Early Breast Cancer Survivors Research Articles

266P - Detecting bone density in early breast cancer survivors: The arm-DXA method

Background: Breast cancer survivors who are on adjunct therapy with Aromatase Inhibitors (AIs) or premature menopause due to chemotherapy are known to have an increased risk of osteoporosis and bone fracture. Being at high risk for osteoporosis, these patients should be screened using with dual energy X-ray absorptiometry (DXA) to measure bone mineral density (BMD) according to national guidelines. This study screened the population of patients with early Breast cancer utilizing the Arm-DXA as a user friendly and efficient method. Methods: All Breast cancer patients at the Tolna County Cancer Center, Szekszárd who are diagnosis of early invasive breast cancer were scanned using Arm-DXA during their regular visit to the center. Cancer patients under hormone therapy were scanned annually. Patients who have metastatic disease or known to have osteoporosis were excluded from the study. A total of 431 patients were subject of an arm-DEXA scan for BMD during the period February 2015 to September 2017. Results: Out of the 431 patients, normal T score −1,5 detected in 223 patients (51,7%), clinically significant osteopenia (CSO) T score −1,5, −2,5 detected in 129 patients (29,9%), and osteoporosis T score < −2,5 detected in 79 patients (18,3%). For the 224 Patients who were under hormone therapy or/and chemotherapy about 29,9% (n: 67) had a CSO, and 20,5% (n:46) had osteoporosis. Conclusions: This study highlights the fact that osteoporosis is under-detected in early breast cancer survivors who are on or after hormone and chemotherapy. About 48% of early breast cancer survivors found to have osteoporosis or clinically significant osteopenia in our study. Our BMD test results shows that half the 224 patients who were under hormone therapy need to take treatment (zoledronic -acid or denosumab) to prevent bone fracture. Legal entity responsible for the study: Al-Farhat Yousuf. Funding: Has not received any funding. Disclosure: The author has declared no conflicts of interest.

Breast Cancer

Invasive breast cancer, the most common nonskin cancer in women in the United States, will be diagnosed in 235,000 women in this country in 2013 and is expected to result in approximately 40,000 deaths. Incidence and mortality reached a plateau and appear to be dropping in both the United States and parts of western Europe. This decline has been attributed to several factors, such as early detection through the use of screening mammography and appropriate use of systemic adjuvant therapy, as well as decreased use of hormone replacement therapy. However, the global burden of breast cancer remains great, and global breast cancer incidence increased from 641,000 in 1980 to 1,643,000 in 2010, an annual rate of increase of 3.1%. This chapter examines the etiology, epidemiology, prevention, screening, staging, and prognosis of breast cancer. The diagnoses and treatments of the four stages of breast cancer are also included. Figures include algorithms used for the systemic treatment of stage IV breast cancer and hormone therapy for women with stage IV breast cancer. Tables describe selected outcomes from the National Surgical Adjuvant Breast and Bowel Project (NSABP) P-1 and P-2 chemoprevention trials, tamoxifen chemoprevention trials for breast cancer, the TNM staging system and stage groupings for breast cancer, some commonly used adjuvant chemotherapy regimens, an algorithm for suggested treatment for patients with operable breast cancer from the 2011 St. Gallen consensus conference, guidelines for surveillance of asymptomatic early breast cancer survivors from the American Society of Clinical Oncology, and newer agents for metastatic breast cancer commercially available in the United States. This review contains 2 highly rendered figures, 8 tables, and 108 references.

