Breast Cancer Patients In Hospital Research Articles

Validity of distress thermometer for screening of anxiety and depression in family caregivers of Chinese breast cancer patients receiving postoperative chemotherapy

ObjectiveFamily caregivers (FCs) of breast cancer patients play a vital role throughout the treatment process. Psychological distress of FCs is common and often ignored. A simple and effective instrument for screening psychological distress would help in selecting those FCs requiring special attention and intervention. Here, the validity of distress thermometer (DT) in FCs of Chinese breast cancer patients receiving postoperative chemotherapy was assessed, and the prevalence of anxiety and depression was evaluated.MethodsWe recruited 200 FCs of hospitalized breast cancer patients in this cross-sectional descriptive study. Before the first cycle of adjuvant chemotherapy, the levels of anxiety and depression among FCs were assessed using DT and Hospital Anxiety and Depression Scale (HADS). In total, 191 valid cases were analyzed. HADS was used as the diagnostic standard to assess the effectiveness of DT as a screening tool for anxiety and depression as well as to analyze the diagnostic efficiency of DT at various cutoff points.ResultsThe definitive prevalence of both anxiety and depression was 8.90%. The mean level of anxiety and depression among FCs was 5.64±3.69 and 5.09±3.85, respectively, both of which were significantly higher than corresponding Chinese norms (P<0.01). The areas under receiver operating characteristic curves of DT for the diagnoses of FCs’ anxiety and depression were 0.904 and 0.885, respectively. A cutoff value of 5 produced the best diagnostic effects of DT for anxiety and depression.ConclusionsThe levels of both anxiety and depression were higher in the FCs of Chinese breast cancer patients receiving postoperative chemotherapy than the national norm. DT might be an effective tool to initially screen psychological distress among FCs. This process could be integrated into the palliative care of breast cancer patients and warrant further research.

191P - Imaging-proven venous thromboembolism among breast cancer patients in a tertiary hospital in the Philippines from 2010-2015

Background: Venous thromboembolism (VTE) is a common cause of mortality in cancer patients. This paper looks into prevalent characteristic of breast cancer in association with VTE, if any. Methods: Hospital patient database were gathered from 2010-2015 with Venous Dupplex Scan or Computed Tomographic Pulmonary Angiography. Each result were reviewed for final conclusion bearing acute pulmonary embolism or acute thrombosis. Only the first VTE event after the diagnosis of cancer was considered. Results: There were 10,380 CTPA/Venous duplex scan performed for the year 2010-2015, where 916 (8.8%) had positive venous thromboembolism. Of the patients who had positive for venous thromboembolism, 208 (2%) had malignancy. Among all the malignancy-associated venous, majority 17.9% (n = 37) had breast cancer. Mean age for Breast cancer patients who had positive VTE was 60.9(46-84) with majority 64.8% having normal BMI. Most had VTE of lower extremities 75.67%, presented with swelling of extremities 48.6%. Twenty-one patients (57.7%) had VTE within one year of cancer diagnosis, 8(21.6%) had VTE more than two years from cancer diagnosis. Sixteen (43.2%) were alive for more than two years from VTE diagnosis, 14 (37.8%) died within 3 months to one years from VTE diagnosis. During the time of VTE diagnosis, active cancer management were chemotherapy 17 (45.9%), hormonal therapy 12 (32.4%), surgery 4(10.8%), while 4(10.8%) had VTE as the presenting symptom of cancer diagnosis. Among those receiving chemotherapy, 11(64.7%) had VTE during chemotherapy days while 35% had VTE with one month after completion of chemotherapy. Those with hormonal therapy 83.3% had aromatase inhibitor, while only 5.4% received tamoxifen. Conclusions: Breast cancer patients with VTE have normal BMI, presenting as swelling of the lower extremity. VTE presented within one year of cancer diagnosis and were mostly alive for more than two years. Active cancer management during VTE diagnosis was mostly during chemotherapy and hormonal with aromatase inhibitor. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.

