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Journal articles on the topic 'Breast cancer survivors'
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Moskowitz, Chaya S., Joanne F. Chou, Joseph P. Neglia, Ann H. Partridge, Rebecca M. Howell, Lisa R. Diller, Danielle Novetsky Friedman, et al. "Mortality After Breast Cancer Among Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study." Journal of Clinical Oncology 37, no. 24 (August 20, 2019): 2120–30. http://dx.doi.org/10.1200/jco.18.02219.
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PURPOSE Female survivors of childhood cancer have a high risk of subsequent breast cancer. We describe the ensuing risk for mortality and additional breast cancers. PATIENTS AND METHODS Female participants in the Childhood Cancer Survivor Study, a cohort of 5-year survivors of cancer diagnosed between 1970 and 1986 before age 21 years, and subsequently diagnosed with breast cancer (n = 274; median age at breast cancer diagnosis, 38 years; range, 20 to 58 years) were matched to a control group (n = 1,095) with de novo breast cancer. Hazard ratios (HRs) and 95% CIs were estimated from cause-specific proportional hazards models. RESULTS Ninety-two childhood cancer survivors died, 49 as a result of breast cancer. Overall survival after breast cancer was 73% by 10 years. Subsequent risk of death as a result of any cause was higher among childhood cancer survivors than among controls (HR, 2.2; 95% CI, 1.7 to 3.0) and remained elevated after adjusting for breast cancer treatment (HR, 2.4; 95% CI, 1.7 to 3.2). Although breast cancer–specific mortality was modestly elevated among childhood cancer survivors (HR, 1.3; 95% CI, 0.9 to 2.0), survivors were five times more likely to die as a result of other health-related causes, including other subsequent malignant neoplasms and cardiovascular or pulmonary disease (HR, 5.5; 95% CI, 3.4 to 9.0). The cumulative incidence of a second asynchronous breast cancer also was elevated significantly compared with controls ( P < .001). CONCLUSION Mortality after breast cancer was higher in childhood cancer survivors than in women with de novo breast cancer. This increased mortality reflects the burden of comorbidity and highlights the need for risk-reducing interventions.
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Jackeline, Rangel. "Importance of Physical Therapy in Breast Cancer Survivors." Women's Health Science Journal 4, no. 2 (2020): 1–7. http://dx.doi.org/10.23880/whsj-16000150.
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Women diagnosed with breast cancer have had a significant increase in life expectancy in recent years. However, many of these women are living with chronic complications resulting from treatment. It is common during and after the treatment of breast cancer, particularly at the trunk and upper limb (pain, movement disorders, among others). Physical therapy may play an important role in the immediate and late postoperative period of breast cancer surgery where it can be considered one of the main preventive agents for disorders after surgery. Physical therapy is considered an effective intervention for pain control, postural realignment and recovery of functional autonomy and is important at all stages of treatment, and helps overcome the side effects of breast cancer treatment.
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Dabeer, Mugdha, Michelle Cororve Fingeret, Fatima Merchant, Gregory P. Reece, Elisabeth K. Beahm, and Mia K. Markey. "Article Commentary: A Research Agenda for Appearance Changes Due to Breast Cancer Treatment." Breast Cancer: Basic and Clinical Research 2 (January 2008): BCBCR.S784. http://dx.doi.org/10.4137/bcbcr.s784.
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Breast cancer is one of the most prevalent forms of cancer in the US. It is estimated that more than 180,000 American women will be diagnosed with invasive breast cancer in 2008. Fortunately, the survival rate is relatively high and continually increasing due to improved detection techniques and treatment methods. However, maintaining quality of life is a factor often under emphasized for breast cancer survivors. Breast cancer treatments are invasive and can lead to deformation of the breast. Breast reconstruction is important for restoring the survivor's appearance. However, more work is needed to develop technologies for quantifying surgical outcomes and understanding women's perceptions of changes in their appearance. A method for objectively measuring breast anatomy is needed in order to help both the breast cancer survivors and their surgeons take expected changes to the survivor's appearance into account when considering various treatment options. In the future, augmented reality tools could help surgeons reconstruct a survivor's breasts to match her preferences as much as possible.
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Moon, Tae-Joon, Ming-Yuan Chih, Dhavan V. Shah, Woohyun Yoo, and David H. Gustafson. "Breast Cancer Survivors’ Contribution to Psychosocial Adjustment of Newly Diagnosed Breast Cancer Patients in a Computer-Mediated Social Support Group." Journalism & Mass Communication Quarterly 94, no. 2 (January 19, 2017): 486–514. http://dx.doi.org/10.1177/1077699016687724.
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This study investigated the role of breast cancer survivors in a computer-mediated social support (CMSS) group for women with breast cancer. Applying a computer-aided content analytic method, the present study examined the differences in support provision between survivors and newly diagnosed patients. This study further investigated the impacts of survivor-provided social support on psychosocial adjustment of newly diagnosed patients. The results revealed that, compared with newly diagnosed patients, breast cancer survivors provided more emotional and informational support. Receiving emotional support from survivors contributed to an improvement in the quality of life and the depression of patients. The effects of survivor-provided informational support were not significant.
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McDaniel, DNP, APRN, FNP-C, AOCNP, Dana. "Advanced Practitioner-Led Shared Visits: A Novel Approach to Cancer Survivorship." Journal of the Advanced Practitioner in Oncology 13, no. 8 (November 1, 2022): 766–74. http://dx.doi.org/10.6004/jadpro.2022.13.8.3.
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Background: The continued increase in the number of cancer survivors is encouraging and credited to better prevention, screening, and treatment. Cancer care authorities call for survivorship follow-up focusing on surveillance, health behaviors, and lingering effects of treatment. Despite the recommendations, cancer centers struggle to provide cost-effective, time efficient, comprehensive programming to address this call. Objectives: The primary objectives of this quality improvement project were to (1) develop and pilot a shared survivorship visit for breast cancer survivors and (2) evaluate the feasibility and acceptability of the program. Methods: The participants in this 4-week pilot project included five female breast cancer survivors, ages 18 and older, diagnosed with stage I, II, or III breast cancer within the past year. Each survivor completed a one-time, 2-hour shared survivorship visit. Results: The shared, interdisciplinary survivorship visit was directed by an advanced practice nurse. A team of nursing and ancillary experts presented information on their specialized area. Upon completion of the visit, the survivor received an individualized survivorship care plan. There were 21 eligible breast cancer survivors and 5 participants. The pilot was successfully implemented, acknowledged the feasibility, and identified the adaptability to other cancer survivors. An evaluation concluded that the APRN-led, shared survivorship visit model was accepted by the patients and the survivorship team. The shared survivorship visits will be implemented into the cancer care program to address the needs of breast cancer survivors. Furthermore, there will be an expansion of the shared survivorship visits to meet the needs of those with other types of cancers.
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Shin, Woo-kyoung, Sihan Song, Eunkyung Hwang, Hyeong-Gon Moon, Dong-Young Noh, and Jung Eun Lee. "Development of a FFQ for breast cancer survivors in Korea." British Journal of Nutrition 116, no. 10 (November 15, 2016): 1781–86. http://dx.doi.org/10.1017/s000711451600372x.
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AbstractDiet may play an important role in breast cancer recurrence or survival, and therefore assessment of long-term diet among breast cancer survivors is important in breast cancer survivorship research. Given that the diet of breast cancer survivors may differ from that of the general population, the use of a FFQ specific to this group may be needed. The objective of this study was to develop a FFQ for breast cancer survivors, the most commonly used tool to measure long-term dietary patterns in nutritional epidemiological studies. We collected information on the foods and amounts of foods consumed using 3-d dietary records from a total of 192 women who had been diagnosed with stage I–III breast cancers and had undergone breast cancer surgery at least 6 months before the baseline study. A total of 1254 foods and dishes consumed were re-grouped by the similarity of the main ingredients and/or serving units, and several dishes commonly consumed among the Korean population were added. After we performed contribution analyses and variability analyses to detect between-person variation for selected nutrients, we listed a total of 123 foods and dishes for the FFQ specific to breast cancer survivors. Our breast cancer survivor-specific FFQ can be used to estimate long-term dietary intake and to examine its association with breast cancer prognosis in epidemiological studies of breast cancer in Korea.
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Hinson-Smitb, Vicki. "Breast cancer survivors:." Nurse Practitioner 25, no. 10 (October 2000): 2–7. http://dx.doi.org/10.1097/00006205-200025100-00013.
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Cappiello, Michelle, Regina S. Cunningham, M. Tish Knobf, and Diane Erdos. "Breast Cancer Survivors." Clinical Nursing Research 16, no. 4 (November 2007): 278–93. http://dx.doi.org/10.1177/1054773807306553.
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Wyatt, Gwen, Margot E. Kurtz, and Michelle Liken. "Breast cancer survivors." Cancer Nursing 16, no. 6 (December 1993): 440???448. http://dx.doi.org/10.1097/00002820-199312000-00003.
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Fredette, Sheila LaFortune. "Breast cancer survivors." Cancer Nursing 18, no. 1 (February 1995): 35???46. http://dx.doi.org/10.1097/00002820-199502000-00006.
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Kuzmiak, Cherie M. "Breast Cancer Survivors." Academic Radiology 22, no. 11 (November 2015): 1329–30. http://dx.doi.org/10.1016/j.acra.2015.09.001.
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Altundag, Kadri, Ibrahim Petekkaya, Ugur Sahin, Mustafa Solak, and Yavuz Ozisik. "Non-breast solid malignancies among breast cancer survivors." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): e11092-e11092. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.e11092.
