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7. Restoring Well-Being for Physicians Through Lifestyle Medicine.

Author

Lee, Hannah, Going, Michelle, Tivnan, Valeria, Tollefson, Michelle, Comander, Amy, and Frates, Elizabeth

Subjects
WELL-being, LIFESTYLES, PSYCHOLOGICAL burnout, PERFECTIONISM (Personality trait), PHYSICIANS' attitudes, WORK-life balance, UNCERTAINTY, COMMUNITIES, CREATIVE ability, CONCEPTUAL structures, ORGANIZATIONAL change, HEALTH behavior, PSYCHOLOGY of physicians, COVID-19 pandemic, PSYCHOLOGICAL stress, MENTAL health services, CORPORATE culture, BEHAVIOR modification
Abstract

In the wake of the COVID-19 pandemic, physician burnout is a more relevant concern than ever. Pre-existing stressors in health care, such as poor work-life balance, perfectionism, and inadequate social support, have been exacerbated by uncertainty, increased risk exposure, and general anxiety. Burnout places not only physicians, but also patients, systems, and communities at risk. The promotion of physician well-being is critical to sustaining the health care system. Actions to reduce burnout and increase well-being can and should occur on multiple levels. Organizations and leaders must take steps to create a culture of support and respect for health care providers. Such steps may include improved time-off policies, destigmatizing the use of mental health services, and reducing administrative burden. Physician well-being may benefit from action on an individual level as well. The pillars of Lifestyle Medicine provide a framework for engaging in behaviors compatible with overall well-being, such as physical activity, social connection, and sleep. Lifestyle Medicine plays a key role in mitigating the impact of physician burnout, and will be essential to the success of the health care system moving forward. [ABSTRACT FROM AUTHOR]

Published
2024
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10. Ask a Doctor: Which cancers can be detected through genetic testing?

Author

Comander, Amy and Md

Subjects
Cancer -- Diagnosis, Genetic screening -- Usage, General interest, News, opinion and commentary
Abstract

Byline: Amy Comander and MD Q: Which cancers can be detected through genetic testing? A: Genetic testing is a powerful tool to detect changes in our genes that are associated [...]

Published
2023

13. Abstract PD17-03: Cell-free DNA monitoring in a phase II study of adjuvant endocrine therapy with CDK 4/6 inhibitor ribociclib for localized HR+/HER2- breast cancer (LEADER)

Author

Medford, Arielle J., primary, Scarpetti, Lauren, additional, Niemierko, Andrzej, additional, Isakoff, Steven J., additional, Moy, Beverly, additional, Wander, Seth A., additional, Deluca, Elizabeth, additional, Abraham, Elizabeth, additional, Shin, Jennifer, additional, Schnipper, Lowell, additional, Comander, Amy E., additional, Mulvey, Therese, additional, Spickard, Erik, additional, Kalashnikova, Ekaterina, additional, Rodriguez, Angel, additional, Ellisen, Leif, additional, Bardia, Aditya, additional, and Spring, Laura M., additional

Published
2023
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14. Treatment-related changes in insomnia, anticipatory pleasure, and depression symptoms: A proof-of-concept study with cancer survivors

Author

Wieman, Sarah T., primary, Arditte Hall, Kimberly A., additional, Park, Elyse R., additional, Gorman, Mark J., additional, Comander, Amy, additional, Goldstein, Michael R., additional, Cunningham, Tony J., additional, Mizrach, Helen R., additional, Juhel, Brooke, additional, Li, Raissa, additional, Markowitz, Alexandros, additional, Grandner, Michael, additional, Liverant, Gabrielle I., additional, and Hall, Daniel L., additional

Published
2023
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15. Phase 2 study of response-guided neoadjuvant sacituzumab govitecan (IMMU-132) in patients with localized triple-negative breast cancer: Results from the NeoSTAR trial.

