Diagnosed Breast Cancer Patients Research Articles

SENODAY: A New Perspective of Handling Breast Cancer

BackgroundTo evaluate the feasibility of a same day breast cancer diagnosis and management protocol, consequently decreasing time to treatment and immediately reassuring patients with benign diagnosis. Materials and MethodsA total of 60 women underwent breast exam during SENODAY in our cancer center between January 2020 and December 2022. Patients are first seen by a breast surgeon who mentions whether the patient's history and physical exam are suspicious of malignancy. Patients are then sent to the radiologist who performs a complete radiologic assessment, classifies the lesions, and performs a biopsy when necessary. The specimen is sent to the pathologist who uses the imprint cytology technique to obtain a preliminary diagnosis. Effective counseling is established in case of breast cancer diagnosis. ResultsAmong 60 women, 25 patients were reassured by breast imaging and 35 underwent histopathological analysis (17 patients with a 1-day protocol and 18 with the standard definitive technique). Clinical examination was found to have a sensitivity of 100% and a specificity of 89.47%. The positive predictive value was 80 % and the negative predictive value was 100%. However, we did not find a strong correlation between imaging and definitive pathology. Moreover, on imprint cytology, sensitivity, specificity, PPV, and NPV were 100%. Finally, the mean time-to-treat was 28.6 days. ConclusionsSENODAY reassured 68.3% of patients. It also offered effective counseling and a treatment plan to newly diagnosed breast cancer patients within 1 day. Same day histological diagnosis by imprint cytology is effective and feasible with an excellent accuracy.

The effect of acute exercise on circulating immune cells in newly diagnosed breast cancer patients

The role of exercise in cancer prevention and control is increasingly recognized, and based on preclinical studies, it is hypothesized that mobilization of leukocytes plays an important role in the anti-tumor effect. Thus, we examined how 10-min acute exercise modulates immune cells in newly diagnosed breast cancer patients. Blood samples were taken at rest, immediately after exercise and 30 min after exercise and phenotypic characterization of major leukocyte subsets was done using 9-color flow cytometry. Total leukocyte count increased by 29%, CD8+ T cell count by 34%, CD19+ B cell count by 18%, CD56+CD16+ NK cell count by 130%, and CD14+CD16+ monocyte count by 51% immediately after acute exercise. Mobilization of CD45+, CD8+, CD19+, and CD56+CD16+ cells correlated positively with exercising systolic blood pressure, heart rate percentage of age predicted maximal heart rate, rate pressure product, and mean arterial pressure. Our findings indicate that a single bout of acute exercise of only 10 min can cause leukocytosis in breast cancer patients. Mobilization of leukocytes appear to be directly related to the intensity of exercise. It is possible that the positive effect of exercise on oncologic outcome might be partly due to immune cell mobilization as documented in the present study.

Emotion regulation and choice of bilateral mastectomy for the treatment of unilateral breast cancer.

There has been steadily increasing use of bilateral mastectomy (BMX) in the treatment of primary breast cancer (BC). In this study, we utilized functional magnetic resonance imaging (fMRI) to examine the influence of emotion regulation on the decision of newly diagnosed BC patients to choose BMX rather than non-BMX treatments. We recruited 123 women with unilateral BC, 61 of whom received BMX and 62 of whom received non-BMX treatments, and 39 healthy controls. While participants were in the fMRI scanner, we showed them BC-related and non-BC-negative images. In one condition, they were instructed to watch the images naturally. In another, they were instructed to regulate their negative emotion. We compared the fMRI signal during these conditions throughout the brain. With non-BC-negative images as the baseline, BC patients showed greater self-reported reactivity and neural reactivity to BC-related images in brain regions associated with self-reflection than did controls. Among the BC patients, the BMX group showed weaker activation in prefrontal emotion regulation brain regions during emotion regulation than did the non-BMX group. BC patients are understandably emotionally hyper-reactive to BC-related stimuli and those who ultimately received BMX experience more difficulty in regulating BC-related negative emotion than non-BMX BC patients. These findings offer neuropsychological evidence that difficulty in managing anxiety related to the possibility of cancer recurrence is a factor in surgical treatment decision-making and may be an intervention target with the goal of strengthening the management of cancer-related anxiety by nonsurgical means. NCT03050463.