Effectiveness of Antiemetic Treatment Among Breast Cancer Patients in Inpatient Unit Sardjito General Hospital

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Langer's axillary arch lymph node metastasis in breast cancer patients: A prospective clinical study

Background and objectivesLatissimus dorsi, an anatomical landmark for axillary lymph node dissection, was reported to harbor an anatomical variation named Langer's axillary arch (LAA). However, the incidence and clinical significance of LAA in breast cancer remain obscure. MethodsWe conducted a six-year prospective study, including 1724 breast cancer patients in Qilu hospital between January 2012 to February 2018. All patients received ALND were inspected for existence of LAA. All the surgeries were completed with the involvement of same experienced surgeon. Once the LAA was identified, all the lymph nodes located lateral to it, named LAA's lymph node, were dissected and collected for pathologic examination. ResultsAmong 1724 breast cancer patients, LAA was identified in 132 patients (7.66%). 120 out of the 132 patients (90.91%) had at least two LAA's lymph nodes. 21 out of 120 patients (17.50%) were confirmed with cancer cell metastasis in LAA's lymph nodes. Among the 23 patients received sentinel lymph node tracing, sentinel lymph node was located lateral to LAA in 3 patients (13.04%). ConclusionsOur results indicated that it is of great importance for surgeons to correctly ascertain LAA, and it should be taken as a nonnegligible parts during ALND or SLNB.

Effects of body mass index on pathological complete response and prognosis of breast cancer patients receiving neoadjuvant chemotherapy

Objective To investigate the correlation of body mass index (BMI) on pathological complete response (pCR) and prognosis of breast cancer patients receiving neoadjuvant chemotherapy. Methods A retrospective analysis was performed on 98 cases of breast cancer patients in the Tumor Hospital Affiliated to Zhengzhou University from December 2013 to November 2015. Patients were divided into normal or underweight (N/U, BMI <25.0 kg/m2) group, overweight (OW, BMI 25.0-29.9 kg/m2)group and obese (OB, BMI ≥30.0 kg/m2) group according to BMI. A total number of 50 (51.0%) patients were N/U, 32 (32.6%) patients were OW, and 16 (16.3%) patients were OB. The pathological complete remission after neoadjuvant chemotherapy was observed, and the prognostic evaluation index was disease-free survival rates. Univariate analysis of BMI and pCR correlations was performed by Chi-square test or Fisher exact test, and logistic regression for multivariate analysis. Kaplan-Meier analysis and log-rank test were used to analyze survival status, and Cox proportional hazard model analysis for multivariate analysis. Results In this study, A statistically significant difference was found in the molecular subtypes of the three groups(P 0.05). Multivariate logistic regression analysis showed that obesity and molecular subtype were independent factors of pCR in all patients(P 0.05). Multivariate survival analysis showed that the BMI was not an independent prognostic factor for the 3-year disease free survival rate (P>0.05). Conclusion Excessive BMI (obesity) is an independent predictor of pCR in breast cancer patients receiving neoadjuvant chemotherapy, but does not affect the prognosis of these patients. Key words: Breast neoplasms; Prognosis; Body mass index; Neoadjuvant chemotherapy; Pathological complete response

A Nurse-Led Care Program for Breast Cancer Patients in a Chemotherapy Day Center: A Randomized Controlled Trial.

Healthcare providers are facing the challenge of helping cancer patients cope with the impact of outpatient-based chemotherapy. A nurse-led care program was proposed to address this challenge. The aim of this study was to examine the effects of a nurse-led care program for patients receiving outpatient-based chemotherapy. This was a single-center, open-label, 2-arm parallel trial with equal randomization (NCT02228200). Breast cancer patients in Hong Kong were randomly allocated to the intervention arm or the control arm. The control arm received routine hospital care. The intervention arm received the nurse-led care plus the routine hospital care. The quality of life, self-efficacy, symptom distress levels, and satisfaction with care were evaluated with questionnaires before randomization (T0), in the middle of chemotherapy (T1), and 1 month after chemotherapy (T2). Individual interviews were conducted with some participants in the intervention arm at T2. The intervention arm participants reported significantly lower distress levels from oral problems, fatigue, peripheral neuropathy, distressful feelings, and higher satisfaction with care. According to the satisfaction evaluation and the interviews, the participants stated that the service was helpful in providing information and communication opportunities, filling the service gap after drug administration, providing psychological support, relieving discomfort, and building confidence. Breast cancer patients received support from the provision of comprehensive, continuous, and individualized care. The nurse-led care program could be applied to breast cancer patients in other hospitals in Hong Kong. Exploring its applicability to cancer settings in other countries is recommended.