Author

Spring, Laura, primary, Tolaney, Sara M., additional, Desai, Neelam Vijay, additional, Fell, Geoffrey, additional, Trippa, Lorenzo, additional, Comander, Amy H., additional, Mulvey, Therese Marie, additional, McLaughlin, Shannon, additional, Ryan, Phoebe, additional, Rosenstock, Aron S., additional, Garrido-Castro, Ana Christina, additional, Lynce, Filipa, additional, Moy, Beverly, additional, Isakoff, Steven J., additional, Tung, Nadine M., additional, Mittendorf, Elizabeth A., additional, Ellisen, Leif W., additional, and Bardia, Aditya, additional

Published
2022
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17. Abstract PD5-11: Pilot study to assess prolonged nightly fasting in breast cancer survivors (LONGFAST)

Author

O'Donnell, Elizabeth K., primary, Shapiro, Yael N., additional, Comander, Amy, additional, Isakoff, Steven J., additional, Moy, Beverly, additional, Spring, Laura, additional, Wander, Seth, additional, Kuter, Irene, additional, Shin, Jennifer, additional, Younger, Jerry, additional, Specht, Michelle, additional, Kourniotis, Chryssanthi, additional, Sullivan, Carol, additional, Winters, Loren, additional, Horick, Nora, additional, and Peppercorn, Jeffrey, additional

Published
2022
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18. Abstract P1-14-02: Phase II study of adjuvant endocrine therapy with CDK 4/6 inhibitor, ribociclib, for localized ER+/HER2- breast cancer (LEADER, part 1)

Author

Spring, Laura M, primary, Scarpetti, Lauren, additional, Niemierko, Andrzej, additional, Isakoff, Steven J, additional, Moy, Beverly, additional, Wander, Seth A, additional, Smith, Elisabeth, additional, Abraham, Elizabeth, additional, Shin, Jennifer, additional, Patel, Jaymin M, additional, Comander, Amy, additional, Mulvey, Therese, additional, and Bardia, Aditya, additional

Published
2022
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19. sj-docx-1-tam-10.1177_17588359221119370 – Supplemental material for Immunogenicity of SARS-CoV-2 vaccines in patients with breast cancer

Author

Denault, Elyssa, Nakajima, Erika, Naranbhai, Vivek, Hutchinson, Jennifer A., Mortensen, Lindsey, Neihoff, Elizabeth, Barabell, Caroline, Comander, Amy, Juric, Dejan, Kuter, Irene, Mulvey, Theresa, Peppercorn, Jeffrey, Rosenstock, Aron S., Shin, Jennifer, Vidula, Neelima, Wander, Seth A., Moy, Beverly, Ellisen, Leif W., Isakoff, Steven J., Iafrate, A. John, Gainor, Justin F., Bardia, Aditya, and Spring, Laura M.

Subjects
110203 Respiratory Diseases, FOS: Clinical medicine, 111702 Aged Health Care, FOS: Health sciences, 111599 Pharmacology and Pharmaceutical Sciences not elsewhere classified, 111299 Oncology and Carcinogenesis not elsewhere classified
Abstract

Supplemental material, sj-docx-1-tam-10.1177_17588359221119370 for Immunogenicity of SARS-CoV-2 vaccines in patients with breast cancer by Elyssa Denault, Erika Nakajima, Vivek Naranbhai, Jennifer A. Hutchinson, Lindsey Mortensen, Elizabeth Neihoff, Caroline Barabell, Amy Comander, Dejan Juric, Irene Kuter, Theresa Mulvey, Jeffrey Peppercorn, Aron S. Rosenstock, Jennifer Shin, Neelima Vidula, Seth A. Wander, Beverly Moy, Leif W. Ellisen, Steven J. Isakoff, A. John Iafrate, Justin F. Gainor, Aditya Bardia and Laura M. Spring in Therapeutic Advances in Medical Oncology

Published
2022
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20. Immunogenicity of SARS-CoV-2 vaccines in patients with breast cancer