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e11092 Background: Due to advances in treatment modalities and palliative care patients with breast cancer live longer compared to the past and thus encounter an increased risk for secondary cancers. This study aims at finding the frequency of other solid cancers in a retrospective cohort. Methods: A search for the history of a non-breast solid tumor (NBST) among 1914 women admitted to our institute with stage I to IV breast cancer between 2006 – 2012 was conducted. Frequency of NBST according to temporal relation with breast cancer diagnosis was calculated Results: Overall 79 NBST and 75 patients (3.9 %) with another solid tumor were discovered. Of the patients 4 had more than one tumor. For these patients the median age at diagnosis was 55 (28 – 93), median follow-up time for breast cancer was 32 months (1 – 132). Post-menopausality was 60.8 %. The most common breast cancer histology was infiltrative ductal carcinoma (70.9 %). Of the 79 NBST, 34 (43.0 %) were diagnosed after breast cancer; 30 (38.0 %) before; and 15 (19.0 %) synchronously. Median time of diagnosis for NBST after breast cancer was 21 months (7 – 296). The most common malignancies were cancers of the ovary, thyroid and uterus (17.7, 15.2 and 11.4 %, respectively). Conclusions: The frequency of gynecological cancers and thyroid cancer along the course of breast cancer is high. Common environmental and genetic factors and may be involved. These patients should be followed closely
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Moskowitz, Chaya S., Joanne F. Chou, Suzanne L. Wolden, Jonine L. Bernstein, Jyoti Malhotra, Danielle Novetsky Friedman, Nidha Z. Mubdi, et al. "Breast Cancer After Chest Radiation Therapy for Childhood Cancer." Journal of Clinical Oncology 32, no. 21 (July 20, 2014): 2217–23. http://dx.doi.org/10.1200/jco.2013.54.4601.
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Purpose The risk of breast cancer is high in women treated for a childhood cancer with chest irradiation. We sought to examine variations in risk resulting from irradiation field and radiation dose. Patients and Methods We evaluated cumulative breast cancer risk in 1,230 female childhood cancer survivors treated with chest irradiation who were participants in the CCSS (Childhood Cancer Survivor Study). Results Childhood cancer survivors treated with lower delivered doses of radiation (median, 14 Gy; range, 2 to 20 Gy) to a large volume (whole-lung field) had a high risk of breast cancer (standardized incidence ratio [SIR], 43.6; 95% CI, 27.2 to 70.3), as did survivors treated with high doses of delivered radiation (median, 40 Gy) to the mantle field (SIR, 24.2; 95% CI, 20.7 to 28.3). The cumulative incidence of breast cancer by age 50 years was 30% (95% CI, 25 to 34), with a 35% incidence among Hodgkin lymphoma survivors (95% CI, 29 to 40). Breast cancer–specific mortality at 5 and 10 years was 12% (95% CI, 8 to 18) and 19% (95% CI, 13 to 25), respectively. Conclusion Among women treated for childhood cancer with chest radiation therapy, those treated with whole-lung irradiation have a greater risk of breast cancer than previously recognized, demonstrating the importance of radiation volume. Importantly, mortality associated with breast cancer after childhood cancer is substantial.
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Mayer, Erica L., Adrienne B. Gropper, Bridget A. Neville, Ann H. Partridge, Danielle B. Cameron, Eric P. Winer, and Craig C. Earle. "Breast Cancer Survivors' Perceptions of Survivorship Care Options." Journal of Clinical Oncology 30, no. 2 (January 10, 2012): 158–63. http://dx.doi.org/10.1200/jco.2011.36.9264.
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Purpose As the number of breast cancer survivors increases, a durable model of comprehensive survivor care is needed, incorporating providers and/or visit types both within and outside of oncology. The objective of this study was to explore survivors' comfort with different clinician types or with a telephone/Internet-based virtual visit as components of survivorship care. Methods Breast cancer survivors participating in a general survivorship survey completed an additional breast cancer–specific questionnaire evaluating the self-perceived impact of follow-up visits to various clinician types, or follow-up by a virtual visit, on survival, worrying, and stress related to cancer. Results A total of 218 breast cancer survivors completed the questionnaire. Most favored medical oncologist follow-up visits over those with primary care physicians (PCPs) or nurse practitioners (NPs) in terms of reduced worrying about cancer (odds ratio [OR], 2.21; P < .001), reduced stress around the visit (OR, 1.40; P = .002), and improved effect on cancer survival (OR, 2.38; P < .001). However, the majority also displayed substantial comfort with both PCPs and NPs in the same domains. Patients rated a virtual visit as having a less favorable impact on cancer survival and cancer-related worrying compared with in-person visits with clinicians. Conclusion Breast cancer survivors are comfortable with both PCPs and NPs providing follow-up care, although they indicate a preference for medical oncologists. Given patients' negative impressions of a virtual visit, increased familiarity with and research investigating this emerging concept are needed. The NP-led survivorship clinic model, with increased guidance for PCPs, offers a promising route for improving quality of and satisfaction with survivor care.
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Chlebowski, Rowan T., and Marina M. Reeves. "Weight Loss Randomized Intervention Trials in Female Cancer Survivors." Journal of Clinical Oncology 34, no. 35 (December 10, 2016): 4238–48. http://dx.doi.org/10.1200/jco.2016.69.4026.
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Purpose Observational study evidence has associated overweight/obesity with decreased survival in women with breast cancer and with several other cancers. Although full-scale, definitive weight loss adjuvant intervention trials with cancer end points remain to be conducted, a number of randomized controlled trials have evaluated weight loss interventions in survivors of cancer in women. Findings from these trials in breast, endometrial, and ovarian cancer are reviewed. Methods A systematic review of randomized controlled clinical trials evaluating weight loss interventions was updated (for studies published 2013 to 2016), and clinical trials registers were searched for ongoing trials. Results Six new randomized trials in breast cancer survivors and two randomized trials in endometrial cancer survivors were identified. Evidence from these trials and the 10 earlier randomized trials in female cancer survivors provide support for the feasibility of recruiting women closer to the cancer diagnosis and efficacy for achieving weight loss, in particular with telephone-based interventions, and have identified the challenge of achieving significant weight loss in African American cancer survivors and of maintaining weight loss in any cancer survivor group. Seven ongoing randomized trials are evaluating the influence of weight loss interventions on cancer end points (five in breast cancer, one in ovarian cancer, and one in endometrial cancer). Conclusion After a decade of preliminary studies, ongoing randomized, controlled clinical trials will potentially provide definitive assessment of whether weight loss can improve breast cancer clinical outcome. Longer-term interventions (> 2 years’ duration) may be needed to optimize weight loss maintenance and any potential benefits on cancer end points.
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Arrington, Amanda K., Leanne Goldstein, Laura Kruper, Courtney Vito, John Yim, and Steven L. Chen. "Life Expectancy after Curative-intent Treatment of Breast Cancer: Impact on Long-term Follow-up Care." American Surgeon 80, no. 6 (June 2014): 604–9. http://dx.doi.org/10.1177/000313481408000626.
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Long-term survival rates after treatment for breast cancer are directly influenced by early deaths resulting from disease. For longer-term breast cancer survivors, survival rates appear deceptively low. We hypothesize that the actual survival curve for long-term survivors approaches the overall survival of the general population. The Surveillance, Epidemiology, and End Results database (1988 to 2002) was used to identify patients with nonmetastatic breast cancer who underwent definitive surgical treatment. The survival of the general population was constructed by using national life tables with an age-matched population. Comparisons of survivals were made for 3-, 5-, and 7-year breast cancer survivor cohorts. Of 237,180 patients, 92.4 per cent survived three years, 82.1 per cent five years, and 58.1 per cent seven years. Stage I patients have equivalent or better survivals compared with the age-matched general population in all three cohorts. Stage II patients reached equivalent conditional survival between eight and nine years after diagnosis regardless of cohort. Stage III patients required achieving nine to 10 years after diagnosis to achieve equivalent survival probability, except in 7-year survivors, in whom 10 to 11 years was required. In all stages, once equivalence was reached, survival exceeded the general population over the remaining years. Initial cancer stage influences overall survival for many years after diagnosis. Patients with Stage I cancer return to the general population risk as early as three years after diagnosis, whereas higher stages can require up to nine years to achieve parity with a more generalized population. These findings should be factored into general health screening issues for long-term breast cancer survivors.
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Laufer, Talya, Bryan Lerner, Anett Petrich, Anna M. Quinn, Leah Ernst, Alicin Roop, Janet Knoblauch, et al. "Evaluation of a Technology-Based Survivor Care Plan for Breast Cancer Survivors: Pre-Post Pilot Study." JMIR Cancer 5, no. 2 (December 20, 2019): e12090. http://dx.doi.org/10.2196/12090.
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Background As of 2016, almost 16 million individuals were cancer survivors, including over 3.5 million survivors of breast cancer. Because cancer survivors are living longer and have unique health care needs, the Institute of Medicine proposed a survivor care plan as a way to alleviate the many medical, emotional, and care coordination problems of survivors. Objective This pilot study for breast cancer survivors was undertaken to: (1) examine self-reported changes in knowledge, confidence, and activation from before receipt to after receipt of a survivor care plan; and (2) describe survivor preferences for, and satisfaction with, a technology-based survivor care plan. Methods A single group pretest-posttest design was used to study breast cancer survivors in an academic cancer center and a community cancer center during their medical visit after they completed chemotherapy. The intervention was a technology-based survivor care plan. Measures were taken before, immediately after, and 1 month after receipt of the survivor care plan. Results A total of 38 breast cancer survivors agreed to participate in the study. Compared to baseline levels before receipt of the survivor care plan, participants reported increased knowledge both immediately after its receipt at the academic center (P<.001) and the community center (P<.001) as well as one month later at the academic center (P=.002) and the community center (P<.001). Participants also reported increased confidence immediately following receipt of the survivor care plan at the academic center (P=.63) and the community center (P=.003) and one month later at both the academic center (P=.63) and the community center (P<.001). Activation was increased from baseline to post-survivor care plan at both the academic center (P=.05) and community center (P<.001) as well as from baseline to 1-month follow-up at the academic center (P=.56) and the community center (P<.001). Overall, community center participants had lower knowledge, confidence, and activation at baseline compared with academic center participants. Overall, 22/38 (58%) participants chose the fully functional electronic survivor care plan. However, 12/23 (52%) in the community center group chose the paper version compared to 4/15 (27%) in the academic center group. Satisfaction with the format (38/38 participants) and the content (37/38 participants) of the survivor care plan was high for both groups. Conclusions This study provides evidence that knowledge, confidence, and activation of survivors were associated with implementation of the survivor care plan. This research agrees with previous research showing that cancer survivors found the technology-based survivor care plan to be acceptable. More research is needed to determine the optimal approach to survivor care planning to ensure that all cancer survivors can benefit from it.
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Daly, Corinne, Elisabeth M. Del Giudice, Rinku Sutradhar, Lawrence Frank Paszat, Drew Wilton, Linda Rabeneck, and Nancy N. Baxter. "Follow-up of long-term young breast cancer survivors." Journal of Clinical Oncology 30, no. 34_suppl (December 1, 2012): 8. http://dx.doi.org/10.1200/jco.2012.30.34_suppl.8.
