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Ahn J, Lee KE. Experiences of peer support activities and the need for a metaverse-based program in young women with breast cancer: A qualitative study. Asia Pac J Oncol Nurs 2023; 10:100253. [PMID: 37448532 PMCID: PMC10336407 DOI: 10.1016/j.apjon.2023.100253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 05/25/2023] [Indexed: 07/15/2023] Open
Abstract
Objective This study aimed to explore young breast cancer survivors' experiences of peer support activities and their need for a metaverse-based peer support program. Methods This qualitative content analysis study involved 15 young women with breast cancer under the age of 40. Participants with diverse experiences in peer support activities were purposefully selected. Data were collected in March 2023 through three focus group interviews and three additional individual interviews. Saturation was reached when no new themes emerged from the interviews. The interviews were transcribed verbatim and analyzed using conventional content analysis. This study ensured the trustworthiness of the data based on criteria including truth value, applicability, consistency, and neutrality. Results Four categories emerged: advantages, disadvantages, preferences for peer support activities, and the need for metaverse-based peer support programs. Participants valued peer support activities for exchanging information, nurturing empathy, and encouraging healthy behaviors. Challenges included information confusion, peer conflict, isolation, and stigma. Preferences for group composition, size, and medium varied; however, all participants agreed on the importance of operational guidelines. Participants expected a metaverse-based peer support program to provide safe and enjoyable experiences despite concerns about unfamiliar platforms. Conclusions This study highlights the unique needs and preferences of young breast cancer survivors regarding peer support activities. Well-organized and tailored peer support can significantly enhance their quality of life. These findings provide valuable insights for developing effective metaverse-based peer support programs to meet the needs of young women with breast cancer.
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Affiliation(s)
- Jeonghee Ahn
- Department of Medicine, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Kyoung-Eun Lee
- Department of Nursing Science, SunMoon University, 70, Sunmoon-ro 221beon-gil, Tangjeong-myeon, Asan-si, Chungcheongnam-do, Republic of Korea
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2
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Fergus K, Tanen A, Ahmad S, Gardner S, Warner E, McLeod D, Stephen J, Carter W, Periera A. Treatment Satisfaction With Couplelinks Online Intervention to Promote Dyadic Coping in Young Couples Affected by Breast Cancer. Front Psychol 2022; 13:862555. [PMID: 35783696 PMCID: PMC9245623 DOI: 10.3389/fpsyg.2022.862555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 03/17/2022] [Indexed: 11/30/2022] Open
Abstract
Background This study evaluated participant satisfaction with “Couplelinks,” an online psychological intervention designed for younger couples coping with breast cancer. The program included six experiential learning exercises (plus one optional module), psychoeducational information, and support from a personal mental health professional. Objective The primary objectives were to examine participants’ perceptions of: the online intervention’s structure and content; the value of including a professional facilitator; and benefits and drawbacks of the program. Methods A treatment satisfaction questionnaire comprised of Likert indices and open-ended questions pertaining to treatment satisfaction was completed by 26 patients and 27 male partners (N = 53) approximately 1–2 weeks following the intervention which occurred in the context of a randomized controlled trial. Descriptive statistics were used to summarize satisfaction ratings and generalized linear models with fixed effect for gender were used to test for differences in male-female outcomes. A thematic analysis was undertaken in order to understand, organize and summarize the qualitative textual feedback. Results Participants reported an overall satisfaction rating of 4.3 out of 5 (SD = 0.54) with patient satisfaction ratings being higher than that of male partners’ (p = 0.01). The majority of participants considered the facilitator’s role to be necessary 4.6 (SD = 0.60), and found the program to be convenient 4.1 (SD = 0.81) despite some participants struggling to keep up with the modules. Subjective data revealed participants valued the convenience and flexibility of the online intervention and appreciated the program’s involvement of both partners. Participants also reported that including a professional facilitator humanized the intervention, served as motivation to progress through the program, facilitated insight into their relationship, and was reassuring. Experiential gains noted by participants included that the program: helped couples to open channels of communication; prompted them to designate quality time for one another; evoked feelings of unity and togetherness; and inspired new insight in the relationship. Conclusion Such feedback supports the feasibility and acceptability of the Couplelinks program while offering directions for improvement of online couple-based interventions in cancer.
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Affiliation(s)
- Karen Fergus
- Psychosocial Oncology Lab, Department of Psychology, York University, Toronto, ON, Canada
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- *Correspondence: Karen Fergus, ,
| | - Adina Tanen
- School of Medicine, University of Toronto, Toronto, ON, Canada
| | - Saunia Ahmad
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Toronto Psychology Clinic, Toronto, ON, Canada
| | - Sandra Gardner
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
- Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Ellen Warner
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Deborah McLeod
- School of Nursing, Dalhousie University, Halifax, NS, Canada
| | - Joanne Stephen
- Clinical Neurosciences, Alberta Health Services, Calgary, AB, Canada
| | - Wendy Carter
- Toronto Academic Pain Institute, Women’s College Hospital, Toronto, ON, Canada
| | - Amanda Periera
- Psychosocial Oncology Lab, Department of Psychology, York University, Toronto, ON, Canada
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3
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Clinical outcomes and prognostic biomarkers among pregnant, post-partum and nulliparous women with breast cancer: a prospective cohort study. Breast Cancer Res Treat 2021; 189:797-806. [PMID: 34318391 DOI: 10.1007/s10549-021-06327-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 07/07/2021] [Indexed: 12/20/2022]
Abstract
PURPOSE To compare clinical-pathologic characteristics and outcomes of pregnancy-associated, post-partum (PP) and nulliparous (NP) breast cancer (BC) patients and explore mediators of the poor prognosis associated with post-partum BC. METHODS A prospective database of 233 women ≤ 40 years of age diagnosed with BC between February 2008 and January 2015 was analysed. Clinical-pathologic characteristics and outcomes among pregnant, PP and NP patients were compared using chi-square or Kruskal-Wallis tests. The Kaplan-Meier method was used to estimate disease-free survival (DFS), distant DFS and overall survival (OS). Survival curves were compared using the log-rank test. Univariable Cox proportional hazards regression models were used to evaluate factors that were potentially prognostic for the clinical outcomes of interest; a multivariable Cox model was constructed using a forward stepwise selection process. Androgen receptor (AR), GATA3, PDL1 status and the presence/absence of tumour-infiltrating lymphocytes (TILs) were assessed when possible. Pre-treatment neutrophil and lymphocyte counts were abstracted retrospectively. Statistical significance was defined as a p value ≤ 0.05. RESULTS Women ≤ 2 years PP had a numerically higher incidence of lymph node-positive and high-grade disease and were significantly more likely to have estrogen receptor-negative BC compared to NP controls. With a median follow-up of 7.2 years, increasingly poor outcomes were observed among NP (longest OS), > 2 years PP, ≤ 2 years PP and pregnant (shortest OS) patients, but these differences were not statistically significant. The ≤ 2 years PP group had significantly lower AR expression, a strong trend toward higher PDL1 expression and a higher expression of stromal TILs compared to NP women. CONCLUSIONS PPBC patients had numerically lower DFS and OS compared to NP controls. Higher PDL1 and stromal TILs in PPBC suggest that adjuvant immunotherapy may be effective in the post-partum BC subgroup.
