Understanding Breast Cancer From the Patients' Perspective

Objectives: We performed this study to seek what patients think about their diagnosis, treatment process and survi vorship. Methods: We evalued 125 breast cancer patients receiving chemotherapy in a descriptive and prospective study using a well-structured questionnaire. Results: Most of the patients had information about breast cancer screening at the time of the questionnaire (57.6%), but the proportion of those who had prior knowledge of the disease was low (29.6%). While the most frequent sign of breast cancer was reported to be a palpable mass (53.6%), the most frequent detection method was breast self examination (67.2%). The most frequent adverse effect of chemotherapy were reported to be hair loss (98.4%). Patients’ expectations regarding the disease and adverse events were mostly stated as “I will be completely cured” (79.2% and 53.6%, respectively). Etiological factor most frequently accepted by the patients were stress (85.6%). Most of the pa tients received support from their families during the course of the disease (91.2%). Conclusion: This study provides important new information for every stage of the fight against breast cancer from the perspective of cancer patients. These findings are useful for new programs and clinical decision-making

The influence of visual objects and music on anxiety levels of breast cancer patients scheduled to experience chemotherapy for the first time: a prospective randomized clinical study

Objective: To investigate the influence of music together with visual objects as an ambiance in the waiting room on anxiety levels of breast cancer patients scheduled to receive chemotherapy in outpatient setting for the first time. Material and method: Breast cancer patients planned to receive adjuvant or neoadjuvant chemotherapy for the first time between November 1, 2020, and July 31, 2021, were included. Two designs, including a standard waiting room (StWR) and an intervention waiting room (IWR) that was created by adding music and visual objects to the standard room, were constructed. These 2 designs were repeated sequentially in monthly periods, and a total of 104 patients with 52 in each group were randomized. The State Trait Anxiety Inventory (STAI) and Hospital Anxiety and Depression Scale (HADs) were used for assessments. Results of the patients in StWR and IWR groups were compared. Results: Both HADs anxiety and STAI-state anxiety scale scores were lower in patients who waited in IWR compared to those who waited in StWR (p = 0.041, p = 0.012, respectively). In patients in the IWR group, mean heart rate was lower by 7.6 bpm (p = 0.009). No difference was found between the groups with regard to HADs depression score and STAI-trait anxiety score (p = 0.305, p = 0.535, respectively). For all patients, HADs anxiety scale (r = 0.400, p = < 0.001) and STAI-state anxiety scale (r = 0.475, p = < 0.001) scores increased as the waiting time increased. Discussion and conclusion: The present study is the first to investigate the influence of adding music together with visual objects to the standard ambiance of the chemotherapy waiting room on anxiety levels of breast cancer patients. We propose that introduction of paintings, artificial plants, and music to the ambiance of the waiting room has a significantly positive effect on alleviating anxiety levels of cancer patients waiting for chemotherapy. © 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.The funding was supported by the authors themselves without the involvement of grants, research scholarships, or any other funding sources

Immunogenicity and safety of the CoronaVac vaccine in patients undergoing treatment for breast and lung cancer

BACKGROUND: Patients with cancer receiving an active systemic therapy are at a high risk for coronavirus disease (COVID-19); however, the antibody response and long-term results of the inactivated whole-virion SARS-CoV-2 (CoronaVac) vaccine in these patients compared to the non-cancer population are unknown. OBJECTIVE: To compare seroconversion for SARS-CoV-2 receptor-binding domain (RBD) specific IgG positivity against two doses of the CoronaVac vaccine in breast and lung cancer patients receiving systemic therapy, to determine the factors affecting seropositivity, and to observe long-term results up to a secondary booster vaccine. RESULTS: The analysis included 201 cancer patients (99 breasts, 102 lungs; median age: 59 years (range: 28-92), 42.3 % men) and 97 controls (median age: 62 years (range: 24-87), 38.1 % men). The seropositivity rate for RBD IgG after 2 doses of vaccine in the cancer group was 81.6 % (n=164) and 93.8 % (n=91) in the control group (p=0.005). The median IgG titer of cancer patients was significantly lower than in the control group (338 (IQR, 95-933) AU/mL vs 676 (IQR, 389-1270) AU/mL; p= 60 patients than in <60 patients (75.9 % vs 89.4 %, p=0.014). DISCUSSION AND CONCLUSION: Cancer patients receiving an active systemic therapy with two doses of the CoronaVac vaccine had a lower antibody response than the non-cancer population, and deaths due to COVID-19 may occur in these patients despite the vaccine. Therefore, extensive protective measures should be taken to protect against COVID-19 in cancer patients aged 60 years and older, who have received two doses of the CoronaVac vaccine

A logarithmic model for hormone receptor-positive and breast cancer patients treated with neoadjuvant chemotherapy