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8 Background: Evidence suggests breast cancer patients can be offered follow-up by family physician without concern of important recurrence–related serious clinical events occurring more frequently or quality of life being negatively affected. This study describes population-based patterns of follow-up care in 5-year recurrence-free young breast cancer survivors to determine factors influencing continued oncology follow-up in Ontario, Canada. Methods: We conducted a retrospective population-based cohort study using cancer registry and administrative data. Women diagnosed with an incident breast cancer aged 20-44 between 1992 and 1999, survived for at least 5 years and recurrence-free for 5 years past diagnosis were identified in the Ontario Cancer Registry. Each survivor was matched to 5 control women with the same calendar year of birth and place of residence in Ontario. We determined outpatient physician visits with primary care, medical, radiation and surgical oncology physicians to investigate trends associated with increasing survivorship and compared visit rates to controls. We used negative binomial regression to investigate factors predicting high utilization of oncology services among survivors after 5-year recurrence survival. Results: We identified 4,581 survivors and 22,898 controls. By year 10, 51% breast cancer survivors were still being followed by an oncologist. In the survivors, fewer physician visits were observed among recurrence-free breast cancer survivors as time increased from diagnosis (Visit Rate Ratio [VRR] =0.95, 95% CI: 0.94, 0.96). Breast cancer survivors diagnosed from 1992-1995 had a higher rate of physician visits than those diagnosed from 1996-1999 (VRR = 1.16, 95% CI: 1.07, 1.25). More oncologist visits were associated with patients visiting a female oncologist (VRR = 1.20, 95% CI: 1.09, 1.33) and fewer visits were associated with patients visiting an oncologist who practiced outside of a regional cancer center (VRR = 0.67, 95% CI: 0.58, 0.77). Conclusions: Oncology visits of young breast cancer survivors after 5-year survival were associated with oncologist factors indicating that prolonged oncology follow-up in breast cancer survivors may be driven by practice patterns rather than patients’ needs.
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Champion, Victoria, Andrea A. Cohee, Patrick Monahan, Timothy E. Stump, Kathy Miller, Lynne Wagner, David Cella, and George Sledge. "Quality of life difficulties in partners of young breast cancer survivors." Journal of Clinical Oncology 34, no. 3_suppl (January 20, 2016): 188. http://dx.doi.org/10.1200/jco.2016.34.3_suppl.188.
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188 Background: Although breast cancer is more commonly diagnosed in post-menopausal women, there are a significant number of survivors diagnosed at age 45 or younger. Compared to older survivors, younger survivors have significantly more problems with depression sexual functioning, marital satisfaction, and overall well-being, but there is little research on the partners of these younger survivors. The purpose of this study is to determine if the partners of young survivors experience more problems with depression, sexual functioning, marital satisfaction, and overall well-being than partners of age-matched controls. Methods: Survivors and partners (n=227) were enrolled in a large cross-sectional study, executed through the ECOG-ACRIN Cancer Research Group. Eligibility for survivors included being 45 or under at diagnosis, 3 to 8 years from treatment without a breast cancer recurrence, and with similar chemotherapy treatment regimens. Survivors identified age-matched acquaintance controls without breast cancer. These age matched controls and their partners (n=170) were also included. All groups completed a survey assessing demographic characteristics, depression, sexual functioning (enjoyment and difficulty), marital satisfaction, and overall well-being. The partners of both young survivors and acquaintance controls were compared on all study variables adjusting for demographic variables. Results: Partners of young survivors reported significantly more depression (effect size [ES] = -0.23, p=.0199), worse sexual functioning as indicated by lower enjoyment (ES= 0.32, p=.0019) and more sexual difficulty (ES= -0.24, p=.0164), lower marital satisfaction (ES=0.24, p=.0189), and lower overall well-being (ES= 0.40, p=.0001). Conclusions: Partners of breast cancer survivors suffer from problems similar to breast cancer survivors. Further research is needed to fully understand the impact of a breast cancer diagnosis on both the partner as well as the survivor, especially when problems exist that are related to the dyadic relationship.
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Gorman, Jessica R., Paula M. Usita, Lisa Madlensky, and John P. Pierce. "Young Breast Cancer Survivors." Cancer Nursing 34, no. 1 (January 2011): 32–40. http://dx.doi.org/10.1097/ncc.0b013e3181e4528d.
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Cureton, A., W. Pritham, M. Royce, and K. Zahn. "Nurse practitioner-led breast cancer survivorship clinic." Journal of Clinical Oncology 27, no. 15_suppl (May 20, 2009): e20723-e20723. http://dx.doi.org/10.1200/jco.2009.27.15_suppl.e20723.
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e20723 Background: The 2.5 million breast cancer survivors in the US demands increasing awareness of and need for healthcare organizations to address survivorship issues. Cancer survivorship care has become a specialty emphasizing health promotion, disease prevention, and patient satisfaction. It is a natural setting for advanced practice nurses to be leaders. This abstract presents a model for a nurse practitioner-led breast cancer survivorship clinic. Methods: Eligible patients are those previously diagnosed with invasive and/or in situ breast cancer and at least 5 years post-diagnosis without recurrence. Eligible survivors are identified annually through the University of New Mexico Tumor Registry. Clinic notes are reviewed to confirm the patient has not had a recurrence, new diagnosis, or death. Letters are sent to eligible survivors introducing the Breast Cancer Survivorship Clinic (Clinic) and inviting them to participate, and oncologists are encouraged to transfer eligible patients into the Clinic. Results: Eighty-six survivors are currently participating in the Clinic. Survivors are seen on an annual basis after mammogram. Each survivor receives a personalized Survivorship Care Plan at the first visit. The care plan was developed by a multi-disciplinary team of a breast oncologist, psychologist, social worker, nutritionist, and patient educator to provide input on the issues that survivors face. Components of Survivorship Care Plan: pathologic and genetic findings, summary of treatment, bloodwork, bone health, lymphedema, secondary malignancies, health maintenance recommendations, psychological assessment, nutrition/weight assessment. Conclusions: The establishment of the Clinic has several advantages: Breast cancer survivors are being followed in this specialty clinic after 5 years instead of being discharged from the Cancer Center. The Clinic has allowed oncologists more time for patients actively on therapy and more time to accommodate newly diagnosed patients. The Clinic addresses the unique issues faced by long term survivors, which could increase patient satisfaction. A multi-disciplinary team is key to developing a care plan for a survivorship clinic. However, the day-to-day operation of the clinic can be effectively led by a nurse practitioner. No significant financial relationships to disclose.
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Boangmanalu, Abby Gina, and Atnike Nova Sigiro. "Personal Experiences of Women Surviving Breast Cancer as a Confrontation of the Meaning of the Women's Body." Jurnal Perempuan 24, no. 3 (September 12, 2019): 221. http://dx.doi.org/10.34309/jp.v24i3.353.
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<p>This study highlights the experiences faced by women breast cancer survivor in Jakarta in defining their bodies. Despite of medical assessment, breast cancer needs to be analyzed through feminist’s lense because breast cancer has close link with discourse of sexual body and engendered body. This study used a qualitative methodology that emphasizes critical analysis. Data collection was gathered through interviews with 8 women who are breast cancer survivors. The research reveals that under the normality of femininity of the patriarchal society, the women breast cancer survivors could confront the dominant interpretation upon women’s body</p>
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García-Torres, Francisco, and Rosario Castillo-Mayén. "Differences in Eysenck’s Personality Dimensions between a Group of Breast Cancer Survivors and the General Population." International Journal of Environmental Research and Public Health 16, no. 7 (April 8, 2019): 1240. http://dx.doi.org/10.3390/ijerph16071240.
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Cancer may influence personality in patients and survivors. However, the possible relations between the treatments that the patients have undergone and the personality in survivors are not clear. This study aimed to establish the differences in personality between a group of breast cancer survivors and a control group, and to test the predictive utility of the treatments on the personality traits in survivors. Thirty breast cancer survivors and thirty participants from the general population completed the Eysenck personality questionnaire-revised (EPQ-R) and a socio-demographic questionnaire. Survivors had lower scores on extraversion and higher scores on neuroticism than the control group, but these differences were not significant. However, differences in psychoticism were significant, with higher scores in the survivor group. Breast-conserving therapy predicted extraversion while breast reconstruction predicted psychoticism. These results suggest that the physical consequences of surgery may lead to social and psychological impairments in this group of patients.
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Denny, Margaret. "The Impact of Dragon Boating on Fatigue for Breast Cancer Survivors." Psychology and Mental Health Care 6, no. 1 (March 28, 2021): 01–07. http://dx.doi.org/10.31579/2637-8892/103.
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Background: Fatigue following treatment for breast cancer has a profound impact on quality of life. Dragon boating is known to be beneficial because of its networking and social function. Objective: The objective of this study was to explore the effects of dragon boating on fatigue and health related quality of life. Intervention/Methods: Individual and Family Self-Management Theory guided the study. The methodology was a multiple point cohort panel design. Data were collected from breast cancer survivors (n=26) to measure fatigue, quality of life and upper arm functioning at the beginning of the racing season timepoint 1 (T1), midway through the programme, timepoint 2 (T2), and at the end of the dragon boat season, timepoint 3 (T3). Results: Fatigue levels fell significantly between T1and T2 (p<.033) and from T2 to T3 (p<.048). Similarly, upper limb functioning improved from T1 to T2 (p<.002), but showed no significant change between T2 andT3 (p<.58). Fatigue was significantly related to quality of life at each time point. Conclusion: While this was a small scale study, the findings suggest that dragon boating appears to have beneficial effects on well-being including reduction of fatigue, which impacts on health related quality of life for women post breast cancer. Implications for Practice: This study confirms the benefits of dragon boating in upper limb functioning and reduction of fatigue. Health care professionals could advise cancer survivors on the benefits of dragon boating exercise, post cancer treatment.
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Salz, Talya, Jessica A. Lavery, Allison N. Lipitz-Snyderman, Denise M. Boudreau, Natalie Moryl, Erin F. Gillespie, and Deborah Korenstein. "Trends in Opioid Use Among Older Survivors of Colorectal, Lung, and Breast Cancers." Journal of Clinical Oncology 37, no. 12 (April 20, 2019): 1001–11. http://dx.doi.org/10.1200/jco.18.00938.