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4
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Villarreal-Garza C, Ferrigno AS, Mesa-Chavez F, Platas A, Miaja M, Fonseca A, Cruz-Ramos M, Mohar A, Bargallo-Rocha JE, Chapman JAW. Improving Collection of Real-World Data: The Experience of the Joven & Fuerte Prospective Cohort for Mexican Young Women With Breast Cancer. Clin Breast Cancer 2021; 21:e675-e680. [PMID: 34020878 DOI: 10.1016/j.clbc.2021.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 03/20/2021] [Accepted: 04/11/2021] [Indexed: 10/21/2022]
Abstract
The prospective collection of clinical data can generate detailed information on heterogeneous populations. This article reviews the strengths and limitations of the collection of real-world data and provides insight into the feasibility of routine collection of high-quality evidence even in a resource-constrained setting. The acquisition of high-quality data to assess the clinical and psychosocial needs of young Mexican patients with breast cancer has been enhanced through the use of preplanned, standardized data definitions and instrumentation to provide internally and externally comparable results, optimization of data collection with web-based surveys, engagement of participants to minimize missing data, and routine review for data consistency. A similar approach by other research groups could improve the quality of real-world data and accomplish enhanced inference of information.
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Affiliation(s)
- Cynthia Villarreal-Garza
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico; Centro de Cancer de Mama, Hospital Zambrano Hellion TecSalud, Tecnologico de Monterrey, San Pedro Garza Garcia, Mexico
| | - Ana S Ferrigno
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico; Centro de Cancer de Mama, Hospital Zambrano Hellion TecSalud, Tecnologico de Monterrey, San Pedro Garza Garcia, Mexico
| | - Fernanda Mesa-Chavez
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico; Centro de Cancer de Mama, Hospital Zambrano Hellion TecSalud, Tecnologico de Monterrey, San Pedro Garza Garcia, Mexico
| | - Alejandra Platas
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico; Departamento de Tumores Mamarios y Departamento de Investigacion, Instituto Nacional de Cancerologia, Ciudad de Mexico, Mexico
| | - Melina Miaja
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico; Centro de Cancer de Mama, Hospital Zambrano Hellion TecSalud, Tecnologico de Monterrey, San Pedro Garza Garcia, Mexico
| | - Alan Fonseca
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico; Departamento de Tumores Mamarios y Departamento de Investigacion, Instituto Nacional de Cancerologia, Ciudad de Mexico, Mexico
| | - Marlid Cruz-Ramos
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico; Departamento de Tumores Mamarios y Departamento de Investigacion, Instituto Nacional de Cancerologia, Ciudad de Mexico, Mexico
| | - Alejandro Mohar
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico; Departamento de Tumores Mamarios y Departamento de Investigacion, Instituto Nacional de Cancerologia, Ciudad de Mexico, Mexico
| | - Juan E Bargallo-Rocha
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico; Departamento de Tumores Mamarios y Departamento de Investigacion, Instituto Nacional de Cancerologia, Ciudad de Mexico, Mexico
| | - Judy-Anne W Chapman
- Public Health Sciences Department and Canadian Cancer Trials Group, Queen's University, Kingston, Ontario, Canada (retired).
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5
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Eiriz IF, Vaz Batista M, Cruz Tomás T, Neves MT, Guerra-Pereira N, Braga S. Breast cancer in very young women-a multicenter 10-year experience. ESMO Open 2021; 6:100029. [PMID: 33399090 PMCID: PMC7807935 DOI: 10.1016/j.esmoop.2020.100029] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 11/21/2020] [Accepted: 11/26/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Breast cancer (BC) is the most prevalent cancer in adult young women in Europe. Although rare, it is one of the leading causes of death in this age group. The aim of this study is to characterize a cohort of young women regarding tumor stage, biology, treatment and survival. PATIENTS AND METHODS We present a multicenter retrospective analysis of women <35 years of age, diagnosed with BC between 2008 and 2017. A total of 207 patients from five Portuguese centers were included, from whom 172 were eligible for analysis. Data were analyzed using IBM SPPSS statistics. RESULTS Median age at diagnosis was 31 years. Fifty-one percent of tumors were hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-negative, 20% HR-positive/HER2-positive, 8% HR-negative/HER2-positive and 20% triple-negative BC. Twenty-two percent of patients were diagnosed in stage I, 26% stage II, 45% stage III and 6% had de novo metastatic cancer. Thirty-nine percent of patients were treated with neoadjuvant chemotherapy. Mean follow-up time was 64.9 months and overall survival at 5 years, of the entire cohort and metastatic patients, was 86.5% and 26%, respectively. CONCLUSIONS In our study we found similar population characteristics to other cohorts <35 years of age. To our knowledge, this is one of the largest cohorts in very young women. BC in young women is an important issue and further studies are needed to provide better care and survivorship to patients.
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Affiliation(s)
- I F Eiriz
- Oncology Department, Hospital Prof. Doutor Fernando Fonseca, Amadora, Lisbon, Portugal.
| | - M Vaz Batista
- Oncology Department, Hospital Prof. Doutor Fernando Fonseca, Amadora, Lisbon, Portugal
| | - T Cruz Tomás
- Oncology Department, Hospital Prof. Doutor Fernando Fonseca, Amadora, Lisbon, Portugal
| | - M T Neves
- Oncology Department, Centro Hospitalar Lisboa Ocidental, Hospital S. Francisco Xavier, Lisboa, Portugal
| | - N Guerra-Pereira
- Oncology Department, Centro Hospitalar Barreiro Montijo, Barreiro, Portugal
| | - S Braga
- Oncology Department, Hospital Prof. Doutor Fernando Fonseca, Amadora, Lisbon, Portugal; Oncology Department, Hospital Vila Franca de Xira, Lisbon, Portugal; Oncology Department, Cuf Hospitals, Lisbon, Portugal
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6
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Franzoi MA, Rosa DD, Zaffaroni F, Werutsky G, Simon S, Bines J, Barrios C, Cronemberger E, Queiroz GS, Cordeiro de Lima V, Júnior RF, Couto J, Emerenciano K, Resende H, Crocamo S, Reinert T, Van Eyli B, Nerón Y, Dybal V, Lazaretti N, de Cassia Costamillan R, Pinto de Andrade DA, Mathias C, Vacaro GZ, Borges G, Morelle A, Filho CAS, Mano M, Liedke PER. Advanced Stage at Diagnosis and Worse Clinicopathologic Features in Young Women with Breast Cancer in Brazil: A Subanalysis of the AMAZONA III Study (GBECAM 0115). J Glob Oncol 2020; 5:1-10. [PMID: 31730380 PMCID: PMC6882517 DOI: 10.1200/jgo.19.00263] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Breast cancer (BC) in young women is uncommon and tends to present with more aggressive characteristics. To better understand and characterize this scenario in Brazil through real-world data, we performed a subanalysis of AMAZONA III study (ClinicalTrials.gov identifier: NCT02663973). METHODS The AMAZONA III study (GBECAM 0115) is a prospective registry that included 2,950 women newly diagnosed with invasive BC in Brazil from January 2016 until March 2018 at 22 sites. Valid data were obtained from 2,888 patients regarding age at diagnosis and complete baseline information. To compare epidemiologic and clinicopathological features at the time of diagnosis, patients with BC were divided into two groups according to age: ≤ 40 years and > 40 years. Quantitative variables were described as means, and categorical variables were described as frequencies and percentages and compared using the Pearson’s χ2 test. RESULTS Of 2,888 women diagnosed with BC, 486 (17%) were ≤ 40 years old. Young women had higher educational level, most were employed and a significant number were married (P < .001 for all associations). Younger patients were more symptomatic at BC diagnosis (P < .001), and they also presented more frequently with stage III, T3/T4, grade 3 tumors, HER-2–positive, luminal B, and triple-negative subtypes. CONCLUSION Brazilian women younger than age 40 years have unfavorable clinicopathological features of BC at diagnosis, with more aggressive subtypes and advanced stage when compared with older women. These differences are not explained by socioeconomic or ethnic imbalances. The causes of a higher prevalence of BC among young women in Brazil deserve additional investigation.
