Chemotherapy is associated with longer periods of sick leave. Cognitive functions do not predict RTW. Independently of any adjuvant therapy, most women eventually RTW in a few months. The ability to predict RTW after BC treatment should help prepare higher-risk patients for delayed RTW and allow earlier interventions to restore their social relations and quality of life.

The practice of fertility preservation (FP) in women with breast cancer (BC) is spreading, but long-term reproductive outcomes after FP are largely unknown. OBJECTIVE To investigate the long-term reproductive outcomes in women who did or did not undergo FP at the time of BC diagnosis. DESIGN, SETTING, AND PARTICIPANTS A Swedish nationwide cohort study was conducted to investigate the long-term reproductive outcomes of women with BC receiving FP at 1 of the regional FP programs from 1994 to 2017 (n = 425). Population comparators with BC but without history of FP (n = 850) were sampled from regional BC registers, matched on age, calendar period of diagnosis, and county. Data on live births, assisted reproductive technology (ART) use, and mortality were retrieved from population-based registers. Data analysis was performed from January to September 2020. EXPOSURES History of having received FP compared with no history of FP (unexposed). MAIN OUTCOMES AND MEASURES The primary outcome was hazard ratios (HRs) of live births and ART treatments following BC in women with vs without FP and the cumulative incidence of these events in the presence of the competing risk of death. RESULTS Women who had undergone FP (n = 425) had lower parity (302 [71.1%] were nulliparous compared with 171 [20.1%] in the unexposed group), were younger (mean [SD] age, 32.1 [4.0] vs 33.3 [3.6] years), more often had estrogen receptor-positive tumors (289 [68.0%] vs 515 [60.6%]), and were more often scheduled for chemotherapy (399 [93.9%] vs 745 [87.7%]). Of 425 women exposed to FP, 97 (22.8%) had at least 1 post-BC live birth (mean follow-up, 4.6 years), compared with 74 of 850 women (8.7%) unexposed to FP (mean follow-up, 4.8 years). Overall, live birth rates after BC were significantly higher among women with FP (adjusted hazard ratio [aHR], 2.3; 95% CI, 1.6-3.3). The 5-year and 10-year cumulative incidence of post-BC live births was 19.4% and 40.7% among FP-exposed women vs 8.6% and 15.8% among comparators, respectively. Rates of ART use were also higher in the FP group (aHR, 4.8; 95% CI, 2.2-10.7). The all-cause mortality rate was lower in women exposed to FP (aHR, 0.4; 95% CI, 0.3-0.7), with 5-year cumulative incidence of death of 5.3% (95% CI, 3.1%-9.0%) vs 11.1% (95% CI, 8.7%-14.1%) for women with vs without FP. CONCLUSIONS AND RELEVANCE In this cohort study of Swedish women after a BC diagnosis, successful pregnancy after BC was possible both in women with and without FP at the time of diagnosis, but a significantly higher likelihood of post-BC live births and ART treatments was observed in women who underwent FP, without any negative association with all-cause survival. This information is valuable for health care clinicians responsible for oncologic treatment and reproductive counseling of women diagnosed with breast cancer at reproductive age.

Anxiety and spiritual distress are the most common problems among the patients admitted in intensive care units. The elderly are more vulnerable to this problem due to impairment of their adaptation mechanisms. Hence, helping to reduce anxiety is one of the most effective nursing interventions. Therefore, this study aimed at investigating the effect of need-based spiritual/religious interventions on spiritual well-being (SWB) and anxiety of the elderly admitted to coronary care unit (CCU). This quasi-experimental study with pre- and posttest control group design was conducted on 66 patients admitted to CCU of Imam Reza hospital in Lar, southern Iran, in 2014. After obtaining informed consents, the data were collected using the Spielberger State-Trait Anxiety Inventory, the SWB Scale, and a demographic questionnaire. The questionnaires were completed through interviewing the patients before and after the intervention. The participants of the intervention group underwent 60- to 90-minute sessions of spiritual and religious need-based interventions for 3 consecutive days. The results showed a significant increase in the mean scores of SWB in the intervention group after the intervention (P = .001). Also, a significant decrease was found in mean scores of trait and state anxiety in the intervention group in comparing to control group (P < .001). Moreover, a significant correlation was observed between the mean scores of SWB and state and trait anxiety. Spiritual/religious interventions could enhance SWB and reduce anxiety in the elderly admitted to CCU.

This study confirms the long-term risk of VTE in breast cancer patients and identifies a comprehensive set of clinical risk predictors. Temporal associations with patient, tumor, and treatment characteristics provide insight into the time-dependent etiology of VTE. Cancer 2017;123:468-475. © 2016 American Cancer Society.