Psychosocial Impact Of Breast Cancer Research Articles

A Comprehensive Review of Breast Cancer: Prevalence, Diagnosis, and Gender Disparities

Breast cancer remains a leading cause of cancer-related morbidity and mortality worldwide, with significant variations in prevalence, diagnosis, and outcomes across different regions and genders. This comprehensive review examines the global and regional epidemiology of breast cancer, highlighting the increasing incidence driven by demographic changes, lifestyle factors, and urbanization. It explores the impact of gender on breast cancer, noting unique challenges faced by men and women, including diagnostic delays and treatment disparities. The review delves into the risk factors associated with breast cancer, such as genetic mutations, hormonal influences, and lifestyle choices, and discusses advancements in diagnostic technologies, including mammography, ultrasound, MRI, and emerging tools like liquid biopsies and AI-based imaging. Treatment options are analyzed, focusing on personalized medicine, targeted therapies, and the challenges of therapy resistance and recurrence. Preventive strategies, including lifestyle modifications, prophylactic surgeries, and chemoprevention, are reviewed alongside public health initiatives aimed at increasing awareness and screening. The psychosocial impact of breast cancer on patients and their families is also addressed, emphasizing the need for supportive care, patient advocacy, and integrative approaches to improve quality of life. The review concludes with recommendations for future research, policy initiatives, and strategies to address gender disparities and enhance breast cancer care globally. Keywords: Breast Cancer, Epidemiology, Gender Disparities, Risk Factors, Diagnosis

Abstract PO4-18-10: Randomized controlled trial of Young, Empowered & Strong (YES), a web-based patient-reported symptom monitoring and self-management portal for adolescent and young adult (AYA) breast cancer (BC) survivors

Abstract Background: BC is the most common malignancy diagnosed in AYAs. AYAs develop more biologically aggressive BC and present at more advanced stages, necessitating more intensive therapy with curative intent. While acute physical sequelae often resolve following initial treatment, the long-term physical and psychosocial impact of BC on a survivor’s life may worsen or emerge in survivorship. This impact includes symptoms (e.g., sexual problems, anxiety, fatigue, stress, sleep issues, hot flashes) as well as concerns unique to, or accentuated by, being young (e.g., fertility, genetics, childrearing, educational/work attainment). With provider attention to these issues often sub-optimal, strategies that empower patients have the potential to improve their well-being. To engage and activate AYA BC survivors, we developed YES, a web-based portal that leverages electronic patient-reported outcomes (ePROs) to facilitate self-monitoring and management of symptoms/AYA concerns. In contrast to ePRO models dependent on clinician interaction, our approach emphasizes self-management of chronic survivorship concerns outside of the clinic environment. This model is grounded in the reality that most clinicians have limited bandwidth to address these needs and considers that AYAs can have competing demands (e.g., missing work, child-care) that may make accessing in-person support challenging. Methods: The YES study is a randomized controlled trial of the YES intervention vs. usual care. YES supports participants to 1) self-monitor needs/symptoms; and 2) provides a repository for information and resources on self-management of symptoms/AYA concerns. Eligibility criteria include: female, age 15-39 years at diagnosis, stage 0-III BC, within 3 years of diagnosis, no recurrent/second primary BC, no other malignancy since BC diagnosis, and English speaking. Participants randomized to the YES arm are prompted through a monthly text or email to complete an ePRO assessment regarding current symptoms/AYA concerns. For each symptom/concern endorsed, information/resources to address the symptom/concern is automatically provided via the YES portal. The portal is monitored, and providers are contacted if participants report severe distress or suicidality. YES also provides peer support via a chat room and self-support through a journaling platform in the portal. Participants in the usual care group are offered access to YES for up to 3 months at the end of their 9-month study participation. All participants complete a REDCap survey with validated measures of quality of life (QOL), symptoms, and other PROs at baseline, 3, 6, and 9 months after randomization and provide a dried blood spot specimen via a self-administration kit at baseline and 6 months. The primary study aim is to determine the efficacy of YES vs. usual care in improving life quality measured by the QOL in Adult Cancer Survivors [QLACS] scale at 6 months post-randomization. With a planned sample size of 360 participants, the study will have ≥90% power to detect a 6-point mean change (6 months vs. baseline) in the cancer-specific QLACS score between arms. Secondary outcomes include efficacy of YES in reducing symptoms/AYA concerns at 6 months and sustainability of the effects of YES at 9 months. Repeated measures regression will be used with link functions selected based on the type of outcome data analyzed. Exploratory aims will evaluate moderators and mediators of intervention efficacy and the effects of YES on inflammatory biomarkers. At study completion, a subset of 30 participants diverse in age, race, ethnicity, and gender identity are invited to participate in an interview to understand their survivorship preferences/concerns and to understand how the portal supported their self-management. The YES trial opened to enrollment in 9/2021. As of 6/2023, 245 participants are enrolled. Clinical Trials Information: NCT04906200 Citation Format: Shoshana Rosenberg, Yue Zheng, Dawn Hershman, Craig Snow, Kate Dibble, Magnolia Contreras, Noel Roma, Nabihah Tayob, Michelle Naughton, Ann Partridge. Randomized controlled trial of Young, Empowered & Strong (YES), a web-based patient-reported symptom monitoring and self-management portal for adolescent and young adult (AYA) breast cancer (BC) survivors [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO4-18-10.

