scholarly journals Factors influencing efficacy of complete decongestive treatment in patients with breast cancer-linked arm lymphoedema

2021 ◽  
Vol 52 (2) ◽  
pp. 132-137
Author(s):  
Dragana Bojinović-Rodić ◽  
Samra Pjanić ◽  
Tamara Popović ◽  
Tatjana Nožica-Radulović
Keyword(s):  
Breast Cancer ◽  
Predictive Factors ◽  
Linear Regression Analysis ◽  
Breast Tumour ◽  
Multivariate Linear Regression Analysis ◽  
Malignant Breast ◽  
History Of ◽  
The Mean ◽  
Arm Lymphoedema ◽  
Mean Compliance

Background/Aim: The most recommended form of lymphoedema therapy is complete decongestive treatment (CDT). Efficacy of CDT in patients with arm lymphoedema related to malignant breast tumour has reported in many studies, but the predictive factors of outcome of this therapy have not been yet sufficiently investigated. The purpose of this research was to identify predictive factors of efficacy of CDT in patients with breast cancer-linked arm lymphoedema throughout the intensive phase of therapy. Methods: The prospective study included 51 patients with breast cancer-linked arm lymphoedema who were subjected to a 3-week program of CDT. Patients' clinical and demographic features, breast cancer treatment characteristics, lymphoedema and CDT characteristics were collected and assessed for their prognostic value. The influence of certain predictors on the degree of lymphoedema reduction was evaluated by multivariate linear regression analysis. Results: Mean age was 58.1 ± 8.0 (95 % CI: 55.8 - 60.3), median of BMI was 28.4 kg/m2 (95 % CI: 27.2 - 29.6). The average duration of lymphoedema was 36.5 ± 43.9 months (95 % CI: 24.1 - 48.8). The mean size of lymphoedema before CDT was 6.99 ± 5.36 %, and the mean degree of lymphoedema reduction was 63.7 ± 28.6 %. The mean compliance to bandages was 217.5 ± 97.8 hours (95 % CI: 190.0 - 245.0) and 7 (13.7 %) patients had a history of erysipelas of the ipsilateral arm. When observing each individual predictor, statistically most significant contribution showed the size of lymphoedema before the therapy (p < 0.001), then history of erysipelas (p < 0.01), and patients' age (p < 0.05). Conclusion: Size of lymphoedema before treatment is the most crucial prognostic factor of the efficacy of CDT in the patients with breast cancer-linked arm lymphoedema. The present study also identified history of erysipelas and patients age as independent predictors of the CDT efficacy.

scholarly journals Patterns of Sequelae in Women with a History of Localized Breast Cancer: Results from the French VICAN Survey

Cancers ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1161
Author(s):  
Lidia Delrieu ◽  
Liacine Bouaoun ◽  
Douae El Fatouhi ◽  
Elise Dumas ◽  
Anne-Deborah Bouhnik ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Latent Class ◽  
Early Stage ◽  
Current Analysis ◽  
Functional Pain ◽  
Cognitive Sequelae ◽  
History Of ◽  
The Mean ◽  
Study Participants ◽  
Changes Over Time

Breast cancer (BC) remains complex for women both physically and psychologically. The objectives of this study were to (1) assess the evolution of the main sequelae and treatment two and five years after diagnosis in women with early-stage breast cancer, (2) explore patterns of sequelae associated with given sociodemographic, clinical, and lifestyle factors. The current analysis was based on 654 localized BC patients enrolled in the French nationwide longitudinal survey “vie après cancer” VICAN (January–June 2010). Information about study participants was collected at enrollment, two and five years after diagnosis. Changes over time of the main sequelae were analyzed and latent class analysis was performed to identify patterns of sequelae related to BC five years after diagnosis. The mean age (±SD) of study participants at inclusion was 49.7 (±10.5) years old. Six main classes of sequelae were identified two years and five years post-diagnosis (functional, pain, esthetic, fatigue, psychological, and gynecological). A significant decrease was observed for fatigue (p = 0.03) and an increase in cognitive sequelae was reported (p = 0.03). Two latent classes were identified—functional and esthetic patterns. Substantial sequelae remain up to five years after BC diagnosis. Changes in patient care pathways are needed to identify BC patients at a high risk.

