Search

Purpose: To evaluate the reliability and validity of the Chinese version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Breast Cancer (EORTC QLQ-BR53) questionnaire firstly in north of China., Methods: A total of 294 outpatients with breast cancer in Tianjin Cancer Institution and Hospital from November 2014 to August 2015 were enrolled in this study. All patients self-administered the EORTC QLQ-BR25 and the Short Form 36 Health Survey (SF-36). The Eastern Cooperative Oncology Group (ECOG) scoring was performed to evaluate scores. Internal consistency reliability was determined by Cronbach's α coefficient for each dimension, with a Cronbach's α coefficient ≥0.7 considered to be statistically significant., Results: A satisfactory internal consistency reliability for most multi-item scales was confirmed, as Cronbach's α coefficients were close or greater than 0.7 except for breast symptoms (0.615). Multiple-trait scaling analysis demonstrated a good convergent and divergent validity of EORTC QLQ-BR53. Using SF-36 as a reference standard to evaluate the dimensions of EORTC QLQ-BR53, most items in EORTC QLQ-BR53 possessed a favorable correlation with its own dimension (r > 0.4). A statistically significant difference was discovered in dimension scores between patients grouped by ECOG scores except for individual dimensions., Conclusions: The Chinese version of EORTC QLQ-BR53 is a reliable and valid instrument for measuring the quality of life among Chinese patients with breast cancer., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Purpose: Despite the increasing burden, breast cancer control in sub-Saharan Africa is insufficient. Late diagnosis and lack of early detection and screening services contribute to high mortality. Clinical breast exam (CBE) screening can be valuable in low-income countries, including use of community health workers and non-health professionals to conduct exams. We assessed experiences of women who underwent CBE screening by trained laywomen in Lilongwe, Malawi, as part of a pilot program., Methods: The pilot study invited women attending urban health clinics to a breast cancer educational talk followed by CBE screening by trained laywomen. We purposively sampled participants from the pilot study and interviewed them about the screening experience and future cancer education programs and services., Results: Overall participants had positive experiences and were willing to undergo CBE screening by trained laywomen. Participants were motivated by the educational talk, shared newly acquired cancer knowledge with their social networks, and encouraged others to seek screening. Screened women suggested strategies for future interventions including combining breast and cervical cancer screening, using female providers, partnering with community leaders to increase uptake, and expanding services into the community., Conclusions: Asymptomatic Malawian women accepted CBE screening by trained laywomen and considered breast cancer an important health issue. Women appreciated combined education and screening services and proposed further linkage of breast and cervical cancer screening. Based on our results, training laywomen to educate the public on breast cancer and conduct CBE is a feasible breast cancer control strategy in sub-Saharan Africa.

Objective: Many women in Africa are diagnosed with advanced breast cancer. We explored Malawian breast cancer patients' perspectives about their diagnosis and ability to access care to identify help-seeking behaviors and to describe factors influencing delay., Methods: We purposively sampled 20 Malawian breast cancer patients to conduct in-depth interviews. Transcripts were double coded to identify major themes of breast cancer help-seeking behaviors and what delayed or facilitated access to care., Results: We outlined a breast cancer help-seeking pathway describing decisions, behaviors, and interactions from symptom presentation to receipt of cancer care. Patients were largely unaware of breast cancer and did not immediately notice or interpret symptoms. As symptoms progressed, women inferred illness and sought help from social networks, traditional remedies, and medical care. Economic hardship, distance to the facility, provider knowledge, health system factors, and social norms often delayed reaching the facility, referrals, diagnosis, and receipt of care., Conclusions: Social-contextual factors at the individual, interpersonal, health system, and societal levels delay decisions, behaviors, and access to breast cancer detection and appropriate care., Practice Implications: A comprehensive approach to improving breast cancer early detection must address public awareness and misconceptions, provider knowledge and communication, and cancer care delivery., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