Associations between health-related fitness and quality of life in newly diagnosed breast cancer patients

Newly diagnosed breast cancer patients face substantial stress and uncertainty that may undermine their quality of life (QoL). The purpose of the present study was to examine the associations between health-related fitness (HRF) and QoL in newly diagnosed breast cancer patients from the Alberta Moving Beyond Breast Cancer Study. Newly diagnosed breast cancer patients with early-stage disease (n = 1458) were recruited between 2012 and 2019 in Edmonton and Calgary, Canada to complete baseline HRF and QoL assessments within 90days of diagnosis. HRF assessments included cardiorespiratory fitness (VO2peak treadmill test), muscular fitness (upper and lower body strength and endurance tests), and body composition (dual x-ray absorptiometry). QoL was assessed by the Medical Outcomes Study Short Form 36 (SF-36) version 2. We used logistic regression analyses to examine the associations between quartiles of HRF and poor/fair QoL (bottom 20%) after adjusting for key covariates. In multivariable analysis, the least fit groups compared to the most fit groups for relative upper body strength (OR = 3.19; 95% CI = 1.98-5.14), lean mass percentage (OR = 2.31; 95% CI = 1.37-3.89), and relative VO2peak (OR = 2.08; 95% CI = 1.21-3.57) were independently at a significantly higher risk of poor/fair physical QoL. No meaningful associations were found for mental QoL. The three main components of HRF (muscular fitness, cardiorespiratory fitness, and body composition) were independently associated with physical QoL in newly diagnosed breast cancer patients. Exercise interventions designed to improve these components of HRF may optimize physical QoL and help newly diagnosed breast cancer patients better prepare for treatments and recovery.

Automated Triage of Screening Breast MRI Examinations in High-Risk Women Using an Ensemble Deep Learning Model.

The aim of the study is to develop and evaluate the performance of a deep learning (DL) model to triage breast magnetic resonance imaging (MRI) findings in high-risk patients without missing any cancers. In this retrospective study, 16,535 consecutive contrast-enhanced MRIs performed in 8354 women from January 2013 to January 2019 were collected. From 3 New York imaging sites, 14,768 MRIs were used for the training and validation data set, and 80 randomly selected MRIs were used for a reader study test data set. From 3 New Jersey imaging sites, 1687 MRIs (1441 screening MRIs and 246 MRIs performed in recently diagnosed breast cancer patients) were used for an external validation data set. The DL model was trained to classify maximum intensity projection images as "extremely low suspicion" or "possibly suspicious." Deep learning model evaluation (workload reduction, sensitivity, specificity) was performed on the external validation data set, using a histopathology reference standard. A reader study was performed to compare DL model performance to fellowship-trained breast imaging radiologists. In the external validation data set, the DL model triaged 159/1441 of screening MRIs as "extremely low suspicion" without missing a single cancer, yielding a workload reduction of 11%, a specificity of 11.5%, and a sensitivity of 100%. The model correctly triaged 246/246 (100% sensitivity) of MRIs in recently diagnosed patients as "possibly suspicious." In the reader study, 2 readers classified MRIs with a specificity of 93.62% and 91.49%, respectively, and missed 0 and 1 cancer, respectively. On the other hand, the DL model classified MRIs with a specificity of 19.15% and missed 0 cancers, highlighting its potential use not as an independent reader but as a triage tool. Our automated DL model triages a subset of screening breast MRIs as "extremely low suspicion" without misclassifying any cancer cases. This tool may be used to reduce workload in standalone mode, to shunt low suspicion cases to designated radiologists or to the end of the workday, or to serve as base model for other downstream AI tools.

Health-Seeking Behavior Returning to Normalcy Overcoming COVID-19 Threat in Breast Cancer.