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Affiliation(s)
- Maria Alice Franzoi
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Jules Bordet Institut, Brussels, Belgium.,Latin American Cooperative Oncology Group, Porto Alegre, Brazil
| | - Daniela D Rosa
- Latin American Cooperative Oncology Group, Porto Alegre, Brazil.,Grupo Brasileiro de Estudos em Câncer de Mama, Porto Alegre, Brazil.,Hospital Moinhos de Vento, Porto Alegre, Brazil
| | | | - Gustavo Werutsky
- Latin American Cooperative Oncology Group, Porto Alegre, Brazil.,Grupo Brasileiro de Estudos em Câncer de Mama, Porto Alegre, Brazil
| | - Sérgio Simon
- Latin American Cooperative Oncology Group, Porto Alegre, Brazil.,Grupo Brasileiro de Estudos em Câncer de Mama, Porto Alegre, Brazil
| | - José Bines
- Latin American Cooperative Oncology Group, Porto Alegre, Brazil.,Grupo Brasileiro de Estudos em Câncer de Mama, Porto Alegre, Brazil.,Instituto Nacional do Cancer, Rio de Janeiro, Brazil
| | - Carlos Barrios
- Latin American Cooperative Oncology Group, Porto Alegre, Brazil.,Grupo Brasileiro de Estudos em Câncer de Mama, Porto Alegre, Brazil
| | | | | | | | | | - José Couto
- Hospital do Câncer de Londrina, Londrina, Brazil
| | | | | | | | - Tomás Reinert
- Centro de Pesquisa e Educação da Serra Gaúcha- DeVita, Caxias do Sul, Brazil
| | | | - Yeni Nerón
- Centro de Pesquisas em Oncologia, Florianópolis, Brazil
| | - Vanessa Dybal
- Clínica Assistência Multidisciplinar em Oncologia, Salvador, Brazil
| | | | | | | | | | | | | | | | | | - Max Mano
- Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil
| | - Pedro E R Liedke
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Latin American Cooperative Oncology Group, Porto Alegre, Brazil.,Grupo Brasileiro de Estudos em Câncer de Mama, Porto Alegre, Brazil
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7
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Villarreal-Garza C, Platas A, Miaja M, Fonseca A, Mesa-Chavez F, Garcia-Garcia M, Chapman JA, Lopez-Martinez EA, Pineda C, Mohar A, Galvez-Hernandez CL, Castro-Sanchez A, Martinez-Cannon BA, Barragan-Carrillo R, Muñoz-Lozano JF, Goss P, Bargallo-Rocha JE, Aguilar D, Cardona S, Canavati M. Young Women With Breast Cancer in Mexico: Results of the Pilot Phase of the Joven & Fuerte Prospective Cohort. JCO Glob Oncol 2020; 6:395-406. [PMID: 32142405 PMCID: PMC7113130 DOI: 10.1200/jgo.19.00264] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2020] [Indexed: 01/28/2023] Open
Abstract
PURPOSE The pilot-phase report of the Joven & Fuerte prospective cohort broadly characterizes and assesses the needs of Mexican young women with breast cancer (YWBC). PATIENTS AND METHODS Women age ≤ 40 years with nonmetastatic primary breast cancer were consecutively accrued from 2 hospitals. Data were collected at the first/baseline oncology visit and 2 years later using a sociodemographic survey, European Organisation for Research and Treatment of Cancer Quality-of-Life (QOL) Questionnaire Core 30 (QLQ-C30) and Breast Cancer-Specific QOL Questionnaire (QLQ-BR23), Hospital Anxiety and Depression Scale (HADS), Female Sexual Functioning Index (FSFI), Sexual Satisfaction Inventory, and patients' medical records. Pearson χ2 and 2-sided t tests were used for statistical analysis. An unadjusted P value < .05 was considered significant. RESULTS Ninety patients were included, all with government health care coverage. Most had low monthly household incomes (98%) and at least a high school education (59%). There was a considerable prevalence of unpartnered patients (36%) and unmet parity (25%). Patients' most common initial symptom was a palpable mass (84%), and they were most frequently diagnosed with stage III disease (48%), with 51% having had a physician visit ≤ 3 months since detection but 39% receiving diagnosis > 12 months later. At baseline, 66% of patients were overweight/obese, and this proportion had significantly increased by 2 years (P < .001). Compared with baseline, global QLQ-C30 had improved significantly by 2 years (P = .004), as had HADS-Anxiety (P < .001). However, both at baseline and at 2 years, nearly half of patients exhibited FSFI sexual dysfunction. CONCLUSION These preliminary findings demonstrate that YWBC in Mexico have particular sociodemographic and clinicopathologic characteristics, reinforcing the necessity to further describe and explore the needs of these young patients, because they may better represent the understudied and economically vulnerable population of YWBC in limited-resource settings.