Author

Denault, Elyssa, primary, Nakajima, Erika, additional, Naranbhai, Vivek, additional, Hutchinson, Jennifer A., additional, Mortensen, Lindsey, additional, Neihoff, Elizabeth, additional, Barabell, Caroline, additional, Comander, Amy, additional, Juric, Dejan, additional, Kuter, Irene, additional, Mulvey, Theresa, additional, Peppercorn, Jeffrey, additional, Rosenstock, Aron S., additional, Shin, Jennifer, additional, Vidula, Neelima, additional, Wander, Seth A., additional, Moy, Beverly, additional, Ellisen, Leif W., additional, Isakoff, Steven J., additional, Iafrate, A. John, additional, Gainor, Justin F., additional, Bardia, Aditya, additional, and Spring, Laura M., additional

Published
2022
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21. The Survivorship Sleep Program (SSP): A synchronous, virtual cognitive behavioral therapy for insomnia pilot program among cancer survivors

Author

Hall, Daniel L., primary, Arditte Hall, Kimberly A., additional, Gorman, Mark J., additional, Comander, Amy, additional, Goldstein, Michael R., additional, Cunningham, Tony J., additional, Wieman, Sarah, additional, Mizrach, Helen R., additional, Juhel, Brooke C., additional, Li, Raissa, additional, Markowitz, Alexandros, additional, Grandner, Michael, additional, and Park, Elyse R., additional

Published
2021
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23. Pilot study to assess prolonged overnight fasting in breast cancer survivors (longfast).

Author

O'Donnell, Elizabeth, Shapiro, Yael, Comander, Amy, Isakoff, Steven, Moy, Beverly, Spring, Laura, Wander, Seth, Kuter, Irene, Shin, Jennifer, Specht, Michelle, Kournioti, Chryssanthi, Hu, Bonnie, Sullivan, Carol, Winters, Loren, Horick, Nora, and Peppercorn, Jeffrey

Abstract

Purpose: Retrospective analysis of nightly fasting among women with breast cancer suggests that fasting < 13 h may be associated with a higher risk of breast cancer recurrence. We sought to evaluate prolonged overnight fasting (POF), an accessible nonpharmacological intervention, in a prospective feasibility study. Methods: We designed a single-arm, pilot study to evaluate the feasibility of fasting for 13 h overnight for 12 weeks among women with a history of early-stage breast cancer survivors. Baseline and end of study assessments included measurements of body mass index (BMI), blood biomarkers, quality of life (QOL), mood, fatigue, and physical activity. Patient-reported outcome questionnaires were also administered at 6 weeks. Feasibility was defined as ≥ 60% of participants documenting fasting for 13 h on at least 70% of nights during the study period. Results: Forty women with a history of breast cancer were enrolled with a median age of 60 (range 35–76) and median time since diagnosis of 4.5 years (range 0.8–20.7). At baseline, BMI was ≥ 25 in 37.5%. Ninety-five percent of participants fasted ≥ 13 h for at least 70% of study days (95% CI 83–99%). There was a statistically significant improvement in anxiety (p = 0.0007) at 6 weeks and BMI (p = 0.0072), anxiety (p = 0.0141), depression (p = 0.0048), and fatigue (p = 0.0105) at 12 weeks. There was no significant change in overall QOL, physical activity levels, or blood biomarkers at 12 weeks. Conclusions: POF is feasible among patients with a history of breast cancer and may potentially improve BMI, mood, and fatigue without detrimental effects on overall QOL. [ABSTRACT FROM AUTHOR]

Published
2022
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24. Selection of Optimal Adjuvant Chemotherapy and Targeted Therapy for Early Breast Cancer: ASCO Guideline Update

Author

Denduluri, Neelima, primary, Somerfield, Mark R., additional, Chavez-MacGregor, Mariana, additional, Comander, Amy H., additional, Dayao, Zoneddy, additional, Eisen, Andrea, additional, Freedman, Rachel A., additional, Gopalakrishnan, Ragisha, additional, Graff, Stephanie L., additional, Hassett, Michael J., additional, King, Tari A., additional, Lyman, Gary H., additional, Maupin, Gillian Rice, additional, Nunes, Raquel, additional, Perkins, Cheryl L., additional, Telli, Melinda L., additional, Trudeau, Maureen E., additional, Wolff, Antonio C., additional, and Giordano, Sharon H., additional