Breast cancer and body image: The roles of the male partner

Background: Cancer is a group of diseases with different causes, manifestations, treatment, and prognosis, characterized with an uncontrolled growth of abnormal cell. In women; cancer of the breast is the second most common cancer after cervical cancer and the second leading cancer’s death following lung cancer among women in Sub-Saharan Africa. In Nigeria, it has become the most common female malignancy with a prevalence of 12.5%. However, the same treatment that offers better cure rates may also result in a serious decrease in quality of life, psychological problems, as well as provoking changes in their bodies. Societal behavior towards breast cancer patients makes a woman that is newly diagnosed with breast cancer become tearful, ashamed, and discouraged. Aims: To examine breast cancer, body image and the roles of the male partner. Methods: The data for this review paper are from published studies. Electronic databases of Medline, Scopus, PubMed, CINAHL, and Google Scholar were searched using the keywords: breast cancer, body image, roles of the male partner and literature were retrieved and screened for eligibility. The date limit considered in the literature search was from 2016-2021 to capture only the variables identified in this seminar objective. The author defined the topic of interest and the goal was to address the objective of the seminar topic. Results: Four themes (issues) emerged which are: (1) The Model of Whole-Person Caring, (2) Disturbed Body Image, (3) Psycho-Social Impact of Breast Cancer and (4) Roles of the Male Partner. Conclusion: Breast cancer poses a significant financial and psychosocial burden not only on patients, but also on their spouses, families, and broader social network. Breast cancer disease usually changes spousal roles as the women’s husbands take over their responsibilities. The disease influenced both partners and made stress a common factor shared by them. Husband plays a vital role in the lives of breast cancer patients through managing the finance, decision-making, providing emotional support, and remaining involved throughout the disease. Therefore, involving the husband in planned psycho-social interventions produces better results than merely patient-focused strategies. Male partners have a great role to play and should be encouraged and allow partaking in the treatment process of their spouses as this will positively influence their recovery.

Breast cancer or chest cancer? The impact of living with a ‘woman's disease’

Breast cancer in men is rare. Diagnostic methods and treatment are the same as for women, but awareness of male breast cancer is low, as breast cancer is often perceived as a disease specific to women. This can delay diagnosis and cause psychological distress by threatening men's gendered sense of identity. In this article, Helena Lewis-Smith reviews research exploring the psychosocial impact of breast cancer for men

Capturing the Experience: Reflections of Women With Breast Cancer Engaged in an Expressive Writing Intervention.

Expressive writing has been shown to improve quality of life, fatigue, and posttraumatic stress among breast cancer patients across cultures. Understanding how and why the method may be beneficial to patients can increase awareness of the psychosocial impact of breast cancer and enhance interventional work within this population. Qualitative research on experiential aspects of interventions may inform the theoretical understanding and generate hypotheses for future studies. The aim of the study was to explore and describe the experience and feasibility of expressive writing among women with breast cancer following mastectomy and immediate or delayed reconstructive surgery. Seven participants enrolled to undertake 4 episodes of expressive writing at home, with semistructured interviews conducted afterward and analyzed using experiential thematic analysis. Three themes emerged through analysis: writing as process, writing as therapeutic, and writing as a means to help others. Findings illuminate experiential variations in expressive writing and how storytelling encourages a release of cognitive and emotional strains, surrendering these to reside in the text. The method was said to process feelings and capture experiences tied to a new and overwhelming illness situation, as impressions became expressions through writing. Expressive writing, therefore, is a valuable tool for healthcare providers to introduce into the plan of care for patients with breast cancer and potentially other cancer patient groups. This study augments existing evidence to support the appropriateness of expressive writing as an intervention after a breast cancer diagnosis. Further studies should evaluate its feasibility at different time points in survivorship.

