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Miret C, Orive M, Sala M, García-Gutiérrez S, Sarasqueta C, Legarreta MJ, Redondo M, Rivero A, Castells X, Quintana JM, Garin O, Ferrer M. Reference values of EORTC QLQ-C30, EORTC QLQ-BR23, and EQ-5D-5L for women with non-metastatic breast cancer at diagnosis and 2 years after. Qual Life Res 2023; 32:989-1003. [PMID: 36630024 PMCID: PMC10063520 DOI: 10.1007/s11136-022-03327-4] [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] [Accepted: 12/11/2022] [Indexed: 01/12/2023]
Abstract
PURPOSE To obtain reference norms of EORTC QLQ-C30, EORTC QLQ-BR23, and EQ-5D-5L, based on a population of Spanish non-metastatic breast cancer patients at diagnosis and 2 years after, according to relevant demographic and clinical characteristics. METHODS Multicentric prospective cohort study including consecutive women aged ≥ 18 years with a diagnosis of incident non-metastatic breast cancer from April 2013 to May 2015. Health-related quality of life (HRQoL) questionnaires were administered between diagnosis and beginning the therapy, and 2 years after. HRQoL differences according to age, comorbidity and stage were tested with ANOVA or Chi Square test and multivariate linear regression models. RESULTS 1276 patients were included, with a mean age of 58 years. Multivariate models of EORTC QLQ-C30 summary score and EQ-5D-5L index at diagnosis and at 2-year follow-up show the independent association of comorbidity and tumor stage with HRQoL. The standardized multivariate regression coefficient of EORTC QLQ-C30 summary score was lower (poorer HRQoL) for women with stage II and III than for those with stage 0 at diagnosis (- 0.11 and - 0.07, p < 0.05) and follow-up (- 0.15 and - 0.10, p < 0.01). The EQ-5D-5L index indicated poorer HRQoL for women with Charlson comorbidity index ≥ 2 than comorbidity 0 both at diagnosis (- 0.13, p < 0.001) and follow-up (- 0.18, p < 0.001). Therefore, we provided the reference norms at diagnosis and at the 2-year follow-up, stratified by age, comorbidity index, and tumor stage. CONCLUSION These HRQoL reference norms can be useful to interpret the scores of women with non-metastatic breast cancer, comparing them with country-specific reference values for this population.
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Affiliation(s)
- Carme Miret
- Department of Pediatrics, Obstetrics and Gynecology, Preventive Medicine and Public Health, Universitat Autònoma de Barcelona (UAB), 08193, Bellaterra, Barcelona, Spain
- Preventive Medicine and Public Health Training Unit PSMar-UPF-ASPB, Parc de Salut Mar, Agència de Salut Pública de Barcelona, i Universitat Pompeu Fabra, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Miren Orive
- Departamento Psicología Social, Facultad Farmacia, UPV/EHU, Vitoria-Gasteiz, Araba, Spain
- KRONIKGUNE-Institute for Health Service Research, Barakaldo, Bizkaia, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Galdakao, Bizkaia, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Madrid, Spain
| | - Maria Sala
- Preventive Medicine and Public Health Training Unit PSMar-UPF-ASPB, Parc de Salut Mar, Agència de Salut Pública de Barcelona, i Universitat Pompeu Fabra, Barcelona, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Galdakao, Bizkaia, Spain
| | - Susana García-Gutiérrez
- Osakidetza Basque Health Service, Research Unit, Galdakao-Usansolo University Hospital, Galdakao, Bizkai, Spain
- KRONIKGUNE-Institute for Health Service Research, Barakaldo, Bizkaia, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Galdakao, Bizkaia, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Madrid, Spain
| | - Cristina Sarasqueta
- Health Services Research on Chronic Patients Network (REDISSEC), Galdakao, Bizkaia, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Madrid, Spain
- Biodonostia Health Research Institute, Donostia University Hospital, Donostia, Gipuzkoa, Spain
| | - Maria Jose Legarreta
- Osakidetza Basque Health Service, Research Unit, Galdakao-Usansolo University Hospital, Galdakao, Bizkai, Spain
- KRONIKGUNE-Institute for Health Service Research, Barakaldo, Bizkaia, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Galdakao, Bizkaia, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Madrid, Spain
| | - Maximino Redondo
- Health Services Research on Chronic Patients Network (REDISSEC), Galdakao, Bizkaia, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Madrid, Spain
- Research and Innovation Unit, Hospital Costa del Sol, Marbella, Spain
| | - Amado Rivero
- Servicio de Evaluación y Planificación del Servicio Canario de la Salud (SESCS), Tenerife, Spain
| | - Xavier Castells
- Preventive Medicine and Public Health Training Unit PSMar-UPF-ASPB, Parc de Salut Mar, Agència de Salut Pública de Barcelona, i Universitat Pompeu Fabra, Barcelona, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Galdakao, Bizkaia, Spain
| | - José M Quintana
- Osakidetza Basque Health Service, Research Unit, Galdakao-Usansolo University Hospital, Galdakao, Bizkai, Spain
- KRONIKGUNE-Institute for Health Service Research, Barakaldo, Bizkaia, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Galdakao, Bizkaia, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Madrid, Spain
| | - Olatz Garin
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Doctor Aiguader 88, 08003, Barcelona, Spain
| | - Montse Ferrer
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Doctor Aiguader 88, 08003, Barcelona, Spain.
- CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
- Departament de Medicina i Ciències de la Vida, Universitat Pompeu Fabra (UPF), Barcelona, Spain.
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Stakeholders' Experiences and Perspectives Regarding Care Quality for Women With Breast Cancer: A Systematic Review. Cancer Nurs 2022:00002820-990000000-00039. [PMID: 35637166 DOI: 10.1097/ncc.0000000000001119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
BACKGROUND The considerable growth in the number of patients with breast cancer leads to substantial pressure on healthcare services; however, the main measures that will evaluate what is important to the key stakeholders in improving the quality of breast cancer care are not well defined. OBJECTIVE This study aimed to synthesize providers' and patients' experiences and perspectives regarding barriers and quality breast cancer care in health services. METHODS PubMed, Scopus, MEDLINE, Web of Knowledge, and the Cochrane Library databases were searched, and articles published in English up to August 2020 were screened. Two reviewers independently screened all articles. Data were obtained directly from different stakeholder groups including patients, health providers, and professionals. RESULTS The search strategy identified 21 eligible articles that met inclusion criteria and reported perspectives of 847 health providers and 24 601 patients regarding healthcare quality. Health providers and patients with breast cancer noted information needs, psychosocial support, responsibility for care, and coordination of care as important quality improvement characteristics of the healthcare system. CONCLUSION Shifting to high-quality breast cancer care would likely be a complicated process, and there is a need for the cancer care services to consider important characteristics of quality cancer care as a care priority, that is, to be responsive. IMPLICATION FOR PRACTICE Breast cancer survivorship care programs and interventions may need to consider the barriers or common challenges to care noted in this review, especially regarding information sharing and the need for social support and care cooperation.
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Hernandez LI, Araúzo-Bravo MJ, Gerovska D, Solaun RR, Machado I, Balian A, Botero J, Jiménez T, Zuriarrain Bergara O, Larburu Gurruchaga L, Urruticoechea A, Hernandez FJ. Discovery and Proof-of-Concept Study of Nuclease Activity as a Novel Biomarker for Breast Cancer Tumors. Cancers (Basel) 2021; 13:cancers13020276. [PMID: 33451046 PMCID: PMC7828568 DOI: 10.3390/cancers13020276] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 01/08/2021] [Accepted: 01/09/2021] [Indexed: 01/22/2023] Open
Abstract
Simple Summary A diagnostic biomarker for the detection of breast cancer remains an unmet clinical need despite decades of intensive research efforts. Herein, we describe, for the first time, the use of nuclease activity as a biomarker to discriminate between healthy and cancer biopsy samples. We have identified a panel of three nucleic acid probes able to target nucleases derived from breast cancer tumors with high sensitivity and specificity. These results are in good agreement with histopathological analysis as the diagnostic gold standard. Moreover, these findings support nuclease activity as a potential adjacent diagnostic tool and shed light on the use of nuclease activity as a detection biomarker in breast cancer. Abstract Breast cancer is one of the most common pathologies diagnosed in the clinical practice. Despite major advancements in diagnostic approaches, there is no widely accepted biomarker in the clinical practice that can diagnose breast malignancy. Confirmatory diagnosis still relies on the pathological assessment of tissue biopsies by expert pathologists. Thus, there is an unmet need for new types of biomarkers and novel platform technologies that can be easily and robustly integrated into the clinic and that can assist pathologists. Herein, we show that nuclease activity associated to malignant tumors can be used as a novel biomarker in breast cancer, which can be detected via specific degradation of nucleic acid probes. In this study we have identified a set of three chemically modified nucleic acid probes that can diagnose malignancy in biopsy samples with high accuracy (89%), sensitivity (82%) and specificity (94%). This work represents a breakthrough for the potential clinical use of nuclease activity as biomarker, which can be detected via nucleic acids probes, for the clinical diagnosis of malignancy in breast tissue biopsies. This platform technology could be readily implemented into the clinic as adjunct to histopathological diagnostic.