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Affiliation(s)
- Cynthia Villarreal-Garza
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
- Centro de Cancer de Mama, Tecnologico de Monterrey, Monterrey, Mexico
| | - Alejandra Platas
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
- Departamento de Tumores Mamarios y Departamento de Investigacion, Instituto Nacional de Cancerologia, Ciudad de Mexico, Mexico
| | - Melina Miaja
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
- Centro de Cancer de Mama, Tecnologico de Monterrey, Monterrey, Mexico
| | - Alan Fonseca
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
| | - Fernanda Mesa-Chavez
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
- Centro de Cancer de Mama, Tecnologico de Monterrey, Monterrey, Mexico
| | - Marisol Garcia-Garcia
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
- Centro de Cancer de Mama, Tecnologico de Monterrey, Monterrey, Mexico
| | - Judy-Anne Chapman
- Canadian Cancer Trials Group, Queen’s University, Kingston, ON, Canada (retired)
| | - Edna A. Lopez-Martinez
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
- Centro de Cancer de Mama, Tecnologico de Monterrey, Monterrey, Mexico
| | - Claudia Pineda
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
| | - Alejandro Mohar
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
- Departamento de Tumores Mamarios y Departamento de Investigacion, Instituto Nacional de Cancerologia, Ciudad de Mexico, Mexico
| | - Carmen L. Galvez-Hernandez
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
- Departamento de Tumores Mamarios y Departamento de Investigacion, Instituto Nacional de Cancerologia, Ciudad de Mexico, Mexico
| | - Andrea Castro-Sanchez
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
| | - Bertha-Alejandra Martinez-Cannon
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
- Centro de Cancer de Mama, Tecnologico de Monterrey, Monterrey, Mexico
| | - Regina Barragan-Carrillo
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
- Centro de Cancer de Mama, Tecnologico de Monterrey, Monterrey, Mexico
| | - Jose F. Muñoz-Lozano
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
- Centro de Cancer de Mama, Tecnologico de Monterrey, Monterrey, Mexico
| | | | - Juan E. Bargallo-Rocha
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
- Departamento de Tumores Mamarios y Departamento de Investigacion, Instituto Nacional de Cancerologia, Ciudad de Mexico, Mexico
| | - Dione Aguilar
- Joven & Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama, Ciudad de Mexico, Mexico
- Centro de Cancer de Mama, Tecnologico de Monterrey, Monterrey, Mexico
| | - Servando Cardona
- Centro de Cancer de Mama, Tecnologico de Monterrey, Monterrey, Mexico
| | - Mauricio Canavati
- Centro de Cancer de Mama, Tecnologico de Monterrey, Monterrey, Mexico
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8
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Castro-Sanchez A, Martinez-Cannon BA, Platas A, Mohar A, Fonseca A, Vega Y, Fimbres-Morales A, Villarreal-Garza C. Suboptimal Use of Effective Contraceptive Methods in Young Mexican Women With Breast Cancer. J Glob Oncol 2019; 4:1-7. [PMID: 30300053 PMCID: PMC7010441 DOI: 10.1200/jgo.18.00064] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Purpose Contraceptive counseling and adherence in young women with breast cancer (BC) is a relevant issue because chemotherapy and hormonal treatment resulting in amenorrhea do not preclude unintended pregnancies. Currently, there is limited evidence from high-income countries; however, there are no studies regarding use of contraceptives in patients with BC in Mexico. This study aimed to determine the rate of contraceptive use in young Mexican women with BC during cancer treatment, characterize their contraceptive preferences, and assess contraceptive counseling by Mexican physicians. Patients and Methods A cross-sectional survey was conducted regarding contraceptive use and counseling among women age 40 years or younger at BC diagnosis who had completed chemotherapy in the previous 5 years or who were currently receiving long-term treatment with hormonal therapy and/or trastuzumab at a large tertiary health care facility in Mexico. Results Of a total of 104 eligible women with median age at diagnosis of 34 years, 51.1% reported using a contraceptive during chemotherapy and 45.7% reported using a contraceptive during other types of cancer treatment (hormonal therapy and trastuzumab). Of the 51 patients (49%) who were sexually active during chemotherapy, 76.5% used contraception, but only 29.4% used an effective contraceptive method. When asked about contraceptive counseling, only 16.7% recalled being advised by their health care provider. Sexually active women who received contraceptive counseling used contraceptives more often than women who were not counseled (83.3% v 22.2%). Conclusion A minority of young women with BC in Mexico use effective contraception methods during cancer treatment and receive contraceptive counseling. Informing all premenopausal patients with BC about effective use of contraception methods during treatment should be an essential aspect of the supportive care of young women.
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Affiliation(s)
- Andrea Castro-Sanchez
- Andrea Castro-Sanchez, Bertha Alejandra Martinez-Cannon, Alejandra Platas, Alejandro Mohar, Alan Fonseca, Yoatzin Vega, Adrian Fimbres-Morales, and Cynthia Villarreal-Garza, Joven y Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama; Andrea Castro-Sanchez, Instituto Nacional de Cancerologia; Alejandra Platas, Alejandro Mohar, and Cynthia Villarreal-Garza, Instituto Nacional de Cancerologia, Mexico City; and Bertha Alejandra Martinez-Cannon and Cynthia Villarreal-Garza, Tecnologico de Monterrey, Monterrey, Mexico
| | - Bertha Alejandra Martinez-Cannon
- Andrea Castro-Sanchez, Bertha Alejandra Martinez-Cannon, Alejandra Platas, Alejandro Mohar, Alan Fonseca, Yoatzin Vega, Adrian Fimbres-Morales, and Cynthia Villarreal-Garza, Joven y Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama; Andrea Castro-Sanchez, Instituto Nacional de Cancerologia; Alejandra Platas, Alejandro Mohar, and Cynthia Villarreal-Garza, Instituto Nacional de Cancerologia, Mexico City; and Bertha Alejandra Martinez-Cannon and Cynthia Villarreal-Garza, Tecnologico de Monterrey, Monterrey, Mexico
| | - Alejandra Platas
- Andrea Castro-Sanchez, Bertha Alejandra Martinez-Cannon, Alejandra Platas, Alejandro Mohar, Alan Fonseca, Yoatzin Vega, Adrian Fimbres-Morales, and Cynthia Villarreal-Garza, Joven y Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama; Andrea Castro-Sanchez, Instituto Nacional de Cancerologia; Alejandra Platas, Alejandro Mohar, and Cynthia Villarreal-Garza, Instituto Nacional de Cancerologia, Mexico City; and Bertha Alejandra Martinez-Cannon and Cynthia Villarreal-Garza, Tecnologico de Monterrey, Monterrey, Mexico
| | - Alejandro Mohar
- Andrea Castro-Sanchez, Bertha Alejandra Martinez-Cannon, Alejandra Platas, Alejandro Mohar, Alan Fonseca, Yoatzin Vega, Adrian Fimbres-Morales, and Cynthia Villarreal-Garza, Joven y Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama; Andrea Castro-Sanchez, Instituto Nacional de Cancerologia; Alejandra Platas, Alejandro Mohar, and Cynthia Villarreal-Garza, Instituto Nacional de Cancerologia, Mexico City; and Bertha Alejandra Martinez-Cannon and Cynthia Villarreal-Garza, Tecnologico de Monterrey, Monterrey, Mexico
| | - Alan Fonseca
- Andrea Castro-Sanchez, Bertha Alejandra Martinez-Cannon, Alejandra Platas, Alejandro Mohar, Alan Fonseca, Yoatzin Vega, Adrian Fimbres-Morales, and Cynthia Villarreal-Garza, Joven y Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama; Andrea Castro-Sanchez, Instituto Nacional de Cancerologia; Alejandra Platas, Alejandro Mohar, and Cynthia Villarreal-Garza, Instituto Nacional de Cancerologia, Mexico City; and Bertha Alejandra Martinez-Cannon and Cynthia Villarreal-Garza, Tecnologico de Monterrey, Monterrey, Mexico
| | - Yoatzin Vega
- Andrea Castro-Sanchez, Bertha Alejandra Martinez-Cannon, Alejandra Platas, Alejandro Mohar, Alan Fonseca, Yoatzin Vega, Adrian Fimbres-Morales, and Cynthia Villarreal-Garza, Joven y Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama; Andrea Castro-Sanchez, Instituto Nacional de Cancerologia; Alejandra Platas, Alejandro Mohar, and Cynthia Villarreal-Garza, Instituto Nacional de Cancerologia, Mexico City; and Bertha Alejandra Martinez-Cannon and Cynthia Villarreal-Garza, Tecnologico de Monterrey, Monterrey, Mexico
