1
|
Beverly Hery CM, Janse SA, Van Zee KJ, Naftalis EZ, Paskett ED, Naughton MJ. Factors associated with insomnia symptoms over three years among premenopausal women with breast cancer. Breast Cancer Res Treat 2023; 202:155-165. [PMID: 37542630 PMCID: PMC10504151 DOI: 10.1007/s10549-023-07058-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 07/16/2023] [Indexed: 08/07/2023]
Abstract
PURPOSE We examined longitudinal trends and factors associated with insomnia over 3 years in a cohort of young breast cancer patients. METHODS Women with stage I-III breast cancer at ≤ 45 years were recruited at five institutions from New York, Texas, and North Carolina, within 8 months of diagnosis (n = 836). Participants completed questionnaires every 6 months for 3 years. Linear mixed-effects models were used to examine insomnia over time, using the Women's Health Initiative Insomnia Rating Scale (WHIIRS). We evaluated the relations of insomnia with demographic (age, race, education, income, employment, marital status), clinical (cancer stage, histologic grade, chemotherapy, radiation, hormone therapy, surgery, tumor size, body mass index, hot flashes), and social/behavioral variables (smoking status, social support, physical activity, depressive symptoms). RESULTS At baseline, 57% of participants met or exceeded the cut-off for clinical insomnia (WHIIRS score ≥ 9). Insomnia symptoms were most prevalent at baseline (p < 0.0001), but decreased significantly throughout follow-up (p < 0.001). However, 42% of participants still experienced insomnia symptoms 3 years after diagnosis. In multivariable models, older age (p = 0.02), hot flashes (p < 0.0001), and depressive symptoms (p < 0.0001) remained significantly associated with insomnia over time. CONCLUSIONS Insomnia symptoms were most frequent closer to breast cancer diagnosis and treatment, but persisted for some women who were older and those reporting higher hot flashes and depressive symptoms. Survivorship care should include assessing insomnia symptoms, particularly during and immediately after primary treatment. Implementing early interventions for sleep problems may benefit young breast cancer survivors and improve their quality of life.
Collapse
Affiliation(s)
- Chloe M Beverly Hery
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, 43210, USA.
- Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, 43210, USA.
| | - Sarah A Janse
- Center for Biostatistics, Department of Biomedical Informatics, The Ohio State University, Columbus, OH, 43210, USA
| | - Kimberly J Van Zee
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Elizabeth Z Naftalis
- Director of Breast Services, Health Texas Community Health Services Corporate, Dallas, TX, 75001, USA
| | - Electra D Paskett
- Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, 43210, USA
| | - Michelle J Naughton
- Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, 43210, USA
| |
Collapse
|
2
|
Nolan TS, Ivankova N, Carson TL, Spaulding AM, Dunovan S, Davies S, Enah C, Meneses K. Life after breast cancer: 'Being' a young African American survivor. ETHNICITY & HEALTH 2022; 27:247-274. [PMID: 31642349 DOI: 10.1080/13557858.2019.1682524] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 09/23/2019] [Indexed: 06/10/2023]
Abstract
Objective: In the United States, 26,534 young women (≤45 years) were diagnosed with breast cancer in 2017. Young African American (AA) women have higher incidence and mortality rates than Whites and Hispanics. Yet, few published studies describe survivorship (life after breast cancer diagnosis) experiences among this group. Here, we explore the lived experience of young AA breast cancer survivorship (via quality of life [QOL]).Design: This phenomenological study was framed by the QOL Applied to Breast Cancer model. Fifteen young AA survivors from the Southern U. S. participated in two semi-structured interviews. Methods of transcendental phenomenology were used for data collection and analysis.Results: Five themes emerged from participants' (mean age = 35 years; survivorship = 4 years) descriptions of survivorship experience: (1) actively managing spiritual self, (2) actively managing physical self, (3) actively managing psychological self, (4) actively managing social self, and (5) seeking survivorship knowledge. Participants perceived survivorship as a labile 'new normal' and 'ongoing struggle,' in which spirituality and survivorship knowledge were key to restructuring their lives.Conclusions: Survivorship among young AA survivors was more fluid and complex than the QOL model explained. Findings describe young AA breast cancer survivorship and indicate areas of potential strengths and distress. Healthcare providers and ancillary staff must exercise cultural competence to assess and anticipate young AA survivors' needs and concerns. Implementing targeted survivorship interventions, accounting for cultural contexts (e.g. high spirituality) and need for age-specific survivorship information, may improve QOL among young AA survivors.
