Predicting psychological morbidity in Chinese women after surgery for breast carcinoma

Abstract

BACKGROUND Between 30% and 70% of western women experience psychological morbidity after undergoing surgery for breast carcinoma; however, the rates and risk factors among Chinese women are unknown. Identifying at‐risk women enables preventive intervention. METHODS Among 430 Chinese women who were approached within 1 week after undergoing surgery for early‐stage breast carcinoma (baseline), 405 women (94%) completed measures of self‐efficacy and psychological morbidity (the Chinese Health Questionnaire 12‐item instrument [CHQ12]) and completed retrospective measures of treatment decision‐making (TDM) difficulties, satisfaction with TDM involvement, and satisfaction with consultation and treatment outcome expectations. One‐month postsurgery follow‐up (follow‐up), CHQ12 scores for 367 of 405 women (91%) were adjusted for concurrent physical symptom distress and trait optimism (the revised Chinese Life Orientation Test) and baseline predictors using stepwise multivariate regression. RESULTS At baseline 28% of women evidenced mild psychological morbidity, and 42% of women evidenced moderate‐to‐severe psychological morbidity: At follow‐up, the respective rates were 32% and 36%. Preferred TDM involvement was associated with lower psychological morbidity (F = 6.702; P < 0.001). Baseline CHQ12 scores were predicted by outcome expectancies and TDM difficulties (adjusted regression coefficient [R2] = 0.192). Baseline CHQ12 scores and follow‐up chemotherapy, in turn, predicted physical symptom distress at follow‐up. After adjustment, high physical symptom distress, baseline psychological morbidity, low optimism, and no chemotherapy independently predicted follow‐up CHQ12 scores (adjusted R2 = 0.585). CONCLUSIONS Psychological morbidity was linked to women's TDM difficulties, their inability to anticipate treatment effects accurately, and physical symptom distress, possibly exacerbated by symptom misattribution. Optimizing TDM support and helping women accurately determine outcomes in terms of symptom experience and meaning and physical appearance may help to reduce psychological morbidity. Women who have TDM difficulties should be considered to be at high risk for psychological distress. Cancer 2005. © 2004 American Cancer Society.

Tissue array for Tp53 , C-myc , CCND1 gene over-expression in different tumors

“…In our study, a significant difference was found in positive expression rate of CCND1 between different tumors except for tumors of esophagus (c 2 = 7.500, P = 0.058) and colon (c 2 = 7.273, P = 0.064). These results agree with the conclusions of other studies [23,24] . The expression of CCND1 plays an important role in the early staging of carcinogenesis in Caucasian females with breast carcinoma.…”

“…A recent study indicated that even a brief reactivation of endogenous Tp53 in Tp53-deficient tumors can lead to a complete tumor regression [22] . At present, the expression of CCND1 has been investigated in several differences tumors, showing that patients with positive expression of CCND1 usually have a poor prognosis compared to those with negative expression of CCND1 in lung cancer, head and neck squamous cell carcinoma, and bladder cancer [23] . Although positive expression of CCND1 can serve as a poor prognostic factor or is associated with a worse prognosis, the expression of CCND1 is not correlated with the prognosis of cancer patients [24] .…”

“…Although positive expression of CCND1 can serve as a poor prognostic factor or is associated with a worse prognosis, the expression of CCND1 is not correlated with the prognosis of cancer patients [24] . Furthermore, intensive investigations have been done on the correlation between CCND1 expression and patient survival in Caucasian females with breast carcinoma, but systematic investigations on alteration of CCND1 in Asian females are rare [23,24] . Whether CCND1 expression, clinicopathological parameters, survival rate and other prognostic markers are associated with cell cycle is not clear.…”

Multi-step process of human breast carcinogenesis: A role for BRCA1, BECN1, CCND1, PTEN and UVRAG

“…In 2005, breast cancer caused 502,000 deaths worldwide (7% of cancer mortality; almost 1% of all mortality) (2). During recent years, the incidence rate of breast carcinoma has gradually increased in Asia and has become the second most common malignant tumor of Chinese women, with the number of new cases currently at approximately 60,000 in China annually (3). Ductal breast cancer is the most common type of breast cancer.…”

Prognostic Role of PTEN Gene Expression and Length of Survival of Breast Cancer Patients in the North East of Iran

“…Breast cancer is the second leading cause of mortality in women (Dunning et al, 1999). In Asia, the prevalence of breast cancer has been increasing during the recent years (Lam et al, 2005). Moreover, the mean age of onset of breast cancer is reduced in Iran (Golmohammadi and Pejhan, 2012).…”