scholarly journals N-Terminal Pro Brain Natriuretic Peptide, sST2 and Galectin-3 Levels in Breast Cancer Survivors

2021 ◽  
Vol 10 (15) ◽  
pp. 3313
Author(s):  
Shruti Rajesh Patel ◽  
Joerg Herrmann ◽  
Robert A. Vierkant ◽  
Janet E. Olson ◽  
Fergus J. Couch ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Cardiac Dysfunction ◽  
Breast Cancer Survivors ◽  
Elevated Serum ◽  
Breast Cancer Diagnosis ◽  
Serum Levels ◽  
Logistic Regression Models ◽  
Galectin 3 ◽  
Serum Storage

NT-proBNP, soluble ST2 (sST2), and galectin-3 are biomarkers of cardiac dysfunction that have been proposed as identifiers of patients experiencing asymptomatic cardiac dysfunction after anthracycline-based chemotherapy. This study aimed to compare the proportion of breast cancer (BC) survivors with elevated serum levels of these three putative biomarkers by prior receipt of anthracycline (yes vs. no). Five-hundred-eighty survivors of BC who had received anthracycline-based chemotherapy were matched by age and time between diagnosis and serum storage to 580 who had not. Cardiac biomarker levels were analyzed using immunoassays. Analyses were carried out using linear and logistic regression models. Anthracycline recipients had higher values of NT-proBNP than non-recipients (mean 116.0 ng/L vs. 97.0 ng/L, respectively; p < 0.001). Values for ST2 and galectin-3 did not significantly differ by receipt of anthracycline. After further adjustment for age at breast cancer diagnosis, ethnicity, and receipt of trastuzumab, associations between receipt of anthracycline and higher NT-proBNP persisted (p < 0.001), showing that NT-proBNP may be a biomarker of cardiovascular toxicity after receipt of anthracycline-based chemotherapy. Further research to assess the clinical utility of NT-proBNP testing after receipt of anthracycline is recommended. sST2 and galectin-3 do not appear to differentiate between anthracycline recipients and non-recipients amongst breast cancer survivors.

scholarly journals Fatigue among Long-Term Breast Cancer Survivors: A Controlled Cross-Sectional Study

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1301
Author(s):  
Saskia W. M. C. Maass ◽  
Daan Brandenbarg ◽  
Liselotte M. Boerman ◽  
Peter F. M. Verhaak ◽  
Geertruida H. de Bock ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Logistic Regression ◽  
General Practitioner ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Breast Cancer Diagnosis ◽  
Reference Population ◽  
Cross Sectional ◽  
Symptoms Of Depression

Background: Fatigue is the most common and persistent symptom among women in the first five years after a breast cancer diagnosis. However, long-term prevalence of fatigue, among breast cancer survivors, needs further investigation. Aim: To compare fatigue experienced by long-term breast cancer survivors with that in a reference population and to evaluate the determinants of that fatigue. Design and Setting: A cross-sectional cohort study of 350 breast cancer survivors ≥5 years after diagnosis and a reference population of 350 women matched by age and general practitioner. Method: Fatigue was measured using the Multidimensional Fatigue Inventory (MFI-20), and a sum score of >60 (multidimensional fatigue) was the primary outcome. Logistic regression was applied to compare the prevalence of multidimensional fatigue between the survivor and reference populations, adjusted for body mass index (BMI) and for cardiovascular and psychological variables. Odds ratios (ORs) and 95% confidence intervals (95%CIs) were estimated. Logistic regression was applied to evaluate the determinants of multidimensional fatigue among the survivors. Results: Breast cancer survivors (median 10 years after diagnosis), more often experienced multidimensional fatigue than the reference population (26.6% versus 15.4%; OR, 2.0 [95%CI, 1.4–2.9]), even after adjusting for confounders. The odds of multidimensional fatigue were also higher among survivors with symptoms of depression (32.2% versus 2.7%; OR, 17.0 [95%CI, 7.1–40.5]) or anxiety (41.9% versus 10.1%; OR, 6.4 [95%CI, 3.6–11.4]). Conclusion: One in four breast cancer survivors experience multidimensional fatigue and fatigue occurs more frequently than in women of the same age and general practitioner. This fatigue appears to be associated with symptoms of depression and anxiety.