Breast Cancer

Invasive breast cancer, the most common nonskin cancer in women in the United States, will be diagnosed in 266,120 In 2018, along with 63,960 new cases of non-invasive (in situ) breast cancer. Incidence and mortality reached a plateau and appear to be dropping in both the United States and parts of western Europe. This decline has been attributed to several factors, such as early detection through the use of screening mammography and appropriate use of systemic adjuvant therapy, as well as decreased use of hormone replacement therapy. However, the global burden of breast cancer remains great, and global breast cancer incidence increased from 641,000 in 1980 to 1,643,000 in 2010, an annual rate of increase of 3.1%. This chapter examines the etiology, epidemiology, prevention, screening, staging, and prognosis of breast cancer. The diagnoses and treatments of the four stages of breast cancer are also included. Figures include algorithms used for the systemic treatment of stage IV breast cancer and hormone therapy for women with stage IV breast cancer. Tables describe selected outcomes from the National Surgical Adjuvant Breast and Bowel Project (NSABP) P-1 and P-2 chemoprevention trials, tamoxifen chemoprevention trials for breast cancer, the TNM staging system and stage groupings for breast cancer, some commonly used adjuvant chemotherapy regimens, an algorithm for suggested treatment for patients with operable breast cancer from the 2011 St. Gallen consensus conference, guidelines for surveillance of asymptomatic early breast cancer survivors from the American Society of Clinical Oncology, and newer agents for metastatic breast cancer commercially available in the United States. This review contains 2 highly rendered figures, 8 tables, and 108 references.

Factors associated with imaging in patients with early breast cancer after initial treatment.

Overuse of surveillance imaging in patients after curative treatment for early breast cancer (ebc) was recently identified as one of the Choosing Wisely Canada initiatives to improve the quality of cancer care. We undertook a population-level examination of imaging practices in Ontario as they existed before the launch of that initiative. Patients diagnosed with ebc between 2006 and 2010 in Ontario were identified from the Ontario Cancer Registry. Records were linked deterministically to provincial health care databases to obtain comprehensive follow-up. We identified all advanced imaging exams [aies: computed tomography (ct), bone scan, positron-emission tomography] and basic imaging exams (bies: ultrasonography, chest radiography) occurring within the first 2 years after curative treatment. Poisson regression was used to assess associations between patient or provider characteristics and the rate of aies. Of 30,006 women with ebc, 58.6% received at least 1 bie, and 30.6% received at least 1 aie in year 1 after treatment. In year 2, 52.7% received at least 1 bie, and 25.7% received at least 1 aie. The most common aies were chest cts and bone scans. The rate of aies increased with older age, higher disease stage, comorbidity, chemotherapy exposure, and prior staging investigations (p < 0.001). Imaging was ordered mainly by medical oncologists (38%), followed by primary care physicians (23%), surgeons (13%), and emergency room physicians (7%). Despite recommendations against its use, imaging is common in ebc survivors. Understanding the factors associated with aie use helps to identify areas for further research and is required to lower imaging rates and to improve survivorship care.

EP-1265: Quality of Life in long term premenopausic early stages breast cancer survivors. QL determinants

EP-1265: Quality of Life in long term premenopausic early stages breast cancer survivors. QL determinants

3LBA - Long-term psychological distress in early breast cancer survivors and their matched controls: a population-based cohort

3LBA - Long-term psychological distress in early breast cancer survivors and their matched controls: a population-based cohort

Sexual functioning among early post-treatment breast cancer survivors.

This study aims (1) to estimate percentages of partnered women who are sexually active over the first 2years post-breast cancer diagnosis; (2) to identify factors related to sexual inactivity; and (3) to evaluate separately, among both sexually active and inactive survivors, the relation between sexual problems and treatment-related variables, symptoms, and psychosocial factors. Longitudinal observational study of breast cancer survivors recruited within 8months of cancer diagnosis and followed for 18months. The main outcome measures were (1) being sexually active/inactive in the past month and (2) sexual problems assessed with the four-item sexual problem domain of the Quality of Life in Adult Cancer Survivors (QLACS) scale. At baseline, 52.4% of women reported being sexually active in the past month. This percentage increased to 60.7% 18months later. In multivariable repeated-measures analyses, age, past chemotherapy, depressive symptoms, and lower perceived attractiveness were related to inactivity. Sexually inactive women reported more problems on the QLACS than sexually active women. In stratified multivariable analyses, depressive symptoms were related to greater sexual problems for both sexually active and inactive women, as was vaginal dryness. Among the sexually active women, younger age at diagnosis, less illness intrusiveness, and lower perceived attractiveness were related to more problems. Research has shown that sexual functioning/sexual health are key aspects of quality of life for many cancer survivors, and are often not addressed by health care providers. Future studies should examine how such topics are handled by clinicians in their interactions with survivors.

Cancer-related fatigue in cancer survivors (CS) with no active treatment.