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PURPOSE Cancer survivors may be at increased risk for opioid-related harms. Trends in opioid use over time since diagnosis are unknown. METHODS Using data from SEER and Medicare, we conducted multilevel logistic regression analyses to compare chronic opioid use (≥ 90 consecutive days) among opioid-naïve survivors of colorectal, lung, and breast cancers diagnosed from 2008 to 2013 and matched with noncancer controls. Among cases and controls with chronic use, we compared rates of high-dose opioid use (average ≥ 90 morphine milligram equivalents daily). RESULTS We included 46,789 survivors and 138,136 noncancer controls. In the first year after the index date (survivor’s diagnosis date), chronic use among colorectal and lung cancer survivors exceeded chronic use among controls (colorectal cancer: odds ratio, 1.34; 95% CI, 1.22 to 1.47; lung cancer: odds ratio, 2.55; 95% CI, 2.34 to 2.77). Differences in chronic use between survivors and controls declined each year after the index date. Chronic use among breast cancer survivors was less than that of controls each year after the index date. Survivors with chronic use were more likely to have a high daily dose than controls with chronic use in the first 3 to 5 years. CONCLUSION Among three large populations of older cancer survivors, chronic opioid use varied by cancer. However, by 6 years after diagnosis, survivors were no longer more likely to be chronic users than controls. Strategies for appropriate pain management during and after cancer treatment should take into account the risks associated with chronic high-dose opioid use.
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Jung, Hong Kyu, Jihyoun Lee, Zisun Kim, Min Hyuk Lee, and Ilkyun Lee. "Development of second primary cancers in breast cancer survivors." Journal of Clinical Oncology 34, no. 3_suppl (January 20, 2016): 257. http://dx.doi.org/10.1200/jco.2016.34.3_suppl.257.
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257 Background: Breast cancer survivors have slightly increased risk of second primary cancers. Importance of screening for second cancers has been raised due to increased survival in those populations. Not only having genetic risk such as BRCA mutation, but also treatment-related risk presents. The most common second primary cancer is breast cancer. Colon cancer, uterine cancer, and ovarian cancer showed increased cumulative incidence. In this study, we assessed development second primary cancers in breast cancer survivors. Methods: Medical record of breast cancer patients was reviewed retrospectively in three tertiary medical institutions. Available data of ICD-9 record after breast cancer diagnosis was evaluated. Diagnosis of second primary breast cancer was excluded in evaluation. Results: Since Jan 1989 to Jan 2014, available medical records were reviewed in breast cancer patients(N = 5880) in three institutions(one urban and the other two rural institutions). Cumulative incidence of overall second primary cancers was 4.57%. Among 269 second primary cancers, thyroid cancer(44.2%) was most common second primary cancer, followed by gastric cancer(10.0%). Gastric cancers were more common in rural institution than urban area(14.2 % vs 5.5%), while incidence of thyroid cancer is elevated in urban institution(57.8% vs 31.9%). Among 9 patients who has been diagnosed endometrial cancer, 7 patients had history of selective estrogen receptor modulator(tamoxifen or toremifen) treatment. Development of lung cancer was not related to breast cancer radiation treatment(4 of 15 patients). Leukemia after breast cancer treatment was diagnosed in 5 patients (8.5% of second primary cancers), three of them were adult T cell leukemia and two of them were acute myeloid leukemia. Conclusions: Incidence of cancer in general population was reflected to development of second primary cancer in breast cancer survivors. Endocrine treatment was related increased incidence of endometrial cancer, respectively. Application of personalized cancer screening plan would be important in this patient group.
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Choi, Eunji, Justin Lee, Julie T. Wu, Heather A. Wakelee, Lidia Schapira, Allison W. Kurian, and Summer S. Han. "Abstract P055: Risk factors for second primary lung cancer among breast cancer survivors." Cancer Prevention Research 16, no. 1_Supplement (January 1, 2023): P055. http://dx.doi.org/10.1158/1940-6215.precprev22-p055.
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Abstract Introduction: Breast cancer is the most common cancer in women in the U.S. As survival in breast cancer has improved, one of the key clinical problems in breast cancer survivors is the increased risk of second cancers. Over half (55%) of breast cancer survivors die from second cancers, of which lung cancer (i.e., second primary lung cancer [SPLC]) is the most frequent type. While smoking and radiotherapy have been identified as the risk factors for SPLC among breast cancer survivors, other potential factors (e.g., comorbidity, and medication) have been underexamined. In addition, women in general have shown higher susceptibility to smoking-induced lung cancer than men, suggesting the potential involvement of hormonal factors; however, the effect of hormone replacement therapy (HRT) on lung cancer risk has been controversial and has never been examined among breast cancer survivors. We aimed to examine the factors associated with SPLC risk among breast cancer survivors, focusing on the effect of HRT and its interaction with smoking. We also explored the potential of tailored risk-based management of SPLC for breast cancer survivors. Methods: We identified 5,552 patients diagnosed with breast cancer in 1993-2014 from the Prostate, Lung, Colorectal, and Ovarian Cancer (PLCO) Screening Trial. SPLC was defined as a newly diagnosed lung cancer after 6 months from the time of breast cancer diagnosis. We applied multivariable cause-specific Cox regression to identify new factors associated with SPLC risk, adjusting for multiple testing using the Bonferroni method (P<0.01). We developed a prediction model to predict a 5-year risk of SPLC among breast cancer survivors that included both ever- and never-smokers and evaluated the predictive accuracy vs. a well-established lung cancer risk model, PLCOm2012, that was developed for a cancer-free population who ever smoked. Results: Of 5,552 patients, 89 (1.6%) developed SPLC over 102,545 person-years. Several factors measured at baseline in PLCO were significantly associated with SPLC risk among breast cancer survivors, including liver comorbidity (Hazard Ratio [HR] 3.28; P<.001), prior history of other cancer (HR 2.02; P=0.01), and regular use of ibuprofen (HR 0.52; P=0.01). In addition, ever-use of HRT was associated with a 51% reduction in SPLC risk (HR 0.49; P=0.001). The effect of active smoking on SPLC risk vs non-active smoking (HR 7.09; P<.001) was validated in PLCO. Notably, the effect of active smoking was intensified among ever-HRT users (HR=10.5; P<.001) vs. never-HRT users (HR 4.1; P<.001), thus showing a significant interaction (Pinteraction=0.003). The prediction model for SPLC risk was validated through bootstrap and demonstrated higher discrimination (AUC 0.83) vs. the PLCOm2012 model (AUC 0.79). Conclusions: In a large prospective cohort of breast cancer survivors, smoking and HRT use showed a significant interaction on SPLC risk. The prediction model for SPLC could identify high-risk survivors for SPLC for tailored surveillance to improve the management of breast cancer survivors. Citation Format: Eunji Choi, Justin Lee, Julie T. Wu, Heather A. Wakelee, Lidia Schapira, Allison W. Kurian, Summer S. Han. Risk factors for second primary lung cancer among breast cancer survivors. [abstract]. In: Proceedings of the AACR Special Conference: Precision Prevention, Early Detection, and Interception of Cancer; 2022 Nov 17-19; Austin, TX. Philadelphia (PA): AACR; Can Prev Res 2023;16(1 Suppl): Abstract nr P055.
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Shital, Kolekar, Kulkarni Kajol, Shinde Sandeep, and Shilpa Pise. "Correlation between Postural Impairment and Lymphedema in Breast Cancer Survivors." Asian Pacific Journal of Health Sciences 9, no. 2 (April 1, 2022): 125–29. http://dx.doi.org/10.21276/apjhs.2022.9.2.25.
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The major complication of breast cancer is secondary lymphedema seen within few days to months after the surgery. Lymphedema has a debilitating effect on posture. The significance of this study is to show the effect of lymphedema on posture. These all have a huge impact on the quality of life of patients, within her family as well as working places. This study provides a platform to assess the spinal posture which may be at risk due to lymphedema in breast cancer survivors. Hence, the study is to find out correlation between spinal postural impairment and lymphedema in breast cancer survivors and to assess the correlation between demographic variables and lymphedema in breast cancer survivors. The aim of the study was to study and find out the correlation between postural impairment and lymphedema in breast cancer survivors. This was an observational study with the total of 116 breast cancer survivor women’s who had undergone radiotherapy and surgery were selected from Krishna Institute of Medical Sciences, Karad. Their age ranged from 35 to 60 years old. The outcome measures which were included are postural examination chart in the anterior, posterior, lateral views by plumb line, muscle length test, muscle strength test, pain assessment using visual analog scale, and lymphedema measurement using inch tape. The obtained results showed statistically high significant increase in the forward head posture, rounded shoulders, thoracic kyphosis and scoliosis, scapular dyskinesis, and increased volume of affected arm. There were high significant correlation between spinal postural impairments and lymphedema in breast cancer survivors and also correlation between demographic variables and lymphedema in breast cancer survivors.
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Henderson, Tara O., Chaya S. Moskowitz, Joanne F. Chou, Angela R. Bradbury, Joseph Phillip Neglia, Chau T. Dang, Kenan Onel, et al. "Breast Cancer Risk in Childhood Cancer Survivors Without a History of Chest Radiotherapy: A Report From the Childhood Cancer Survivor Study." Journal of Clinical Oncology 34, no. 9 (March 20, 2016): 910–18. http://dx.doi.org/10.1200/jco.2015.62.3314.
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Purpose Little is known about the breast cancer risk among childhood cancer survivors who did not receive chest radiotherapy. We sought to determine the magnitude of risk and associated risk factors for breast cancer among these women. Patients and Methods We evaluated cumulative breast cancer risk in 3,768 female childhood cancer survivors without a history of chest radiotherapy who were participants in the Childhood Cancer Survivor Study. Results With median follow up of 25.5 years (range, 8 to 39 years), 47 women developed breast cancer at a median age of 38.0 years (range, 22 to 47 years) and median of 24.0 years (range, 10 to 34 years) from primary cancer to breast cancer. A four-fold increased breast cancer risk (standardized incidence ratio [SIR] = 4.0; 95% CI, 3.0 to 5.3) was observed when compared with the general population. Risk was highest among sarcoma and leukemia survivors (SIR = 5.3; 95% CI, 3.6 to 7.8 and SIR = 4.1; 95% CI, 2.4 to 6.9, respectively). By the age of 45 years, the cumulative incidence of breast cancer in sarcoma and leukemia survivors was 5.8% (95% CI, 3.7 to 8.4) and 6.3% (95% CI, 3.0 to 11.3), respectively. No other primary cancer diagnosis was associated with an elevated risk. Alkylators and anthracyclines were associated with an increased breast cancer risk in a dose-dependent manner (P values from test for trend were both < .01). Conclusions Women not exposed to chest radiotherapy who survive childhood sarcoma or leukemia have an increased risk of breast cancer at a young age. The data suggest high-dose alkylator and anthracycline chemotherapy increase the risk of breast cancer. This may suggest a possible underlying gene-environment interaction that warrants further study.