Impact of a randomized weight loss trial on breast tissue markers in breast cancer survivors.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e12501-e12501
Author(s):  
Christina Marie Dieli-Conwright ◽  
Maura Harrigan ◽  
Brenda Cartmel ◽  
Anees B. Chagpar ◽  
Yalai Bai ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Weight Loss ◽  
Body Composition ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Breast Tissue ◽  
Serum Levels ◽  
Serum Biomarkers ◽  
Weight Loss Intervention ◽  
Tissue Biomarkers

e12501 Background: Weight loss interventions are effective approaches to reduce body weight and alter serum biomarkers in breast cancer survivors, however the impact on breast tissue biomarkers is unknown. The Lifestyle, Exercise and Nutrition (LEAN) study was a randomized trial designed to test the effect of a weight loss intervention on body composition and breast tissue and serum biomarkers. Methods: Fifity-one women with a BMI ³ 25.0 kg/m2 diagnosed with breast cancer, who had completed chemotherapy and/or radiation therapy were randomized to weight loss intervention or usual care. Breast tissue biopsies from the unaffected breast, fasting serum samples, and body composition were measured at baseline and 6-months. Ki67, insulin receptor (IR), CD68 and CD163 were measured by Automated Quantitative Analysis (AQUA) method. Mean baseline to 6-month changes were compared using ANCOVA adjusting for baseline values. Results: Pre- and post-intervention biopsies were conducted in 49 and 42 women respectively, with both pre- and post- epithelial tissue available from 25 women; epithelial tissue was unavailable in the remaining 66 women. Women were 56.8 ± 8.9 years old, diagnosed 3.3 + 3.8 years prior, primarily Stage I breast cancer (54%), with a BMI of 32.8 ± 6.0 kg/m2. At baseline, breast tissue levels of IR were inversely associated with both percent body fat (r = -0.47, p = .03) and serum insulin levels (r = -0.45, p = .04); serum insulin levels were inversely associated with CD68 (r = -0.47, p = .03). Significant between-group biomarker changes are presented in Table 1. At month 6, loss in percent body fat was associated with increased IR (r = -0.42, p = .05). Increased CD68 breast tissue expression was associated with reductions in serum levels of CRP (r = -0.49, p=0.02). There was no significant effect of the intervention on IR expression or Ki67 (p>0.10). Conclusions: Breast tissue biopsies are feasible to collect in a clinical research setting among breast cancer survivors. A 6-month weight loss intervention led to decreased levels of CD163 in breast tissue and serum levels of leptin, and increased serum levels of adiponectin among breast cancer survivors. At baseline and month 6, changes in breast tissue biomarkers were favorably associated with serum biomarkers and body composition. Future confirmation is required to confirm the added benefit of tissue biomarkers beyond serum as an endpoint for lifestyle interventions among breast cancer survivors. Clinical trial information: NCT02110641. [Table: see text]

Divorce after breast cancer diagnosis and its impact on quality of life

2021 ◽  
pp. 1-6
Author(s):  
Danbee Kang ◽  
Nayeon Kim ◽  
Gayeon Han ◽  
Sooyeon Kim ◽  
Hoyoung Kim ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cancer Survivors ◽  
Cancer Diagnosis ◽  
Breast Cancer Survivors ◽  
Breast Cancer Diagnosis ◽  
Factors Associated ◽  
After Cancer ◽  
The Impact