Objective: The aim of this study was to evaluate the relationship of satisfaction with the cancer care doctor and health-related quality of life (HRQOL) among Latina breast cancer survivors (BCS) by (1) assessing whether satisfaction would be positively correlated with HRQOL and (2) assessing whether satisfaction would significantly influence HRQOL while controlling for covariates., Methods: The cross-sectional study used self-report data from 117 Latina BCS. Satisfaction was measured with the Hall Satisfaction Index, and HRQOL was measured with the Functional Assessment of Cancer Therapy-General (FACT-G). Analyses included calculation of descriptive statistics, t tests, bivariate correlations, analyses of variance (ANOVAs), and multivariate analyses., Results: Latina BCS had high satisfaction and generally good HRQOL. The Hall Satisfaction Index total score was positively associated with FACT-G functional well-being (r=0.265, p=0.004). Multivariate analyses showed that the Hall Satisfaction Index total score was a significant predictor of FACT-G functional well-being (p=0.012). Employment status was also a significant predictor, where being employed or retired resulted in better functional well-being than being unemployed., Conclusions: Latina BCS were quite satisfied with their cancer care doctors, and high levels of satisfaction with the cancer care doctor influenced functional well-being when confounding variables were controlled. Despite reportedly high satisfaction, Latina BCS did report barriers to satisfaction that could be considered cultural. Implications are discussed.

Objective: The study evaluated the association of religiosity/spirituality (R/S) and health-related quality of life (HRQOL) among Latina breast cancer survivors (BCS) in order to determine whether R/S would be positively correlated with HRQOL and whether R/S would significantly influence HRQOL., Methods: The cross-sectional study utilized self-report data from 117 Latina BCS survivors. R/S was measured with the Systems of Belief Inventory-15 Revised (SBI-15R) and HRQOL was measured with the Functional Assessment of Cancer Therapy-General (FACT-G). Analyses included calculation of descriptive statistics, t-tests, bivariate correlations, and multivariate analyses., Results: Latina BCS had very high levels of R/S and generally good HRQOL. The SBI-15R total score was positively correlated with FACT-G social well-being (SWB) (r=0.266, p=0.005), relationship with doctor (RWD) (r=0.219, p=0.020), and functional well-being (FWB) (r=0.216, p=0.022). Multivariate analyses revealed that SBI-15R was a significant predictor of FACT-G FWB (p=0.041) and satisfaction with the relationship with the doctor (p=0.050), where higher levels of R/S predicted higher levels of well-being., Conclusions: Latina BCS had very high levels of R/S, which were significantly, positively correlated with dimensions of HRQOL (SWB, FWB, RWD). Furthermore, these high levels of R/S predicted better FWB and satisfaction with the patient-doctor relationship while controlling for potentially confounding variables. Implications are discussed.

Objective: To increase accrual among Hispanics to the Cancer Genetics Network national cancer genetics registry., Methods: Drawing from South Texas cancer registries, 444 Hispanic men and women were randomly assigned to one of three experimental conditions: standard direct-mailed procedures (X1), X1 plus culturally tailored materials (X2), and X2 plus interpersonal phone contact (X3). Participants were also surveyed about the effectiveness of the education materials and the phone contact. A refusal survey was provided for those who declined to join the study., Results: A total of 154 individuals joined the Cancer Genetics Network. The X3 condition yielded the greatest accrual (43.2%) compared to X1 (30.9%) and X2 (29.9%; p < 0.05). Tailored materials appeared to have no effect but were highly regarded. The main reasons for not participating were a lack of interest and time requirements., Conclusion: Interpersonal communication can have a powerful effect on recruitment. However, more research is needed to determine the cost-efficacy of more labor-intensive approaches to registry accrual., (Copyright 2008 S. Karger AG, Basel.)

Objective: To provide a preliminary description of the interest, awareness, and perceptions of genetic testing among Hispanics with a family history of breast cancer, Design: This cross-sectional pilot study used interpersonal structured interviews for data collection., Participants: We interviewed 48 Hispanics without breast cancer but who had a family member with breast cancer; participants lived in San Antonio and the surrounding area., Main Outcome: The outcomes were interest in breast cancer genetic testing, awareness about genetic testing, perceived risk of carrying a breast cancer susceptibility gene, and the perceived benefits and risks associated with a genetic test., Measures: Items previously used in research regarding interest and perceived genetic risk and a previously validated benefits and risks-limitations scale for genetic testing commonly used by other researchers were used to measure the outcomes., Results: Awareness of genetic testing for breast cancer susceptibility was very low, yet most (82%) participants were interested in a genetic test for breast cancer susceptibility. Participants were more likely to identify with the benefits than the potential risks of genetic testing. The most highly endorsed benefits were to know to take better care of one's self and to undergo more frequent screening., Conclusions: Hispanics seem to have positive perceptions about genetic testing for breast cancer susceptibility. However, the high level of interest in genetic testing may be driven by a lack of knowledge about genetic testing. Culturally sensitive and appropriate educational programs about breast cancer genetic testing and the surrounding issues are needed for the Hispanic population.