The coronavirus disease 2019 (COVID-19) outbreak has significantly impacted the diagnosis and treatment of breast cancer. Our study investigated the change in diagnosis and treatment of breast cancer with the progress of COVID-19 pandemic. The study group comprised 6,514 recently diagnosed breast cancer patients between January 1, 2019, and February 28, 2021. The patients were divided into two groups: pre-COVID-19 period (3,182; January 2019 to December 2019) and COVID-19 pandemic period (3,332; January 2020 to February 2021). Clinicopathological information related to the first treatment after breast cancer diagnosis was retrospectively collected and analyzed in the two groups. Among the 6,514 breast cancer patients, 3,182 were in the pre-COVID-19 period and 3,332 were in the COVID-19 pandemic period. According to our evaluation, the least breast cancer diagnosis (21.8%) was seen in the first quarter of 2020. The diagnosis increased gradually except for the fourth quarter in 2020. While early-stage breast cancer was diagnosed 1,601 (48.1%) during the COVID-19 pandemic (p=0.001), the number of surgical treatments increased 4.6% (p < 0.001), and the treatment time was slightly shorter 2 days (p=0.001). The breast cancer subtype distribution was not statistically different between the pre-COVID-19 and COVID-19 period groups. In the early stages of the pandemic, the number of breast cancer cases temporarily decreased; however, they stabilized soon, and no significant differences could be identified in the diagnosis and treatment when compared to the period before the pandemic.

Health-Related Quality of Life (HRQoL) Using EQ-5D-5L: Value Set Derived for Indian Breast Cancer Cohort.

The purpose of this study was to report quality of life of newly diagnosed breast cancer patients from India in a large cohort using the EQ-5D-5L instrument. The study used longitudinal data of 500 breast cancer and 200 non-cancer subjects registered at our centre, during June 2019 and March 2022. The EQ-5D-5L and EQ-VAS instruments were used to measure and compare utility scores among cancer and non-cancer subjects. Descriptive statistics were analyzed and Tobit regression model were used to confirm the predictors of the utility score. The cancer subjects had a mean EQ-ED-5L utility score of 0.8703 (SD=0.121), 0.8745 (SD=0.094) and 0.8902 (SD=0.107) at the time of baseline, completion and follow up surveys respectively. EQ-5D-5L values had significantly worsened after diagnosis of cancer as compared to the non-cancer cohort (0.87 vs. 0.93, p value 0.000). EQ-5D-5L utility scores as per stage for the cancer cohort were 0.88, 0.86 and 0.83 respectively for stage I-II, III and IV. Similarly, the EQ-VAS scores for stage I-II, III and IV were 74.9, 72.6 and 73.2 respectively. Multivariate analysis confirmed strong association of age, religion and income with the utility-values. This is the first longitudinal study reporting the utility scores derived from a large cohort of breast cancer patients demonstrating lower utility scores compared to non-cancer cohort. The utility scores also improve post treatment completion for cancer patients and decrease with higher stage at diagnosis. This information will be useful for future health economic research in India pertaining to breast cancer.

Progranulin and Breast Cancer Mortality: 13-Year Follow-Up of a Cohort Study.

We have reported that serum progranulin (PGRN) levels are clinically significant in predicting recurrence in patients with HR-positive breast cancer. The aim of the present study was to examine whether PGRN levels might be associated with breast cancer mortality. This was a cohort study of 695 newly diagnosed breast cancer patients who underwent curative surgery between 2001 and 2004. The relationship between breast cancer mortality and pre-operative serum PGRN levels in these patients with a median follow-up of 12.7 years was evaluated until May 2020. A total of 118 (17%) deaths were identified in the cohort. According to the HR status, (10, 15, and 20)-year overall survival (OS) rates were (91.4, 81.1, and 75.9) % for HR-positive patients, and (76.5, 74.2, and 69.8) % for HR-negative patients, respectively (p = 0.003). Higher levels of PGRN were significantly associated with poor OS in the HR-positive group (p for trend = 0.001). In particular, hazard ratios for PGRN quartiles suggested a dose-response relationship, with the highest quartile having the worst OS in the HR-positive group (highest vs lowest: 15-year OS, (68.3 vs 90.0) %; 20-year OS, (62.3 vs 84.8) %, even after adjusting for age, tumor stage, and metabolic confounders. Pre-operative serum PGRN levels had clinical significance for predicting cancer mortality in breast cancer patients independent of tumor stage and metabolic parameters, especially in HR-positive tumors.