Validity of process indicators of screening for breast cancer to predict mortality reduction

2005 ◽  
Vol 12 (1) ◽  
pp. 33-37 ◽  
Author(s):  
T Sarkeala ◽  
A Anttila ◽  
I Saarenmaa ◽  
M Hakama
Keyword(s):  
Breast Cancer ◽  
European Community ◽  
Cancer Detection ◽  
Detection Rate ◽  
Randomized Trials ◽  
Recall Rate ◽  
Cancer Detection Rate ◽  
Process Indicators ◽  
The Mean ◽  
Mean Compliance

The aim of the study was to empirically assess the acceptable levels of process indicators as described in the European Community Guidelines using materials from the mammography service screening programmes. The Finnish programme was evaluated for effectiveness with a prior estimateof 0.74 for RR in Finland and 0.81 in Helsinki. Hence, the Finnish programme was likely to be somewhat less effective in terms of reduction in mortality than implied on the basis of early randomized trials, but probably approaching the same level of effectiveness. Finland therefore providesbackground data on the applicability of the process indicators that are indicators of performance and surrogates for effectiveness. The performance data on 10 Finnish screening centres at subsequent screens were used. These centres invited 687,000 women aged 50–64 years in 1991–2000.The mean compliance was 93% and the corresponding recall rate was 2.3%. The benign to malignant biopsy ratio was 0.43:1. The average breast cancer detection rate was 0.36%, 2.1 compared with the background incidence. The proportion of screen-detected stage II+ cancers was 26%. Most, but notall, of these process indicators met the desirable reference values of the European Community. The specific criteria of the European Community on stage distribution, rates of screen-detected cancers by stage and detection rate to background incidence may need reconsideration.

scholarly journals Predictability of 21-Gene Recurrence Score Assay by Using Pathological and Immunohistochemical Parameters in Breast Cancer

2020 ◽  
Vol 14 ◽  
pp. 117822342097784
Author(s):  
Abdulmohsen Alkushi ◽  
Ahmad Omair ◽  
Haitham Arabi ◽  
Emad Masuadi ◽  
Omalkhair Abualkhair
Keyword(s):  
Breast Cancer ◽  
Regression Analysis ◽  
Linear Regression ◽  
Linear Regression Analysis ◽  
Recurrence Score ◽  
Tumor Grade ◽  
Multivariate Linear Regression ◽  
Oncotype Dx ◽  
Clinicopathological Parameters ◽  
Multivariate Linear Regression Analysis

Background: Oncotype Dx is used to predict the long-term recurrence risk in patients with estrogen receptor (ER)-positive and human epidermal growth factor receptor 2 (HER2)-negative invasive breast cancer (BC). This study aimed at establishing a correlation between clinicopathological parameters and recurrence score (RS), subsequently improving predictability and ultimately justifying the use of the multigene assay. Materials and methods: A retrospective analysis of the pathology and clinical data of 114 female patients with BC who had Oncotype Dx testing between 2012 and 2019. The pathological parameters included are tumor cell type, tumor grade, pathological stage, and mitotic index (MI). The expression of ER, progesterone receptor (PR), HER2, and Ki67 was assessed by immunohistochemistry. A univariate and multivariate linear regression analysis was performed to assess the correlation between these parameters and the RS. Results: In univariate analysis, age (˂40 years), higher tumor grade, and low PR expression were significantly associated with higher RS ( P = .02; ˂.001; and ˂.001, respectively). Both MI and Ki67 were also strongly correlated with an increase in the RS with a P value of .01 (Spearman correlation 0.34 and 0.33). In multivariate linear regression analysis, age, MI, and Ki67 lost their significance, but both higher grade and PR remained significantly associated with a higher RS along with the tumor stage ( P ˂ .001; ˂.001; and .04, respectively). Conclusions: Tumor grade and PR immunohistochemical expression are the main predictors of RS in our study population. Other clinicopathological features were not significant predictors of change in RS in multivariate analysis.

The study of tamoxifen and raloxifene (STAR): Initial findings from the NSABP P-2 breast cancer prevention study

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. LBA5-LBA5 ◽  
Author(s):  
D. L. Wickerham ◽  
J. P. Costantino ◽  
V. Vogel ◽  
W. Cronin ◽  
R. Cecchini ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Invasive Breast Cancer ◽  
Cardiac Events ◽  
Degree Relative ◽  
Treatment Groups ◽  
Increased Risk ◽  
History Of ◽  
The Mean