| | - Adrian Fimbres-Morales
- Andrea Castro-Sanchez, Bertha Alejandra Martinez-Cannon, Alejandra Platas, Alejandro Mohar, Alan Fonseca, Yoatzin Vega, Adrian Fimbres-Morales, and Cynthia Villarreal-Garza, Joven y Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama; Andrea Castro-Sanchez, Instituto Nacional de Cancerologia; Alejandra Platas, Alejandro Mohar, and Cynthia Villarreal-Garza, Instituto Nacional de Cancerologia, Mexico City; and Bertha Alejandra Martinez-Cannon and Cynthia Villarreal-Garza, Tecnologico de Monterrey, Monterrey, Mexico
| | - Cynthia Villarreal-Garza
- Andrea Castro-Sanchez, Bertha Alejandra Martinez-Cannon, Alejandra Platas, Alejandro Mohar, Alan Fonseca, Yoatzin Vega, Adrian Fimbres-Morales, and Cynthia Villarreal-Garza, Joven y Fuerte: Programa para la Atencion e Investigacion de Mujeres Jovenes con Cancer de Mama; Andrea Castro-Sanchez, Instituto Nacional de Cancerologia; Alejandra Platas, Alejandro Mohar, and Cynthia Villarreal-Garza, Instituto Nacional de Cancerologia, Mexico City; and Bertha Alejandra Martinez-Cannon and Cynthia Villarreal-Garza, Tecnologico de Monterrey, Monterrey, Mexico
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Srikanthan A, Amir E, Gupta A, Baxter N, Kennedy ED. Assisting with Decision-Making: How Standardized Information Impacts Breast Cancer Patient Decisions Regarding Fertility Trade-Offs and Chemotherapy. J Adolesc Young Adult Oncol 2019; 8:660-667. [PMID: 31241397 DOI: 10.1089/jayao.2019.0027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: Fertility is a concern for young women with breast cancer. We explore patient preferences for chemotherapy and whether women will trade-off survival benefits to maintain fertility following standardized information delivery. Methods: During a standardized interview, outcomes associated with adjuvant chemotherapy and 5 years of tamoxifen (CT) or 5 years of tamoxifen alone (NoCT) were described to participants. A threshold task was performed, in which each participant participated in two scenarios: (1) 10% absolute survival benefit from treatment and (2) 25% absolute survival benefit from treatment. The threshold point represented the reduction in fertility post-treatment that a participant would accept before she would trade-off CT benefit. Descriptive statistics were used to characterize participants. Demographic factors (age, marital status, parity at diagnosis, and education) associated with willingness to trade-off survival benefits were evaluated with logistic regression. Results: Analysis comprised 50 women with a median age of 34.5 years (range 25-39 years). Thirty-nine women (78%) completed university education. Thirty-four (68%) and 45 (90%) women in scenarios 1 and 2, respectively, were willing to trade-off all fertility (i.e., reduce fertility to 0% chance of conceiving naturally) to undertake CT and maintain survival benefits. Eight (16%) and three (6%) women in scenarios 1 and 2, respectively, chose to not pursue CT at all to maintain natural fertility. Regression analysis did not identify any variables that were predictive of participants' preferences. Conclusion: Most women with breast cancer are not willing to trade-off survival benefits of adjuvant therapy to maintain fertility.
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Affiliation(s)
- Amirrtha Srikanthan
- Division of Medical Oncology, The Ottawa Hospital Cancer Centre, Ottawa, Ontario, Canada
| | - Eitan Amir
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Abha Gupta
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.,Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Nancy Baxter
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada.,Keenan Research Centre of the Li Ka Shing Knowledge Institute, Toronto, Ontario, Canada
| | - Erin Diane Kennedy
- Keenan Research Centre of the Li Ka Shing Knowledge Institute, Toronto, Ontario, Canada.,Department of Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada
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10
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Villarreal-Garza C, Lopez-Martinez EA, Muñoz-Lozano JF, Unger-Saldaña K. Locally advanced breast cancer in young women in Latin America. Ecancermedicalscience 2019; 13:894. [PMID: 30792811 PMCID: PMC6372300 DOI: 10.3332/ecancer.2019.894] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Indexed: 01/07/2023] Open
Abstract
The purpose of this review is to organise, summarise and critically assess existing knowledge on locally advanced breast cancer (LABC) among young women in Latin America. We discuss the most relevant findings in six sections: 1) epidemiology of breast cancer in young women in Latin America; 2) being young as a factor for worse prognosis; 3) LABC in young women in the region; 4) aggressive tumour behaviour among young women; 5) delays in diagnosis and treatment and 6) burden of advanced disease. We point out the need to dedicate resources to enhance earlier diagnosis and prompt referrals of young women with breast cancer; promote research regarding prevalence, biologic characteristics, outcomes and reasons for diagnosis and treatment delays for this age group; and finally, implement supportive care programmes as a means of improving patients and their families’ well-being. The recognition of the current standpoint of breast cancer in young patients across the continent should shed some light on the importance of this pressing matter.
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Affiliation(s)
- Cynthia Villarreal-Garza
- Breast Cancer Center, TecSalud, Tecnologico de Monterrey, Monterrey 66278, Mexico.,Research and Breast Cancer Department, Mexican National Cancer Institute, Mexico City 14080, Mexico.,Joven and Fuerte Program for Young Women with Breast Cancer, Mexico City 03720, Mexico
| | - Edna A Lopez-Martinez
- Breast Cancer Center, TecSalud, Tecnologico de Monterrey, Monterrey 66278, Mexico.,Joven and Fuerte Program for Young Women with Breast Cancer, Mexico City 03720, Mexico
| | - Jose Felipe Muñoz-Lozano
- Breast Cancer Center, TecSalud, Tecnologico de Monterrey, Monterrey 66278, Mexico.,Joven and Fuerte Program for Young Women with Breast Cancer, Mexico City 03720, Mexico
| | - Karla Unger-Saldaña
- CONACYT fellow-Epidemiology Unit, Mexican National Cancer Institute, Mexico City 14080, Mexico
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11
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Gálvez-Hernández CL, Ortega Mondragón A, Villarreal-Garza C, Ramos del Río B. Mujeres Jóvenes con Cáncer de Mama: Necesidades de Apoyo en Atención y Resiliencia. PSICOONCOLOGIA 2018. [DOI: 10.5209/psic.61436] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Antecedentes: las mujeres menores de 40 años con cáncer de mama (CaMa) presentan características bio-psico-sociales únicas que ameritan ser atendidas y estudiadas. Objetivo: evaluara) la percepción de necesidades de apoyo en la atención (NAT) insatisfechas y nivel de resiliencia,b) la diferencia de NAT entre pacientes en tratamiento y sobrevivientes y c) la relación entre NAT y resiliencia, y su asociación con variables clínicas y sociodemográficas, respectivamente. Método: se estudiaron transversalmente a 150 mujeres jóvenes con CaMa en tratamiento y sobrevivientes, con una encuesta de NAT y una de resiliencia mexicanas. Resultados: la mediana de edad de las participantes fue de 36 años. Las necesidades menos satisfechas fueron las de sistema de salud e información. El grupo de tratamiento presentó más NAT comparado con las sobrevivientes (p=0,005). Se encontró que cuanto más NAT insatisfechas (globales, psicológicas, cuidado y apoyo, e información), menores valores en los dominios de resiliencia (p<0,005) en ambos grupos y por separado. Conclusiones: las condiciones externas (infraestructura, servicios de salud proporcionados y apoyo en seguridad social), habilidades propias (auto-confianza, estructura y organización) y/o recursos de apoyo externo (social y familiar) pudieron contribuir a que las pacientes percibieran pocas NAT insatisfechas. Los resultados resaltan la relevancia clínica de implementar intervenciones basadas en resiliencia.
