The journal of breast health最新文献

Objective: Breast cancer-related lymphedema is an important health problem. The aim of this study is to ensure early diagnosis of patients at risk of developing lymphedema and revealing the predisposing factors.

Materials and methods: Measurements in the pre-operative period and in postoperative months 3, 6, 9 and 12 and years 2 and 3 were performed prospectively with bio-impedance spectroscopy for patients treated for breast cancer between November, 2013 and November, 2016. Demographic and clinical-pathological data of the patients were investigated to assess the factors that affect the development of lymphedema.

Results: 245 measurements were obtained from the 67 patients who participated in the study. 18 (26.8%) patients were diagnosed with lymphedema and 16 (89%) of these patients were clinically diagnosed with stage 0 and 2 (1%) patients with stage 1 lymphedema. The median age was 50.7 (32-77) years. Performing axillary dissection and positivity in more than 3 nodes were found to be statistically significant with a percentage of 63.3% (n=15) and 64.7% (n=11) p=0.049 and p<0.001, respectively.

Conclusion: Periodic measurements with bio impedance spectroscopy can be an effective method to diagnose early stage lymphedema after breast cancer, and enable selecting the group of patients who would benefit from early treatment.

Breast cancer is the most frequent cancer in Turkey and other countries. It is not sufficient for women with breast cancer to receive medical treatment protocols (i.e. surgery, chemotherapy, radiotherapy and hormone therapy) to overcome their disease. Breast cancer has biopsychosocial effects on the patients. Provision and maintenance of biopsychosocial wellbeing of the patients during and after the medical treatment process should be one of the primary treatment criteria. It is important for women with breast cancer to develop new strategies to adapt to the disease and treatment processes and to cope with their disease. Support groups and education are quite frequently utilized to achieve this adaptation and coping. Support group interventions allow the women to discuss, receive education and share their experiences. These opportunities guide the patients about how to manage their disease and help them fulfill their social support needs. Support groups are very important to promote physical and psychological health, expand social network and increase social support for breast cancer women. The aim of this review is to reveal experiences in the preparatory and implementation stages of a support group intervention designed for women diagnosed with breast cancer in the framework of a PhD dissertation.

Objective: The aim of this study was to evaluate the performance of ultrasound (US) guided Vacuum Assisted Biopsy (VAB) in the therapeutic excision of breast fibroadenomas.

Materials and methods: Patients who underwent excisional US guided VAB of their fibroadenomas between December 1999-May 2001 were retrospectively evaluated. Seventy-eight patients with BI-RADS category 3 and 4a lesions (one lesion per patient) with a maximum diameter smaller than 3 cm were enrolled in the study. Fifty-one of those were diagnosed with fibroadenoma. Biopsies were performed with a 11G needle using the Mammotome (Johnson & Johnson, New Jersey, USA) vacuum biopsy device. Patients were followed up with US for three years. Follow-ups were done semiannually in the first year and annually afterwards.

Results: Ten patients (19%) were found to have residual lesions in the first week after the biopsy. Additional eight patients (15%) were found to have residual-recurrent lesions in their annual follow up. However, none of these eight lesions demonstrated growth during the three year follow-up. The initial size of the FA was not found to be significantly different between the lesions which were completely excised with no residue or recurrence and those which were not (p>0.05).

Conclusion: The VAB method for the therapeutic excision of small FAs or other benign lesions is practical and easily tolerated by patients. Lesions smaller than 3 cm should be preferred for VAB. A multidisciplinary clinical environment is necessary for each step of the treatment.