Exploring the nature of situational goal-based coping in early-stage breast cancer patients: A contextual approach

PurposeThe psychosocial impact of breast cancer varies widely across patients and over time. Greater insight into goal-based coping processes theorised to underpin psychological resilience may inform efforts to support the maintenance and recovery of psychological wellbeing in the context of breast cancer treatment and recovery. This prospective study adopted a qualitative descriptive design to better understand the nature of situational goal-based coping in response to personal goal interference encountered across the six months following surgery for early-stage breast cancer. MethodResponses to specific instances of goal interference were derived from semi-structured interviews conducted at three time-points following surgery (i.e., approximately two, four, and six months post-surgery). Thematic and cross-case analytic techniques were utilised to identify broad patterns across the goal-specific response trajectories. ResultsThree broad response patterns were identified – goal-based coping only, combined goal-based coping and other (i.e., informed waiting and/or passive) responses, and informed waiting and/or passive responses only. Specific response patterns were further identified within each category. The majority of response trajectories incorporated the utilisation of assimilative and/or accommodative goal-based coping. ConclusionsEarly-stage breast cancer patients utilised goal-based coping in response to many instances of goal-specific interference encountered during the study period. While the initial or delayed activation of these processes appeared generally adaptive, there was also evidence of maladaptive coping and blocked goal pursuit. Further insight into the nature of adaptive and maladaptive goal-based coping in this context could help oncology nurses facilitate ongoing personal goal pursuit and psychological resilience across the cancer continuum.

Cultural considerations for South Asian women with breast cancer.

Cultural values shape a woman's experience of disease and introduce novel stressors that influence psychosocial needs and adaptation. This literature review examines the psychosocial impact of breast cancer in South Asian women, a large group that has received little attention in this regard. We conducted a comprehensive review of the literature published before April 2014 using Ovid MEDLINE, PsychINFO, PubMED, CINHAL, EMBASE, and Sociological Abstracts. We searched for articles about the psychosocial impact of breast cancer in South Asian women. We retained 23 studies for review. The literature concerning South Asian women's experiences identified culturally linked themes that play significant roles in shaping the illness experience; e.g., stigma and breast cancer, low priority of women's health, collective experience of disease, and religion and spirituality. There is a growing need for culturally sensitive care for South Asian women. By understanding the core cultural values and integrating them into clinical practice, Western healthcare providers may improve the quality of care they deliver and help women to extract the maximum benefit. Developing culturally competent support services may enhance effectiveness in addressing the healthcare needs of South Asian women and may serve other ethnic minorities in North America.

Black and South Asian women’s experiences of breast cancer: A qualitative study

Breast cancer is one of the most common forms of cancer in the UK, and affects women of all ethnic groups. The psychosocial impact of breast cancer has been well documented. However, research conducted in this area has been primarily focused on white women. There is very little work within the breast cancer literature that captures the experiences of black and minority ethnic (BME) women. The aim of this qualitative study was to explore the experiences of breast cancer diagnosis and treatment in black and South Asian women living in the UK. Individual semi-structured interviews were conducted with 22 English-speaking breast cancer survivors (11 black and 11 South Asian women). Thematic analysis of the data revealed five key themes, namely social support, spirituality, body image concerns, healthcare experiences and life after cancer. The findings showed that although the BME women shared similar concerns to white women, their experiences were also influenced by cultural specific concerns. This study has implications for healthcare professionals and recognises the need to provide culturally sensitive care and support to BME women, tailored specifically to their values and beliefs.

Impacto psicosocial del cáncer de mama en la etapa de larga supervivencia: propuesta de un plan de cuidados integral para supervivientes

The aim of the article is to show the psychosocial impact of breast cancer in the long-term survival and to promote the idea of implementing a follow-up plan for survivors. A narrative review of published articles on the experience of survival in breast cancer survivors was conducted. Data were organised according to the domains of measurement (physical, psychological and social) of the Quality of Life of Long-term Breast Cancer Survivors Scale (LTQOL-BC). Breast cancer survivors may feel emotionally affected by the physical sequels (mastectomy, lymphedema, early menopause, and infertility), psychological (fear of recurrence and emotional stress) and/or social (family relationships and employment changes). The data are the foundation of a proposal of specific follow-up care for breast cancer survivors.

Patient experience with survivorship care plans: Findings from an online registry of breast cancer survivors.