OBJECTIVE: The aim of this study was to investigate the predictive importance of the previously validated log(ER)*log(PgR)/Ki-67 predictive model in a larger patient population.METHODS: Patients with hormone receptor positive/HER-2 negative and clinical node positive before chemotherapy were included. Log(ER)*log(PgR)/ Ki-67 values of the patients were determined, and the ideal cutoff value was calculated using a receiver operating characteristic curve analysis. It was analyzed with a logistic regression model along with other clinical and pathological characteristics.RESULTS: A total of 181 patients were included in the study. The ideal cutoff value for pathological response was 0.12 (area under the curve=0.585, p=0.032). In the univariate analysis, no statistical correlation was observed between luminal subtype (p=0.294), histological type (p=0.238), clinical t-stage (p=0.927), progesterone receptor level (p=0.261), Ki-67 cutoff value (p=0.425), and pathological complete response. There was a positive relationship between numerical increase in age and residual disease. As the grade of the patients increased, the probability of residual disease decreased. Patients with log(ER)*log(PgR)/Ki-67 above 0.12 had an approximately threefold increased risk of residual disease when compared to patients with 0.12 and below (odds ratio: 3.17, 95% confidence interval: 1.48-6.75, p=0.003). When age, grade, and logarithmic formula were assessed together, the logarithmic formula maintained its statistical significance (odds ratio: 2.47, 95% confidence interval: 1.07-5.69, p=0.034).CONCLUSION: In hormone receptor-positive breast cancer patients receiving neoadjuvant chemotherapy, the logarithmic model has been shown in a larger patient population to be an inexpensive, easy, and rapidly applicable predictive marker that can be used to predict response

Soluble B7H3 level in breast cancer and its relationship with clinicopathological variables and T-cell infiltration

Aim of the study Although early diagnosis of breast cancer (BC) is often associated with a good prognosis, there is currently no biomarker with high sensitivity serving this purpose. B7H3, a recently identified member of the B7 family, appears to inhibit antitumor immunity. We investigated the soluble B7H3 (sB7H3) level in BC and its relationship with clinicopathological variables and stromal tumor-infiltrating lymphocytes (sTILs). Material and methods: The study which was designed as a cross-sectional trial between January 2020 and September 2021, included 93 BC patients, 20 patients with benign breast disease (BBD) and 14 healthy volunteers as the control group. Serum sB7H3 levels were measured using the ELISA (enzyme-linked immunosorbent assay) method and sTlLs were measured by immunohistochemistry using Tru-cut biopsy materials. Results: sB7H3 levels in BC patients were significantly higher than those in patients with BBD and healthy volunteers. Receiver operating characteristic curve analysis results showed that sB7H3 level may be a potential biomarker for distinguishing patients with BC from those with BBD (AUC: 0.807; sensitivity: 0.786; specificity: 0.706) and from healthy volunteers (AUC: 0.731; sensitivity: 0.700; spedicity: 0.692). Conclusions: To the best of our knowledge, the present study is the first to investigate the relationship between sB7H3 and disease parameters in BC. We found that sB7H3 may be a clinically practical and meaningful biomarker in differentiating BC from BBD. In order to evaluate the relationship of B7H3 with clinical variables in BC, and especially with sTILs, tissue-based studies with higher numbers of patients are needed

A new predictive marker for predicting response after neoadjuvant chemotherapy in hormone receptor positive/HER2-negative patients: a logarithmic model

Purpose: Estrogen receptor (ER) and progesterone receptor (PgR) levels as well as Ki-67 expression levels are independent predictive markers in patients with hormone receptor-positive breast cancer. In this study, we investigated the predictive significance of the formula of log (ER)*log (PgR)/Ki-67, which was created using 3 independent predictive markers, for the pathological complete response of the Hormone Receptor (HR)-positive/HER2-negative breast cancer patients receiving neoadjuvant chemotherapy (NACT). Methods: This retrospective study included 126 patients with HR-positive/HER2-negative breast cancer and axillary lymph node metastasis who received NACT. The log (ER)*log (PgR)/Ki-67 value was calculated from the pre-NACT pathological evaluation results in all patients. We determined the ideal predictive cut-off value, which separates patients into 2 groups according to pathological complete response (pCR) and pathological non-complete response (non-pCR), using Receiver Operating Characteristic (ROC) curve analysis. According to this cut-off point, patients were divided into 2 groups as cut-off ratio high and cut-off ratio low and were compared using logistic regression analysis along with clinicopathological features. Results: According to the predictive model, we estimated the ideal cut-off value that distinguishes patients as pCR and non-pCR to be 0.12 (p=0.015). According to this cut off value, %54.8 of the patients were categorized as cut-off value high and %46.2 were cut-off value low. The non-pCR rates of the groups were 91.3% and %71.9, respectively(p=0.004). A cutoff value of 0.12 provided the feature of being a predictive marker in the univariate analysis for distinguishing between pCR and non-pCR (OR=4.09 95% CI 1.48-11.33, p=0.007), and it preserved this feature in the multivariate analysis. (OR=3.27, 95% CI 1.12-9.56, p=0.030). Conclusion: The formula of log (ER)*log (PgR)/Ki-67 can be used as a simple and easy-to-use predictive marker for response to neoadjuvant therapy in patients with HR-positive/HER2-negative breast cancer receiving NACT. © 2021 Zerbinis Publications. All rights reserved