Abstract Objective This study aims to identify factors associated with divorce following breast cancer diagnosis and measures the impact of divorce on the quality of life (QoL) of patients. Methods We used cross-sectional survey data collected at breast cancer outpatient clinics in South Korea from November 2018 to April 2019. Adult breast cancer survivors who completed active treatment without any cancer recurrence at the time of the survey (N = 4,366) were included. The participants were classified into two groups: “maintaining marriage” and “being divorced,” between at the survey and at the cancer diagnosis. We performed logistic regression and linear regression to identify the factors associated with divorce after cancer diagnosis and to compare the QoL of divorced and nondivorced survivors. Results Approximately 11.1/1,000 of married breast cancer survivors experienced divorce after cancer diagnosis. Younger age, lower education, and being employed at diagnosis were associated with divorce. Being divorced survivors had significantly lower QoL (Coefficient [Coef] = −7.50; 95% CI = −13.63, −1.36), social functioning (Coef = −9.47; 95% CI = −16.36, −2.57), and body image (Coef = −8.34; 95% CI = −6.29, −0.39) than survivors who remained married. They also experienced more symptoms including pain, insomnia, financial difficulties, and distress due to hair loss. Conclusion Identifying risk factors of divorce will ultimately help ascertain the resources necessary for early intervention.

Trajectories of Depression and Anxiety in Latina Breast Cancer Survivors

2019 ◽  
pp. 217-227 ◽  
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Multinomial Logistic Regression ◽  
Secondary Analysis ◽  
Growth Mixture Modeling ◽  
Psychosocial Interventions ◽  
Depression And Anxiety ◽  
Logistic Regression Models ◽  
Growth Mixture

Objectives: To identify subgroups of Latina breast cancer survivors with unique trajectories of depression and anxiety and examine predictors associated with these subgroups. Sample & Setting: Secondary analysis of Latina breast cancer survivors (N = 293) from three psychosocial intervention studies. Methods & Variables: Depression and anxiety were assessed at intake and at weeks 8 and 16. Group-based growth mixture modeling was used to identify subgroups who followed distinct trajectories of depression and anxiety. Multinomial logistic regression models were used to identify predictors of trajectory-based subgroup membership. Results: Three trajectories emerged for depression: low/moderate-stable (78%), high-improving (7%), and high-stable (15%). Three subgroups based on the trajectories of anxiety were low-stable (73%), high-improving (18%), and high-worsening (9%). Chemotherapy, age, and social support discriminated among the three depression trajectory subgroups. All anxiety trajectory subgroups had significantly different initial scores. No demographic or clinical factors were associated with anxiety trajectories. Implications for Nursing: Latina women treated for breast cancer are at an elevated risk for depression and anxiety and follow distinct trajectories of these symptoms. Psychosocial interventions are needed to manage these symptoms, particularly for subgroups in which depression and anxiety persist or worsen.

Coexistence of an imbalance of cytokines, chemokines and growth factors serum levels and symptoms of fatigue and pain in long-term breast cancer survivors.

2015 ◽  
Vol 33 (15_suppl) ◽  
pp. e20626-e20626
Author(s):  
Antonella Daniele ◽  
Rosa Divella ◽  
Ines Abbate ◽  
Francesco Giotta ◽  
Pierpaolo Trerotoli ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Growth Factors ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Serum Levels

Mammography use in breast cancer survivors: An administrative claims study.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 6531-6531 ◽  
Author(s):  
Kathryn Jean Ruddy ◽  
Lindsey R. Sangaralingham ◽  
Heather B. Neuman ◽  
Caprice Christian Greenberg ◽  
Rachel A. Freedman ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Cancer Diagnosis ◽  
Breast Cancer Survivors ◽  
Breast Tissue ◽  
Early Stage ◽  
Breast Cancer Diagnosis ◽  
First Year ◽  
Administrative Claims ◽  
Mammography Use