Repeated chemotherapy cycles produced progressively worse and enduring impairments in the sleep–wake profile of hospitalized breast cancer patients

ABSTRACT Cross-sectional studies, conducted previously, reported disruption of the sleep–wake rhythms of cancer patients on chemotherapy. Although few studies highlighted the effect of hospitalization on sleep, no data were obtained on the effects of longitudinal repeated chronotherapy cycles on sleep pattern of cancer patients. In this study, using the two-factor repeated-measures design, we attempted to assess longitudinally the quality and pattern in sleep–wake behavior of breast cancer in- and outpatients, who received multiple cycles of chemotherapy. We randomly selected the patients from the Regional Cancer Center, Dr. B.R. Ambedkar Memorial Hospital, Raipur, India. We used wrist-worn actigraphs to record the sleep–wake pattern both objectively and subjectively. Additionally, we administered Pittsburgh Sleep Quality Index questionnaire to each patient. Results revealed statistically significant effects of chemotherapy with and without hospitalization mostly on all objective [total sleep time, sleep onset latency, wake after sleep onset, fragmentation index, and sleep efficiency (SE)] and subjective [duration of sleep, sleep disturbance, sleep latency, daytime dysfunction due to sleepiness, SE, and overall sleep quality] sleep–wake parameters of cancer patients. Cancer patients, who received repeated chemotherapy administration followed by hospitalization on each occasion, experienced severely impaired sleep–wake cycle as compared with those who went home after receiving chemotherapy.

Use of Complementary and Alternative Medicine (CAM) among Breast Cancer Patients in a Public Hospital in Padang, Indonesia

Objective: Number of CAM user among person suffer from cancer was high, especially breast cancer. The aim of this study was to investigate the use of CAM in breast cancer patients in a public hospital in Padang, Indonesia. Methods: This study was descriptive study with cross-sectional design done for three months for all patients suffering from breast cancer in oncology unit in a public hospital in Padang, Indonesia. Breast cancer patients who are unable to communicate well and/or are unwilling to take part in the study are excluded. Data were collected by structured interview for patients who used CAM and open interview for patients who not use CAM. Results: Among 85 participants, 8 of them (9.41%) never use CAM, 22 of them (25.88%) had used CAM for some period and 55 of them (64.71%) had been using CAM. Herbal medicine was the most commonly used in CAM therapies, followed by supplement, spiritual healing, and Chinese medicine. The reason to use the CAM is their belief that the CAM has a positive impact to help them fight the cancer. Family and friends were the most common source of CAM information. Only 29.09% of participants had discussed CAM that they want to use with health care providers. Conclusion: It is necessary for health care providers to give information to patients about safety and efficacy of CAM therapy. Key words: Complementary and alternative medicine, Complementary and alternative therapy, Herbal therapy, Herbal medicine, Breast cancer, Hospital pharmacy, Indonesia.

Morbidity, mortality and cost associated with venous thromboembolism among hospitalized breast cancer patients: Results from national inpatient sample.

e13573 Background: Venous thromboembolism (VTE) is an important cause of morbidity and mortality among hospitalized cancer patients. We aimed to study prevalence of VTE and its impact among hospitalizations in patients with breast cancer (BC). Methods: We used the National Inpatient Sample (NIS) database from 2001 to 2013 to identify adults ( > = 18 yrs) with BC as well as presence of VTE using ICD-9 codes and compared demographic characteristics and in-hospital outcomes between BC with and without VTE. Regression analysis was used to calculate odds of association. Results: 267,714 (3.01%) of a total of 8,880,681 hospitalized breast cancer patients had associated VTE. Demographic characteristics including age, race, comorbidity index and gender are shown in the table. BC patients with VTE had a longer mean length of stay (LOS) (7.16 days vs 4.54 days, OR 2.6 (CI 2.5 – 2.7), p < 0.001), higher average cost of hospitalization ($14518 vs $10513, OR 1.4 (CI 1.3 – 1.5), p < 0.001) and higher inpatient mortality (5.67% vs 2.92%, OR 2.0 (CI 1.9 – 2.1), p < 0.001). Factors associated with higher odds of VTE were male sex, African-American race, higher comorbidity index and use of chemotherapy based on multivariate analysis. Interestingly, smoking and female sex were associated with lower odds of occurrence of VTE. Conclusions: VTE in BC is associated with increased mortality, longer hospitalization and higher cost. Effective measures to reduce the VTE among the BC patients could help improve in-hospital outcomes. VTE No VTE DVT PE Age (yrs) 69.26 69.18 69.56 68.25 Female (%) 98.79 98.79 98.73 98.95 Race: Caucasian 75.79 79.37 74.34 76.92 African American 15.24 10.75 16.00 14.96 Others 8.96 9.88 9.66 8.12 Charlson comorbidity Index (%) < = 2 52.15 63.66 3 8.62 9.40 > = 4 39.22 26.93 Mean LOS (days) 7.16 4.54 7.48 6.48 Mortality 5.67% 2.92% 4.35% 8.15% Cost of hospital stay ($) 14517.77 10512.85 14906.57 13566.18 Factors associated with VTE: Multivariate regression, OR (CI) Smoking Chemotherapy Age Female Race Charlson Comorbidity Index AA Others 3 4 0.90 (0.87 – 0.92) 1.49 (1.42- 1.1.56) 1.00 (1.003 – 1.004) 0.76 (0.70- 0.83) 1.40(1.36– 1.44) 0.92(0.87 – 0.96) 1.10(1.05 – 1.14) 1.72(1.67 – 1.78)