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Affiliation(s)
- Luiza I. Hernandez
- SOMAprobes S.L, Science and Technology Park of Gipuzkoa, 20009 San Sebastian, Spain; (L.I.H.); (I.M.); (J.B.); (T.J.)
| | - Marcos J. Araúzo-Bravo
- Department of Cell and Developmental Biology, Max Planck Institute for Molecular Biomedicine, 48149 Münster, Germany;
- Computational Biology and Systems Biomedicine, Biodonostia Health Research Institute, 20014 San Sebastian, Spain;
- IKERBASQUE, Basque Foundation for Science, Calle María Díaz Harokoa 3, 48013 Bilbao, Spain
| | - Daniela Gerovska
- Computational Biology and Systems Biomedicine, Biodonostia Health Research Institute, 20014 San Sebastian, Spain;
| | | | - Isabel Machado
- SOMAprobes S.L, Science and Technology Park of Gipuzkoa, 20009 San Sebastian, Spain; (L.I.H.); (I.M.); (J.B.); (T.J.)
| | - Alien Balian
- Wallenberg Center for Molecular Medicine (WCMM), 58185 Linköping, Sweden;
- Department of Physics, Chemistry and Biology, Linköping University, 58185 Linköping, Sweden
| | - Juliana Botero
- SOMAprobes S.L, Science and Technology Park of Gipuzkoa, 20009 San Sebastian, Spain; (L.I.H.); (I.M.); (J.B.); (T.J.)
| | - Tania Jiménez
- SOMAprobes S.L, Science and Technology Park of Gipuzkoa, 20009 San Sebastian, Spain; (L.I.H.); (I.M.); (J.B.); (T.J.)
| | - Olaia Zuriarrain Bergara
- Department of Oncology, Onkologikoa Foundation, 20014 San Sebastián, Spain; (O.Z.B.); (L.L.G.); (A.U.)
| | - Lide Larburu Gurruchaga
- Department of Oncology, Onkologikoa Foundation, 20014 San Sebastián, Spain; (O.Z.B.); (L.L.G.); (A.U.)
| | - Ander Urruticoechea
- Department of Oncology, Onkologikoa Foundation, 20014 San Sebastián, Spain; (O.Z.B.); (L.L.G.); (A.U.)