6531 Background: Annual mammography is recommended to screen residual breast tissue for new cancers and recurrent disease after treatment for early stage breast cancer. This study aimed to assess mammography rates over time in breast cancer survivors. Methods: We used administrative claims data from a large U.S. commercial insurance database, OptumLabs, to retrospectively identify privately- and Medicare Advantage-insured women with operable breast cancer who had residual breast tissue after definitive breast surgery between 2006 and 2015. We required coverage for at least 13 months following surgery. For each subsequent 13-month time period, we only included women without a loss of coverage, bilateral mastectomy, metastatic breast cancer diagnosis, or non-breast cancer diagnosis. We calculated the proportion of patients who had a mammogram during each 13-month period following breast surgery. We used multivariable logistic regression to test for factors associated with mammography in the first 13 months. Results: The cohort included 26,011 women followed for a median of 2.9 years (IQR 1.9-4.6) after surgery; 63.1% were less than 65 years of age, and 74.4% were white. In their first year of follow-up, 86% underwent mammography, but by year 7, this decreased to 73%. Fewer than 1% underwent MRI instead of mammography. In multivariable analysis, mammograms were less likely during the first year after surgery among women aged < 50 years (odds ratio [OR], 0.7; 95% confidence interval [CI], 0.6 to 0.8), African Americans (OR, 0.7; 95% CI, 0.7 to 0.8), patients who underwent mastectomy (OR, 0.7; 95% CI, 0.6 to 0.7), and patients residing in the Western part of the country (OR, 0.9; 95% CI, 0.7 to 0.9). Those with 1-2 comorbidities were more likely (OR, 1.1; 95% CI 1.1-1.2) than those with none to have a mammogram during that period. Mammography use did not differ significantly by year of diagnosis (2006-2015). Conclusions: Even in an insured cohort, a substantial proportion of breast cancer survivors do not undergo annual surveillance mammography. Mammography use falls as the time from the early stage breast cancer diagnosis increases. Understanding factors associated with lack of mammographic screening may help improve survivorship care.

scholarly journals Serial Assessment of Urinary Incontinence in Breast Cancer Survivors Undergoing (Neo)Adjuvant Therapy

2020 ◽  
Vol 18 (6) ◽  
pp. 712-716
Author(s):  
Christopher P. Chung ◽  
Carolyn Behrendt ◽  
Louise Wong ◽  
Sarah Flores ◽  
Joanne E. Mortimer
Keyword(s):  
Breast Cancer ◽  
Urinary Incontinence ◽  
Adjuvant Therapy ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Early Stage ◽  
Treatment Strategies ◽  
Breast Cancer Diagnosis ◽  
Urinary Symptoms ◽  
The Impact

Background: Among breast cancer survivors, urinary incontinence (UI) is often attributed to cancer therapy. We prospectively assessed urinary symptoms before and after (neo)adjuvant treatment of early-stage breast cancer. Methods: With consent, women with stage I–III breast cancer completed the Urogenital Distress Inventory and the Incontinence Impact Questionnaire before and 3 months after initiating (neo)adjuvant therapy. Patients with UI were at least slightly bothered by urinary symptoms. If UI was present pretreatment, it was considered prevalent; if UI was new or worse at 3 months posttreatment, it was considered incident; if prevalent UI was no worse at 3 months posttreatment, it was considered stable. Ordinal logistic regression models identified characteristics associated with the level of prevalent UI and with the degree of UI impact on quality of life (QoL). Results: On pretreatment surveys, participants (N=203; age 54.5 ± 11.4 years) reported 79.8% prevalence of UI, including overactive bladder (29.1%), stress incontinence (10.8%), or both (39.9%). The level of prevalent UI increased with body mass index (BMI; P<.05). Of 163 participants assessed at both time points, incident UI developed in 12 of 32 patients without prevalent UI and 27 of 131 patients with prevalent UI. Regardless of whether UI was prevalent (n=162), incident (n=39), or stable (n=94) at QoL assessment, the impact of UI increased (P<.01) with the number and severity of UI symptoms, subjective urinary retention, and BMI. Adjusted for those characteristics, incident UI had less impact on QoL (P<.05) than did prevalent or stable UI. Conclusions: We found that UI is highly prevalent at breast cancer diagnosis and that new or worsened UI is common after (neo)adjuvant therapy. Because UI often impairs QoL, appropriate treatment strategies are needed.

