Novel evaluation scale for QOL (QOL-ACD-BP) in preoperative chemotherapy for breast cancer

Takada, Koji; Kashiwagi, Shinichiro; Goto, Wataru; Asano, Yuka; Takahashi, Katsuyuki; Morisaki, Tamami; Takashima, Tsutomu; Tomita, Shuhei; Hirakawa, Kosei; Ohira, Masaichi

doi:10.1007/s00432-018-2670-0

Cited by 6 publications

(7 citation statements)

References 37 publications

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“…We believe that complications did not affect prognosis in our study because our study was retrospective and all treatments were the same. The group with low QOL in the present study, as well as our previous study (21), had advanced local progression before treatment. Breast cancer occurs in a location that allows its presence to be felt from the outside; hence, patients are more often aware of breast cancer than of other types of cancer.…”

Section: Discussionsupporting

confidence: 64%

Prognostic Value of Quality of Life in Endocrine Therapy for Elderly Patients With Breast Cancer: A Retrospective Study

Takada¹,

Kashiwagi²,

Asano³

et al. 2019

Anticancer Res

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Background: Several studies have established a positive relationship between quality of life (QOL) and prognosis in patients with various cancer types. This study investigated QOL of elderly patients with primary hormone receptor-positive breast cancer who chose endocrine therapy as their first-line treatment. Patients and Methods: QOL-ACD-B scores were evaluated before and after endocrine therapy for 75 patients. The results of the interviews were used to determine the Charlson Comorbidity Index. Results: In a univariate analysis, baseline objective response rate (p=0.009), and increase in QOL (p=0.037) significantly correlated with longer progression-free survival time. There was a correlation between 3-month QOL score and longer overall survival in the multivariate analysis (p=0.035). Conclusion: In elderly patients with breast cancer who underwent first-line endocrine therapy, improved QOL at 3 months after treatment initiation correlated with prolonged progression-free survival. High QOL scores were associated with prolonged overall survival.Breast cancer incidence in the elderly has been increasing yearly. Owing to morbidities or poor performance status (PS), elderly patients are often ineligible for standard treatments. Moreover, patients or their families sometimes refuse guideline-recommended treatments. Surgery for breast cancer often requires general anesthesia, which may be contraindicated in patients in poor general condition. Chemotherapy can cause severe side-effects and exacerbate the patient's quality of life (QOL). According to previous reports, side-effects are more frequent in elderly patients than young patients, as are deaths due to treatment-related complications (1-3).Once breast cancer has spread beyond the regional lymph nodes, complete recovery is difficult. The treatment objective then shifts from recovery to palliative care, with the goals of controlling symptoms, improving QOL, and prolonging overall survival (OS). In particular, when treating conditions that are non-life-threatening, it is important to select therapies that maintain QOL. Endocrine therapy (ET) causes milder adverse events than does chemotherapy, and is therefore often chosen in cases of hormone receptor-positive breast cancer (HRBC) (Hortobagyi's algorithm) (4).Several studies have established a positive relationship between QOL and prognosis in patients with various cancer types (5-8). Other studies showed that early introduction of psychological care and palliative treatment improved both QOL and prognosis (9, 10). Hence, we hypothesized that even therapies that prioritize QOL rather than therapeutic responses will affect the prognosis of elderly patients with breast cancer. This study tested this hypothesis in elderly patients with primary HRBC who chose ET as their first-line treatment. Materials and MethodsPatient background. Our study targeted patients with primary HRBC who were aged ≥65 years at diagnosis and who underwent first-line ET. There were 75 eligible patients from November 2007 to December 2017 at t...

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Section: Discussionsupporting

confidence: 64%

Prognostic Value of Quality of Life in Endocrine Therapy for Elderly Patients With Breast Cancer: A Retrospective Study

Takada¹,

Kashiwagi²,

Asano³

et al. 2019

Anticancer Res

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“…During ongoing chemotherapy, HQol and functional scales usually decrease and symptoms like fatigue, insomnia, dyspnea, sleep problems, and nausea increase [47][48][49][50][51][52]. The overall worsening of physical symptoms correlates with the decrease of the overall HQoL [53,54]. These preliminary findings suggest that participation in the program might improve HQoL, stress, anxiety and depression during ongoing chemotherapy.…”

Section: Discussionmentioning

confidence: 98%

“…These preliminary findings suggest that participation in the program might improve HQoL, stress, anxiety and depression during ongoing chemotherapy. The HQoL after neoadjuvant chemotherapy might affect prognosis, so that it seems to be highly important to enhance it [53]. Perceived stress shortly after diagnosis probably influences the prospective HQoL (especially pain and fatigue) one to two years after diagnosis [55,56].…”

Section: Discussionmentioning

confidence: 99%

Effects of an Integrative Mind-Body-Medicine Group Program on Breast Cancer Patients During Chemotherapy: An Observational Study