DRUG PRESCRIPTION PATTERN OF BREAST CANCER PATIENTS IN A TERTIARY CARE HOSPITAL IN WEST BENGAL: A CROSS-SECTIONAL AND QUESTIONNAIRE-BASED STUDY

Objective: Cancer is a disease of uncontrolled division of cells in any part of the body. Breast cancer most common in women accounts for 13% of the death worldwide. The objective of the present study was to evaluate the drug prescription pattern of breast carcinoma patients in a tertiary care hospital of West Bengal.Methods: This was a cross-sectional observational questionnaire-based study done for a period of 6 months at the Department of Pharmacology in Collaboration with the Department of Surgery and Department of Radiotherapy of a Tertiary Care Hospital at Kolkata, West Bengal, India. Female patients with breast cancer (originated from epithelial tissues) of different types and grade attending surgery outdoor patient department were taken as subjects for the study, after signing informed consent.Results: The present study evaluated 28 patients (n=28) diagnosed as breast cancer by the physicians of the department of surgery and radiotherapy. It was observed that breast cancer was mostly found in the middle age group. Breast carcinoma in postmenopausal women accounted to 75%. The most prevalent breast cancer was invasive ductal carcinoma, accounting to 75% of the study population. 5-Fluorouracil, epirubicin, doxorubicin, cyclophosphamide, docetaxel/paclitaxel, and carboplatin were mostly used as chemotherapeutic agent.Conclusion: Breast carcinoma being a prevalent type of cancer in females, the present study tried to evaluate the pattern of prescribing chemotherapeutic agents for breast cancer patients in a tertiary care hospital. Such study is essential to evaluate and refine the therapeutic regimen of the cancer patients to reduce their sufferings.

Age at diagnosis predicted survival outcome of female patients with breast cancer at a tertiary hospital in Yogyakarta, Indonesia.

IntroductionBreast cancer is the most common cancer in women in Indonesia. Patients' survival depends on various factors, namely patient-, tumor-, and treatment-related factors. Survival analysis on Indonesian patients has only been reported in a few studies. This study aimed to identify the factors that are associated with five-year overall survival (OS) among patients with breast cancer at a local tertiary hospital in Indonesia.MethodsA retrospective cohort study was conducted at Dr Sardjito Hospital, Yogyakarta. Female patients diagnosed with breast cancer between January and December 2009 were studied. Socio-demographic and clinicopathological data were collected from the medical and pathological records. The five-year OS rate was assessed using Kaplan Meier method and prognostic factors were analyzed using Cox regression.ResultsA total of 213 eligible patients with breast cancer were recruited. The five-year OS probability of the breast cancer patient was 51.07%. The majority of the patients (151, 70.9%) presented an advanced stage at the time of diagnosis. In the bi-variable analysis, cases who were younger, of a lower educational status, at a more advanced stage, with a bigger tumor size, and a central tumor location showed a worse five-year OS compared to their counterparts (p = 0.005, 0.001, 0.004, 0.011 and 0.023, respectively). In the multivariable analysis, age was an independent predictor for the OS (HR = 3.73; 95% CI = 1.0-13.6, p = 0.046).ConclusionThe five-year OS of breast cancer patients in the local tertiary hospital was 51.07%. The patients' age at diagnosis was the only significant prognostic factor for the patients' survival.