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12
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Cohen L, Schwartz N, Guth A, Kiss A, Warner E. User survey of Nanny Angel Network, a free childcare service for mothers with cancer. ACTA ACUST UNITED AC 2017; 24:220-227. [PMID: 28874889 DOI: 10.3747/co.24.3512] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE The purpose of the present study was to determine user satisfaction with Nanny Angel Network (nan), a free childcare service for mothers undergoing cancer treatment. METHODS All 243 living mothers who had used the nan service were invited by telephone to participate in an online research survey; 197 mothers (81%) consented to participate. The survey, sent by e-mail, consisted of 39 items divided into these categories: demographics, supports, use, satisfaction, and general comments. RESULTS Of the 197 mothers who consented to receive the e-mailed survey, 104 (53%) completed it. More than 90% of the mothers were very satisfied with the help and support from their Nanny Angel. Many mothers mentioned that the Nanny Angel was most helpful during treatment and medical appointments, with 75% also mentioning that their Nanny Angel helped them to adhere to their scheduled medical appointments. However, 64% felt that they had not received enough visits from their Nanny Angel. CONCLUSIONS Satisfaction with the nan childcare provider was high, but mothers wished the service had been available to them more often. Our study highlights the importance of providing childcare to mothers with inadequate support systems, so as to allow for greater adherence to treatment and medical appointments, and for more time to recover.
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Affiliation(s)
- L Cohen
- Faculty of Medicine, University of Toronto, and.,Division of Medical Oncology, Sunnybrook Odette Cancer Centre, Toronto, ON
| | - N Schwartz
- Technion American Medical School, Haifa, Israel
| | - A Guth
- Nanny Angel Network, Toronto, ON
| | - A Kiss
- Department of Research Design and Biostatistics, Sunnybrook Research Institute, University of Toronto, Toronto, ON
| | - E Warner
- Division of Medical Oncology, Sunnybrook Odette Cancer Centre, Toronto, ON
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13
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Walter JR, Xu S, Paller AS, Choi JN, Woodruff TK. Oncofertility considerations in adolescents and young adults given a diagnosis of melanoma: Fertility risk of Food and Drug Administration-approved systemic therapies. J Am Acad Dermatol 2017; 75:528-534. [PMID: 27543212 DOI: 10.1016/j.jaad.2016.04.031] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 04/06/2016] [Accepted: 04/09/2016] [Indexed: 01/23/2023]
Abstract
BACKGROUND Melanoma is the most common cancer diagnosed for patients ages 25 to 29 years, the group with the highest birth rates in the United States. Oncofertility is a new field addressing the reproductive needs of patients with cancer facing fertility-threatening treatments. OBJECTIVE We sought to assess gender-specific fertility risk for Food and Drug Administration (FDA)-approved melanoma therapies with a new risk category system. METHODS We conducted a retrospective review of FDA, European Union, and Health Canada regulatory filings, along with previously published reports to grade fertility risk of systemic melanoma therapies. The proposed fertility risk category system is analogous to the FDA's A/B/C/D/X/N pregnancy-risk categories. RESULTS For female patients, 58% of treatments represent a fertility risk (Category C and D), 33% have unknown risk (Category N), and 1 therapy (vemurafenib) did not show animal ovarian toxicity (Category B). For male patients, 33% represented a fertility risk (Category C and D), 50% of treatments had unknown risk (Category N), and 17% did not show animal testicular toxicity (Category B). LIMITATIONS Data on fertility risk for melanoma therapies approved after 2009 are limited to preclinical animal studies. CONCLUSION Dermatologists have an opportunity to discuss fertility preservation, make appropriate referrals, and steward registries on reproductive outcomes for patients with melanoma.
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Affiliation(s)
- Jessica R Walter
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Shuai Xu
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Amy S Paller
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Jennifer N Choi
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Teresa K Woodruff
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.,Women's Health Research Institute, Northwestern University, Chicago, Illinois
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Rana P, Ratcliffe J, Sussman J, Forbes M, Levine M, Hodgson N. Young women with breast cancer: Needs and experiences. COGENT MEDICINE 2017. [DOI: 10.1080/2331205x.2017.1278836] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- Punam Rana
- Department of Oncology, Juravinski Cancer Centre, McMaster University/Hamilton Health Sciences, 699 Concession Street, Suite 4–214, Hamilton, Ontario, Canada L8V 5C2
| | - Jenna Ratcliffe
- Department of Oncology, Juravinski Cancer Centre, McMaster University/Hamilton Health Sciences, 699 Concession Street, Suite 4–214, Hamilton, Ontario, Canada L8V 5C2
| | - Jonathan Sussman
- Department of Oncology, Juravinski Cancer Centre, McMaster University/Hamilton Health Sciences, 699 Concession Street, Suite 4–214, Hamilton, Ontario, Canada L8V 5C2
| | - Margaret Forbes
- Department of Oncology, Juravinski Cancer Centre, McMaster University/Hamilton Health Sciences, 699 Concession Street, Suite 4–214, Hamilton, Ontario, Canada L8V 5C2
| | - Mark Levine
- Department of Oncology, Juravinski Cancer Centre, McMaster University/Hamilton Health Sciences, 699 Concession Street, Suite 4–214, Hamilton, Ontario, Canada L8V 5C2
| | - Nicole Hodgson
- Department of Oncology, Juravinski Cancer Centre, McMaster University/Hamilton Health Sciences, 699 Concession Street, Suite 4–214, Hamilton, Ontario, Canada L8V 5C2
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15
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Srikanthan A, Amir E, Warner E. Does a dedicated program for young breast cancer patients affect the likelihood of fertility preservation discussion and referral? Breast 2016; 27:22-6. [DOI: 10.1016/j.breast.2016.02.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 02/21/2016] [Accepted: 02/28/2016] [Indexed: 11/25/2022] Open
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Abstract
PURPOSE OF REVIEW Because of the recognized impact of breast cancer and its treatment on a young woman's life, initiatives are being established worldwide. The main aim of this review was to describe existing specialized programs that support young women with breast cancer (YWBC), advances to date, current challenges and future actions. RECENT FINDINGS Current programs for YWBC are now educating professionals, patients, and communities on their specific needs. Also, support groups have helped break isolation and connect YWBC together. Research on biology, treatment, adverse effects, risk factors, genetics, and social aspects on YWBC is now being actively conducted. In low- and middle-income countries, the particular issues of young women are, however, still not systematically addressed, because of scarce funding, lack of awareness of YWBC needs, and deficient provider training. SUMMARY Practice guidelines and algorithms should be disseminated and available for their widespread use to allow standard clinical and supportive care for YWBC even in oncologic centers where no specific programs exist. Also, cancer centers should formally commit to financing, at least partially, dedicated services, and existing programs for YWBC, guaranteeing their continuity. Finally, interinstitutional and international collaborations should be encouraged to facilitate adequately powered research, to avoid repetitive efforts, and to promote knowledge sharing and translation.