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Snyder, Claire F., Kevin D. Frick, Melinda E. Kantsiper, Kimberly S. Peairs, Robert J. Herbert, Amanda L. Blackford, Antonio C. Wolff, and Craig C. Earle. "Prevention, Screening, and Surveillance Care for Breast Cancer Survivors Compared With Controls: Changes from 1998 to 2002." Journal of Clinical Oncology 27, no. 7 (March 1, 2009): 1054–61. http://dx.doi.org/10.1200/jco.2008.18.0950.
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Purpose To examine how care for breast cancer survivors compares with controls. Patients and Methods Using the Surveillance, Epidemiology, and End Results–Medicare database, we examined five cohorts of stages 1 to 3 breast cancer survivors diagnosed from 1998 to 2002. For each survivor cohort (defined by diagnosis year), we calculated the number of visits to oncology specialists, primary care providers (PCPs), and other physicians and the percentage who received influenza vaccination, cholesterol screening, colorectal cancer screening, bone densitometry, and mammography during survivorship year 1 (days 366 to 730 postdiagnosis). We compared survivors' care to that of five cohorts of screening controls who were matched to survivors on age, ethnicity, sex, and region and who had a mammogram in the survivor's year of diagnosis and to that of five cohorts of comorbidity controls who were matched on age, ethnicity, sex, region, and comorbidity. We examined whether survivors' care was associated with the mix of physician specialties that were visited. Results A total of 23,731 survivors were matched with 23,731 screening controls and 23,396 comorbidity controls. There was no difference in trends over time in PCP visits between survivors and either control group. The survivors' rate of increase in other physician visits was greater than screening controls (P = .002) but was no different from comorbidity controls. Survivors were less likely to receive preventive care than screening controls but were more likely than comorbidity controls. Trends over time in survivors' care tended to be better than screening controls but were no different than comorbidity controls. Survivors who visited both a PCP and oncology specialist were most likely to receive recommended care. Conclusion Involvement by both PCPs and oncology specialists can facilitate appropriate care for survivors.
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Martinez-Ramos, Gloria P., Mary Jo Garcia Biggs, and Yvonne Lozano. "Quality of Life of Latina Breast Cancer Survivors: From Silence to Empowerment." Advances in Social Work 14, no. 1 (September 4, 2013): 82–101. http://dx.doi.org/10.18060/3551.
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Breast cancer is the most common form of cancer among Latinas living in the United States. This article reports the findings of a qualitative study aimed at understanding the experiences of 25 Latinas between the ages of 28 and 83 who are long-term (at least five years post diagnosis) breast cancer survivors. The findings show three key issues and concerns: (a) fear of being stigmatized and being treated differently if they talked about their breast cancer experience; (b) overcoming the perceived negative effects that breast cancer has on their femininity; (c) the effects of breast cancer recovery and survivorship on social relationships of family and community. Family support and peer advocacy helped survivors in several areas: (a) to cope with the fear of recurrence; (b) to combat the fear of social stigma; (c) to become stronger as they dealt with the permanent life changes as a Latina breast cancer survivor; (d) to support them in the struggle for the provision of culturally sensitive health care; and (e) to provide social support in the form of advocacy for other Latina breast cancer survivors.
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Forbes, Cynthia C., Chris M. Blanchard, W. Kerry Mummery, and Kerry S. Courneya. "A Comparison of Physical Activity Preferences Among Breast, Prostate, and Colorectal Cancer Survivors in Nova Scotia, Canada." Journal of Physical Activity and Health 12, no. 6 (June 2015): 823–33. http://dx.doi.org/10.1123/jpah.2014-0119.
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Background:Physical activity (PA) preferences may vary by cancer survivor group, but few studies have made direct comparisons. The purpose of this study was to compare the PA preferences of breast, prostate, and colorectal cancer survivors in Nova Scotia (NS), Canada.Methods:Two thousand sixty-two breast, prostate, and colorectal cancer survivors diagnosed between 2003 to 2011 were identified by the Nova Scotia Cancer Registry and mailed a questionnaire assessing PA preferences and standard demographic and medical variables.Results:Based on 741 respondents, numerous differences emerged among the cancer sites. Some of the larger differences (>20% difference) among breast, prostate, and colorectal cancer survivors, respectively, were identified for engaging in PA with other cancer survivors (42% vs. 22% vs. 30%; P < .001) and with their friends (65% vs. 40% vs. 64%; P < .001); engaging in PA at a community fitness center (59% vs. 39% vs. 45%; P < .001); and preferring supervised (60% vs. 34% vs. 45%; P < .001) and group (53% vs. 24% vs. 41%; P < .001) sessions. Differences were also found within each survivor group based on demographic and medical variables including PA behavior, age, and perceived general health.Conclusion:Breast, prostate, and colorectal cancer survivors have some differences in PA preferences that may inform targeted PA program interventions.
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Nathan, Paul C., Mark L. Greenberg, Kirsten K. Ness, Melissa M. Hudson, Ann C. Mertens, Martin C. Mahoney, James G. Gurney, et al. "Medical Care in Long-Term Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study." Journal of Clinical Oncology 26, no. 27 (September 20, 2008): 4401–9. http://dx.doi.org/10.1200/jco.2008.16.9607.
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Purpose To evaluate whether childhood cancer survivors receive regular medical care focused on the specific morbidities that can arise from their therapy. Patients and Methods We conducted a cross-sectional survey of health care use in 8,522 participants in the Childhood Cancer Survivor Study, a multi-institutional cohort of childhood cancer survivors. We assessed medical visits in the preceding 2 years, whether these visits were related to the prior cancer, whether survivors received advice about how to reduce their long-term risks, and whether screening tests were discussed or ordered. Completion of echocardiograms and mammograms were assessed in patients at high risk for cardiomyopathy or breast cancer. We examined the relationship between demographics, treatment, health status, chronic medical conditions, and health care use. Results Median age at cancer diagnosis was 6.8 years (range, 0 to 20.9 years) and at interview was 31.4 years (range, 17.5 to 54.1 years). Although 88.8% of survivors reported receiving some form of medical care, only 31.5% reported care that focused on their prior cancer (survivor-focused care), and 17.8% reported survivor-focused care that included advice about risk reduction or discussion or ordering of screening tests. Among survivors who received medical care, those who were black, older at interview, or uninsured were less likely to have received risk-based, survivor-focused care. Among patients at increased risk for cardiomyopathy or breast cancer, 511 (28.2%) of 1,810 and 169 (40.8%) of 414 had undergone a recommended echocardiogram or mammogram, respectively. Conclusion Despite a significant risk of late effects after cancer therapy, the majority of childhood cancer survivors do not receive recommended risk-based care.
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Chan, Alexandre, Zheng Kang Lum, Terence Ng, Tewodros Eyob, Xiao Jun Wang, Jung-woo Chae, Sreemanee Dorajoo, et al. "Perceptions and Barriers of Survivorship Care in Asia: Perceptions From Asian Breast Cancer Survivors." Journal of Global Oncology 3, no. 2 (April 2017): 98–104. http://dx.doi.org/10.1200/jgo.2016.004929.
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Purpose With the long-term goal to optimize post-treatment cancer care in Asia, we conducted a qualitative study to gather in-depth descriptions from multiethnic Asian breast cancer survivors on their perceptions and experiences of cancer survivorship and their perceived barriers to post-treatment follow-up. Methods Twenty-four breast cancer survivors in Singapore participated in six structured focus group discussions. The focus group discussions were voice recorded, transcribed verbatim, and analyzed by thematic analysis. Results Breast cancer survivors were unfamiliar with and disliked the term “survivorship,” because it implies that survivors had undergone hardship during their treatment. Cognitive impairment and peripheral neuropathy were physical symptoms that bothered survivors the most, and many indicated that they experienced emotional distress during survivorship, for which they turned to religion and peers as coping strategies. Survivors indicated lack of consultation time and fear of unplanned hospitalization as main barriers to optimal survivorship care. Furthermore, survivors indicated that they preferred receipt of survivorship care at the specialty cancer center. Conclusion Budding survivorship programs in Asia must take survivor perspectives into consideration to ensure that survivorship care is fully optimized within the community.
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Ambali Parambil, Neethu, and Srinivasan Kannan. "Breast Cancer Survivorship Experiences." Social Science Protocols 5, no. 1 (March 25, 2022): 1–10. http://dx.doi.org/10.7565/ssp.v5.6913.
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Background: With advancement in early detection and treatment number of breast cancer survivors are on the rise. Long term survivors have in addition to medical problems related to treatment, psychological distress and challenges related to body image, sexuality and stigma. The survivorship issues related to breast cancer are largely under studied in India.
Methods/Design: This is a retrospective cohort study of breast cancer survivors from 2016 Hospital-Based Cancer Registry (HBCR) of a Tertiary Cancer Centre (TCC). Baseline data will be collected from registry. Quantitative data on present status and issues of survivors will be done by a cross sectional survey. In depth interviews will be done to explore the challenges of survivors and lived experiences of the co- survivors. Documents about cancer will also be reviewed to find out existing guidelines on breast cancer control.
Discussion: Understanding survivorship experiences will help to improve their quality of life and guide health workers and caregivers in providing the much-needed supportive care in their journey throughout the disease.
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Ambali Parambil, Neethu, and Srinivasan Kannan. "Breast Cancer Survivorship Experiences." Social Science Protocols 5, no. 1 (March 25, 2022): 1–10. http://dx.doi.org/10.7565/ssp.v5.6913.
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Background: With advancement in early detection and treatment number of breast cancer survivors are on the rise. Long term survivors have in addition to medical problems related to treatment, psychological distress and challenges related to body image, sexuality and stigma. The survivorship issues related to breast cancer are largely under studied in India.