Collapse
Affiliation(s)
- Timiya S Nolan
- College of Nursing, The Ohio State University, Columbus, OH, USA
| | - Nataliya Ivankova
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Tiffany L Carson
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Shanon Dunovan
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
| | - Susan Davies
- School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Comfort Enah
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Karen Meneses
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| |
Collapse
|
3
|
Icen-Taskin I, Irtegun-Kandemir S, Munzuroglu O. TP53 rs1042522 polymorphism and early-onset breast cancer. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2020; 25:25. [PMID: 32419782 PMCID: PMC7213006 DOI: 10.4103/jrms.jrms_506_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 10/21/2019] [Accepted: 02/18/2020] [Indexed: 02/04/2023]
Abstract
Background: Breast cancer is the leading cause of cancer deaths among women. Early-onset breast cancer is well recognized as it clinically differs from old-age diagnosed breast neoplasms. TP53 rs1042522 polymorphism relates to the risk of breast neoplasms, but this relationship in Turkish early-onset breast cancer patients has not been investigated yet. We aimed to search the relationship between TP53 rs1042522 polymorphism and young Turkish breast cancer patients. Materials and Methods: Ninety-six female breast cancer patients who were ≤ 40 years of age and 96 healthy controls were enrolled in our study. Participants were genotyped by the hybridization probe system. Results: We identified that the genotype frequencies of rs1042522 were significantly different between controls and cases (P = 0.027). Participants carrying CG genotype had also reduced breast cancer risk (odds ratio = 0.4196, 95% confidence interval: 0.1941–0.9067, P = 0.027). Our results revealed that there is an association between GG and CG + CC genotype groups with progesterone receptor (PgR) status (P = 0.0219). Conclusion: Our findings indicate that the CG genotype is a protective factor against breast neoplasms. No other clinicopathologic parameters except for PgR status were found to be related to rs1042522 polymorphism in young Turkish breast cancer patients.
Collapse
Affiliation(s)
- Irmak Icen-Taskin
- Department of Molecular Biology and Genetics, Faculty of Science and Art, Inonu University, Malatya, Turkey
| | - Sevgi Irtegun-Kandemir
- Department of Medical Biology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
| | - Omer Munzuroglu
- Department of Bioengineering, Faculty of Engineering, Firat University, Elazig, Turkey
| |
Collapse
|
4
|
Sheppard VB, de Mendoza AH, He J, Jennings Y, Edmonds MC, Oppong BA, Tadesse MG. Initiation of Adjuvant Endocrine Therapy in Black and White Women With Breast Cancer. Clin Breast Cancer 2017; 18:337-346.e1. [PMID: 29422259 DOI: 10.1016/j.clbc.2017.12.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 10/20/2017] [Accepted: 12/01/2017] [Indexed: 01/18/2023]
Abstract
BACKGROUND Adjuvant endocrine therapy reduces risk of recurrence and mortality in women with hormone receptor-positive breast cancer, yet many women never initiate it. We examined the influence of race, sociocultural factors, and process-of-care factors on initiation of adjuvant endocrine therapy in a racially diverse sample. PATIENTS AND METHODS Eligible women were originally recruited for the Narrowing the Gaps in Adjuvant Therapy Study (2006-2011). Sociocultural and process-of-care factors were collected via telephone surveys before adjuvant therapy. Clinical factors were abstracted from charts. Penalized LASSO (least absolute shrinkage and selection operator) logistic regression model was used to identify variables associated with initiation. RESULTS Of the 270 women, 55.6% were black and the rest were white. Most women (74.8%) initiated therapy. A significant interaction (P = .008) was found between race and age. Black women aged ≤ 50 years had the lowest initiation (59.7%) compared to black women > 50 years (87.1%), white women ≤ 50 years (73.7%), or white women > 50 years (72.0%). Multivariate analysis found that younger black women exhibited a marginally higher risk of noninitiation compared to older black women. Additionally, ratings of financial access, presence of comorbidities, and levels of communication were all associated with endocrine therapy initiation. CONCLUSION Black women ≤ 50 years of age and women with financial constraints may be important subgroups for interventions. Patient-provider communication appears to be an important leverage point to foster therapy uptake.