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17
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Cohen L, Hamer J, Helwig C, Fergus K, Kiss A, Mandel R, Dawson B, Landsberg A, Shein K, Kay N, Warner E. Formal evaluation of PYNK: Breast Cancer Program for Young Women-the patient perspective. ACTA ACUST UNITED AC 2016; 23:e102-8. [PMID: 27122977 DOI: 10.3747/co.23.2773] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE The aim of the present study was to assess patient satisfaction with pynk: Breast Cancer Program for Young Women so as to determine how the program might be improved and to provide feedback to donors. METHODS All pynk patients who had consented to have their information entered in our database and who supplied us with their e-mail address were invited to complete a 58-item online questionnaire consisting of multiple choice and open-ended questions. Domains included demographics, provision of written and spoken information, support, infertility risk, research awareness, attitudes toward discharge, and general feedback. RESULTS Of 120 pynk patients approached, 61 (51%) participated. More than 90% were satisfied or very satisfied with the timing, usefulness, and clarity of spoken and written information given, and 69% found the service and support provided by the nurse navigator to be the most helpful component of the program. Of those who had received systemic therapy, 93% recalled a health care provider initiating a discussion of the risk of treatment-related infertility, and 67% were referred to a fertility clinic. On the negative side, 11%-27% were unaware of various services provided by pynk, and 11% were unaware of pynk's ongoing research. One third of patients were unhappy or ambivalent about the prospect of discharge from the program. CONCLUSIONS Patient satisfaction with this novel program for young women with breast cancer is high. This study highlights the critical role that the nurse navigator plays in patient support and dissemination of information. In contrast to other reported surveys of young cancer patients, pynk patients are routinely given the opportunity to undergo fertility preservation.
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Affiliation(s)
- L Cohen
- Division of Medical Oncology, Sunnybrook Research Institute, University of Toronto, Toronto, ON
| | - J Hamer
- Division of Medical Oncology, Sunnybrook Research Institute, University of Toronto, Toronto, ON
| | - C Helwig
- Division of Medical Oncology, Sunnybrook Research Institute, University of Toronto, Toronto, ON
| | - K Fergus
- Division of Psychology, Patient and Family Support Program, Sunnybrook Odette Cancer Centre, Toronto, ON
| | - A Kiss
- Department of Research Design and Biostatistics, Sunnybrook Research Institute, University of Toronto, Toronto, ON
| | - R Mandel
- Division of Medical Oncology, Sunnybrook Research Institute, University of Toronto, Toronto, ON
| | - B Dawson
- Division of Medical Oncology, Sunnybrook Research Institute, University of Toronto, Toronto, ON
| | - A Landsberg
- Division of Medical Oncology, Sunnybrook Research Institute, University of Toronto, Toronto, ON
| | - K Shein
- Division of Medical Oncology, Sunnybrook Research Institute, University of Toronto, Toronto, ON
| | - N Kay
- Division of Medical Oncology, Sunnybrook Research Institute, University of Toronto, Toronto, ON
| | - E Warner
- Division of Medical Oncology, Sunnybrook Research Institute, University of Toronto, Toronto, ON
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Providing Supportive Care for Young Breast Cancer Patients: Exploring the Comfort Level and Educational Needs of the Interprofessional Health Care Team at a Comprehensive Cancer Centre. J Med Imaging Radiat Sci 2015; 46:S69-S74. [PMID: 31052111 DOI: 10.1016/j.jmir.2015.04.015] [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] [Received: 01/30/2015] [Revised: 04/24/2015] [Accepted: 04/27/2015] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Younger patients diagnosed with breast cancer have unique issues compared with their older counterparts, including premature menopause, body image, and fertility/relationship concerns. However, breast cancer information tends to focus on older patients. The interprofessional team at a large hospital was surveyed to assess comfort level and knowledge of supportive care for the younger population. METHODS A one-time, cross-sectional survey was distributed to oncologists, nurses, radiation therapists, and other supportive care professionals. The survey included multiple-choice, Likert scale, and open-ended questions asking participants to assess their knowledge and comfort level around the issues faced by younger breast cancer patients. Demographic information was collected, and results were analyzed using descriptive statistics. RESULTS In total, 67 questionnaires were returned (22% response rate); 92% of respondents felt comfortable providing care to young breast cancer patients, whereas 72% were confident in their ability to provide support for their psychosocial needs. However, most participants rated their knowledge of issues specific to these patients higher than their comfort level. Disparity between the professions occurred, with oncologists and nurses reporting a higher comfort level than other professions. CONCLUSIONS Although most professionals felt they had good knowledge of the issues faced by young breast cancer patients, many felt less confident addressing these issues with their patients. This informational needs gap presents an opportunity for the emergence of champions to heighten awareness and educate colleagues in the supportive care of this patient population.
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Prevalence and clinical outcomes of young breast cancer (YBC) patients according to intrinsic breast cancer subtypes: Single institutional experience in Korea. Breast 2015; 24:213-7. [PMID: 25728283 DOI: 10.1016/j.breast.2015.01.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 12/24/2014] [Accepted: 01/28/2015] [Indexed: 02/08/2023] Open
Abstract
The purpose of our study was to investigate and identify comprehensively the clinicopathological features and long-term outcome of young breast cancer (YBC) according to intrinsic subtype. We analyzed clinical and pathological characteristics of 2844 women who were diagnosed with invasive breast cancer from 2000 to 2007 and the treatment outcomes by age at diagnosis. The median age of the patients was 46 years (range, 21-83 years), and we divided them into three age group: ≤35 years (Group 1), 36-50 years (Group 2), and >50 years (Group 3). During a median follow-up of 100 months, the 5-year recurrence-free survival rate (RFSR) and overall survival rate (OSR) were 90.8% and 94.6%, respectively. The 10-year estimated RFSR and OSR were 81.9% and 86.9%, respectively. The prognosis of TN subtype appeared not to be worse than that of other subtypes in Group 1. In Group 1 alone (≤35 years), subtype was not identified as an independent risk factor for distant recurrence-free survival (DRFS) in a Cox-regression multivariate model (hazard ratio, 0.85; 95% CI, 0.68-1.06; p = 0.148). This analysis revealed a very high prevalence of YBC in this cohort. The poor outcomes of YBC patients might result from an increased frequency of triple negative (TN)/HER2 subtypes and the more aggressive clinical behavior of ER-positive tumors compared with older patients. Further research to elucidate the biologic difference of the ER+ tumors of YBC patients is warranted.
