: Between December 2012 and April 2013, 40 breast cancer patients who received postoperative RT were prospectively enrolled in this study and randomly assigned to receive human recombinant EGF-based cream (intervention group) or general supportive skin care (control group). The grade of radiation dermatitis and pain score were examined at weekly intervals during RT and 6 weeks after RT completion. Results: All patients completed the planned RT and complied well with instructions for applying the study cream and general supportive skin care. In the intervention group, radiation dermatitis of maximum grade 3, 2, and 1 developed in 3 (15%), 11 (55%), and 6 patients (30%), respectively. In comparison, in the control group, radiation dermatitis of maximum grade 3, 2, and 1 developed in 8 (40%), 10 (50%), and 2 patients (10%), respectively. The intervention group showed lower incidence of grade 3 radiation dermatitis than the control group (p=0.068 in univariate analysis and p=0.035 in multivariate analysis). There was no statistically significant difference in the maximal pain score between the two groups (p=0.934). Conclusions: This single-blind randomized preliminary study showed that recombinant human EGF-based cream can have a beneficial role in preventing or minimizing radiation dermatitis in breast cancer patients. To confirm the results of our study, additional studies with a large sample size are required.

Beliefs and Behaviors of Breast Cancer Screening in Women Referring to Health Care Centers in Northwest Iran According to the Champion Health Belief Model Scale

  • Fouladi, Nasrin;Pourfarzi, Farhad;Mazaheri, Effat;Asl, Hossein Alimohammadi;Rezaie, Minoo;Amani, Fiouz;Nejad, Masumeh Rostam
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.6857-6862
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    • 2013
  • Background: Breast cancer is the most common cancer in women. All ages are susceptible and more than 90% of the patients can be cured with early diagnosis. Breast self-examination (BSE) and mammography can be useful for this aim. In this study we examined the components of the Champion health belief model to identify if they could predict the intentions of women to perform such screening. Materials and Methods: A total of 380 women aged 30 and above who had referred to health-care centers were assessed for use of breast cancer screening over the past year with a modified health belief model questionnaire. Logistic regression was applied to identify leading independent predictors. Results: In this study 27% of the women performed BSE in the last year but only 6.8% of them used mammography as a way of screening. There were significant differences regarding all components of the model except for perceived severity between women that underwent BSE. over the past year and those that did not. Findings were similar for mammography. Regression analysis revealed that intentions to perform BSE were predicted by perceived self-efficacy and perceived barriers to BSE while intentions to perform mammography were predicted by perceived barriers. Conclusions: This study indicated that self-efficacy can support performance of BSE while perceived barriers are important for not performing both BSE and mammography. Thus we must educate women to increase their self-efficacy and decrease their perceived barriers.

Association of Knowledge and Cultural Perceptions of Malaysian Women with Delay in Diagnosis and Treatment of Breast Cancer: a Systematic Review

  • Khan, Tahir Mehmood;Leong, Jamie Pik Yan;Ming, Long Chiau;Khan, Amer Hayat
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.13
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    • pp.5349-5357
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    • 2015
  • Background: Breast cancer is the most common cancer and the leading cause of cancer mortality among women of all ethnic and age groups in Malaysia. Delay in seeking help for breast cancer symptoms is preventable and by identifying possible factors for delayed diagnosis, patient prognosis and survival rates could be improved. Objectives: This narrative review aimed to understand and evaluate the level of in-depth breast cancer knowledge in terms of clinical breast examination and breast self-examination, and other important aspects such as side-effects and risk factors in Malaysian females. Since Malaysia is multicultural, this review assessed social perceptions, cultural beliefs and help-seeking behaviour in respect to breast cancer among different ethnic groups, since these may impinge on efforts to 'avoid' the disease. Materials and Methods: A comprehensive literature search of seven databases was performed from December 2015 to January 2015. Screening of relevant published journals was also undertaken to identify available information related to the knowledge, perception and help-seeking behaviour of Malaysian women in relation to breast cancer. Results: A total of 42 articles were appraised and included in this review. Generally, women in Malaysia had good awareness of breast cancer and its screening tools, particularly breast self-examination, but only superficial in-depth knowledge about the disease. Women in rural areas had lower levels of knowledge than those in urban areas. It was also shown that books, magazines, brochures and television were among the most common sources of breast cancer information. Delay in presentation was attributed mainly to a negative social perception of the disease, poverty, cultural and religion practices, and a strong influence of complementary and alternative medicine, rather than a lack of knowledge. Conclusions: This review highlighted the need for an intensive and in-depth breast cancer education campaigns using media and community health programmes, even with the existing good awareness of breast cancer. This is essential in order to avoid misconceptions and to frame the correct mind-set about breast cancer among women in Malaysia. Socio-cultural differences and religious practices should be taken into account by health care professionals when advising on breast cancer. Women need to be aware of the risk factors and symptoms of breast cancer so that early diagnosis can take place and the chances of survival improved.