Published
2021
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25. Abstract OT-03-06: Phase 2 study of response-guided neoadjuvant sacituzumab govitecan (IMMU-132) in patients with localized triple-negative breast cancer (NeoSTAR)

Author

Spring, Laura M., primary, Tolaney, Sara M., additional, Desai, Neelam, additional, Comander, Amy, additional, Mulvey, Therese, additional, Krop, Ian E., additional, Winer, Eric P., additional, Mittendorf, Elizabeth A., additional, Ellisen, Leif W., additional, and Bardia, Aditya, additional

Published
2021
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28. Development and Refinement of a Telehealth Intervention for Symptom Management, Distress, and Adherence to Adjuvant Endocrine Therapy after Breast Cancer

Author

Jacobs, Jamie M., primary, Walsh, Emily A., additional, Rapoport, Chelsea S., additional, Antoni, Michael H., additional, Park, Elyse R., additional, Post, Kathryn, additional, Comander, Amy, additional, Peppercorn, Jeffrey, additional, Safren, Steven A., additional, Temel, Jennifer S., additional, and Greer, Joseph A., additional

Published
2020
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29. The Survivorship Sleep Program (SSP): A synchronous, virtual cognitive behavioral therapy for insomnia pilot program among cancer survivors.

Author

Hall, Daniel L., Arditte Hall, Kimberly A., Gorman, Mark J., Comander, Amy, Goldstein, Michael R., Cunningham, Tony J., Wieman, Sarah, Mizrach, Helen R., Juhel, Brooke C., Li, Raissa, Markowitz, Alexandros, Grandner, Michael, and Park, Elyse R.

Subjects
COGNITIVE therapy, CANCER survivors, SLEEP hygiene, INSOMNIA, SLEEP quality, PILOT projects
Abstract

Background: For cancer survivors, insomnia is prevalent, distressing, and persists for years if unmanaged. Cognitive behavioral therapy for insomnia (CBT‐I) is an effective treatment yet can be difficult to access and may require modification to address survivorship‐specific barriers to sleep. In this 2‐phase study, the authors adapted and assessed the feasibility, acceptability, and preliminary effects of synchronous, virtual CBT‐I adapted for cancer survivors (the Survivorship Sleep Program [SSP]). Methods: From April to August 2020, cancer survivors with insomnia (N = 10) were interviewed to refine SSP content and delivery. From October 2020 to March 2021, 40 survivors were recruited for a randomized controlled trial comparing 4 weekly SSP sessions with enhanced usual care (EUC) (CBT‐I referral plus a sleep hygiene handout). Feasibility and acceptability were assessed by enrollment, retention, attendance, fidelity, survey ratings, and exit interviews. Insomnia severity (secondary outcome), sleep quality, sleep diaries, and fatigue were assessed at baseline, postintervention, and at 1‐month follow‐up using linear mixed models. Results: The SSP included targeted content and clinician‐led, virtual delivery to enhance patient centeredness and access. Benchmarks were met for enrollment (56% enrolled/eligible), retention (SSP, 90%; EUC, 95%), attendance (100%), and fidelity (95%). Compared with EUC, the SSP resulted in large, clinically significant improvements in insomnia severity (Cohen d = 1.19) that were sustained at 1‐month follow‐up (Cohen d = 1.27). Improvements were observed for all other sleep metrics except sleep diary total sleep time and fatigue. Conclusions: Synchronous, virtually delivered CBT‐I targeted to cancer survivors is feasible, acceptable, and seems to be efficacious for reducing insomnia severity. Further testing in larger and more diverse samples is warranted. In this 2‐phase study, the authors adapt and assess the feasibility, acceptability, and preliminary effects of synchronous, virtual cognitive behavioral therapy for insomnia in cancer survivors compared with an enhanced usual care control. The adapted intervention is feasible, acceptable, and associated with large, clinically meaningful reductions in insomnia severity that are sustained at 1‐month follow‐up. [ABSTRACT FROM AUTHOR]

Published
2022
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31. Phase II study of adjuvant endocrine therapy with CDK 4/6 inhibitor, ribociclib, for localized ER+/HER2- breast cancer (LEADER).