Surgeons’ Recommendation is the Factor in Determining the Breast Cancer Surgery Procedures: an Experience from Rural Hospital in Thailand

Introduction:The majority of breast cancer patients in rural hospital in developing countries still warrant for total mastectomy. Surgeon advice regard surgical procedure is one of the most important factors in decision making. Our study aims to compare the rate of breast-conserving surgery (BCS), mastectomy (MT) and mastectomy with immediate breast reconstruction (MTIBR) between the surgeons who offer only MT (group A) and who offer BCS MT and MTIBR (group B).Method:A retrospective cohort study was conducted at Ratchaburi hospital, Thailand from January 2010 to April 2014. We categorized patients into 2 groups (group A and B). Univariated analysis was selected to determine the factors that associated with the breast surgery procedures.Results:From January 2010 to April 2014, we recruited 310 breast cancer patients, 221 patients (71.2%) were treated by surgeons in group A, 89 patients (28.7%) by surgeons in group B. The choice of breast surgery is significantly different between 2 groups (P<0.001). In group A, 213 (96.3%) patient had MT and only 3 (1.3%) BCS and 5 (2.2%) MTIBR. Whilst in group B, 58 (65.1%) patient had MT and 11 (12.3%) BCS and 20(22.4%) MTIBR. Choice of breast surgery in patients with stage 1,2,3 are significantly different between 2 groups (P=0.004, <0.001, 0.025 respectively). Age is the only factor that significantly affects the choice of surgery in the group B but not in group A.Conclusion:Surgeon’s competency and comprehensive preoperative consultation by offering BCS, MT and MTIBR can affect the choice of surgical procedure for breast cancer patient.

Sleep disorder diagnoses and clinical outcomes among hospitalized breast cancer patients: a nationwide inpatient sample study.

Sleep disturbances are recognized as a problem for many cancer patients, but little is known about the prevalence of sleep disorders among women hospitalized with breast cancer, or their relationship to in-hospital outcomes. The present study represents a first step toward determining the clinical significance of sleep disorders for hospitalized breast cancer patients with regard to complications, length of hospital stay, and mortality. The relationships between sleep disorders and in-hospital outcomes among 84,424 hospitalized breast cancer patients were examined. This study analyzed the Nationwide Inpatient Sample (NIS) database (2007 to 2011) for all women ages 40years and older with a primary discharge diagnosis of breast cancer and a secondary discharge diagnosis of sleep disorder. Odds ratios, estimates, and 95% confidence intervals were computed using multivariable regression adjusting for age, comorbidities, race, cancer stage, income, insurance type, residential region, year of discharge, and surgical treatment type. Among women hospitalized with a primary diagnosis of breast cancer, 2% (n = 1807) also received a diagnosis of a sleep disorder during hospitalization, the majority of which were sleep-related breathing disorders (n = 1274). Although there was no significant association between having a diagnosis of a sleep disorder and in-hospital mortality, patients with a sleep disorder were more likely to also experience complications (OR = 1.58, 95% CI 1.29-1.34) and have longer hospital stays (mean = 0.44days longer, 95% CI 0.25-0.63). Hospitalized breast cancer patients with a sleep disorder were more likely to experience clinical complications and stay longer in the hospital. It remains an open and important question for future research whether interventions to improve sleep during hospitalization would help to improve clinical outcomes.

Study of clinico-pathological factors, indications and response to chemotherapy in breast cancer patients in a tertiary care hospital in south India