Methods/Design: This is a retrospective cohort study of breast cancer survivors from 2016 Hospital-Based Cancer Registry (HBCR) of a Tertiary Cancer Centre (TCC). Baseline data will be collected from registry. Quantitative data on present status and issues of survivors will be done by a cross sectional survey. In depth interviews will be done to explore the challenges of survivors and lived experiences of the co- survivors. Documents about cancer will also be reviewed to find out existing guidelines on breast cancer control.
Discussion: Understanding survivorship experiences will help to improve their quality of life and guide health workers and caregivers in providing the much-needed supportive care in their journey throughout the disease.
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Yan, Adam P., Yan Chen, Tara O. Henderson, Kevin C. Oeffinger, Melissa M. Hudson, Todd M. Gibson, Joseph P. Neglia, et al. "Adherence to Surveillance for Second Malignant Neoplasms and Cardiac Dysfunction in Childhood Cancer Survivors: A Childhood Cancer Survivor Study." Journal of Clinical Oncology 38, no. 15 (May 20, 2020): 1711–22. http://dx.doi.org/10.1200/jco.19.01825.
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PURPOSE To evaluate childhood cancer survivors’ adherence to surveillance protocols for late effects of treatment and to determine the factors affecting adherence. METHODS Between 2014 and 2016, 11,337 survivors and 2,146 siblings in the Childhood Cancer Survivor Study completed a survey ascertaining adherence to Children’s Oncology Group (COG) guidelines for survivors at high risk for second malignant neoplasms or cardiac dysfunction and to the American Cancer Society (ACS) cancer screening guidelines for average-risk populations. Adherence rates and factors affecting adherence were analyzed. RESULTS Median age at diagnosis was 7 years (range, 0-20.9 years), and median time from diagnosis was 29 years (range, 15-47 years). Among high-risk survivors, adherence to COG breast, colorectal, skin, and cardiac surveillance was 12.6% (95% CI, 10.0% to 15.3%), 37.0% (34.1% to 39.9%), 22.3% (21.2% to 23.4%), and 41.4% (40.1% to 42.7%), respectively. Among average-risk survivors, adherence to ACS breast, cervical, and colorectal screening was 57.1% (53.2% to 61.0%), 83.6% (82.7% to 84.5%), and 68.5% (64.7% to 72.2%), respectively. Twenty-seven percent of survivors and 20.0% of primary care providers (PCPs) had a survivorship care plan (SCP). For high-risk survivors, SCP possession was associated with increased adherence to COG breast (22.3% v. 8.1%; prevalence ratio [PR], 2.52; CI, 1.59 to 4.01), skin (34.8% v 23.0%; PR, 1.16; CI, 1.01 to 1.33), and cardiac (67.0% v 33.1%; PR, 1.73; CI, 1.55 to 1.92) surveillance. For high-risk survivors, PCP possession of a SCP was associated only with increased adherence to COG skin cancer surveillance (36.9% v 23.2%; PR, 1.24; CI, 1.08 to 1.43). CONCLUSION Guideline adherence is suboptimal. Although survivor SCP possession is associated with better adherence, few survivors and PCPs have one. New strategies to improve adherence are needed.
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Williams, Faustine. "Understanding breast cancer patients’ journey from diagnosis through survivorship." Qualitative Research Journal 15, no. 3 (August 10, 2015): 294–305. http://dx.doi.org/10.1108/qrj-12-2014-0069.
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Purpose – The purpose of this paper was to understand the lived experiences of women who have been diagnosed, treated and are cancer free as survivors. Design/methodology/approach – Using purposive sampling approach, participants were recruited from two Missouri cancer centers. A total of 15 breast cancer free women (ten white and five black) were interviewed. The participants ranged in age from 34 to 62 years, and all had at least a bachelor degree. Findings – Eight unique themes were identified from the interviews. The women noted that maintaining positive attitude, and support from family and friends were the greatest resources that helped them through their cancer journey. They were generally positive about their experiences but uncertain what “survivor” meant individually and personally. Research limitations/implications – All the women in this study had at least a college degree, stable family economic resources and health insurance. Originality/value – The women interviewed in this study did not want to be called breast cancer “survivors” which is a common name for anyone who has been diagnosed, treated and cancer free. For those who are breast cancer educators, nurses, medical practitioners and counselors it is important to consider how they use the word “survivor.” Referring to women who have successfully completed a treatment program for breast cancer as “survivors” attaches an identity that may not be accepted by all.
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Cardoso-Peña, Elías, Alexandra E. Soto Pina, Ángel Gómez Villanueva, Gerardo Emilio López Chavez, Pablo Ramírez Martínez, Humberto Ramírez Montoya, María Guadalupe Berumen Lechuga, et al. "Visceral Adiposity Index in Breast Cancer Survivors: A Case-Control Study." International Journal of Endocrinology 2020 (December 9, 2020): 1–6. http://dx.doi.org/10.1155/2020/8874916.
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Background. Breast cancer (BC) is the first cause of cancer morbidity and mortality in women. This disease has been linked to obesity; however, it is not clear how fat accumulation affects women who survive breast cancer. Although the visceral adiposity index (VAI) is a marker of cardiometabolic risk and adipose tissue dysfunction, it is not clear how it changes in breast cancer survivors. The aim of this investigation was to compare VAI in women with and without breast cancer. Methods. A case-control cross-sectional study was conducted on women who were BC survivors and women without the history of BC (control group). Body composition was assessed using electrical bioimpedance while VAI by means of waist circumference (WC), body mass index (BMI), triacylglycerols (TG), and high-density lipoprotein cholesterol (HDL-C). Results. 49 women in the BC survivor group and 50 in the control group. WC was wider in the survivor group as regards control (93.65 ± 10.48 vs. 88.52 ± 9.61 cm) ( p = 0.025 ); at once, TG and VAI were significantly higher for the survivor group (243.55 ± 199.84 vs. 159.84 ± 75.77) ( p = 0.007 ) and (11.03 ± 11.15 vs. 6.41 ± 3.66) ( p < 0.005 ), respectively. Body composition parameters were similar in both groups. Conclusions. VAI is higher in women who are BC survivors in comparison with controls matched by age and bodyweight.
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Moskowitz, Chaya S., Cécile M. Ronckers, Joanne F. Chou, Susan A. Smith, Danielle Novetsky Friedman, Dana Barnea, Judith L. Kok, et al. "Development and Validation of a Breast Cancer Risk Prediction Model for Childhood Cancer Survivors Treated With Chest Radiation: A Report From the Childhood Cancer Survivor Study and the Dutch Hodgkin Late Effects and LATER Cohorts." Journal of Clinical Oncology 39, no. 27 (September 20, 2021): 3012–21. http://dx.doi.org/10.1200/jco.20.02244.
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PURPOSE Women treated with chest radiation for childhood cancer have one of the highest risks of breast cancer. Models producing personalized breast cancer risk estimates applicable to this population do not exist. We sought to develop and validate a breast cancer risk prediction model for childhood cancer survivors treated with chest radiation incorporating treatment-related factors, family history, and reproductive factors. METHODS Analyses were based on multinational cohorts of female 5-year survivors of cancer diagnosed younger than age 21 years and treated with chest radiation. Model derivation was based on 1,120 participants in the Childhood Cancer Survivor Study diagnosed between 1970 and 1986, with median attained age 42 years (range 20-64) and 242 with breast cancer. Model validation included 1,027 participants from three cohorts, with median age 32 years (range 20-66) and 105 with breast cancer. RESULTS The model included current age, chest radiation field, whether chest radiation was delivered within 1 year of menarche, anthracycline exposure, age at menopause, and history of a first-degree relative with breast cancer. Ten-year risk estimates ranged from 2% to 23% for 30-year-old women (area under the curve, 0.63; 95% CI, 0.50 to 0.73) and from 5% to 34% for 40-year-old women (area under the curve, 0.67; 95% CI, 0.54 to 0.84). The highest risks were among premenopausal women older than age 40 years treated with mantle field radiation within a year of menarche who had a first-degree relative with breast cancer. It showed good calibration with an expected-to-observed ratio of the number of breast cancers of 0.92 (95% CI, 0.74 to 1.16). CONCLUSION Breast cancer risk varies among childhood cancer survivors treated with chest radiation. Accurate risk prediction may aid in refining surveillance, counseling, and preventive strategies in this population.
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McDonald, Andrew M., Yanjun Chen, Jessica Wu, Lindsey Hageman, Liton Francisco, Michelle Kung, F. Lennie Wong, et al. "Total Body Irradiation and Risk of Breast Cancer After Blood or Marrow Transplantation: A Blood or Marrow Transplantation Survivor Study Report." Journal of Clinical Oncology 38, no. 25 (September 1, 2020): 2872–82. http://dx.doi.org/10.1200/jco.20.00231.
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PURPOSE To examine the association between total body irradiation (TBI) and subsequent breast cancer in women treated with blood or marrow transplantation (BMT) for hematologic malignancies. PATIENTS AND METHODS Participants were drawn from the BMT Survivor Study (BMTSS), a retrospective cohort study that included patients who underwent transplantation between 1974 and 2014 and survived for ≥ 2 years after BMT. Patients with pre-BMT chest radiation or a history of breast cancer were excluded. Participants completed the BMTSS survey, which included details regarding breast cancer diagnosis. Subsequent breast cancer was confirmed by pathology report review or physician notes. Cox proportional hazards models assessed the association between TBI and subsequent breast cancer. Standardized incidence ratios were calculated to determine the excess risk of subsequent breast cancer compared with that in the general population. RESULTS A total of 1,464 female BMT survivors (allogeneic: n = 788; autologous: n = 676) participated, with a median follow-up of 9.3 years from BMT. TBI was used in 660 patients (46%). Thirty-seven women developed subsequent breast cancer (allogeneic: n = 19; autologous: n = 18). Multivariable analysis revealed that exposure to TBI was associated with an increased risk of subsequent breast cancer among allogeneic BMT survivors (hazard ratio [HR], 3.7 [95% CI, 1.2 to 11.8]; P = .03) and autologous BMT survivors (HR, 2.6 [95% CI, 1.0 to 6.8]; P = .048). Pre-BMT exposure to alkylating agents was associated with an increased risk of subsequent breast cancer among autologous BMT survivors (HR, 3.3 [95% CI, 1.0 to 9.0]; P = .05). Compared with that in the general population, exposure to TBI at age < 30 years was associated with a 4.4-fold higher risk of subsequent breast cancer in allogeneic BMT survivors and a 4.6-fold higher risk in autologous BMT survivors. CONCLUSION The association between TBI and subsequent breast cancer, especially among those exposed at a young age, as well as pre-BMT exposure to alkylating agents, should inform breast cancer screening for early detection.
