Quality of life among older survivors of breast cancer

This study investigated the relation among perceived social support, uncertainty, and quality of life in older survivors with breast cancer. Proposed hypotheses predicted a significant positive correlation between perceived social support and quality of life, and a significant negative correlation between uncertainty and quality of life. It also was hypothesized that perceived social support and uncertainty, considered together, could explain more quality-of-life variance than either variable considered independently. A sample of 103 breast cancer survivors older than 50 years completed the Social Support Questionnaire, the Mishel Uncertainty in Illness Scale - Community Form, and the Ferrans and Powers Quality-of-Life Index - Cancer Version. Data were analyzed using Pearson product-moment correlation, t tests, analysis of variance, and stepwise multiple regression. All the hypotheses were supported. Additional findings showed significant positive correlations between age and uncertainty, and between support network size and social support. Significant negative correlations were found between age and perceived social support, and between age and size of support network. Uncertainty increased in the presence of other diseases, which were associated with poorer quality of life. The study results underscore the importance of social support in reducing illness uncertainty and improving the quality of life for older survivors of breast cancer.     

Dealing with the financial burden of cancer: perspectives of older breast cancer survivors

Purpose

Financial burden among cancer survivors is often overlooked in survivorship care planning. Cancer survivors with limited incomes may be particularly affected. Yet, little data are available to address financial issues among them. Eliciting the survivors’ perspectives on how to deal with this financial burden is a first crucial step to identifying the means to provide this supportive care.

Methods

In this pilot study, three nominal group technique (NGT) sessions were conducted with a convenience sample of 23 older breast cancer survivors (age 52 to 83) recruited from a county safety net hospital and a Comprehensive Cancer Center. One single NGT question was posed in these sessions, namely “What could help women deal with the financial burden that cancer brings to them and their families?” Survivors responded in an iterative fashion and then ranked the most relevant responses.

Results

The most relevant responses addressed the (1) need for affordable insurance; (2) need to have prompt information on treatment costs patients will face, insurance coverage, and agencies or programs that provide needed products and services; and (3) need to access social workers, navigators, support groups, or others knowledgeable about available resources. Survivors also suggested that physicians become aware of cancer costs and financial issues faced by patients and consider costs in their treatment plans.

Conclusions

Older survivors face financial challenges for which there are few available resources. They suggested several avenues to address cancer-related financial issues that may be considered in developing supportive interventions.     

乳腺癌钼靶X线放大摄影的诊断价值

目的 探讨钼靶X线放大摄影在乳腺癌中的诊断价值。方法 回顾性分析50例经手术病理证实的乳腺癌普通钼靶X线摄影及钼靶X线放大摄影的资料,比较两种方法在显示病变方面的差异。结果 钼靶X线放大摄影在显示肿块的毛刺、分叶、钙化方面明显优于普通X线摄影,在显示乳腺癌的间接征象方面也优于普通钼靶X线摄影。结论 加伏钼靶X线放大摄影可提高乳腺癌诊断的准确率和精确性。     

Status of mammography in breast cancer screening

Doubt no longer exists as to the efficacy of breast cancer detection by mammography. A significant body of evidence supports its value in reducing morbidity and mortality associated with this common malignancy. Physicians must become convinced of its usefulness and recommend the procedure to female patients as part of routine healthcare. Those responsible for reimbursement of healthcare costs should be apprised of its value. Many insurance plans do not reimburse for screening procedures in the absence of clinical symptoms, but with breast cancer, the symptomatic patient may have a greatly diminished possibility of cure. The next decade may hold further diagnostic or therapeutic innovations, and breast cancer may eventually be eradicated. At present, however, no diagnostic method is capable of providing an impact equal to that of screening mammography for those women who have the misfortune of contracting this particular disease. We should all try to maximize the benefits this current technology is capable of providing.     

Sleep disorders in breast cancer survivors

Purpose

The purpose of this study was to evaluate the feasibility, acceptability, and initial results of a structured assessment of sleep disorders in breast cancer survivors (BCS). Our goal was to determine whether the assessment could be easily used and whether it would capture problems suggestive of one or more underlying sleep disorders that require referral to a specialist for diagnostic validation through polysomnography and appropriate specialty treatment.

Methods

A cross-sectional, feasibility study using convenience sampling.

Results

A total of 38 BCS completed the study. Recruitment procedures were adequate in finding eligible BCS, however, procedures used to establish possible patterns of sleep disorders (e.g., interview) were not feasible for screening for sleep disorders in the clinical setting due to the time it took to complete each interview. A total of seven sleep disorder categories were identified in the data with the majority of women having at least one possible sleep disorder.

Conclusions

Study findings suggest that population-based screening for sleep disorders in clinical practice should be a priority for BCS reporting chronic sleep problems.

     

Psychosocial responses in breast cancer survivors

OBJECTIVES: To review the evidence on psychosocial responses in breast cancer survivors (BCS); identify factors that influence those responses; and propose patterns of psychosocial functioning that may provide a framework for assessment and intervention. DATA SOURCES: Research articles/abstracts; literature reviews. CONCLUSION: The majority of breast cancer survivors demonstrate a pattern of recovery. Age, information, communication, social and emotional support, family, and degree of symptom distress are known factors influencing QOL outcomes. IMPLICATIONS FOR NURSING PRACTICE: Assessment of psychosocial functioning is essential to identify needs and risk factors. Interventions should be targeted to meet informational needs, promote effective communication, manage uncertainty, control symptoms, enhance social and emotional support, and address cultural differences.     