Measuring Sarcopenia on MRI among Turkish Female Breast Cancer Patients

Background: Since the presence of sarcopenia in breast cancer patients is associated with increased postoperative complications, it is crucial to know its frequency in the prechemoteraphy period. It has been suggested that there are many factors associated with sarcopenia. This study focused on the frequency of sarcopenia over the pectoralis muscle area obtained in routine breast MRI among Turkish females who were newly diagnosed with breast cancer. Methods: In a prospective study, pectoralis muscle was manually contoured bilaterally, and the cross-sectional area on breast MRI was calculated in newly diagnosed breast cancer patients. The 'Core slices' program was used while calculating SMI. We accepted 7.4 kg/m2 as the threshold value for sarcopenia. Results: Overall, 17 patients (17 %) were sarcopenic. The analysis regarding the detection of sarcopenia in the patient groups &lt; 65 and ≥ 65 years of age was not statistically significant (P&lt;0.156). The relationship between the groups with BMI &lt; 25 and ≥ 25 sarcopenia was statistically significant (P&lt;0.001). Sarcopenia was found significantly more frequently in patients with metastasis (P&lt;0,0001). Conclusion: This study recruited Turkish females who were newly diagnosed breast cancer. It is the first study in the literature to include the same race, gender, and malignancy in which sarcopenia was investigated. It was shown that breast MRI which is radiation-free can be used in the evaluation of sarcopenia in patients with breast cancer. This result is important for being prepared for possible complications before treatment.

J-shaped association between uric acid and breast cancer risk: a prospective case-control study.

In terms of breast cancer risk, there is no consensus on the effect of uric acid (UA) levels. The aim of our study was to clarify the link between UA and breast cancer risk in a prospective case-control study and to find the UA threshold point. We designed a case-control study with 1050 females (525 newly diagnosed breast cancer patients and 525 controls). We measured the UA levels at baseline and confirmed the incidence of breast cancer through postoperative pathology. We used binary logistic regression to study the association between breast cancer and UA. In addition, we performed restricted cubic splines to evaluate the potential nonlinear links between UA and breast cancer risk. We used threshold effect analysis to identify the UA cut-off point. After adjusting for multiple confounding factors, we found that compared with the referential level (3.5-4.4mg/dl), the odds ratio (OR) of breast cancer was 1.946 (95% CI 1.140-3.321) (P < 0.05) in the lowest UA level and 2.245 (95% CI 0.946-5.326) (P > 0.05) in the highest level. Using the restricted cubic bar diagram, we disclosed a J-shaped association between UA and breast cancer risk (P-nonlinear < 0.05) after adjusting for all confounders. In our study, 3.6mg/dl was found to be the UA threshold which acted as the optimal turning point of the curve. The OR for breast cancer was 0.170 (95% CI 0.056-0.512) to the left and 1.283 (95% CI 1.074-1.532) to the right of 3.6mg/dl UA (P for log likelihood ratio test < 0.05). We found a J-shaped association between UA and breast cancer risk. Controlling the UA level around the threshold point of 3.6mg/dl provides a novel insight into breast cancer prevention.

Impact of Low-Level Knowledge on Breast Cancer in Bangladeshi Patients during Medical Help Seeking

Overall, knowledge on breast cancer acts as a decision maker for medical help seeking during disease diagnosis and treatment. With this study we determined the impact of knowledge on breast cancer and related causes. A cross sectional study was conducted among newly diagnosed breast cancer patients National Institute of Cancer Research and Hospital, Dhaka from July 2017-June 2018. Face to face interview was taken by pretested semi structured questionnaire asking every breast cancer woman regarding knowledge and practice on sign-symptom, Breast-Self-Examination and mammography. After symptom identification first consultation to health care provider was a critical point and homeopathy was the major mean of first consultation. Breast cancer patients did not know the symptoms might cause cancer and as well negligence also play a role in help seeking. Improved knowledge can increase awareness as well influence practice on Breast-Self-Examination. To overcome this problem massive program is needed for early diagnosis and treatment. J MEDICINE 2023; 24: 23-27

Racial Disparities in Breast Cancer Presentation and Diagnosis in COVID-Era Central Texas