9136 Background: The IOM (2005) recognized that survivorship care plans (SCP) and treatment summaries (TS) are critical to the delivery of comprehensive survivorship care. The plans are intended to integrate primary and follow-up cancer care, understanding patients are mobile across healthcare systems. These recommendations present a significant challenge to oncology practices; yet, little is known about their use and value to patients. The Cancer Support Community, the largest provider of psychosocial support to cancer patients in the US, surveyed breast cancer survivors about their experience with SCPs to identify areas of unmet need. Methods: To date nearly 3,000 breast cancer survivors have joined the Breast Cancer M.A.P. (Mind Affects the Physical) Project, an online registry designed to examine the psychosocial impact of breast cancer. In November 2010,844 consecutive registrants were provided study-specific questions: 1) receipt of a SCP or TS, 2) if received, satisfaction with SCPs, and 3) queries about information desired but not provided. This sample was 99% female, 88% Caucasian, and the mean age was 55. 72% had at least a college degree. The majority (58%) was initially diagnosed with at least Stage II disease; 14% reported having had a recurrence. Results: Of the respondents, only 12% of breast cancer survivors had received a treatment summary (n=101) and 10.5% had received a survivorship care plan (n=90). Of those who received a SCP, 53% found it to be useful or very useful. Among registrants who received a SCP, 25% reported that information about test results, dates of treatment, and information about future tests were missing from their SCP. Registrants would have also liked their SCP to include information about: 1) general survivorship resources, 2) complementary and alternative treatments, 3) recurrence, 4) late effects, and a summary of the diagnosis and prognosis. Conclusions: The data from the MAP Project indicate that the majority of breast cancer survivors did not receive a survivorship care plan and of those who did receive a plan, a substantial proportion did not find it useful. There continues to be gaps in the adoption, delivery, and utility of cancer survivorship plans.

Psychosocial effects of mastectomy on married African women in Northwestern Nigeria

Few studies have examined the psychosocial impact of breast cancer and its treatment on African women who come from a poverty-stricken, uneducated background in a developing country. The purpose of this study was to describe the specific psychosocial effects of breast cancer on married African women in order to help physicians educate and counsel future women and their families in Northwestern Nigeria. Two semi-structured, self-report questionnaires were given to 81 consenting married African women treated with unilateral total mastectomy secondary to operable breast cancer at the Ahmadu Bello University Teaching Hospital. Questionnaires were answered at the time of the diagnosis and treatment consultation and at 6 months postmastectomy and included questions about demographics, frequency of conjugal relations and how the woman's sense of femininity was affected. Marital status was also tracked up to 3 years. Six months after surgery, the survey responses revealed that 67.9% of women felt inadequate as a woman because of the mastectomy and that 79.0% experienced a decrease in frequency of conjugal relations. Three years after primary breast cancer treatment, 61.7% of the participants were still married while 38.3% reported being divorced/separated from their husbands. These results indicated that married African women face significant physical, emotional and social changes and difficulties following primary breast cancer treatment. Culturally sensitive therapeutic groups and interventions should be established to help Nigerian women with breast cancer and their spouses and families understand and cope with the disease and its long-term health and quality-of-life implications.

Psychosocial impact of breast cancer diagnosis and treatment in African, Caribbean and South Asian women

Breast cancer is one of the most common forms of cancers in the UK and affects women of all ethnic groups. The psychosocial impact of breast cancer has been well documented. However, the research conducted in this area has been primarily focused on mainstream Caucasian women. There is very little work within the breast cancer literature that captures the experiences of Black and Minority Ethnic (BME) women.

Older women, breast cancer, and social support

IntroductionOne in ten women over the age of 65 will develop breast cancer. Despite this high incidence of breast cancer among older women, social support for them is often inadequate. This paper describes a qualitative study of the impact of a breast cancer diagnosis on older women from racially/ethnically diverse populations and their subsequent need for social support.MethodsForty-seven older African American, Asian American, Caucasian and Latina women between the ages of 65 to 83 participated in a larger study examining the impact of breast cancer on women from racially/ethnically diverse populations and the meaning and nature of social support. The women completed an in-depth qualitative interview on the psychosocial impact of breast cancer and the meaning and nature of social support.Results and ConclusionThe results indicate that there are variations in reactions to a breast cancer diagnosis among older women, and that these reactions impact their experiences with seeking social support at diagnosis and during treatment. Respondents were concerned about their aging bodies, potential dependency on others, and loss of autonomy. At the same time, the severity of cancer treatment and existing co-morbidities often meant they needed to learn to receive support, and to reach out if they had no support. The implications of these findings underscore the older cancer patient’s need to strengthen her supportive networks at the time of diagnosis, during treatment, and post-treatment.

Understanding the breast cancer experience of women: a qualitative study of African American, Asian American, Latina and Caucasian cancer survivors.