238 Background: Fatigue is a subjective experience that should be systematically assessed at the initial visit, at regular intervals and as clinically indicated. Quality of fatigue management should be included in institutional continuous quality improvement projects. The PERFORM questionnaire (PQ) was developed among Spanish speaking patients for the assessment of fatigue. Methods: Outpatients recruited for projects in which physical condition and physical activity (PA) were evaluated, rated their fatigue severity on the PQ (12-60, being 60 no fatigue). PHUEM-01 evaluated early colon CS after finishing adjuvant treatment (AT). PHUEM-02 early breast CS at the end of AT. PH-UEM-03 evaluated colorectal CS (localized and metastatic) at the time of diagnosis. MS-04 evaluated fatigue at the time of diagnosis of different tumors (localized and metastatic). Physical condition was evaluated through the one-mile walk test (VO2MAX) and handgrip dynamometer. Heart rate was measured as a sign of autonomic dysfunction. PA was objectively evaluated through accelerometers generating weekly MVPA information. Results: 262 CS (63% women) were recruited, (110 breast, 119 colorectal, 14 other), mean age 60. 30% of survivors reported no fatigue. Mean PERFORM score 48,34; VO2max 25.5 ml/kg/min; handgrip 29,14 kg; HR 75 bpm. Women, younger CS, CS with worse physical condition, higher BMI, higher HR and less active CS reported more fatigue (only sex, handgrip strength and weekly PA were statistically significant for the overall population). Breast CS reported higher scores of fatigue than colorectal CS (p &lt; 0.000). For breast CS there was an association between fatigue and HR which was not seen in the overall population. Metastatic colorectal did not report worse scores of fatigue than CS with localized tumors. Conclusions: As a subjective symptom, fatigue is unpredictable and its severity and interference with daily activities can be bothersome in an unexpected population (young CS, early stages) with no active treatment. More physically active and fitter CS are less fatigued. Mechanisms underlying cancer-related fatigue could be different for different tumors. More research in prevalence, evaluation, mechanisms and management of fatigue is needed.

Met and Unmet Expectations for Breast Reconstruction in Early Posttreatment Breast Cancer Survivors

Met and Unmet Expectations for Breast Reconstruction in Early Posttreatment Breast Cancer Survivors

Met and Unmet Expectations for Breast Reconstruction in Early Posttreatment Breast Cancer Survivors.

The purpose of this study was to evaluate the prevalence of met and unmet expectations after breast reconstruction among breast cancer survivors following mastectomy. A secondary objective was to examine reasons women report their experiences of reconstructive surgery were better or worse than expected. As part of a larger study of breast cancer survivors, participants completed self-administered questionnaires within 8 months of diagnosis and at 6, 12, and 18 months later. At the 18-month follow-up, women who had breast reconstruction were asked whether their reconstruction was better, the same, or worse than expected. The sample consisted of 130 survivors (mean age = 48.5 years) who had breast reconstruction following mastectomy and completed the 18-month follow-up, 42% of whom reported their reconstruction was worse than expected and only 25% reported it was better. Most frequently reported reasons for reconstruction being worse than expected were related to appearance of the reconstructed breast and pain. A high percentage of patients with breast cancer undergoing breast reconstruction following mastectomy reported the results as worse than expected, with the primary reasons for dissatisfaction related to the feel and appearance of the reconstructed breast. Patients with breast cancer considering breast reconstruction need better preoperative education or understanding about what to expect from reconstruction.

The prevalence of unmet needs in 625 women living beyond a diagnosis of early breast cancer

Background:There are over half a million women with a previous breast cancer diagnosis living in the UK. It is important to establish their level of unmet physical and psychosocial needs, as many are not routinely seen for follow-up under current models of care.Methods:We conducted a retrospective analysis of early breast cancer survivors entering an Open Access Follow-Up (OAFU) programme in 2015. Unmet needs were assessed using the Holistic Needs Assessment (HNA) or extracted directly from the electronic patient record (EPR), when the HNA had not been completed.Results:Six hundred and twenty-five patients were eligible. Sixty-one per cent of the survivors had at least one unmet need and 18% had ⩾5 needs. Consistently higher levels of unmet needs were identified using the formal HNA checklist as opposed to extraction from EPR (P<0.001). Physical and emotional needs were the most frequently reported (55 and 24% respectively). Patients receiving endocrine therapy and those who had received chemotherapy were more likely to report unmet needs (both P<0.001).Conclusions:Unmet physical and emotional needs are common in breast cancer survivors. It is vital that the services are available for these patients as they transition from hospital-based follow-up to patient-led self-management models of care.