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Maass, Saskia W. M. C., Daan Brandenbarg, Liselotte M. Boerman, Peter F. M. Verhaak, Geertruida H. de Bock, and Annette J. Berendsen. "Fatigue among Long-Term Breast Cancer Survivors: A Controlled Cross-Sectional Study." Cancers 13, no. 6 (March 15, 2021): 1301. http://dx.doi.org/10.3390/cancers13061301.
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Background: Fatigue is the most common and persistent symptom among women in the first five years after a breast cancer diagnosis. However, long-term prevalence of fatigue, among breast cancer survivors, needs further investigation. Aim: To compare fatigue experienced by long-term breast cancer survivors with that in a reference population and to evaluate the determinants of that fatigue. Design and Setting: A cross-sectional cohort study of 350 breast cancer survivors ≥5 years after diagnosis and a reference population of 350 women matched by age and general practitioner. Method: Fatigue was measured using the Multidimensional Fatigue Inventory (MFI-20), and a sum score of >60 (multidimensional fatigue) was the primary outcome. Logistic regression was applied to compare the prevalence of multidimensional fatigue between the survivor and reference populations, adjusted for body mass index (BMI) and for cardiovascular and psychological variables. Odds ratios (ORs) and 95% confidence intervals (95%CIs) were estimated. Logistic regression was applied to evaluate the determinants of multidimensional fatigue among the survivors. Results: Breast cancer survivors (median 10 years after diagnosis), more often experienced multidimensional fatigue than the reference population (26.6% versus 15.4%; OR, 2.0 [95%CI, 1.4–2.9]), even after adjusting for confounders. The odds of multidimensional fatigue were also higher among survivors with symptoms of depression (32.2% versus 2.7%; OR, 17.0 [95%CI, 7.1–40.5]) or anxiety (41.9% versus 10.1%; OR, 6.4 [95%CI, 3.6–11.4]). Conclusion: One in four breast cancer survivors experience multidimensional fatigue and fatigue occurs more frequently than in women of the same age and general practitioner. This fatigue appears to be associated with symptoms of depression and anxiety.
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Wen, Kuang-Yi, Xiang S. Ma, Carolyn Fang, Yuan Song, Yin Tan, Brenda Seals, and Grace X. Ma. "Psychosocial correlates of benefit finding in breast cancer survivors in China." Journal of Health Psychology 22, no. 13 (March 23, 2016): 1731–42. http://dx.doi.org/10.1177/1359105316637839.
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Breast cancer is number one in incidence and sixth in mortality among all cancers of women in China. Prior work identified positive consequences following diagnosis and treatment, including benefit finding among breast cancer survivors from Western countries. This study evaluated psychosocial correlates of benefit finding in breast cancer survivors in China. A total of 148 participants completed measures of coping, perceived stress, depressive symptoms, social support, and benefit finding. Results indicated that benefit finding was positively related to active coping and negatively related to depression. Future research may evaluate whether interventions to enhance active coping will improve outcomes among Chinese breast cancer survivors.
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Tsai, Meng-Han, Justin X. Moore, Lorriane Odhiambo, Sydney E. Andrzejak, and Martha S. Tingen. "Abstract A121: Colorectal cancer screening utilization among breast, cervical, prostate, skin, and lung cancer survivors." Cancer Epidemiology, Biomarkers & Prevention 32, no. 1_Supplement (January 1, 2023): A121. http://dx.doi.org/10.1158/1538-7755.disp22-a121.
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Abstract Background: Advancement in cancer detection and treatment has improved survival rates leading to a growing population of cancer survivors, yet cancer survivors are at a 20% increased risk of developing a secondary cancer. Breast, cervical, prostate, and lung cancer survivors as well as malignant melanoma survivors have been reported an increased risk for developing colorectal cancer (CRC). Although receiving appropriate cancer screening for secondary cancers is recommended, evidence on CRC screening among different cancer survivors are lacking. Methods: We examined the relationship between sociodemographic characteristics, access to care, risk behavior factors, and chronic health conditions in cancer survivors, with up-to-date CRC screening utilization (colonoscopy, flexible sigmoidoscopy, fecal occult blood test) among breast, cervical, prostate, skin (including melanoma), and lung cancer survivors, using data from the 2020 Behavioral Risk Factor Surveillance System. Descriptive statistics were used to summarize the data and multivariable logistic regressions were applied to assess the association of these characteristics with up-to-date CRC screening use. Results: Among 9,780 cancer survivors included in the analysis, most were age 60-69 years, had first cancer at 41-59 years, were Non-Hispanic White, and had some college or college graduate education. Compared to CRC screening rates in breast, prostate, skin, and lung cancer survivors, cervical cancer survivors had a lower rate of screening at 65% (breast cancer: 82%, prostate cancer: 88%, skin cancer: 78%, and lung cancer: 80%). In multivariable analysis, breast, cervical, and skin cancer survivors aged ≥ 60 years were associated with higher odds of receiving CRC screening compared to adults aged 45-59 years (p-value <0.05). Respondents that had their last routine checkup two or more years prior, had lower odds of having CRC screening among cervical (OR=0.06; 95% CI, 0.02-0.22), prostate (OR=0.26; 95% CI, 0.14-0.49), and skin cancer (OR=0.50; 95% CI, 0.36-0.70) survivors. The presence of one or more chronic diseases were associated with higher odds of having up-to-date CRC screening among breast, prostate, and skin cancer survivors; however, lung cancer survivors with one or two chronic diseases exhibited lower odds of receiving CRC screening (OR=0.16; 95% CI, 0.04-0.61) compared to respondents without chronic disease. Conclusion: Findings from this study provide important evidence on factors that may be associated with up-to-date CRC screening use across different cancer survivors which include older age, routine checkup, and multiple chronic diseases. Moreover, variations of CRC screening utilization among cancer survivors may highlight missed opportunities for secondary cancer prevention. These findings will inform the importance of secondary cancer prevention in survivorship care plans for breast, cervical, prostate, skin, and lung cancer survivors and effective implementation of these plans through primary health care initiatives. Citation Format: Meng-Han Tsai, Justin X. Moore, Lorriane Odhiambo, Sydney E. Andrzejak, Martha S. Tingen. Colorectal cancer screening utilization among breast, cervical, prostate, skin, and lung cancer survivors [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr A121.
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Schonfeld, Sara J., Amy Berrington de Gonzalez, Kala Visvanathan, Ruth M. Pfeiffer, and William F. Anderson. "Declining Second Primary Ovarian Cancer After First Primary Breast Cancer." Journal of Clinical Oncology 31, no. 6 (February 20, 2013): 738–43. http://dx.doi.org/10.1200/jco.2012.43.2757.
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Purpose Although ovarian cancer incidence rates have declined in the United States, less is known of ovarian cancer trends among survivors of breast cancer. Therefore, we examined second primary ovarian cancers after first primary breast cancer. Methods Data were obtained from the Surveillance, Epidemiology, and End Results program (1973 to 2008). Standardized incidence ratios (SIRs) were calculated as the observed numbers of ovarian cancers among survivors of breast cancer compared with the expected numbers in the general population. Absolute rates were measured as the incidence rates for second primary ovarian cancer by year of diagnosis of the first primary breast cancer adjusted for age of breast cancer diagnosis and years since diagnosis. Results SIRs for second primary ovarian cancer were elevated over the entire study period (SIR, 1.24; 95% CI, 1.2 to 1.3), whereas the absolute rates declined with an estimated annual percentage change near 1% (−1.34% to −0.09% per year). Secular trends for second ovarian cancers were similar after estrogen receptor (ER) –positive and ER-negative breast cancers, whereas the age-specific patterns varied significantly by ER expression (P for interaction < .001). The largest SIR was among women age less than 50 years with ER-negative breast cancer (SIR, 4.35; 95% CI, 3.5 to 5.4). Conclusion Persistently elevated SIRs along with decreasing absolute rates over the entire study period suggest that ovarian cancers in both the general population and survivors of breast cancer are declining in parallel, possibly because of common risk factor exposures. Analytic studies are needed to further assess the parallel overall trends and the age-specific interaction by ER expression.
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Kwon, Janice S., Angelica M. Gutierrez-Barrera, Diana Young, Charlotte C. Sun, Molly S. Daniels, Karen H. Lu, and Banu Arun. "Expanding the Criteria forBRCAMutation Testing in Breast Cancer Survivors." Journal of Clinical Oncology 28, no. 27 (September 20, 2010): 4214–20. http://dx.doi.org/10.1200/jco.2010.28.0719.
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PurposeEvery year approximately 25% of women diagnosed with breast cancer are younger than 50 years of age, and almost 10% of them have a BRCA mutation. Not all potential carriers are identified by existing criteria for BRCA testing. We estimated the costs and benefits of different BRCA testing criteria for women with breast cancer younger than 50 years.MethodsWe developed a Markov Monte Carlo simulation to compare six criteria for BRCA mutation testing: (1) no testing (reference); (2) medullary breast cancer in patients younger than 50 years; (3) any breast cancer in patients younger than 40 years; (4) triple negative (TN) breast cancer in patients younger than 40 years; (5) TN breast cancer in patients younger than 50 years; (6) any breast cancer in patients younger than 50 years. Net health benefits were life expectancy and quality-adjusted life expectancy, and primary outcome was the incremental cost-effectiveness ratio (ICER). The model estimated the number of new breast and ovarian cancer cases.ResultsBRCA mutation testing for all women with breast cancer who were younger than 50 years could prevent the highest number of breast and ovarian cancer cases, but with unfavorable ICERs. Testing women with TN breast cancers who were younger than 50 years was cost-effective with an ICER of $8,027 per year of life gained ($9,084 per quality-adjusted life-year), and could reduce subsequent breast and ovarian cancer risks by 23% and 41%, respectively, compared with the reference strategy.ConclusionTesting women with TN breast cancers who were younger than 50 years for BRCA mutations is a cost-effective strategy and should be adopted into current guidelines for genetic testing.