LBA5 Background: The STAR trial was designed to compare raloxifene to tamoxifen in terms of relative effect on invasive breast cancer risk and on other beneficial and detrimental outcomes associated with the use of tamoxifen. Methods: The trial opened on 7-1-1999, and accrual was completed November 4, 2004, with 19,747 women enrolled. To be eligible, a woman had to be postmenopausal with a 5-year predicted breast cancer risk of 1.66% as determined by the modified Gail model. Women were randomized and treated in a double-blinded fashion to receive 5 yr of therapy with either 20 mg per day of tamoxifen or 60 mg per day of raloxifene. The protocol-defined monitoring plan called for a final analysis and release of findings when 327 invasive breast cancer cases had been diagnosed in the total population. The mean age of the population at the time of entry into this trial was 58 yr, and the mean 5-yr risk of breast cancer was 4.04%. 93.5% of the women were white; 51.5% had a hysterectomy before entry into the study; 9.2% had a history of LCIS; 71.1% had at least one first-degree relative with a history of breast cancer. The average time on the study is 47 months. Results: There was no difference between the treatment groups in terms of effect on invasive breast cancer: 163 cases in women assigned to tamoxifen and 167 in women assigned to raloxifene (RR = 1.02, 95% CI = 0.82–1.27). The risk of invasive uterine malignancies was 40% less in the raloxifene group (36 in women assigned tamoxifen and 23 in women assigned raloxifene [RR = 0.62, 95% CI = 0.35–1.08]). The risk of non invasive breast cancer was less in the tamoxifen group (57 cases in those assigned to tamoxifen and 81 in those assigned to raloxifene [RR = 1.41, 95% CI = 1.00–2.02]). There were no significant differences between the treatment groups for any of the other invasive cancer sites or for cardiac events, osteoporotic fractures, or deaths. There were fewer thromboembolic events in women taking raloxifene than in those taking tamoxifen. Conclusions: Raloxifene is an effective alternative to tamoxifen for reducing the incidence of invasive breast cancer in postmenopausal women at increased risk of developing the disease and is associated with fewer endometrial cancers, deep vein thromboses, and pulmonary emboli. [Table: see text]

Palliation of ulcerative breast lesions with radiation.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 199-199
Author(s):  
Prashant Vempati ◽  
Miriam Knoll ◽  
Kavita Vyas Dharmarajan ◽  
Sheryl Green ◽  
Amy Tiersten ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Lesion ◽  
Radiation Treatment ◽  
Academic Medical Center ◽  
Previous History ◽  
Chemotherapeutic Agents ◽  
Breast Lesions ◽  
Median Dose ◽  
History Of ◽  
The Mean

199 Background: Patients with advanced breast cancer may experience ulcerative breast lesions. Breast cancer with ulcerative lesions has been shown to severely affect a patient’s quality of life (QoL). The role of palliative radiation therapy (RT) in the management of ulcerative breast lesions needs to be further explored. Methods: IRB-approval was obtained to retrospectively review the radiation treatment records for all patients who underwent palliative RT for breast cancer at our urban academic medical center. A total of 13 patients were identified, and we herein report their demographics, treatment characteristics, and clinical outcomes. Results: The mean age of the patients receiving palliative RT for ulcerative breast cancer was 64 years. All patients had stage IV disease when they were evaluated for RT. All patients received prior systemic chemotherapy with a mean of four chemotherapeutic agents, the most common of which was Capecitabine. The mean radiation dose received for palliative RT was 27.54 Gy in 11 fractions with a median dose of 30 Gy in 15 fractions. Six (46%) of the patients received prior RT to the same breast, with a median dose of 59.5 Gy in 31 fractions. Among these six patients, the average interval between initial RT and ulcerative breast lesion was 69.5 months. The median overall survival in all patients since ulcerative breast lesion was 5 months and the mean survival did not differ between patients with previous history of RT and RT-naïve patients (4.50 vs. 4.57; p = 0.95). Six out of the 9 (69%) patients who received ≥ 30 Gy reported clinical improvement, whereas none of the 4 patients who received < 30 Gy reported any benefit. There were no radiation-associated toxicities reported by patients. Conclusions: These data suggest that palliative RT ( ≥ 30 Gy) is an efficacious treatment for ulcerative breast cancer with minimal toxicity. Prior RT should not be a contraindication as patients with previous history of RT have similar outcomes compared to RT-naïve patients.

Dermal biomarkers in cancer patients: Monitoring subjective health objectively

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 205-205
Author(s):  
David G Li ◽  
Gabrielle LeCompte ◽  
Lihong Mo ◽  
Miranda Weintraub ◽  
David Irwin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Oxidative Stress ◽  
Cancer Patients ◽  
Linear Regression Analysis ◽  
Breast Cancer Incidence ◽  
Subjective Health ◽  
Multivariate Linear Regression Analysis ◽  
Cancer Stage ◽  
Subjective Stress ◽  
Self Rated Health