Pilates for breast cancer survivors

Pilates has been advocated for rehabilitation of breast cancer survivors despite little scientific evidence. The authors of this article have examined the feasibility of a Pilates program in postmastectomy breast cancer survivors and the impact on physical and psychological parameters. Fifteen breast cancer survivors were recruited in a one-arm study of 12 weeks of Pilates exercises. The authors assessed recruitment, adherence, and attrition, and measured changes in shoulder and neck range of motion, posture, height, arm volume, quality of life, mood, and body image from pre- to postintervention. Of 26 eligible patients, 15 enrolled, 13 completed the study, and 10 performed more than 50% of the recommended sessions. Statistically significant improvements emerged for shoulder abduction and internal rotation on the affected side, neck rotation toward the unaffected side, and neck flexion. The affected side arm volume and the interlimb volume discrepancy increased. Significant improvements were reported in quality of life, mood, and body image. The improvements in physical and psychological outcomes are promising and deserve further evaluation in a randomized, controlled study. The increase in affected arm volume also warrants additional investigation.     

乳腺超声结合钼靶X线检测乳腺癌的临床诊断分析

目的:分析钼靶X线与超声联合对乳腺癌进行诊断分析.方法:回顾分析2016年11月—2018年11月于本院手术治疗的135例乳腺癌患者,将其随机分成三组,即对照组Ⅰ、对照组Ⅱ和观察组,各45例;对照组I行超声检查,对照组Ⅱ行钼靶X线检查,观察组采用钼靶X线联合超声检查,对比分析三组患者的阳性检出率及钼靶X线与超声两种不同...     

钼钯乳腺X线摄影误诊病例分析

目的 分析乳腺钼钯X线摄影误诊的原因及探讨避免误诊的方法和经验。方法 回顾性分析69例经病理证实而乳腺钼钯X线摄误诊的乳腺疾病影像资料。结果 69例误诊中，良性诊断为恶性者24例，恶性诊断为良性者45例。误诊原因主要为乳腺致密肿块难以对比等客观原因，以及病变X线表现不典型所致。结论 规范乳腺的钼钯X线摄影方法以及加强读片一定程度可以减少误诊。     

数字化乳腺X线摄影评价乳腺癌诊断征象

目的 评价数字化乳腺X线摄影对乳腺癌的诊断价值.方法 对256例乳腺病变患者的数字化乳腺X线片征象进行分析,对各项指标的敏感性、特异性、阳性似然率(LR+)进行Logistic回归分析,建立Logistic回归模型.结果 局限性致密浸润、恶性钙化、毛刺、皮肤增厚和局限凹陷、乳头内陷和漏斗征、透亮带、彗星尾征、局部乳腺结构紊乱等征象有助于对肿物良恶性的鉴别.结论 数字化乳腺X线摄影可提高乳腺癌的诊断准确性,以此建立的Logistic回归模型有较强的预测能力.     

乳腺X线钼靶摄影对隐匿性乳腺病灶的诊断价值

目的评价应用乳腺钼钯摄影对隐匿性乳腺癌肿的诊断价值。方法对23例乳腺摄片发现不可触及的乳腺癌肿的病人实行立体定位穿刺活检或定位染色手术病检。结果 23例隐匿性乳腺病灶均经手术病检证实,其中导管原位癌7例、浸润性导管癌5例、小叶原位癌2例、单纯癌3例、导管内乳头状癌4例,硬癌1例,腋下转移性腺癌1例。结论乳腺钼钯摄影是目前诊断隐匿性乳腺癌肿的常用而有效的方法。     

Cancer risk-reduction behaviors of breast cancer survivors

Using secondary data analysis, the aim was to determine if postmenopausal women, who have survived breast cancer, have adopted healthy nutritional and physical activity behaviors recommended in the American Cancer Society guidelines as cancer risk-reduction strategies, and in guidelines for prevention of other chronic diseases or for improving general health. From their personal health history, women who have survived breast cancer would be likely candidates to adopt healthy behaviors recommended as cancer risk-reduction strategies or for prevention of other chronic diseases. A secondary aim was to determine the perceived general health and affective state of these women. These breast cancer survivors had a high perception of their general health, a positive affective state, and have adopted some healthy lifestyle behaviors, but they are not fully adhering to the ACS nutrition and physical activity guidelines or other health related guidelines for cancer risk reduction or prevention of other chronic diseases.     

全数字化乳腺点压摄影诊断致密型乳腺中乳腺癌

目的 探讨数字化乳腺点压摄影对致密型乳腺的乳腺癌的诊断价值。 方法 对68例致密型乳腺的乳腺癌患者经全数字化乳腺X线检查常规检查(首尾位及内外斜位)后,对触诊异常区域加摄无放大点压摄影,分别分析常规摄影和点压摄影的影像表现并进行对比。 结果 点压摄影在肿块显示、毛刺显示方面明显优于常规摄影。两种方法对钙化的显示率无显著差别,但在显示钙化数量、大小、形态及密度等具体特征方面,压点摄影优于常规摄影。4例常规摄影显示乳腺结构扭曲的患者,点压摄影可见小肿块;5例常规摄影显示乳腺局灶性不对称患者,点压摄影均可见肿块。点压摄影的诊断准确率(86.76%)高于常规摄影(63.24%),漏诊及误诊率(4.41%)低于常规摄影(14.70%)。 结论 常规乳腺摄影结合点压摄影能够明显提高致密型乳腺的乳腺癌的诊断准确率。