Strategies to Increase Exercise Compliance and Adherence for Breast Cancer Survivors: A Descriptive Review

  • Yang, Paul;Foroughi, Nasim;Kilbreath, Sharon
    • Journal of International Academy of Physical Therapy Research
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    • v.1 no.2
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    • pp.79-90
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    • 2010
  • Breast cancer is the most frequently diagnosed cancer primarily affecting women and negatively impacting the individuals, families, and the health care system. Despite the well-known benefits of exercise for breast cancer survivors, rate of physical activity declines during adjuvant therapy and may not return to pre-diagnosis levels. In addition, low levels of adherence to exercise have been observed in this cohort. The challenge is to identify strategies that are effective in promoting exercise adherence. Several of the studies use social cognitive theory as a theoretical framework to design exercise interventions that encourage adherence. Within and without this framework, they have implemented interventions within the home and gym-based environments. Strategies used to encourage adherence to exercise programs and which are readily implemented in most situations have included distribution of print materials and pedometers, as well as recommendation from the oncologist. Other strategies that may be less feasible have included provision of trainers, gym memberships, regular phone-calls, and psychologist-lead stress management sessions.

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A Prognostic Model for Patients with Triple-Negative Breast Cancer: Importance of the Modified Nottingham Prognostic Index and Age

  • Kwon, Jeanny;Eom, Keun-Yong;Koo, Tae Ryool;Kim, Byoung Hyuck;Kang, Eunyoung;Kim, Sung-Won;Kim, Yu Jung;Park, So Yeon;Kim, In Ah
    • Journal of Breast Cancer
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    • v.20 no.1
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    • pp.65-73
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    • 2017
  • Purpose: Considering the distinctive biology of triple-negative breast cancer (TNBC), this study aimed to identify TNBC-specific prognostic factors and determine the prognostic value of the Nottingham Prognostic Index (NPI) and its variant indices. Methods: A total of 233 patients with newly diagnosed stage I to III TNBC from 2003 to 2012 were reviewed. We retrospectively analyzed the patients' demographics, clinicopathologic parameters, treatment, and survival outcomes. The NPI was calculated as follows: tumor size $(cm){\times}0.2$+node status+Scarff-Bloom-Richardson (SBR) grade. The modified NPI (MNPI) was obtained by adding the modified SBR grade rather than the SBR grade. Results: The median follow-up was 67.8 months. Five-year disease-free survival (DFS) and overall survival (OS) were 81.4% and 89.9%, respectively. Multivariate analyses showed that the MNPI was the most significant and common prognostic factor of DFS (p=0.001) and OS (p=0.019). Young age (${\leq}35$ years) was also correlated with poor DFS (p=0.006). A recursive partitioning for establishing the prognostic model for DFS was performed based on the results of multivariate analysis. Patients with a low MNPI (${\leq}6.5$) were stratified into the low-risk group (p<0.001), and patients with a high MNPI (>6.5) were subdivided into the intermediate (>35 years) and high-risk (${\leq}35$ years) groups. Age was not a prognostic factor in patients with a low MNPI, whereas in patients with a high MNPI, it was the second key factor in subdividing patients according to prognosis (p=0.023). Conclusion: The MNPI could be used to stratify patients with stage I to III TNBC according to prognosis. It was the most important prognosticator for both DFS and OS. The prognostic significance of young age for DFS differed by MNPI.

Descriptive Study on Selected Risk Factors and Histopathology of Breast Carcinoma in a Tertiary Care Centre in Kerala, India with Special Reference to Women Under 40 Years Old