205 Background: Breast cancer is the most prevalent malignancy among women worldwide. Increased levels of oxidative stress are associated with breast cancer incidence. This study assesses physical, behavioral, and subjective health correlates of oxidative stress and associations between oxidative stress and breast cancer stage. Methods: Current and previous breast cancer patients were asked to participate in this cross-sectional study. After assessing Electronic Medical Record (EMR), a sample of 149 patients met the inclusion criteria. A final sample of 102 (68%) were enrolled. Patients’ skin carotenoid scores (SCS), a dermal measure of oxidative stress, were recorded. Patient demographics, physical health (breast cancer stage, treatment status, weight, height) health behaviors (smoking status, diet) and subjective health (anxiety and self-rated health) were ascertained. Results: No correlation between breast cancer stage and SCS was found. SCS was associated with behavioral health, weight and height (p<0.05), a finding consistent with previous research. A multivariate linear regression analysis, controlling for all covariates, found the two subjective health measures to be associated with SCS scores; the presence of anxiety was associated with lower SCS scores, a novel finding (β=-0.48, 95% CI -0.93, -0.035). Moreover, self-rated health was inversely correlated with SCS, showing those with lower self-reported quality levels paradoxically had higher levels of SCS (β=19.89, 95% CI 6.12, 33.67). Conclusions: Although oxidative stress as measured by SCS may not be associated with breast cancer staging, future research should explore the causal relationship between oxidative stress and subjective stress. Results suggest an unknown biochemical mechanism linking increased levels of oxidative stress with lower subjective health scores. Findings of the study indicate the possibility of utilizing SCS as an objective correlate to gauge an individual’s subjective stress levels in order to optimize cancer treatment.

Diagnostic Accuracy of Ultrasonography for Evaluation Solid Breast Lesions – A Systematic Review

2021 ◽  
Author(s):  
Syed Muhammad Yousaf Farooq ◽  
Guido C Robot ◽  
Syeda Khadija Tul Sughra Murrium ◽  
Aima Gilani ◽  
Hafiz Syed Arsalan Gilani ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Public Health Problem ◽  
High Sensitivity ◽  
Breast Lesions ◽  
Major Public Health Problem ◽  
Cross Sectional ◽  
Malignant Breast ◽  
The Mean ◽  
Methods Analytical ◽  
Key Terms

Breast cancer in women in both developed and developing countries is the most common cancer, and remains a major public health problem. Methods: Analytical cross-sectional studies and only highquality studies were included. The searched databases were: Pub Med (2008-2020), Google scholar (2008-2020) and science direct (20082020). The key terms searched were ultrasound imaging, Breast solid mass or lesions, papillary lesions, Fibro-adenoma, breast cancer. Using these key terms, researchers found total 101 studies from the above-mentioned databases. Among these researchers found 56 studies from Google scholars, 11 from science direct and 34 from Pub Med. After this, researchers separated the relevant and irrelevant data. Results: Table 1 shows the Descriptive results of age from 12 studies, 17641 individuals. The mean age was 46.14697 SD 10.56736. The mean Sensitivity was 91.0200 and mean specificity was 89.35. The pooled results of 8 studies and 2612 individuals, out of 2612 individuals we found 1220 (46.71) benign lesions and 1392 (53.29%) malignant lesions are also shown. Conclusions: In conclusion, Ultrasound can differentiate benign and malignant breast lesions to great extent. This technique has the potential ability to altering the handling of cases in where a biopsy may be recommended, but the risk of carcinoma is known to be relatively low. Ultrasound accuracy is recommended as the first option for follow-up examinations of lesions because of its high sensitivity and ability to detect lesions outside of breast density.

scholarly journals Dermal carotenoid measurement is inversely related to anxiety in patients with breast cancer

2017 ◽  
Vol 66 (2) ◽  
pp. 329-333 ◽  
Author(s):  
David G Li ◽  
Gabrielle LeCompte ◽  
Lev Golod ◽  
Gary Cecchi ◽  
David Irwin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Oxidative Stress ◽  
Chronic Stress ◽  
Linear Regression Analysis ◽  
Subjective Health ◽  
Multivariate Linear Regression Analysis ◽  
Breast Cancer Patients ◽  
Recurrence Rates ◽  
Increased Risk ◽  
Risk Of Cancer