IntroductionThe COVID-19 pandemic has significantly impacted the diagnosis of breast cancer (BC). With a large Hispanic/Latinx population, early revocation of mask mandates, and lower vaccination rate than many other states, this study explores the relationship between COVID-19 and the presentation and diagnosis of BC patients in the unique socio-politico-economic context of Central Texas. MethodsThis study is a retrospective review of the Seton Medical Center Austin tumor registry for BC patients from March 1, 2019 to March 2, 2021. We compared demographics, insurance status, clinical and pathologic stage, and time from diagnosis to intervention between “pre-COVID” (March 1, 2019- March 1, 2020) and “post-COVID” (March 2, 2020-March 2, 2021). We utilized descriptive, univariate, and multivariable logistic regression statistics. ResultsThere were 781 patients diagnosed with BC, with 113 fewer post-COVID compared to pre-COVID. The proportion of Black patients diagnosed with BC decreased post-COVID compared with pre-COVID (10.1%-4.5%, P = 0.002). When adjusting for other factors, uninsured and underinsured patients had increased odds of presenting with late-stage BC (odds ratio:5.40, P < 0.001). There was also an association between presenting with stage 2 or greater BC and delayed time-to-intervention. ConclusionsAlthough fewer women overall were diagnosed with BC post-COVID, the return to baseline diagnoses has yet to be seen. We identified a pandemic-related decrease in BC diagnoses in Black women and increased odds of late-stage cancer among uninsured patients, suggesting a disparate relationship between COVID-19 and health care access and affordability. Outreach and screening efforts should address strategies to engage Black and uninsured patients.

An ultrasensitive label-free fluorescent aptamer sensor based on pH-gated release coumarin for detect HER2

Evaluation of human epidermal growth factor receptor 2 (HER2) molecular markers is a very suitable option for early diagnosis of breast cancer. Metal-organic frameworks (MOFs) have large porosity and surface interactions such as π-π stacking, electrostatics, hydrogen bonding, and coordination. Here, we integrated the HER2 aptamer and fluorescent probe coumarin (COU) with zeolite imidazolic acid framework-8 (ZIF-8) to construct a label-free fluorescent aptamer sensor with pH-gated release of COU. In the presence of the target-HER2, the aptamer adsorbed on the surface of ZIF-8@COU specifically recognizes and falls off the HER2 protein, exposing a portion of the pore size of ZIF-8@COU while reducing the negative charge on the sensor surface, under alkaline hydrolysis conditions, a large number of COU fluorescent molecules can be produced and released in the detection system.The aptamer fluorescence sensor has good detection performance, sensitivity and low background interference, the detection linearity range of HER2 protein is 0.05–10 ng/mL, the detection limit is 0.0005 ng/mL, and it has good recovery rate for the serum detection of clinical breast cancer patients. Therefore, this sensor has high potential in detecting and monitoring HER2 levels for the care and clinical diagnosis of breast cancer patients.

Clinical characteristics and survival of second primary breast carcinoma with extramammary malignancies.

To investigate the characteristics, diagnosis, survival and prognosis of second primary breast carcinoma (SPBC). Records of 123 patients with SPBC in Tianjin Medical University Cancer Institute & Hospital between December 2002 and December 2020 were retrospectively reviewed. Clinical characteristics, imaging features and survival were analyzed and comparisons between SPBC and breast metastases (BM) were made. Of 67156 newly diagnosed breast cancer patients, 123 patients (0.18%) suffered previous extramammary primary malignancies. Of the 123 patients with SPBC, approximately 98.37%(121/123)were female. The median age was 55 years old (27-87). The average diameter of breast mass was 2.7 cm (0.5-10.7). Approximately 77.24% (95/123) of the patients presented with symptoms. The most common types of extramammary primary malignancies were thyroid, gynecological cancers, lung, and colorectal. Patients with the first primary malignant tumor of lung cancer were more likely to develop synchronous SPBC, and those with the first primary malignant tumor of ovarian cancer were more likely to develop metachronous SPBC. When comparing with BM, patients with SPBC were more often older (≥45 years old), at earlier stages (I/II), more microcalcification and less multiple breast masses in imaging. More than half (55.88%) of patients in the metachronous group developed primary breast cancer within 5 years after diagnosis of extramammary primary cancer. The median overall survival time was 71 months. Within 90 months, the prognosis of patients with synchronous SPBC was worse than that of patients with metachronous SPBC (p=0.014). Patients with BM had the worst outcome compared with patients with synchronous SPBC and metachronous SPBC (p<0.001).ER/PR-negative status, an interval of less than 6 months between the onset of two tumors, a late stage of first primary malignancy, and an age of diagnosis of first primary malignancy greater than 60 years predicted a worse prognosis for patients with SPBC. The possibility of SPBC should be considered during the follow-up of patients with primary extramammary malignancy, especially within 5 years of the onset of the first tumor. The stage of first primary malignancy and the age at diagnosis of first primary malignancy have an impact on the prognosis of patients with SPBC.