Breast cancer is the most common form of cancer in American women across most ethnic groups. Although the psychosocial impact of breast cancer is being studied, there is little information on women from diverse ethnic and socioeconomic backgrounds. We conducted a qualitative study with breast cancer survivors (BCS) of various ethnicities. A total of 102 BCS participated in focus group interviews (24 African Americans, 34 Asians, 26 Latinas and 18 Caucasians); 20 health professionals participated in key informant interviews. Important ethnic differences in type of treatment were noted, Asians and Latinas were more likely to receive mastectomies and African American BCS were least likely to receive adjuvant therapies, including radiation and chemotherapy. These BCS enjoyed a fairly good overall health-related quality of life (HRQOL) with some persistent concerns. The prevailing concerns among all women included overall health, moderate physical concerns, cancer recurrence or metastases, psychosocial concerns related to worry about children and burdening the family, and body image and sexual health concerns. Additional challenges included: lack of knowledge about breast cancer; medical care issues such as insurance, cost and amount of time spent with physician; cultural sensitivity of providers, language barriers, cultural factors related to beliefs about illness, gender role and family obligations (e.g. self-sacrifice). These BCS, particularly the women of color, voiced that their spiritual beliefs and practices are central to their coping. This study accomplishes two goals; it adds to the sparse literature concerning the psychosocial sequelae of breast cancer among women of color, and it increases our knowledge of specific cultural influences (e.g. dietary practices, coping) and socio-ecological factors on HRQOL. More importantly, the study addressed areas that have not been studied before, specifically, an in-depth study on BCS QOL comparing multiple ethnic groups in the US. The results of this investigation will provide preliminary information to survivors and health-care providers about the impact of culture and socio-ecological contexts on survivorship. Among women of all major ethnic groups, breast cancer is the most common form of cancer and the second leading cause of cancer death (American Cancer Society (ACS), 2002). In 2002, over 203,000 women in the United States will be diagnosed with breast cancer (ACS, 2002). Ethnic disparities exist for cancer stage, diagnosis, survival, morbidity and mortality. In general, ethnic minority women are diagnosed with more advanced disease and experience greater morbidity and mortality (Haynes & Smedley, 1999; Miller et al., 1996; Ries et al., 2000; Shinagawa, 2000). In general, increases in survival rates have prompted greater interest in the quality of life (QOL) of breast cancer survivors (BCS) over the past two decades. Additionally, the QOL of cancer survivors from diverse ethnic, cultural and socioeconomic backgrounds is an emerging priority area for studies on survivorship research and clinical care (Haynes and Smedley, 1999; National Cancer Institute (NCI), 2002; President's Cancer Panel, 2000).

Understanding the breast cancer experience of Asian American women.

Breast cancer is the most common form of cancer in women and affects women across all ethnic groups. Although the psychosocial impact of breast cancer is being studied, there is little information on ethnic minorities. To better understand the breast cancer experience of Asian American women, we conducted key informant and focus group interviews. Six professionals participated in the key informant interviews. A total of 34 Asian American breast cancer survivors participated in focus group interviews, including Korean (n=10), Chinese (n=11), and a mixed Asian group (n=13). The common themes identified in this series of qualitative studies included: lack of knowledge about breast cancer; medical care issues such as cost and amount of time spent with physician; cultural factors related to beliefs about illness, gender role and family obligations (e.g. self-sacrifice) and language barriers; the importance of spirituality; and psychosocial concerns related to worry about children, burdening the family, body image and sexual health concerns. A primary source of support and coping for Asian American women with breast cancer was their spiritual beliefs. The results from this qualitative study have been used to prepare a survey instrument to examine these issues in a larger sample of Asian American women.

Psychosocial Impact of Breast Cancer: A Critical Review

Abstract This article reviews recent literature on the psychosocial impact of breast cancer, with a focus on the adjustment period, treatment, and psychosocial interventions. These studies have shown that as many as one-quarter of women with breast cancer suffer marked psychological morbidity associated with diagnosis and treatment, though for many women psychological distress declines substantially within a year after treatment. Research regarding treatment options has shown that, for women who can be treated with breast-conserving surgery, less invasive surgery may result in less body image concern and better sexual functioning. Factors which appear to moderate the impact of breast cancer on women's psychological health include coping styles, information preferences, social support, and pre-treatment psychiatric morbidity. Studies of psychosocial interventions suggest positive effects of social support, cognitive therapy, and supportive information. Future research efforts should be directed toward understanding special subgroups of women, and developing and testing behavioral interventions to improve psychosocial adjustment among women at high risk. Approaches which enhance patient–provider communication and patient involvement in care may be most beneficial.