| | - Frank J. Hernandez
- Wallenberg Center for Molecular Medicine (WCMM), 58185 Linköping, Sweden;
- Department of Physics, Chemistry and Biology, Linköping University, 58185 Linköping, Sweden
- Correspondence: ; Tel.: +46-013-281-147
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Padilla-Ruiz M, Zarcos-Pedrinaci I, Rivas-Ruiz F, Téllez T, García-Gutiérrez S, González N, Rivero A, Sarasqueta C, Serrano-Aguilar P, Castells X, Quintana JM, Sala M, Redondo M, Castells X, Comas M, Domingo L, Macià F, Roman M, Romero A, Sala M, Barata T, de la Lastra ID, de la Vega M, Bare M, Torà N, Ferrer J, Castanyer F, Carmona C, García S, Martín M, González N, Orive M, Valverde MA, Saez A, Barredo I, de Toro M, Ferreiro J, Quintana JM, Pérez J, Rivero A, Valcárcel C, Padilla M, Redondo M, Téllez T, Zarcos I, Churruca C, Perales A, Recio J, Ruiz I, Sarasqueta C, Urraca JM, Michelena MJ, Moreno J, Mallabiabarrena G, Cobos P, Otero B, Gorostiaga J, Troya I. Factors that Influence Treatment Delay for Patients with Breast Cancer. Ann Surg Oncol 2020; 28:3714-3721. [PMID: 33247362 DOI: 10.1245/s10434-020-09409-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 11/03/2020] [Indexed: 01/14/2023]
Abstract
INTRODUCTION The diagnosis or treatment of breast cancer is sometimes delayed. A lengthy delay may have a negative psychological impact on patients. The aim of our study was to evaluate the sociodemographic, clinical and pathological factors associated with delay in the provision of surgical treatment for localised breast cancer, in a prospective cohort of patients. METHODS This observational, prospective, multicentre study was conducted in ten hospitals belonging to the Spanish national public health system, located in four Autonomous Communities (regions). The study included 1236 patients, diagnosed through a screening programme or found to be symptomatic, between April 2013 and May 2015. The study variables analysed included each patient's personal history, care situation, tumour history and data on the surgical intervention, pathological anatomy, hospital admission and follow-up. Treatment delay was defined as more than 30 days elapsed between biopsy and surgery. RESULTS Over half of the study population experienced surgical treatment delay. This delay was greater for patients with no formal education and among widows, persons not requiring assistance for usual activities, those experiencing anxiety or depression, those who had a high BMI or an above-average number of comorbidities, those who were symptomatic, who did not receive NMR spectroscopy, who presented a histology other than infiltrating ductal carcinoma or who had poorly differentiated carcinomas. CONCLUSIONS Certain sociodemographic and clinical variables are associated with surgical treatment delay. This study identifies factors that influence surgical delays, highlighting the importance of preventing these factors and of raising awareness among the population at risk and among health personnel.
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Affiliation(s)
- María Padilla-Ruiz
- Research Unit, Agencia Sanitaria Costa del Sol, Hospital Costa del Sol University of Málaga, Marbella, Spain.,Health Services Network for Research into Chronic Diseases (REDISSEC), Madrid, Spain
| | - Irene Zarcos-Pedrinaci
- Oncology Service, Hospital Costa del Sol, Marbella, Spain.,Health Services Network for Research into Chronic Diseases (REDISSEC), Madrid, Spain
| | - Francisco Rivas-Ruiz
- Research Unit, Agencia Sanitaria Costa del Sol, Hospital Costa del Sol University of Málaga, Marbella, Spain.,Health Services Network for Research into Chronic Diseases (REDISSEC), Madrid, Spain
| | - Teresa Téllez
- Health Services Network for Research into Chronic Diseases (REDISSEC), Madrid, Spain
| | - Susana García-Gutiérrez
- Health Services Network for Research into Chronic Diseases (REDISSEC), Madrid, Spain.,Research Unit, Galdakao-Usansolo Hospital Osakidetza, Galdakao, Bizkaia, Spain
| | - Nerea González
- Health Services Network for Research into Chronic Diseases (REDISSEC), Madrid, Spain.,Research Unit, Galdakao-Usansolo Hospital Osakidetza, Galdakao, Bizkaia, Spain
| | - Amado Rivero
- Health Services Network for Research into Chronic Diseases (REDISSEC), Madrid, Spain.,Canary Islands Foundation for Health Care Research (FUNCANIS), Tenerife, Spain
| | - Cristina Sarasqueta
- Unidad de Investigación, Instituto de Investigación Sanitaria BioDonostia, Hospital Universitario Donostia - REDISSEC, Donostia, Gipuzkoa, Spain
| | - Pedro Serrano-Aguilar
- Health Services Network for Research into Chronic Diseases (REDISSEC), Madrid, Spain.,Evaluation Unit of the Canary Islands Health Service (SESCS), Tenerife, Spain
| | - Xavier Castells
- Health Services Network for Research into Chronic Diseases (REDISSEC), Madrid, Spain.,Department of Epidemiology and Evaluation, Hospital del Mar Medical Research Institute (IMIM), Autonomous University of Barcelona, Barcelona, Spain
| | - José María Quintana
- Health Services Network for Research into Chronic Diseases (REDISSEC), Madrid, Spain.,Research Unit, Galdakao-Usansolo Hospital Osakidetza, Galdakao, Bizkaia, Spain
| | - María Sala
- Health Services Network for Research into Chronic Diseases (REDISSEC), Madrid, Spain.,Department of Epidemiology and Evaluation, Hospital del Mar Medical Research Institute (IMIM), Autonomous University of Barcelona, Barcelona, Spain
| | - Maximino Redondo
- Research Unit, Agencia Sanitaria Costa del Sol, Hospital Costa del Sol University of Málaga, Marbella, Spain. .,Health Services Network for Research into Chronic Diseases (REDISSEC), Madrid, Spain.