Evaluation of liver metastasis in patients with breast cancer: Comparison of single-phase abdominopelvic CT and multi-phase liver CT.

To compare the usefulness of multi-phase liver CT and single-phase abdominopelvic CT (APCT) in evaluating liver metastasis in newly diagnosed breast cancer patients. In this retrospective study, a total of 7621 newly diagnosed breast cancer patients (mean age, 49.7years ± 10.1; 7598 women) who underwent single-phase APCT (n = 5536) or multi-phase liver CT (n = 2085) for staging workup between January 2016 and June 2019 were included. The staging CTs were categorized as having no metastasis, probable metastasis, or indeterminate lesions. MRI referral rate (proportion of patients underwent additional liver MRI), negative MRI rate (patients without true hepatic metastasis / patients underwent liver MRI), true positive CT rate (patients with true metastasis / patients categorized as probable metastasis), true metastasis rate among CT indeterminate (patients with true metastasis / patients categorized as indeterminate lesions), and overall liver metastasis rate were compared between the two groups. Further, the radiation dose was recorded for every patient. The proportions of having no metastasis and indeterminate lesions on the results of CT interpretation were significantly different between the two groups (P = 0.006). However, the MRI referral rate, negative MR rate, true positive CT rate, true metastasis rate among CT indeterminate, and overall liver metastasis rate were not significantly different between the two groups. Radiation dose of multi-phase CT was three times higher than that of single-phase CT. Multi-phase liver CT has little benefit over single-phase APCT in assessing liver metastasis in patients with breast cancer.

Shoulder function and health outcomes in newly diagnosed breast cancer patients receiving surgery: a prospective study

BackgroundBreast cancer surgery is associated with upper-body morbidities that may last several years postsurgery. Research has not determined if the type of surgery leads to differential effects on shoulder function, activity levels, and QoL during the early rehabilitation period. The main objective of this study is to examine changes in shoulder function, health, and fitness outcomes from the day before to surgery to 6 months postsurgery. Patients and MethodsWe recruited breast cancer patients (N = 70) scheduled to receive breast cancer surgery at Severance Hospital in Seoul to participate in this prospective study. Shoulder range of motion (ROM) and upper body strength, the disabilities of Arm, Shoulder, and Hand (quick-DASH), body composition, physical activity levels, and QoL were measured at baseline (presurgery) and then weekly for 4 weeks, and at 3 months and 6 months postsurgery. ResultsDuring 6 months after surgery, shoulder ROM was reduced only affected arm while shoulder strength was significantly declined in both affected and unaffected arms. Within 4 weeks postsurgery, patients who underwent total mastectomy were significantly less recovered than patients with partial mastectomy in ROM of flexion (P < .05) and abduction (P < .05). However, shoulder strength of both arms observed no interaction between surgical type and time. We observed significant changes in body composition, quick-DASH score, physical activity levels, and QoL from presurgery to 6-months postsurgery. ConclusionsShoulder function, activity levels, and QoL improved significantly from surgery to 6-months postsurgery. Surgery type influenced changes in shoulder ROM.

Reliability and Validity of the Malay BREAST-Q in Women Undergoing Breast Cancer Surgery in Malaysia.