Haller

Choi

Lange

et al. 2021

CPD

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Background: Breast cancer is one of the leading cancers in women in the Western world. Cancer treatment, especially chemotherapy, is often associated with physical and psychosocial side effects. Objective: To improve the quality of life and manage side effects, a new integrative mind-body-medicine group concept for breast cancer patients receiving chemotherapy was developed and pilot tested. Methods: Breast cancer patients participated in a 66 hours mind-body-medicine group program tailored to the needs of cancer patients during chemotherapy. The program was integrated into standard care encompassing mindfulness training, yoga, moderate exercise, nutrition, complementary self-help strategies, cognitive restructuring, and acupuncture. Quality of life (EORTC QLQ-C30), depression and anxiety (HADS), stress (PSS-10), and fatigue (BFI) were assessed before and after the program as well as satisfaction and safety. Analyses were carried out exploratory with paired samples t-tests. Results: Fifty-seven female patients, 51.3±10.5 years, with breast cancer diagnoses were enrolled. After completing the program, global EORTC quality of life was improved (Δ=9.5; 95%-CI=[2.9|16.1]; p=.005), although the EORTC-symptom scales fatigue (Δ=9.9; 95%-CI=[1|18.8]; p=.030), nausea (Δ=7.1; 95%-CI=[0.6|13.6]; p=.031), and dyspnea (Δ=12.5; 95%- CI=[2.9|22.1]; p=.011) increased. Stress (Δ=-3.5; 95%-CI=[-5|-2.1]; p=.000), anxiety (Δ=-3.8; 95%-CI=[-4.9|-2.7]; p=.000), and depression (Δ=-3.9; 95%-CI=[-4.9|-2.8]; p=.000) were also significantly reduced. Regarding intensity of (Δ=0.2; 95%- CI=[-0.8|0.5]; p=.644) and the impairment through fatigue (Δ=0.1; 95%-CI=[-0.8|0.6]; p=.696), no significant worsening was observed. Patients were satisfied with the program. No serious adverse events were reported. Conclusion: Breast cancer patients benefit from an integrative mind-body-medicine group program during chemotherapy regarding the quality of life and psychological symptoms. Randomized controlled trials are warranted.

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“…Each breast cancer received a definitive pathological diagnosis and was subjected to immunohistochemistry to determine the expression of ER, PgR, HER2, and Ki-67 (proliferation index). Based on the results, we classified the tumors in accordance with our previous work as hormone receptor-positive breast cancer (HRBC; ER-and/or PgR-positive), HER2-enriched breast cancer (HER2BC; ER−, PgR−, and HER2+), or triple-negative breast cancer (TNBC; ER−, PgR−, and HER2−) [9,10]. We also applied a Ki-67 cutoff of 14% with reference to a previous report [11].…”

Section: Patient Backgroundmentioning

confidence: 99%

The effect of smoking on biological change of recurrent breast cancer

et al. 2020

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Background: The selection of treatment for a patient with breast cancer largely relies on the cancer subtype. However, this process is complicated by changes in tumor biology at relapse. Smoking has been identified as a risk factor for breast cancer. The direct effect of a tobacco component delivered via blood circulation on the mammary gland tissue and subsequent DNA damage have been proposed to explain the association between cigarette smoking and breast cancer carcinogenesis. This postulation is supported by both tissue culture and animal studies demonstrating that the associated DNA damage further alters breast cancer cells, as indicated by an increased proliferative capacity and malignant transformation. In this study, we aimed to explore the relationship between changes in Estrogen receptor (ER), progesterone receptor (PgR), and human epidermal growth factor receptor 2 (HER2) each receptor at recurrence, and smoking and the prognosis after recurrence. Methods: This retrospective study included 989 patients with primary breast cancer who developed relapse after surgery and 50 patients who underwent regenerative biopsy or surgery from December 2007 to March 2018. ER, PgR, and HER2 expression in the primary and recurrent lesions was evaluated using immunohistochemistry, and the correlations of these expression patterns with smoking history (pack-years) were examined. Results: When ER was evaluated in recurrent tumors, negative and positive conversions were recognized in 3 (6.0%) and 1 patient (2.0%), respectively. When PgR was evaluated, negative conversion was recognized in 15 patients (30.0%). When HER2 was evaluated, positive conversion was recognized in 6 patients (12.0%). Consequently, we observed a change in the intrinsic subtype in in 5 patients with recurrent tumors (10.0%). Although most clinical factors were not correlated with smoking, a positive conversion of HER2 in recurrence was significantly more frequent among smokers than among non-smokers (p = 0.024). Conclusions: Biological changes during breast cancer recurrence should be given careful clinical consideration because they affect treatment after recurrence. Our results suggest that smoking may induce increased HER2 expression in recurrent breast tumors.

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Novel evaluation scale for QOL (QOL-ACD-BP) in preoperative chemotherapy for breast cancer

Cited by 6 publications

References 37 publications

Prognostic Value of Quality of Life in Endocrine Therapy for Elderly Patients With Breast Cancer: A Retrospective Study

Prognostic Value of Quality of Life in Endocrine Therapy for Elderly Patients With Breast Cancer: A Retrospective Study

Effects of an Integrative Mind-Body-Medicine Group Program on Breast Cancer Patients During Chemotherapy: An Observational Study

The effect of smoking on biological change of recurrent breast cancer

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