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Padilla-Ruiz M, Redondo M. ASO Author Reflections: Predictive Factors for Surgical Treatment Delay in Localised Breast Cancer. Ann Surg Oncol 2020; 28:3722. [PMID: 33231768 DOI: 10.1245/s10434-020-09411-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 11/10/2020] [Indexed: 01/01/2023]
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Cost–utility analysis of germline BRCA1/2 testing in women with high-grade epithelial ovarian cancer in Spain. Clin Transl Oncol 2019; 21:1076-1084. [DOI: 10.1007/s12094-018-02026-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 12/21/2018] [Indexed: 02/06/2023]
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Lee SB, Lee JW, Kim HJ, Ko BS, Son BH, Eom JS, Lee TJ, Ahn SH. Long-term outcomes of patients with breast cancer after nipple-sparing mastectomy/skin-sparing mastectomy followed by immediate transverse rectus abdominis musculocutaneous flap reconstruction: Comparison with conventional mastectomy in a single center study. Medicine (Baltimore) 2018; 97:e0680. [PMID: 29718895 PMCID: PMC6393080 DOI: 10.1097/md.0000000000010680] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
To evaluate the oncological outcomes of patients with breast cancer after nipple-sparing mastectomy (NSM)/skin-sparing mastectomy (SSM), followed by immediate reconstruction, as compared to conventional mastectomy (CM).SSM/NSM has been increasingly used to treat women with breast cancer who wish to preserve the overlying breast skin, but concern exist regarding its oncological safety due to the potential for residual breast tissue. We report our experience performing SSM/NSM for breast cancer treatment compared to CM with a long follow-up period.All consecutive patients who underwent mastectomy for breast cancer at Asan Medical Center between January 1993 and December 2008 were identified by retrospective medical chart review. The patients who underwent NSM/SSM, followed by immediate breast reconstruction with a pedicled transverse rectus abdominis musculocutaneous flap (TRAM), were compared to the patients who underwent CM in terms of breast-cancer specific survival (BCSS) rate, distant metastasis-free survival (DMFS) rate, and local recurrence (LR) rate.During the study period, 6028 patients underwent mastectomy for breast cancer. Of these, 1032 and 4996 underwent NSM/SSM with TRAM and CM, respectively. Their median follow-up durations were 94.4 (range, 8.1-220.2) and 110.8 (range, 6.1-262.0) months, respectively. Their 5 year BCSS rates were 95.4% and 88.1%, respectively (log-rank, P < .001). Their 5 year DMFS rates were 93.0% and 85.6%, respectively (log-rank, P < .001).Relative to CM, NSM/SSM, followed by immediate breast reconstruction, may be a viable and oncologically safe surgical treatment in selected patients with breast cancer.
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Affiliation(s)
- Sae Byul Lee
- Division of Breast and Endocrine Surgery, Department of Surgery
| | - Jong Won Lee
- Division of Breast and Endocrine Surgery, Department of Surgery
| | - Hee Jeong Kim
- Division of Breast and Endocrine Surgery, Department of Surgery
| | - Beom Seok Ko
- Division of Breast and Endocrine Surgery, Department of Surgery
| | - Byung Ho Son
- Division of Breast and Endocrine Surgery, Department of Surgery
| | - Jin Sup Eom
- Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - Taik Jong Lee
- Department of Plastic Surgery, Boryeong Asan Medical Center, Boryeong, Korea
| | - Sei-Hyun Ahn
- Division of Breast and Endocrine Surgery, Department of Surgery
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