This study aims to translate the BREAST-Q into Malay and validate it in breast cancer patients undergoing surgery. The English BREAST-Q was translated to Malay using the back-translation method. A total of 144 newly diagnosed breast cancer patients were sampled conveniently between December 2015 and November 2016. Test-retest was done after two to three weeks. Data were analyzed using SPSS and AMOS software. Content experts agreed the items in the Malay BREAST-Q were measuring the constructs appropriately. Internal consistencies were good for all items in each subscale (Cronbach's alpha = 0.83-0.95). The highest inter-item correlation for each item with at least one other item in the construct ranged from 0.47 to 0.90. The lowest corrected item-total correlation values ranged from 0.47 to 0.72. The test-retest analysis showed good reproducibility (intraclass correlation coefficient = 0.71-0.98). In exploratory factor analysis, the Kaiser-Meyer-Olkin values were excellent in all four subscales (0.76, 0.92, 0.91, and 0.86). For all subscales, the number of factors extracted cumulatively explained more than 50% of the variance. The Malay BREAST-Q demonstrated good reliability, face validity, content validity, and construct validity.

Abstract P6-05-07: Oncologic outcomes of pregnancy after surgical treatment of breast cancer 35 years old or under

Abstract Purpose: Recent advances in the treatment of breast cancer has led to the improvement of breast cancer patient’s survival. With prolonged survival of these patients, pregnancy became an important issue, especially in those of young cancer patients aged 35 or under. Increased hormone levels during pregnancy, however, raises concerns of elevating the risk of cancer recurrence. The aim of this study was to validate the notion of increased risk associated with pregnancy after breast cancer treatment in young patients. Methods: From January 2009 to December 2020, newly diagnosed breast cancer patients of 35 years old or under who underwent curative surgery in Korea University Guro Hospital were enrolled in this study. Patients were categorized into 3 groups: nulliparous, pregnancy prior to treatment of breast cancer, and patients with pregnancy after breast cancer treatment. Their overall survival and disease-free survival were evaluated. Results: A total of 126 patients was enrolled in this study. Seventeen patients (13.4%) conceived and successfully delivered. The mean age of enrolled patients was 32.0 years old (± 3.1), and the mean follow up period after surgery was 56.8 months (± 34.2). There was no significant difference in overall survival (p=0.490) and disease-free survival (p=0.740) among different groups. Among 22 patients with re-diagnosis of breast cancer, 2 of them (9%) had breast cancer on their contralateral breast. Conclusion: In young patients, pregnancy after treatment for breast cancer did not affect their overall survival or disease-free survival as compared to nullipara or previously delivered groups. Therefore, pregnancy counseling should not be prevented in young breast cancer patients of 35 years old or under. Citation Format: Ji Hye Kim, Sang Uk Woo, Jae Bok Lee, Woo Young Kim, Jai Hyun Chung, Yong Yeup Kim. Oncologic outcomes of pregnancy after surgical treatment of breast cancer 35 years old or under [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P6-05-07.

Abstract P1-05-20: COVID-19 Lockdown Resulting in Advanced Cancer and Worse Histology at Presentation in Hispanics