Purpose: Carrier prediction models estimate the probability that a person has a BRCA mutation. We evaluated the accuracy of the BOADICEA model and compared its performance with that of other models (BRCAPRO, Myriad I and II, Couch, and Manchester Scoring System). We also studied the effect of extended family information on risk estimation using BOADICEA., Methods: We compared the area under receiver operating characteristic curves generated from 472 families with one member tested for BRCA mutations. We calculated sensitivity, specificity, and predictive values at an estimated probability of 10% and explored the biases of carrier prediction., Results: BOADICEA performed better than the other models in Ashkenazi Jewish (AJ) families, BRCAPRO performed slightly better in non-AJ families, and Myriad II performed comparably well in both groups. Including extended family information in BOADICEA yielded slightly better performance than did limiting the information to second-degree relatives. Using a 10% cutoff point, BOADICEA and Myriad II were most sensitive in predicting BRCA1/2 mutations in AJ families, and Myriad II was most sensitive in non-AJ families. The Manchester Scoring System was the most sensitive and least specific in a subgroup of non-AJ families. BOADICEA and BRCAPRO tended to underestimate the observed risk at low estimated probabilities and overestimate it at higher probabilities., Conclusion: The BOADICEA, BRCAPRO, and Myriad II models performed similarly. Including second-degree relatives slightly improved carrier prediction by BOADICEA. The Myriad II model was the easiest to implement.

Background and Objectives: Histologic margin positivity represents a significant source of adverse clinical outcome affecting breast conservation therapy for in situ or invasive malignancy. Elucidation of factors associated with positive margin status might clarify and improve local therapy strategies. In order to define our experience with margin positivity and to identify relevant pathologic criteria, we retrospectively analyzed the cases of 143 patients who underwent resections for carcinoma with intent of breast conservation between 1995 and 1999., Methods: Histologic features and indices of biologic aggressiveness were compared among tumors resected with positive versus negative margins in order to determine whether such markers could be used to anticipate outcome., Results: Twenty-eight pathologic specimens were identified to possess histologically positive margins. Twenty-six patients underwent additional operative procedures. Of the 26 re-excision specimens, 17 (65%) contained residual malignancy. Statistical analysis demonstrated that margin positivity correlated with in situ histology and with Her 2/neu positivity., Conclusions: These data suggest certain pathologic factors that may portend difficulty in achieving negative resection margins in patients in whom breast conservation therapy is considered., (Copyright 2004 Wiley-Liss, Inc.)

Background: Sentinel lymph node mapping (SLNM) and neoadjuvant chemotherapy are becoming established components of therapy for selected patients with breast carcinoma. However, neoadjuvant therapy has been considered a relative contraindication to SLNM. In an effort to learn whether patients who have received preoperative chemotherapy can undergo accurate SLNM, we evaluated our experience with this technique., Methods: From January 1997 to June 2000, SLNM and axillary lymph node dissection were concurrently performed in 35 patients who received preoperative chemotherapy. Mapping was performed with (99m)Tc sulfur colloid only in one patient and Lymphazurin dye only in 15 patients, and the two methods were combined in the remainder., Results: SLNM successfully identified a sentinel lymph node in 30 (86%) patients. Metastatic disease was identified in the sentinel lymph nodes of four patients during surgery. The intraoperative pathologic diagnosis proved to be correct in 19 (79%) of 24 patients. The final pathologic diagnosis of the sentinel lymph node reflected the status of the axillary contents in all patients in whom it was identified., Conclusions: These results demonstrate that SLNM can be consistently performed in patients receiving preoperative chemotherapy for breast cancer, suggesting the utility of this technique in this patient population.