scholarly journals QUALITY OF LIFE IN BREAST CANCER SURVIVORS: AN ASSESSMENT OF INTERNATIONAL BREAST CANCER DRAGON BOAT RACERS

Lymphology ◽  
2021 ◽  
Vol 53 (4) ◽  
Author(s):  
L Koehler ◽  
S Rosenberg ◽  
J Cater ◽  
K Mikolajczyk ◽  
A Moran ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Physical Activity ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Breast Cancer Diagnosis ◽  
Community Based ◽  
Dragon Boat ◽  
Boat Racing

Resistance exercise is deemed safe for women recovering from conventional breast cancer therapies but few clinicians are aware that dragon boat racing, as a form of resistive exercise, is available to the breast cancer community. The objectives of this study were to 1) increase clinician awareness of dragon boat racing (DBR) in breast cancer survivors as a community-based physical activity, and 2) evaluate quality of life (QOL) in breast cancer survivors with or without lymphedema who participate in DBR. This prospective, observational study surveyed 1,069 international breast cancer dragon boat racers from eight countries to compare function, activity, and participation in women with and without self-reported lymphedema using the Lymph-ICF questionnaire. Seventy-one percent of women (n=758) completed the questionnaires. Results revealed significantly higher Lymph-ICF scores in the lymphedema participants, signifying reduced QOL, when compared to the nonlymphedema participants (p&lt;0.05), except for "go on vacation" for which no statistical difference was reported (p=0.20). International breast cancer survivors with lymphedema participating in DBR at an international competition had reduced function, limited activity, and restricted participation compared to participants without lymphedema. Clinicians should consider utilizing DBR as a community-based activity to support exercise and physical activity after a breast cancer diagnosis.

Trajectories of Objectively Measured Physical Function Among Older Breast Cancer Survivors in Comparison With Cancer-Free Controls

2021 ◽  
Author(s):  
Juhua Luo ◽  
Stephen J. Carter ◽  
Elizabeth M Cespedes Feliciano ◽  
Michael Hendryx
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Physical Function ◽  
Grip Strength ◽  
Cancer Diagnosis ◽  
Gait Speed ◽  
Breast Cancer Survivors ◽  
Breast Cancer Diagnosis ◽  
Quadriceps Strength ◽  
Over Time

Abstract PURPOSE: Aging associated with progressive declines in physical function is well-known; however, little is known about the trajectories of physical function before and after breast cancer diagnosis. The current study examined the trajectories in objective measures of physical function over 20 years for women with breast cancer and matched controls. METHODS: 2712 community-dwelling women (452 breast cancer cases and 1:5 matched cancer-free controls) aged 65 years or older at baseline (1986-1988) within the Study of Osteoporotic Fractures were followed for 20 years. Objective physical function was assessed up to 9 times, including hand-grip strength, timed chair stand, gait speed and quadriceps strength. Linear mixed models were used to model physical function changes in terms of secular time trend, group (cases or controls), period (pre-and post-diagnosis status), and their interaction terms. RESULTS: We observed all measures of physical function declined over time. While no differences in trends between cases and controls during the pre-diagnosis period were observed, after cancer diagnosis, grip strength and gait speed declined significantly faster in cases than controls. Quadriceps strength significantly decreased ~7 pounds shortly after breast cancer diagnosis, and then improved over time. CONCLUSION: Our prospective study revealed that older breast cancer survivors had significantly worse declines in grip strength and gait speed and a sharp, short-term drop followed by gradual improvement over time in quadriceps strength, compared to women without cancer. These findings suggest exercise training targeting muscle strength and mobility would be beneficial among older breast cancer survivors.

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