Author

Spring, Laura, primary, Griffin, Colleen, additional, Isakoff, Steven J., additional, Moy, Beverly, additional, Wander, Seth Andrew, additional, Shin, Jennifer, additional, Abraham, Elizabeth, additional, Habin, Karleen, additional, Patel, Jaymin M., additional, Comander, Amy H., additional, Mulvey, Therese Marie, additional, and Bardia, Aditya, additional

Published
2020
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34. Tolerability and effectiveness of pertuzumab-containing neoadjuvant (NA) regimens vs. AC-TH for HER2-positive (+) localized breast cancer (BC).

Author

Spring, Laura, primary, Niemierko, Andrzej, additional, Comander, Amy H., additional, Reynolds, Kerry Lynn, additional, Sajer, Susan A., additional, Shin, Jennifer, additional, Brachtel, Elena F, additional, Specht, Michelle Connolly, additional, Smith, Barbara L., additional, Taghian, Alphonse G., additional, Peppercorn, Jeffrey M., additional, Isakoff, Steven J., additional, Moy, Beverly, additional, and Bardia, Aditya, additional

Published
2016
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36. Isocitrate Dehydrogenase 1 (IDH1) Mutation in Breast Adenocarcinoma Is Associated With Elevated Levels of Serum and Urine 2-Hydroxyglutarate

Author

Fathi, Amir T., primary, Sadrzadeh, Hossein, additional, Comander, Amy H., additional, Higgins, Michaela J., additional, Bardia, Aditya, additional, Perry, Ashley, additional, Burke, Meghan, additional, Silver, Regina, additional, Matulis, Christina R., additional, Straley, Kimberly S., additional, Yen, Katharine E., additional, Agresta, Sam, additional, Kim, Hyeryun, additional, Schenkein, David P., additional, and Borger, Darrell R., additional

Published
2014
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37. Estrogen receptor positive breast cancers in BRCA1 mutation carriers: clinical risk factors and pathologic features

Author

Tung, Nadine, primary, Wang, Yihong, additional, Collins, Laura C, additional, Kaplan, Jennifer, additional, Li, Hailun, additional, Gelman, Rebecca, additional, Comander, Amy H, additional, Gallagher, Bridget, additional, Fetten, Katharina, additional, Krag, Karen, additional, Stoeckert, Kathryn A, additional, Legare, Robert D, additional, Sgroi, Dennis, additional, Ryan, Paula D, additional, Garber, Judy E, additional, and Schnitt, Stuart J, additional

Published
2010
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38. Estrogen receptor positive breast cancers in BRCA1mutation carriers: clinical risk factors and pathologic features

Author

Tung, Nadine, Wang, Yihong, Collins, Laura, Kaplan, Jennifer, Li, Hailun, Gelman, Rebecca, Comander, Amy, Gallagher, Bridget, Fetten, Katharina, Krag, Karen, Stoeckert, Kathryn, Legare, Robert, Sgroi, Dennis, Ryan, Paula, Garber, Judy, and Schnitt, Stuart