Breast cancer is the most prevalent malignancy among women worldwide. Increased oxidative stress and poor subjective health outcomes have been associated with increased risk of cancer recurrence and metastasis, but few studies until now have explored the relationship between oxidative stress and chronic stress/anxiety. This study aims to examine the association between anxiety and a potential dermal correlate of oxidative stress in patients with breast cancer. 102 breast cancer patients were enrolled in a cross-sectional study at Highland Hospital, a county hospital in Oakland, California. Each participant’s skin carotenoid score (SCS), a potential dermal correlate of oxidative stress, was recorded via Raman spectroscopy. Patient demographics, breast cancer stage, and subjective health measures (anxiety and self-rated health) were ascertained. Multivariate linear regression analysis was performed to quantify any associations between SCS and the above health correlates. Higher levels of skin carotenoids were associated with decreased severity of anxiety, lower BMI, increased servings of vegetables/fruits in daily diet, Hispanic race, lower educational status, and nonsmoking status. Severity of anxiety as graded by the GAD-7 was inversely associated with dermal carotenoid measurements via SCS. Conclusions. Increased levels of oxidative stress as quantified by SCS is associated with greater severity of anxiety. Because chronic stress has been associated with tumor progression, increased recurrence rates, and increased metastatic risk in breast cancer,non-invasive dermal carotenoid measurements could be used as a novel objective correlate of subjective health during cancer treatment.

scholarly journals Variables affecting patellar height in patients undergoing primary total knee replacement

2020 ◽  
Author(s):  
Khaled Hamed Salem ◽  
Miten Rajendra Sheth
Keyword(s):  
Surgical Planning ◽  
Linear Regression Analysis ◽  
Patellar Height ◽  
Multivariate Linear Regression Analysis ◽  
Patella Baja ◽  
History Of ◽  
Total Knee ◽  
Male Patients ◽  
Obese Male ◽  
Primary Total Knee

Abstract Background Alteration of patellar height is commonly encountered in total knee arthroplasty (TKA), and failure to address patella baja can result in suboptimal functional outcomes. It may therefore be prudent to evaluate pre-operative patellar height (PPH) and to seek risk factors for patella baja. Methods Two hundred eighty-five patients who underwent TKA were included. Patient’s age, gender, body mass index (BMI), and history of prior arthroscopy were recorded. PPH was measured using plateau-patella angle (PPA) as well as the Blackburn-Peel (BP), Caton-Deschamps (CD), and Insall-Salvati (IS) ratios. Results The average patients’ age was 71 years with a mean BMI of 30.45. There were 191 female and 94 male patients. One-fourth of the cases had at least one prior knee arthroscopy. Multivariate linear regression analysis identified gender and BMI as variables significantly affecting the IS ratio (p: < 0.05). Gender also had a significant correlation with PPA. Male patients were likely to have lower PPA (p: < 0.03). Though increasing age had a positive correlation with patellar height, this was not statistically significant. History of prior arthroscopy had no significant effect on any of the four PPH measurements. Conclusion Lower patellar height is significantly correlated to male gender and high BMI. We suggest that obese male patients be screened for pre-operative patella baja. This can help in surgical planning and optimizing results in TKA.

scholarly journals The Application of Gail Model to Predict the Risk of Developing Breast Cancer among Jordanian Women

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Hikmat Abdel-Razeq ◽  
Luna Zaru ◽  
Ahmed Badheeb ◽  
Shadi Hijjawi
Keyword(s):  
Breast Cancer ◽  
Risk Assessment ◽  
High Risk ◽  
Risk Score ◽  
Assessment Model ◽  
Risk Assessment Model ◽  
Breast Cancer Patients ◽  
Gail Model ◽  
History Of ◽  
The Mean

Background and Objectives. Breast cancer has been the most common cancer affecting women in Jordan. In the process of implementing breast cancer prevention and early detection programs, individualized risk assessment can add to the cost-effectiveness of such interventions. Gail model is a widely used tool to stratify patients into different risk categories. However, concerns about its applicability across different ethnic groups do exist. In this study, we report our experience with the application of a modified version of this model among Jordanian women. Methods. The Gail risk assessment model (RAM) was modified and used to calculate the 5-year and lifetime risk for breast cancer. Patients with known breast cancer were used to test this model. Medical records and hospital database were utilized to collect information on known risk factors. The mean calculated risk score for women tested was 0.65. This number, which corresponds to the Gail original score of 1.66, was used as a cutoff point to categorize patients as high risk. Results. A total of 1786 breast cancer patients with a mean age of 50 (range: 19–93) years were included. The modified version of the Gail RAM was applied on 1213 patients aged 35–59.9 years. The mean estimated risk for developing invasive breast cancer over the following five years was 0.54 (95% CI: 0.52, 0.56), and the lifetime risk was 3.42 (95% CI: 3.30, 3.53). Only 210 (17.3%) women had a risk score >0.65 and thus categorized as high risk. First-degree family history of breast cancer was identified among 120 (57.1%) patients in this high-risk group. Conclusions. Among a group of patients with an established diagnosis of breast cancer, a modified Gail risk assessment model would have been able to stratify only 17% into the high-risk category. The family history of breast cancer contributed the most to the risk score.

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