  • Varughese, Ashley Ann;Poothiode, Usha;Manjula, V.D.
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.1
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    • pp.181-184
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    • 2015
  • Background: Breast cancer is the most common female cancer in Kerala, South India, with the incidence increasing in the past two decades, also in young women. However, there are limited data regarding the burden of disease, its epidemiology and histopathological characteristics in the state. Materials and Methods: This desciptive study covered 303 breast cancers evaluated during the period of December 2011 to August 2013 in the Department of Pathology, Government Medical College, Kottayam.The patients were also interviewed regarding selected risk factors. Results: The majority of the cases were 41-60 years of age with a mean at presentation of 53 years. Infiltrating ductal carcinoma was the most common subtype, followed by pure mucinous carcinoma and then lobular carcinoma. Of the cases, 6.6% were nullipara and 52.8% had fewer than or equal to 2 children. Median age at first child birth was 23 years (national value-19.8 years). A significant proportion (15%) had family history of breast cancer. Some 13.5%(41 cases) comprised the young breast cancer group (${\leq}40$years) with a mean age at first child birth in them was 27.4 years, 5 being nullipara and 6 having a positive family history. Conclusions: Breast cancer awareness, better availability of screening techniques and identification and targeting high risk groups all help to tackle the increasing load of breast carcinoma. A good proportion of cases comprised the young breast cancer group (under 40). Younger women should thus also be educated about breast carcinoma-risk factors, symptoms and diagnostic techniques to help in early detection and effective approach esto treatment.

Breast Cancer Scenario in a Regional Cancer Centre in Eastern India over Eight Years - Still a Major Public Health Problem

  • Datta, Karabi;Choudhuri, Maitrayee;Guha, Subhas;Biswas, Jaydip
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.3
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    • pp.809-813
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    • 2012
  • In spite of screening and early diagnostic tests, the upward trend of breast cancer has become a matter of great concern in both developed and developing countries. The data collected by Population Based Cancer Registry in Chittaranjan National Cancer Institute, a regional cancer centre in Kolkata, from 1997 to 2004 gives an insight about the scenario of Breast Cancer in this part of Eastern India.The total no of female breast cancer cases were steadily increasing from 1997 to 2001 and only slightly lower from 2002 to 2004. and majority were in the 40-49 year old age group during this period. The next most commonly affected age group was 50-59 years. Regarding the distribution according to treatment, the main modality was surgery and radiotherapy followed by combined surgery, chemotherapy and radiotherapy and then combined surgery and chemotherapy. The commonest type was ductal followed by lobular cancer. In this eight year study in CNCI, status of patients on last day of the respective year was assessed. Number of patients alive was 43.5% in 1997. The percentage gradually increased up to 2000 and then gradually decreased to 47.4% in 2004. Also with every passing year, percentage mortality gradually decreased from 25.7% in 1997 to 16.8% in 2004. Better pattern of care (diagnosis and treatment) was reflected in this picture. However, lost to follow up, which also implies non compliance to treatment, increased to 30.8% in 1997 to 35.8% in 2004. Due to the small number of male breast cancers, only female cases were considered. In conclusion, breast cancer continues to be a major problem in Kolkata, India.

Polarization of cancer patient management (암진료의 양극화)

  • Kim, Ku Sang
    • Journal of the Korean Medical Association
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    • v.60 no.3
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    • pp.223-227
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    • 2017
  • The polarization of cancer patient management is rooted in aspects of the Korean health care system, so a solution to this problem should be introduced on the basis of systemic guidelines that shape national policy. Strengthening the capacity of regional cancer centers by establishing organizations of large-scale cancer hospitals, cancer rehabilitation hospitals, and local primary care clinics could be another approach to solving this problem. Large-scale cancer hospitals should pay attention to patient education regarding life after cancer treatment and should provide close assistance to patients. Cancer rehabilitation hospitals should focus on cancer rehabilitation, not unproven therapies. The systematic cooperation of large-scale cancer hospitals, cancer rehabilitation hospitals, and local primary care clinics is of the utmost important for patients.

Predictors of Complementary and Alternative Medicine Use by Breast Cancer Patients in Bandung, Indonesia

  • Azhar, Yohana;Achmad, Dimyati;Lukman, Kiki;Hilmanto, Dany;Aryandono, Teguh
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.2115-2118
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    • 2016
  • Background: The study aimed to assess complementary and alternative medicine (CAM) use and their associated factors with breast cancer patients in Bandung, Indonesia. Materials and Methods: In total, 330 breast cancer patients were administered questionnaires on their CAM use and CAM predictive factors including socio-demographic parameters, clinical data and quality of life, trust in physicians, trust in hospitals, satisfaction and informational needs. Data were analyzed using univariate analysis and multivariate log regreesion analysis. Results: Overall 33.3% of patients reported use of CAM. Lower income, lower education, presence of metastasis, prolonged diagnosis, less trust in physician were found to be highly associated with CAM use. Conclusions: CAM use by breast cancer patients can be interpreted as an attempt to explore all possible options, an expression of an active coping style, or expression of unmet needs in the cancer care continuum. Physicians need to openly discuss the use of CAM with their patients and identify whether they have other unmet supportive needs.