Collapse
Affiliation(s)
- Vanessa B Sheppard
- Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, Richmond, VA.
| | | | - Jun He
- Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, Richmond, VA
| | - Yvonne Jennings
- Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, Richmond, VA
| | - Megan C Edmonds
- Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, Richmond, VA
| | - Bridget A Oppong
- Georgetown University Medical Center, Georgetown University, Washington, DC
| | - Mahlet G Tadesse
- Department of Mathematics and Statistics, Georgetown University, Washington, DC
| |
Collapse
|
5
|
Moore AR, Buchanan ND, Fairley TL, Lee Smith J. Public Health Action Model for Cancer Survivorship. Am J Prev Med 2015; 49:S470-6. [PMID: 26590641 PMCID: PMC4776752 DOI: 10.1016/j.amepre.2015.09.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 08/24/2015] [Accepted: 09/01/2015] [Indexed: 12/17/2022]
Abstract
Long-term objectives associated with cancer survivors have been suggested by Healthy People 2020, including increasing the proportion of survivors living beyond 5 years after diagnosis and improving survivors' mental and physical health-related quality of life. Prior to reaching these objectives, several intermediate steps must be taken to improve the physical, social, emotional, and financial well-being of cancer survivors. Public health has a role in developing strategic, actionable, and measurable approaches to facilitate change at multiple levels to improve the lives of survivors and their families. The social ecological model has been used by the public health community as the foundation of multilevel intervention design and implementation, encouraging researchers and practitioners to explore methods that promote internal and external changes at the individual, interpersonal, organizational, community, and policy levels. The survivorship community, including public health professionals, providers, policymakers, survivors, advocates, and caregivers, must work collaboratively to identify, develop, and implement interventions that benefit cancer survivors. The National Action Plan for Cancer Survivorship highlights public health domains and associated strategies that can be the impetus for collaboration between and among the levels in the social ecological model and are integral to improving survivor outcomes. This paper describes the Public Health Action Model for Cancer Survivorship, an integrative framework that combines the National Action Plan for Cancer Survivorship with the social ecological model to demonstrate how interaction among the various levels may promote better outcomes for survivors.
Collapse
Affiliation(s)
- Angela R Moore
- Division of Cancer Prevention and Control, CDC, Atlanta, Georgia.
| | | | | | - Judith Lee Smith
- Division of Cancer Prevention and Control, CDC, Atlanta, Georgia
| |
Collapse
|
6
|
Zhang B, Su JP, Bai Y, Li J, Liu YH. Inhibitory effects of O-methylated isoflavone glycitein on human breast cancer SKBR-3 cells. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2015; 8:7809-7817. [PMID: 26339345 PMCID: PMC4555673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 05/21/2015] [Indexed: 06/05/2023]
Abstract
Glycitein is an O-methylated isoflavone which accounts for 5-10% of the total isoflavones in soy food products. Cell proliferation studies on the dietary phytoestrogen, glycitein against human breast carcinoma SKBR-3 cells showed that glycitein exhibits biphasic regulation on SKBR-3 cells. At concentrations of less than 10 mg/mL, cells respond to glycitein by increasing cell growth and de novo DNA synthesis whereas the addition of glycitein at concentrations greater than 30 mg/mL significantly inhibited cell growth and DNA synthesis in a dose-dependent manner. Cells treated with 60 mg/mL of glycitein did not regain normal growth after treatment was stopped. Glycitein was found to be cytostatic at low concentrations and cytotoxic at higher concentrations. Treatment with 100 mg/mL of glycitein severely altered the cell morphology. Collective results showed that glycitein damaged the cell membranes by increasing membrane permeability and suggested possible mechanisms of the action of dietary phytoestrogens on human breast carcinoma SKBR-3 cells.