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Villarreal-Garza C, Aguila C, Magallanes-Hoyos MC, Mohar A, Bargalló E, Meneses A, Cazap E, Gomez H, López-Carrillo L, Chávarri-Guerra Y, Murillo R, Barrios C. Breast cancer in young women in Latin America: an unmet, growing burden. Oncologist 2014; 18 Suppl:26-34. [PMID: 24334479 DOI: 10.1634/theoncologist.18-s2-26] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Breast cancer (BC) is the leading cause of malignancy-related deaths among women aged ≤ 45 years. There are unexplored and uncertain issues for BC in this particular group in Latin America. The aim of this study is to evaluate BC incidence and mortality among young women and related clinicopathological and survivorship aspects in this region. MATERIALS AND METHODS Data were obtained from Globocan 2008 and the International Agency for Research on Cancer's Cancer Incidence in Five Continents series plus databases. We requested collaboration from the 12 different national cancer institutes in Latin America through SLACOM, the Latin American and Caribbean Society of Medical Oncology, and conducted a systematic literature review to obtain local data regarding the prevalence of BC among young women and their characteristics, outcomes, and survivorship-related issues. RESULTS BC incidence and mortality proportions for Latin American women aged <44 years were higher when compared with those of developed countries (20% vs. 12% and 14% vs. 7%, respectively). We found only a few Latin American series addressing this topic, and prevalence varied between 8% and 14%. Stage II and III disease, high histological grade, and triple-negative and HER2 BC were features frequently observed among young Latin American BC patients. CONCLUSION The rising incidence and mortality of BC in young Latin American women is a call to action in the region. It is necessary to monitor the epidemiological and clinical data through reliable cancer registries and to consider the implementation of protocols for education of patients and health professionals. This unmet, growing burden must be considered as a top priority of the national programs in the fight against BC, and models of specialized units should be implemented for this particular group of patients to provide better care for this emergent challenge.
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Ali A, Fergus K, Wright FC, Pritchard KI, Kiss A, Warner E. The impact of a breast cancer diagnosis in young women on their relationship with their mothers. Breast 2013; 23:50-5. [PMID: 24290865 DOI: 10.1016/j.breast.2013.10.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2013] [Revised: 09/01/2013] [Accepted: 10/14/2013] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND For young women with breast cancer mothers might either be a source of support or of increased stress, depending on the premorbid relationship and on the psychological effect of the daughter's diagnosis on her mother. OBJECTIVES To examine the effects of a breast cancer diagnosis on young women's relationships with their mothers and the possible support needs of these mothers from the daughters' perspective. PATIENTS AND METHODS We developed and pre-tested a self-administered questionnaire on 10 survivors of breast cancer diagnosed ≤ age 40. Then, consecutive recurrence-free young women diagnosed with breast cancer were asked to complete the modified questionnaire. RESULTS Of 110 daughters approached from July/11 to May/12, 90 (82%) participated. In 11 cases (13%), the daughters had turned to their mothers before approaching anyone else. Of the 83 daughters who disclosed their diagnosis to their mothers, 76 (92%) stated their mothers had been emotionally and/or practically supportive, and 43 (54%) reported that the breast cancer diagnosis had a favorable impact on their relationship with their mothers. Of the 35 employed mothers, 26 had taken time off from work to support their daughters. Nineteen mothers, eight of whom had been living in a different country, had slept over or moved in with daughters during their treatment. Twenty-two daughters believed their mothers felt responsible to some extent for their developing breast cancer. Fifty-nine daughters indicated that health care professionals could help mothers by providing information pamphlets, education sessions, and linking to support groups. CONCLUSION Mothers are an important source of support for young daughters with breast cancer, with the mother-daughter relationship frequently becoming closer after the diagnosis. However, the practical and emotional burden on mothers appears to be high. Future studies should address the effects of a breast cancer diagnosis in young daughters from the mothers' perspective, and the benefit of formal supports for these mothers.
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Affiliation(s)
- Asma Ali
- Department of Medicine, Division of Medical Oncology, Sunnybrook Health Sciences Centre, Odette Cancer Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada.
| | - Karen Fergus
- York University, Department of Psychology, Sunnybrook Health Sciences Centre, Odette Cancer Centre, Patient and Family Support, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Frances C Wright
- Department of Surgery, Division of General Surgery, Sunnybrook Health Sciences Centre, Odette Cancer Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Kathleen I Pritchard
- Department of Medicine, Division of Medical Oncology, Sunnybrook Health Sciences Centre, Odette Cancer Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Alex Kiss
- Department of Research Design and Biostatistics, Sunnybrook Health Sciences Centre, Odette Cancer Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Ellen Warner
- Department of Medicine, Division of Medical Oncology, Sunnybrook Health Sciences Centre, Odette Cancer Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
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Villarreal-Garza C, Aguila C, Magallanes-Hoyos MC, Mohar A, Bargalló E, Meneses A, Cazap E, Gomez H, López-Carrillo L, Chávarri-Guerra Y, Murillo R, Barrios C. Breast cancer in young women in Latin America: an unmet, growing burden. Oncologist 2013; 18:1298-306. [PMID: 24277771 PMCID: PMC3868424 DOI: 10.1634/theoncologist.2013-0321] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
UNLABELLED Breast cancer (BC) is the leading cause of malignancy-related deaths among women aged ≤45 years. There are unexplored and uncertain issues for BC in this particular group in Latin America. The aim of this study is to evaluate BC incidence and mortality among young women and related clinicopathological and survivorship aspects in this region. MATERIALS AND METHODS Data were obtained from Globocan 2008 and the International Agency for Research on Cancer's Cancer Incidence in Five Continents series plus databases. We requested collaboration from the 12 different national cancer institutes in Latin America through SLACOM, the Latin American and Caribbean Society of Medical Oncology, and conducted a systematic literature review to obtain local data regarding the prevalence of BC among young women and their characteristics, outcomes, and survivorship-related issues. RESULTS BC incidence and mortality proportions for Latin American women aged <44 years were higher when compared with those of developed countries (20% vs. 12% and 14% vs. 7%, respectively). We found only a few Latin American series addressing this topic, and prevalence varied between 8% and 14%. Stage II and III disease, high histological grade, and triple-negative and HER2 BC were features frequently observed among young Latin American BC patients. CONCLUSION The rising incidence and mortality of BC in young Latin American women is a call to action in the region. It is necessary to monitor the epidemiological and clinical data through reliable cancer registries and to consider the implementation of protocols for education of patients and health professionals. This unmet, growing burden must be considered as a top priority of the national programs in the fight against BC, and models of specialized units should be implemented for this particular group of patients to provide better care for this emergent challenge.
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23
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Pinto AC. Sexuality and breast cancer: prime time for young patients. J Thorac Dis 2013; 5 Suppl 1:S81-6. [PMID: 23819031 DOI: 10.3978/j.issn.2072-1439.2013.05.23] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 05/19/2013] [Indexed: 01/23/2023]
Abstract
Sexuality and sexual functioning is a cardinal domain of health-related quality of life in breast cancer patients, namely in the younger population. Young women below 40 years of age go through a time in their lives where sexual self-identity has recently matured, their professional obligations are demanding and they bear interpersonal and childbearing expectations, all of which can suffer a devastating turnaround with cancer diagnosis and its physical and psychological aftermath. Although these women's sexuality and directed interventions have remained largely unaddressed so far, concepts are evolving and treatment options are becoming diversified, chiefly on the field of non-hormonal pharmacological therapy of sexual dysfunction. This review will examine the definitions of female sexual dysfunction, the etiology of the disorders in young breast cancer patients, the assessment methods, the non-pharmacological and pharmacological treatment options and the challenges that lie ahead.
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Affiliation(s)
- Ana Catarina Pinto
- Medicine Department, Institut Jules Bordet, Université libre de Bruxelles, Brussels, Belgium; ; Br.E.A.S.T. Data Centre, Institut Jules Bordet, Brussels, Belgium
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