Background: Breast cancer is considered a systemic disease, surgical interventions on most of the patients can reduce the loco regional burden and chemotherapy can reduce systemic burden by reducing chances of metastasis and recurrence and prolong life expectancy. The objective of this study was to assess the clinic-pathological factors of patient presenting with breast cancer and to study the indications and response to chemotherapy for breast cancer.Methods: A prospective study of fifty patients was carried out at Victoria hospital and Bowring and Lady Curzon Hospital between October 2010 to October 2012 who underwent surgery, chemotherapy, radiotherapy and hormonal therapy.Results: Most patients presented with palpable axillary lymph nodes (64%) and belonged to stage II disease (50%). Invasive ductal carcinoma was seen in 90% of cases while medullary in 04%, colloid in 2% and Infiltrating lobular was seen in 04% of patients. Totally 64% cases were ER or PR+, and 36% were ER/PR- among the study participants. 70% of the patients operated had positive nodes. All 50 cases received chemotherapy. Chemotherapy was indicated in node positive patients and in patients whose tumour was measuring more than 1 cm. After follow-up of 50 patients for about a period of two years, 3 patients died, 4 patients had metastasis and in the remaining 47 surviving patients none of them had recurrence at the end of second year.Conclusions: Most cases and belonged to Stage II disease with Invasive ductal carcinoma being most common histological subtype seen in 90% of cases. FNAC is good diagnostic procedure cost effective and reliable as all cases post-operative HPE confirmed malignancy. Patients should be treated by chemotherapy in indicated cases, as carcinoma breast is a systemic disease and chemotherapy can reduce systemic burden by reducing chances of metastasis and recurrence and prolong life expectancy.

Complementary and alternative medicine (CAM) use and delays in presentation and diagnosis of breast cancer patients in public hospitals in Malaysia

Complementary and alternative medicine (CAM) is widely used among the breast cancer patients in Malaysia. Delays in presentation, diagnosis and treatment have been shown to impact the disease prognosis. There is considerable use of CAM amongst breast cancer patients. CAM use has been cited as a cause of delay in diagnosis and treatments in qualitative studies, however there had not been any confirmatory study that confirms its impact on delays. The purpose of this study was to evaluate whether the use of CAM among newly diagnosed breast cancer patients was associated with delays in presentation, diagnosis or treatment of breast cancer. This multi-centre cross-sectional study evaluating the time points of the individual breast cancer patients’ journey from first visit, resolution of diagnosis and treatments was conducted in six public hospitals in Malaysia. All newly diagnosed breast cancer patients from 1st January to 31st December 2012 were recruited. Data were collected through medical records review and patient interview by using a structured questionnaire. Complementary and alternative medicine (CAM) was defined as the use of any methods and products not included in conventional allopathic medicine before commencement of treatments. Presentation delay was defined as time taken from symptom discovery to first presentation of more than 3 months. The time points were categorised to diagnosis delay was defined as time taken from first presentation to diagnosis of more than 1 month and treatment delay was defined as time taken from diagnosis to initial treatment of more than 1 month. Multiple logistic regression was used for analysis. A total number of 340 patients participated in this study. The prevalence of CAM use was 46.5% (n = 158). Malay ethnicity (OR 3.32; 95% CI: 1.85, 5.97) and not interpreting symptom as cancerous (OR 1.79; 95% CI: 1.10, 2.92) were significantly associated with CAM use. The use of CAM was associated with delays in presentation (OR 1.65; 95% CI: 1.05, 2.59), diagnosis (OR 2.42; 95% CI: 1.56, 3.77) and treatment of breast cancer (OR 1.74; 95% CI: 1.11, 2.72) on univariate analyses. However, after adjusting with other covariates, CAM use was associated with delays in presentation (OR 1.71; 95% CI: 1.05, 2.78) and diagnosis (OR 2.58; 95% CI: 1.59, 4.17) but not for treatment of breast cancer (OR 1.58; 95% CI: 0.98, 2.55). The prevalence of CAM use among the breast cancer patients was high. Women of Malay ethnicity and not interpreting symptom as cancerous were significantly associated with CAM use. The use of CAM is significantly associated with delay in presentation and resolution of diagnosis. This study suggests further evaluation of access to breast cancer care is needed as poor access may cause the use of CAM. However, since public hospitals in Malaysia are heavily subsidized and readily available to the population, CAM use may impact delays in presentation and diagnosis.