Nowadays, surgery, radiotherapy and chemotherapy are the most frequently used modalities in the treatment of breast cancer. It is very well-known that some severe complications may result from after these treatments. Early and late complications of radiotherapy are well known. The complications of radiation therapy may be seen in (early) or after three months (late-delayed) of periods. These complications may be related with direct or indirect effect of radiation. The radiation fibrosis syndrome is a progressive fibrotic tissue sclerosis together with various clinical symptoms in the irradiation field. It is usually a late finding of radiation therapy and may be seen weeks or even years after the treatment. Many systems such as musculo-skeletal, soft tissue, neural tissue and cardiopulmonary system may be affected. In this report, we present a case of a breast cancer treated with breast conserving surgery and radiation therapy twelve years ago. The patient had ipsilateral lymphedema, right axillary mass, and pain during arm and shoulder mobilization. Her physical examination and radiologic findings revealed a big mass invading right thoracic wall, thoracic cavity and the axilla. Histopathological evaluation performed after tru-cut and open biopsy from the mass showed fibrosis resulting from radiation therapy.

Objective: The aim of the present study was to compare the effects of clinical Pilates exercises with those of the standard lymphedema exercises on lymphedema developing after breast cancer treatment.

Materials and methods: The study comprised 60 female patients with a mean age of 53.2±7.7 years who developed lymphedema after having breast cancer treatment. The patients were randomized into two groups: the clinical Pilates exercise group (n=30), and the control group (n=30). Before, and at the 8th week of treatment, the following parameters were measured: the severity of lymphedema, limb circumferences, body image using the Social Appearance Anxiety Scale, quality of life with the European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ-BR23), and upper extremity function using the Disabilities of the Arm, Shoulder and Hand (DASH) outcome measure. Both groups performed one-hour exercises three days a week for 8 weeks.

Results: After treatment, the symptoms recovered significantly in both groups. Reductions in the severity of lymphedema, improvements in the social appearance anxiety scale scores, quality of life scores, and upper extremity functions scores in the clinical Pilates exercise group were greater than those in the control group. Clinical Pilates exercises were determined to be more effective on the symptoms of patients with lymphedema than were standard lymphedema exercises.

Conclusions: Clinical Pilates exercises could be considered a safe model and would contribute to treatment programs.

Objective: Breast carcinoma is the most common malignant tumor detected in women. The hypothesis that increased levels of adhesion molecules and Cathepsin D affect cancerous cells moving away the primary tumor and contributes to migration of the cancerous cell and may cause remote organ metastases is defended. The aim of the present study was to search the association of intracellular adhesion molecule-1 (ICAM-1), vascular adhesion molecule-1 (VCAM-1), Cyclin D1, cathepsin D immunohistochemically with clinicopathological parameters in the patients diagnosed with invasive ductal breast carcinoma.

Materials and methods: The pathological slides of 153 patients diagnosed with invasive ductal carcinoma were evaluated retrospectively. Three groups were created. Group 1 consisted of patients with positive lymph node metastasis and extranodal tumor invasion; Group 2 consisted of patients with positive axillary lymph node metastasis and negative extranodal tumor invasion and Group 3 consisted of the patients with negative axillary lymph node metastasis. In all groups, 20 paraffin blocks belonging to the primary tumor in the breast were stained by ICAM-1, VCAM-1, Cyclin D1 and Cathepsin D. Findings were examined by comparing with clinicopathological parameters.

Results: The highest number of metastatic axillary lymph nodes and the highest rate of cathepsin D staining were statistically found in the cases with positive axillary lymph node metastasis and extranodal tumor invasion. CerbB2 was negative in the cases with negative ICAM-1 whereas estrogen receptor and progesterone receptor were positive in the cases with positive VCAM-1.

Conclusion: The present study reveals significant results for the patients diagnosed with invasive ductal carcinoma through breast biopsy especially before mastectomy in terms of increased number of metastatic axillary lymph nodes and extranodal tumor invasion by immunohistochemical Cathepsin D stain without any additional invasive intervention. Results of the present study may contribute to monitoring and treatment of the patients in the future.

Objective: This study was performed to determine the breast cancer risk levels and its relation with the frequency of breast self-examination practices in women who were 20 years old and over.