Detecting bone loss in early breast cancer survivors: The Arm-DXA method.

e12066 Background: Breast cancer survivors who are on adjunct therapy with Aromatase Inhibitors (AIs) or premature menopause due to chemotherapy are known to have an increased risk of osteoporosis and bone fracture. Being at high risk for osteoporosis, these patients should be screened using with dual energy X-ray absorptiometry (DXA) to measure bone mineral density (BMD) according to national guidelines. This study screened the population of patients with early Breast cancer utilizing the Arm-DXA as a user friendly and efficient method. Methods: All Breast cancer patients at the Tolna County Cancer Center, Szekszárd who are diagnosis of early invasive breast cancer were scanned using Arm-DXA during their regular visit to the center. Cancer patients under hormone therapy were scanned annually. Patients who have metastatic disease or known to have osteoporosis were excluded from the study. A total of 431 patients were subject of an arm-DEXA scan for BMD during the period February 2015 to September 2016. Results: Out of the 431 patients, normal T score &gt;-1,5 detected in 223 patients (51,7%), clinically significant osteopenia (CSO) T score -1,5- -2,5 detected in 129 patients (29,9%), and osteoporosis T score &lt; -2,5 detected in 79 patients (18,3%). For the 224 Patients who were under hormone therapy or/and chemotherapy about 29,9% (n: 67) had a CSO, and 20,5% (n:46) had osteoporosis. Conclusions: This study highlights the fact that osteoporosis is under-detected in early breast cancer survivors who are on or after hormone and chemotherapy. About 48% of early breast cancer survivors found to have osteoporosis or clinically significant osteopenia in our study. Our BMD test results shows that half the 224 patients who were under hormone therapy need to take treatment (zoledronic -acid or denosumab ) to prevent bone fracture.

Using health-related quality of life and treatment measures to predict 10-year mortality in older survivors of early stage breast cancer.

e21548 Background: Older women make up the growing majority of breast cancer (BC) survivors. Guideline BC treatments are known contributors to long-term survival, and health-related quality of life (HRQOL) is emerging as not only an important outcome in survivorship care but also as a factor thought to influence mortality. However, prognostic models that include HRQOL alongside BC treatment measures are lacking. We aimed to develop a 10-year mortality risk score based on a priori chosen treatment and HRQOL variables. Methods: We studied 660 women ≥65-years old diagnosed with stage I-IIIA primary breast cancer in years 1997-1999. Data from medical and psychosocial domains were collected over 10 years from interviews, medical records, and death indexes. BC treatment variables included receipt of definitive locoregional surgery +/- radiation, chemotherapy, and tamoxifen. HRQOL variables included physical function [10-item Physical Function Index (PFI-10) from the Medical Outcomes Study Short Form-36 (MOS SF-36)]; mental health [5-item Mental Health Index (MHI-5) from the MOS SF-36]; and social support [8-item modified MOS Social Support Scale (mMOS-SSS)]. We used penalized logistic regression models to develop a 10-year mortality risk score, and investigated its discrimination (c-statistic) and calibration (observed versus predicted mortality using the Hosmer-Lemeshow (HL) test). Results: Mortality though 10-years of follow-up was 34.8% (230 of 660 women). The c-statistic of a risk score using only age, number of comorbidities, stage of BC, and BC treatment was 0.71. The c-statistic increased to 0.74 with the addition of HRQOL measures and showed good calibration (p = 0.72 from HL test). Physical function and mental health had strong independent associations with mortality (women with high PFI-10: OR 0.63, 95% CI 0.43, 0.92; women with high MHI-5: OR 0.57, 95% CI 0.39, 0.85). Conclusions: In older early stage breast cancer survivors, our risk score combining HRQOL with treatment measures showed good discrimination and calibration. HRQOL is independently associated with 10-year mortality and adds predictive ability to age, comorbidity, stage of BC, and BC treatment.