A Survey in the Basal Like Breast Carcinoma Phenotype in North East of Iran

Background: Breast carcinoma is not a homogenous disease. It is divided into 5 pathological subtypes of luminal1, luminal2, strongly Her2 positive, basal like, and normal breast like. Basal like breast carcinoma that accounts for about 15% of all breast cancers has an aggressive clinical behavior with the features of high nuclear grade, negative estrogen receptor, progesterone receptor, and Her2 reactivity (triple negative). Objectives: We aimed at identifying the prevalence of basaloid phenotype among triple negative (TN) cases in our region via immunohistochemistry (IHC) staining using basaloid markers. Methods: We reviewed breast cancer patients in Omid and Imam Reza hospitals, Mashhad, Iran, between 2003 and 2007. We obtained the paraffin blocks from TN cases for immune-staining using cytokeratin 5/6 (CK5/6), cytokeratin 14 (CK14) and epidermal growth factor receptor1 (EGFR1) markers. Results: The incidence of TN disease among breast cancers was 21% (156/747). Based on IHC reactivity with at least one of the basaloid markers, from 59 available samples, 44 (75.4%) were basaloid. Conclusions: In our region, most triple negative tumors were basal like breast cancer (BLBC). Among these cases, most immune-reactivity was observed for EGFR1, followed by CK14 and CK5/6.

PMH2 - Prevalence and Characteristics of Mental Disorders Among Hospitalized Breast Cancer Patients in the United States

PMH2 - Prevalence and Characteristics of Mental Disorders Among Hospitalized Breast Cancer Patients in the United States

Most prevalent unmet supportive care needs and quality of life of breast cancer patients in a tertiary hospital in Malaysia.

BackgroundAddressing breast cancer patients’ unmet supportive care needs in the early stage of their survivorship have become a prime concern because of its significant association with poor quality of life (QOL), which in turn increases healthcare utilization and costs. There is no study about unmet supportive care needs of breast cancer patients in Malaysia. This study aims to assess the most prevalent unmet supportive care needs of Malaysian breast cancer patients and the association between QOL and patients’ characteristics, and their unmet supportive care needs.MethodsA cross-sectional study was conducted at the Surgery and Oncology Clinic between May 2014 and June 2014 in a tertiary hospital in Malaysia. A total of 117 patients out of 133 breast cancer patients recruited by universal sampling were interviewed using a structured questionnaire consisted of three parts: participants’ socio-demographic and disease characteristics, Supportive Care Needs Survey-Short Form Questionnaire (SCNS-SF34) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30).ResultsThe highest unmet supportive care needs were observed in the psychological domain (Mean 53.31; SD ± 21.79), followed by physical domain (Mean 38.16; SD ± 27.15). Most prevalent unmet supportive care needs were uncertainty about the future (78.6 %), fears about the cancer spreading (76.1 %), feelings of sadness (69.2 %), feelings about death and dying (68.4 %), concerns about those close to the patient (65.0 %) and feeling down or depressed (65.0 %). Multivariate linear analysis showed that early breast cancer survivors diagnosed at an advanced stage and with greater physical and psychological needs were significantly (p < 0.05) associated with poorer QOL.ConclusionMost prevalent unmet needs among Malaysian breast cancer patients were found in the psychological domain. Early breast cancer survivors with late stage diagnosis who had more unmet needs in psychological and physical domains were more likely to have a poor QOL.

Race/ethnicity and socio-economic differences in breast cancer surgery outcomes

BackgroundThe purpose of this study is to evaluate racial and socio-economic differences in breast cancer surgery treatment, post-surgical complications, hospital length of stay and mortality among hospitalized breast cancer patients. MethodsWe examined the association between race/ethnicity and socio-economic status with treatment and outcomes after surgery among 71,156 women hospitalized with a primary diagnosis of breast cancer using the Nationwide Inpatient Sample database from 2007 to 2011. Multivariable regression models were used to compute estimates, odds ratios and 95% confidence intervals adjusting for age, comorbidities, stage at diagnosis, insurance, and residential region. ResultsBlack women were more likely to receive breast conserving surgery but less likely to receive mastectomies compared with white women. They also experienced significantly longer hospital stays (β=0.31, 95% CI: 0.24, 0.39), post-surgical complications (OR=1.21, 95% CI: 1.04–1.42) and in-hospital mortality (OR=1.26, 95% CI: 1.07–1.50) compared with Whites, after adjusting for other factors including the number of comorbidities and treatment type. ConclusionAmong patients hospitalized for breast cancer, there were racial differences observed in treatment and outcomes. Further studies are needed to fully characterize whether these differences are due to individual, provider level or hospital level factors, and to highlight areas for targeted approaches to eliminate these disparities.

Breast cancer in their twenties: Clinical outcome of very young breast cancer patients in a cancer hospital in Pakistan.

e12056 Background: Young age breast cancer remains a clinical challenge. The following study aims to review the outcome and treatment options rendered to patients below 30 years of age presenting w...