Collapse
Affiliation(s)
- Bo Zhang
- Department of Surgical Oncology, Cangzhou Central HospitalCangzhou, China
| | - Jun-Ping Su
- Department of Endocrinology, Cangzhou People’s HospitalCangzhou, China
| | - Yang Bai
- Department of Surgical Oncology, Cangzhou Central HospitalCangzhou, China
| | - Jie Li
- Department of Surgical Oncology, Cangzhou Central HospitalCangzhou, China
| | - Yong-Hong Liu
- Department of Surgical Oncology, Cangzhou Central HospitalCangzhou, China
| |
Collapse
|
7
|
Cao YW, Fu XG, Wan GX, Yu SY, Cui XB, Li L, Jiang JF, Zheng YQ, Zhang WJ, Li F. BRCA1 gene exon 11 mutations in Uighur and Han women with early-onset sporadic breast cancer in the northwest region of China. Asian Pac J Cancer Prev 2014; 15:4513-8. [PMID: 24969878 DOI: 10.7314/apjcp.2014.15.11.4513] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The prevalence of BRCA1 gene mutations in breast cancer differs between diverse ethnic groups. Relatively little information is known about patterns of BRCA1 mutations in early-onset breast cancer in women of Uighur or Han descent, the major ethnic populations of the Xinjiang region in China. The aim of this study was to identify BRCA1 mutations in Uighur and Han patients with early-onset (age <35 years), and sporadic breast cancer for genetic predisposition to breast cancer. For detection of BRCA1 mutations, we used a polymerase chain reaction single-stranded conformation polymorphism approach, followed by direct DNA sequencing in 22 Uighur and 13 Han women with early-onset sporadic breast cancer, and 32 women with benign breast diseases. The prevalence of BRCA1 mutations in this population was 22.9% (8/35) among early-onset sporadic breast cancer cases. Of these, 31.8% (7/22) of Uighur patients and 7.69% (1/13) of Han patients were found to have BRCA1 mutations. In 7 Uighur patients with BRCA1 mutations, there were 11 unique sequence alterations in the BRCA1 gene, including 4 clearly disease-associated mutations on exon 11 and 3 variants of uncertain clinical significance on exon 11, meanwhile 4 neutral variants on intron 20 or 2. None of the 11 BRCA1 mutations identified have been previously reported in the Breast Cancer Information Core database. These findings reflect the prevalence of BRCA1 mutations in Uighur women with early-onset and sporadic breast cancer, which will allow for provision of appropriate genetic counseling and treatment for Uighur patients in the Xinjiang region.
Collapse
Affiliation(s)
- Yu-Wen Cao
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China E-mail :
| | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Gewefel H, Salhia B. Breast cancer in adolescent and young adult women. Clin Breast Cancer 2014; 14:390-5. [PMID: 25034440 DOI: 10.1016/j.clbc.2014.06.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 06/07/2014] [Accepted: 06/17/2014] [Indexed: 12/11/2022]
Abstract
Breast cancer is one of the most frequently diagnosed malignancy among adolescent and young adult (AYA) women, accounting for approximately 14% of all AYA cancer diagnoses and 7% of all breast cancer. Breast cancer in AYA women is believed to represent a more biologically aggressive disease, but aside from commonly known hereditary predispositions, little is still known about the underlying molecular genetic causes. This review examines the current trends of breast cancer in AYA women as they relate to clinical, social, genetic, and molecular pathologic characteristics. We highlight existing trends, treatment and imaging approaches, and health burdens as they relate to breast cancer in AYA women and provide a discussion on ways to help improve the overall management of this breast cancer cohort.
Collapse
Affiliation(s)
- Hanan Gewefel
- Faculty of Applied Medical Science, Misr University for Science and Technology, Cairo, Egypt
| | - Bodour Salhia
- Integrated Cancer Genomics Division, Translational Genomics Research Institute, Phoenix, AZ.
| |
Collapse
|
9
|
Prognostic factors of young women (≤ 35 years) with node positive breast cancer: possible influence on post-therapeutic follow-up. Bull Cancer 2013; 100:22-9. [PMID: 23822935 DOI: 10.1684/bdc.2013.1791] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Although young age at diagnosis is an independent prognostic factor of poor survival; no specific recommendation are provided concerning the timing and modalities of follow-up for this population. These patients are followed similarly to older women during post-therapeutic surveillance. The objective of this study is to examine patterns of recurrence in a large series of positive lymph node breast cancer women aged 35 years or below and treated within adjuvant chemotherapy trials. METHODS Data of 200 patients (≤ 35 years) included in three UNICANCER adjuvant trials for node positive breast cancer were used. Competing risks methodology was used to identify prognostic factors associated with time to first failure according to type of event. RESULTS After a median follow-up of 52.4 months, 84 pts had disease related events (17 loco-regional, five contralateral, and 62 distant metastasis). Variables associated with an increased rate of first event were the number of involved lymph nodes and the type of surgery. In univariate analysis, prognostic factors associated with high potential curative recurrence were number of positive lymph nodes and vascular invasion. Only number of positive lymph node remained significant in multivariate analysis. Concerning distant metastasis, only the number of lymph node involved was associated to an increased risk of metastasis. CONCLUSION Using the number of positive nodes as important prognostic factors, it should be possible to identify patients at a higher risk of locoregional relapse or contralateral breast cancer, in order to propose more individualized follow-up.
Collapse
|