Abstract Background In breast cancer, prognosis is marked by histology and stage at diagnosis. Patients presenting with HER-2 positive or triple negative breast (TNBC) often have a worse prognosis. Early detection of breast cancer is mainly based on yearly screening mammograms, which were disrupted during the lockdown stages of the COVID-19 pandemic. In general, underserved populations, especially the Hispanic population often lack access to preventive care due to lack of funding causing delays in access to timely care. The COVID-19 pandemic caused many patients to miss their annual mammogram screening due to lockdown causing subsequent presentation of more advanced cancer. We, therefore, hypothesized that more patients were diagnosed with advanced cancer after lockdown and worse histology in the Hispanic population compared to the non-Hispanic population of San Antonio, Texas. Methods We identified 3 cohorts retrospectively using chart review: Pre-covid-19 era was defined between 2018 to March 2020. Lockdown is defined as a period between April 2020 to December 2020 followed by the post-vaccine era from January 1st 2021 to 2022. Pearson’s Chi-squared and logistic regression tests were used to determine the relationship between time, histology at diagnosis and ethnicity. Results More Hispanic patients were found to present with HER2+ disease (OR: 1.65. p-value .047) compared to non-Hispanic women. When looking at presentation of HER2+ disease in the pre-covid-19 era, there was a 15.11% increase in the presentation of HER2+ disease in the post-vaccine era. When looking at the presentation of TNBC disease in women, there was not a significant correlation seen in the lockdown or post-vaccine period in Hispanic compared non-Hispanic women. Other factors such as funding status were associated with TNBC at presentation independently of ethnicity. In the lockdown era, the number of newly diagnosed breast cancer patients reached an all-time low and during the post-vaccine era, the patient numbers are back to the pre-covid era. Conclusion Ethnicity in part played a role in the number of patients presenting with more aggressive histology such as TNBC and Her 2 positive breast cancer in the post-vaccine era. These findings may be secondary to fact that certain ethnic groups are more likely to miss preventive screenings and the covid 19 pandemic lockdown exacerbated this problem. Diagnosis of advance cancer can further deter patients from seeking care due to socioeconomic factors and possibly increase mortality in these populations. These findings suggest that there seems to be a correlation between race and presentation of more aggressive histology caused by the effects of the pandemic in cancer care affecting minorities. Citation Format: Juzar Hussain, Gabriel Roman Souza, Tamarah Aldawoodi, Lauren C. Jameson, Lauren Rahman, Nomso C. Agim, Jonathan Gelfond, Marcela Mazo-Canola. COVID-19 Lockdown Resulting in Advanced Cancer and Worse Histology at Presentation in Hispanics [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P1-05-20.

Abstract P1-06-06: Access to medical coverage in newly diagnosed Breast cancer patients a minority population during the COVID 19 pandemic

Abstract Background: Hispanics are among the most significant minorities in the United States, and assessing their health needs is vital in formulating health policies. The social, environmental, and biological background affect their morbidity and mortality, with cancer being the leading cause of mortality in Hispanics. Although implementing the Affordable Care Act improved access to health care, disparities and challenges in Hispanics’ access to health care remain. (1) In our study, we are trying to assess the COVID-19 pandemic implications on the socioeconomic status of Hispanics with newly diagnosed breast cancer and how that is affecting their outcome. Methods: This is a retrospective study demonstrating the nature of breast cancer screening, diagnosis, and management during COVID-19 lockdown and post-vaccine compared to the pre-COVID-19 era. The restrospective review was conducted at Mays Cancer Center in San Antonio, IRB approved by UT Health San Antonio. The data were abstracted from the medical record system (EPIC). Pearson’s Chi-squared and logistic regression tests were used to determine the relationship between time and stage at diagnosis and association with funding status Result: 696 subjects with newly diagnosed breast cancer were identified and divided into three cohorts: Cohort A: 264 pts in a pre-covid era: From 2018-February 2020, Cohort B: 171 patients during the covid-19 lockdown, and Cohort C: from April 2020-Dec-2020 with 261 patients in the post-vaccine era. A higher percentage of patients had Tis identified in Cohort A (26%) compared to Cohort B (19%) and Cohort C(12%) (p0.003). These numbers have changed to an increasing percentage of patients with T1 or T2. N0 or N1in Cohort B (62%) and Chohort C (68%), p0.003). Presentation of locally advanced (T3/T4 with any N) and metastatic disease remained relatively similar in all cohorts, with more metastatic cases at presentation in Cohort A (p0.003). Many patients of Hispanic ethnicity (OR 1.47, p0.1) were not funded by commercial insurance or Medicare. (OR 2.33, 95% CI 1.43, 3.77, p&amp;lt; 0.001). A high proportion of Hispanic ethnicity in post covid era (cohort B and C) OR 1.78, 95% CI (1.16,2.79) (p0.009) required neoadjuvant chemotherapy suggesting more advanced and possibly aggressive cancer histology. We observed that unfunded patients are less likely to have hormonal receptor-positive breast cancer (p0.001). Conclusion: Population health is likely affected by socioeconomic status, which eventually affects their health care. In a minority Hispanic population, low average income and educational attainment are likely the obstacles to getting timely appropriate health.(2) A higher proportion of Hispanic patients were not insured when compared to non-Hispanics leading possibly to more advanced and aggressive histologies at presentation.