Materials and methods: This descriptive study was conducted on 867 women, who were 20 years old and over presenting to a family medicine outpatient clinic for any reasons. The participants filled in the "Breast Cancer Risk Assessment Form" which is recommended to assess the risk of breast cancer by the Ministry of Health. The participants' risk levels have been classified as low, medium, high, and the highest risk.

Results: The mean age of the participating women was 38.2±13.4 years, 69.7% (n=604) were married, 54.8% (n=475) were housewives, 33.9% (n=294) were working, 42.7% were graduated from primary school. The average risk score of the patients for breast cancer was 131.26 ±45.11 (50-325). As a result of this study, 87.3% (n=757) of the women were identified as having a low breast cancer risk, 12.6% (n=109) medium and 0.1% (n=1) of them were identified as having a high risk. The data demonstrated that 75.5% (n=655) of the women weren't doing breast self-examination (BSE). The rate of previous breast USG or mammography screening was 33.7% (n=292). There were no statistical relations between the breast cancer risk levels and BSE (p=0.396).

Conclusion: The risk of developing breast cancer was low among the women in the study group and breast self-examination rates were insufficient. In addition to training women by emphasizing the importance of breast self-examination in early diagnosis, the breast cancer risk questionnaire - an easy to implement, simple and costless tool - is recommended to be administered in the primary health care centers.

Objective: Breast Self-Exam (BSE) is a screening method for the early diagnosis of breast cancer in young women. However, the knowledge and applications of the students related to Breast Self-Exam (BSE) are insufficient. This study aims to investigate the knowledge, application and health beliefs of the students related to BSE.

Materials and methods: This descriptive study's sample consisted of 127 third and fourth grade students in the Nursing Department. Socio-demographic Form, Breast Cancer Knowledge Form, Health Belief Model Scale and BSE Checklist were used in order to collect the data. The data were analyzed by using descriptive statistics, chi-squared test, t-test and Mann-Whitney U test.

Results: Although most of the students have knowledge about BSE, the frequency of BSE and CBE were found to be low. The fourth grade students were more confident that they applied BSE correctly and their perceived self-efficacy was higher, but their perceived susceptibility and perceived obstacles were lower (p<.05). The students' knowledge level about BSE was moderate and their BSE proficiency was low. It was found out that there was a statistical difference between BSE knowledge level and perceived susceptibility, health motivation, perceived obstacles and perceived self-efficacy. Also, a statistical difference was found between students' being sure that they applied BSE correctly and perceived obstacles and perceived self-efficacy (p<.05).

Conclusion: These findings lead to the idea that special training programs should be held instead of standard trainings, in order to improve the knowledge, skills, applications and health beliefs of the students regarding BSE. The curriculums should be revised in terms of breast cancer education.

Objective: To assess the relationship between background parenchymal enhancement (BPE) and fibroglandular tissue (FGT) proportion on breast magnetic resonance imaging (MRI) and hormone receptor expression and molecular subtypes in invasive breast cancer.

Materials and methods: This retrospective study enrolled 75 breast cancer patients who underwent breast MRI before treatment. T1-weighted images were reviewed to determine the FGT proportion, and contrast-enhanced fat-suppressed T1-weighted images were reviewed to determine BPE. Estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor 2-neu (HER2) status, and molecular subtypes of the tumors were compared with the BPE and FGT proportions.

Results: Women with high BPE tended to have increased rate of ER and PR positive tumors (p=0.018 and p=0.013). FGT proportion was associated with ER positivity (p=0.009), but no significant differences between FGT proportion and PR positivity were found (p=0.256). There was no significant difference between HER2 status and any of the imaging features (p=0.453 and p=0.922). For premenopausal women, both FGT proportion and BPE were associated with molecular subtypes (p=0.025 and p=0.042). FGT proportion was also associated with BPE (p<0.001).

Conclusion: In women with invasive breast cancer, both high FGT containing breasts and high BPE breasts tended to have ER positive tumors.