Abstract

Most breast cancers that occur in women with germline BRCA1mutations are estrogen receptor-negative (ER-) and also typically lack expression of progesterone receptor (PR) and HER2 overexpression. We undertook a study to assess the clinical factors that predict for an estrogen receptor positive (ER+) breast cancer in BRCA1mutation carriers and to characterize the pathologic features of these tumors. Clinical characteristics of BRCA1carriers with 58 ER+ and 114 ER- first invasive breast cancers were compared. Pathologic features of BRCA1ER+ cancers were compared to those of BRCA1ER- cancers and to age-matched ER+ sporadic cancers. BRCA1carriers aged ≥ 50 at diagnosis of first invasive breast cancer were more likely to have an ER+ cancer compared to those aged < 50 (57% vs 29%, P= 0.005). ER+ BRCA1cancers were less likely than ER- BRCA1cancers to have "BRCA-associated" features such as high mitotic activity, geographic necrosis/fibrotic focus, and pushing margins (RR 0.06, 0.22, 0.24; P< 0.001, 0.02, 0.03 respectively). When compared to sporadic ER+ cancers, ER+ BRCA1cancers were more often of invasive ductal type (RR 2.4, P= 0.03), with a high mitotic rate (RR 5.0, P= 0.006) and absent or mild lymphocytic infiltrate (RR 10.2, P= 0.04). BRCA1carriers who are older at first breast cancer diagnosis are more likely to have ER+ tumors than younger BRCA1carriers. These ER+ cancers appear pathologically "intermediate" between ER- BRCA1cancers and ER+ sporadic breast cancers raising the possibility that either some ER+ BRCA1cancers are incidental or that there is a unique mechanism by which these cancers develop.

Published
2010
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39. Selection of Optimal Adjuvant Chemotherapy and Targeted Therapy for Early Breast Cancer: ASCO Guideline Update.

Author

Denduluri, Neelima, Somerfield, Mark R, Chavez-MacGregor, Mariana, Comander, Amy H, Dayao, Zoneddy, Eisen, Andrea, Freedman, Rachel A, Gopalakrishnan, Ragisha, Graff, Stephanie L, Hassett, Michael J, King, Tari A, Lyman, Gary H, Maupin, Gillian Rice, Nunes, Raquel, Perkins, Cheryl L, Telli, Melinda L, Trudeau, Maureen E, Wolff, Antonio C, and Giordano, Sharon H

Published
2020
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40. Virtual Molecular and Precision Medicine Clinic to Improve Access to Clinical Trials for Patients With Metastatic Breast Cancer: An Academic/Community Collaboration.

Author

Spring LM, Mortensen L, Abraham E, Keenan J, Medford A, Ma A, Padden S, Denault E, Ryan L, Iafrate AJ, Lennerz J, Hochberg E, Wander SA, Moy B, Isakoff SJ, Juric D, Brennan KA, Smith DE, Civiello B, Mulvey T, Comander A, Ellisen LW, Schwartz JH, and Bardia A

Subjects
Humans, Female, Precision Medicine, Delivery of Health Care, Referral and Consultation, Breast Neoplasms genetics, Breast Neoplasms therapy, Telemedicine
Abstract

Purpose: There is a demand for improved care delivery surrounding genomic testing and clinical trial enrollment among patients with metastatic breast cancer (MBC). We sought to improve the current process via real-time informal consultation and prescreening assessment for patients with MBC treated by community and academic medical oncologists by implementing a virtual molecular and precision medicine (vMAP) clinic., Methods: The vMAP program used a virtual referral system directed to a multidisciplinary team with precision medicine expertise. Providers contacted vMAP regarding patients with MBC, and on receipt of referral, the vMAP team engaged in discussion to identify if further diagnostics were needed (including genomic testing) and to identify potential clinical trials or standard treatment options. Recommendations were then sent to the referring provider within 72 hours. Pre-/postsurveys were issued to network physicians to assess for barriers, clinical trial access, and vMAP referral experience. Program implementation was evaluated with the Squire 2.0 reporting guidelines for quality improvement in health care as a framework., Results: Eighty-one cases from 22 providers were referred to vMAP over a 26-month period. The average response time to the referring provider with a finalized recommendation was 1.90 ± 1.82 days. A total of 86.4% of cases had clinical trial options on vMAP prescreen, with 40.7% initiating formal screening assessments and 27 patients (33.3%) ultimately enrolling on trials. On resurvey, 92% of survey responses across community oncology referring providers said that they were very likely to use vMAP again., Conclusion: In the initial 2-year period, vMAP demonstrated an efficient means to offer real-time interpretation of genomic testing and identification of clinical trials for patients with MBC, with effective clinical trial enrollment and high rates of referring provider satisfaction.

Published
2024
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