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Williams, Donna L., Timiya S. Nolan, Yu-wen Chiu, Laura Ricks, Silvia Gisiger Camata, Barbara Craft, and Karen Meneses. "A Partnership in Health-Related Social Media for Young Breast Cancer Survivors." Health Promotion Practice 21, no. 2 (September 25, 2018): 219–27. http://dx.doi.org/10.1177/1524839918797620.
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In the United States, about 11% (26,393) of those diagnosed with breast cancer in 2016 will be young or less than 45 years old. Young breast cancer survivors, compared to older cancer survivors, are a disparate group that experience higher incidence of advanced disease, greater mortality, and poorer quality of life, and are often faced with difficulty locating support that meet the unique needs of young women. The Gulf States Young Breast Cancer Survivor Network, composed of three sister networks, formed a partnership aimed at harnessing the power of social media to reach and impact the lives of young women with breast cancer. The collaborative partnership framework and the power of synergy are shown in merging two existing programs and incorporating a third new program.
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Nathan, P. C., K. K. Ness, M. M. Hudson, M. Mahoney, J. S. Ford, W. Landier, G. Armstrong, T. Henderson, L. L. Robison, and K. C. Oeffinger. "Cancer screening in adult survivors of childhood cancer: A report from the Childhood Cancer Survivor Study (CCSS)." Journal of Clinical Oncology 27, no. 18_suppl (June 20, 2009): CRA6501. http://dx.doi.org/10.1200/jco.2009.27.18_suppl.cra6501.
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CRA6501 Background: Childhood cancer survivors may develop a second malignant neoplasm (SMN) and require surveillance to detect new cancers. Methods: We surveyed survivors and siblings from the CCSS, a cohort study of patients who have survived ≥5 years after a diagnosis of childhood cancer from 1970–86. We assessed compliance with the American Cancer Society's (ACS) guidelines for surveillance mammography, colonoscopy and PAP smears, and compared them to a matched population comparison group drawn from the 2003 National Health Interview Survey. Further, we examined compliance with the Children's Oncology Group (COG) guidelines for more frequent colonoscopy, mammography and skin exams in survivors at high risk for cancers of the colon (≥30 Gy pelvic, abdominal or spinal radiation), breast (≥ 20 Gy breast radiation in females) or skin (any radiation). Proportions screened were compared between groups with adjusted generalized estimating equations or log-binomial regression models. Results: There were 8318 survivors (50.6% male, mean age at interview 31.2 ± 7.3 years), 2661 siblings and 8318 population controls. 141/829 (17.6%), 592/855 (70.4%) and 3362/3690 (92.6%) eligible survivors reported a colonoscopy, mammogram, or PAP smear per ACS guidelines. Survivors were less likely than siblings (odds ratio [OR] 0.30; 95% confidence interval [CI] 0.18–0.49) and population controls (OR 0.63; CI 0.50–0.80) to have a colonoscopy, and less likely than siblings to have a PAP smear (risk ratio [RR] 0.98; CI 0.97–0.99). However, they were more likely than siblings (RR 1.14; CI 1.03–1.27) and population controls (RR 1.05; CI 1.01–1.10) to have a mammogram. Among survivors at increased risk for a SMN, only 92/809 (11.4%) reported a colonoscopy within the COG recommended 5-year period, 164/537 (30.5%) reported a mammogram within a 1-year period and 1288/4833 (26.7%) reported a skin exam. Care at a cancer center was associated with mammography (RR 1.91; 95% CI 1.02–1.27) and skin exam (RR 1.55; 95% CI 1.22–196) in high-risk patients. Conclusions: Childhood cancer survivors are not screened adequately for SMNs. Surveillance is very poor amongst those at highest risk for colon, breast, or skin cancer. Survivors and their physicians need education about the importance of surveillance. No significant financial relationships to disclose.
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Mulder, Renée L., Melissa M. Hudson, Smita Bhatia, Wendy Landier, Gill Levitt, Louis S. Constine, W. Hamish Wallace, et al. "Updated Breast Cancer Surveillance Recommendations for Female Survivors of Childhood, Adolescent, and Young Adult Cancer From the International Guideline Harmonization Group." Journal of Clinical Oncology 38, no. 35 (December 10, 2020): 4194–207. http://dx.doi.org/10.1200/jco.20.00562.
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PURPOSE As new evidence is available, the International Late Effects of Childhood Cancer Guideline Harmonization Group has updated breast cancer surveillance recommendations for female survivors of childhood, adolescent, and young adult cancer. METHODS We used evidence-based methods to apply new knowledge in refining the international harmonized recommendations developed in 2013. The guideline panel updated the systematic literature review, developed evidence summaries, appraised the evidence, and updated recommendations on the basis of evidence, clinical judgement, and consideration of benefits versus the harms of the surveillance interventions while attaining flexibility in implementation across different health care systems. The GRADE Evidence-to-Decision framework was used to translate evidence to recommendations. A survivor information form was developed to counsel survivors about the potential harms and benefits of surveillance. RESULTS The literature update identified new study findings related to the effects of prescribed moderate-dose chest radiation (10 to 19 Gy), radiation dose-volume, anthracyclines and alkylating agents in non–chest irradiated survivors, and the effects of ovarian function on breast cancer risk. Moreover, new data from prospective investigations were available regarding the performance metrics of mammography and magnetic resonance imaging among survivors of Hodgkin lymphoma. Modified recommendations include the performance of mammography and breast magnetic resonance imaging for survivors treated with 10 Gy or greater chest radiation (strong recommendation) and upper abdominal radiation exposing breast tissue at a young age (moderate recommendation) at least annually up to age 60 years. As a result of inconsistent evidence, no recommendation could be formulated for routine breast cancer surveillance for survivors treated with any type of anthracyclines in the absence of chest radiation. CONCLUSION The newly identified evidence prompted significant change to the recommendations formulated in 2013 related to moderate-dose chest radiation and anthracycline exposure as well as breast cancer surveillance modality.
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Di, Mengyang, and Adam J. Olszewski. "Adjuvant Chemotherapy Administration and Survival Outcomes in Lymphoma Survivors with Common Solid Tumors: A Population-Based Study." Blood 132, Supplement 1 (November 29, 2018): 621. http://dx.doi.org/10.1182/blood-2018-99-114250.
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Abstract Background: Adjuvant therapy is an essential component of treatment for many early-stage (stage I-III) breast, colon, or lung cancers after curative surgery. Patients newly diagnosed with these cancers who also have a history of diffuse large B-cell lymphoma (DLBCL) or Hodgkin lymphoma (HL) have typically undergone anthracycline-based chemotherapy to treat their lymphoma, and may be less likely to receive adjuvant chemotherapy for subsequent solid cancers because of prior toxicities or limits on cumulative doses. Some studies suggested lower use of adjuvant chemotherapy in HL survivors with breast cancer (Elkin et al., JCO 2011), and worse overall survival (OS) outcomes in lymphoma survivors with solid tumors (Sanna et al., Ann Oncol 2007). Our objective was to examine the use of adjuvant chemotherapy and OS among DLBCL/HL survivors compared with the general population of patients with three common cancers: breast, colon, and lung. Methods: From the Surveillance, Epidemiology, and End Results (SEER) database, we identified patients aged 20-79 diagnosed with breast (stage I-III), colon (stage II-III), or lung (stage II-IIIA) cancers in 2004-2015, who underwent surgery and were thus candidates for adjuvant chemotherapy by virtue of age and stage. Among them we distinguished "cases" of DLBCL or HL survivors (diagnosed with lymphoma >1 year before the index cancer), treating other patients as "controls". We compared administration of chemotherapy (versus no or unknown administration status, as recorded by SEER) and OS in each cancer, in multivariable robust Poisson regression or Cox models, respectively, reporting relative risk (RR) or hazard ratio (HR) with 95% confidence intervals (CI). All models were adjusted for age, sex, race, year of diagnosis, stage of the index cancer, lymph node involvement, type of surgery (e.g. breast conservation or mastectomy, partial or total colectomy, lobectomy or pneumonectomy), and endocrine receptor status for breast cancer. Results: Among patients with breast cancer (n=532,686), we identified 360 DLBCL and 349 HL survivors (with median latency between lymphoma and cancer diagnoses of 79 and 222 months, respectively). Among patients with colon cancer (n=149,993), there were 165 DLBCL and 88 HL survivors (median latency 71 and 156 months, respectively). Among patients with lung cancer (n=23,396) there were 37 DLBCL and 25 HL survivors (medial latency 60 and 147 months, respectively). In breast and colon cancers, DLBCL survivors were significantly older, and HL survivors younger than controls, but this difference was absent in lung cancer (Table). HL survivors were diagnosed with breast cancer at an earlier stage than controls (P=.006), but in all other studied scenarios we observed no significant difference in stage or extent of nodal spread between DLBCL/HL survivors and controls. After adjustment for baseline characteristics, we observed no significant difference between patients with and without a history of lymphoma in the rates of chemotherapy administration (adjusted RR, 0.87 to 1.04), except HL survivors with colon cancer, who had a 20% lower rate than controls (RR, 0.80, 95% CI, 0.64-1.00). OS was significantly worse for patients with prior HL lymphoma in all 3 cancers, but for DLBCL survivors only in breast cancer. Consistent results were observed in the subpopulation of patients who actually received adjuvant chemotherapy. Conclusions: In most studied scenarios, despite prior exposure to intensive chemotherapy, survivors of DLBCL or HL received adjuvant chemotherapy for common cancers at similar rates relative to patients with no history of lymphoma. Therefore, contrary to prior suggestions, differences in application of chemotherapy cannot explain survival disparities between lymphoma survivors and other patients with the same cancers. HL survivors had consistently worse OS even in the subpopulation receiving chemotherapy, suggesting that other (e.g. cardiovascular) sources of mortality related to late toxicities of HL treatment may be contributing, rather than differences in treatment. Unique survival patterns among DLBCL survivors suggest that limits on anthracycline-based chemotherapy due to cumulative lifetime dosing may impair outcomes in breast cancer, but not in cancers like colon or lung, which are treated with non-overlapping taxane- or fluorouracil-based adjuvant regimens. Disclosures Olszewski: Genentech: Research Funding; TG Therapeutics: Research Funding; Spectrum Pharmaceuticals: Consultancy, Research Funding.