Weight trajectories during first two years of endocrine treatment: Premenopausal compared to postmenopausal early breast cancer survivors.

e12069 Background: Obesity and weight gain in breast cancer survivors (BCS) can impact prognosis, survival, and quality of life. Women who were premenopausal (PreBCS) or postmenopausal (PostBCS) at BC diagnosis are compared regarding weight change during the first 2 years of endocrine treatment (ET) and factors associated with &gt; 2kg weight gain. Methods: Data were gathered by retrospective chart review, with weights assessed by nursing staff during routine clinic visits. Chi-squared and t-tests were used to compare PostBCS and PreBCS characteristics, and log-binomial regression models to evaluate factors associated with &gt; 2kg weight gain. Results: In a final sample of N = 447 BCS, 33% were PreBCS (mean age 44) and 67% were PostBCS (mean age 65). PreBCS had lower BMI at diagnosis (p = 0.003), lower proportion of white (p = 0.04), fewer comorbidities (p &lt; 0.0001); higher stage (p &lt; 0.0001), grade (p = 0.008), node positive (p &lt; 0.0001), PR positive (p = 0.03), and HER2 positive (p = 0.03) BC tumors; higher proportion of mastectomies (p &lt; 0.0001), axillary node dissection (p = 0.005), chemotherapy (p &lt; 0.0001), radiation treatment (p = 0.009), and Tamoxifen use (p &lt; 0.0001); and less weight loss between diagnosis and start of ET (p = 0.013). After 2 years of ET, 48% of PreBCS and 39% of PostBCS had gained &gt; 2kg (p = 0.08). In univariate analysis, factors associated with &gt; 2kg weight gain were: weight loss between BC diagnosis and ET start (p &lt; .0001), lower age at start of ET (p = .002), higher tumor size (p = .003), increasing stage (p &lt; .0001), mastectomy (p = .0002), axillary node dissection (p = .005), positive nodal status (p = 0.0003), and chemotherapy (p &lt; .0001). In multivariable analysis controlling for covariates that differed between PreBCS/PostBCS, only weight change between BC diagnosis and ET start was associated with &gt; 2kg weight gain (p = 0.0005). Conclusions: In our sample, neither menopausal status nor type of ET was significantly associated with weight gain during ET. Our research suggests that BC survivors with higher risk tumors and associated treatments may experience higher weight gain during ET and warrant weight management counseling.

Breast Cancer

Invasive breast cancer, the most common nonskin cancer in women in the United States, will be diagnosed in 235,000 women in this country in 2013 and is expected to result in approximately 40,000 deaths. Incidence and mortality reached a plateau and appear to be dropping in both the United States and parts of western Europe. This decline has been attributed to several factors, such as early detection through the use of screening mammography and appropriate use of systemic adjuvant therapy, as well as decreased use of hormone replacement therapy. However, the global burden of breast cancer remains great, and global breast cancer incidence increased from 641,000 in 1980 to 1,643,000 in 2010, an annual rate of increase of 3.1%. This chapter examines the etiology, epidemiology, prevention, screening, staging, and prognosis of breast cancer. The diagnoses and treatments of the four stages of breast cancer are also included. Figures include algorithms used for the systemic treatment of stage IV breast cancer and hormone therapy for women with stage IV breast cancer. Tables describe selected outcomes from the National Surgical Adjuvant Breast and Bowel Project (NSABP) P-1 and P-2 chemoprevention trials, tamoxifen chemoprevention trials for breast cancer, the TNM staging system and stage groupings for breast cancer, some commonly used adjuvant chemotherapy regimens, an algorithm for suggested treatment for patients with operable breast cancer from the 2011 St. Gallen consensus conference, guidelines for surveillance of asymptomatic early breast cancer survivors from the American Society of Clinical Oncology, and newer agents for metastatic breast cancer commercially available in the United States. This review contains 2 highly rendered figures, 8 tables, and 108 references.

Low income deteriorates quality of life in early breast cancer survivors

BackgroundPatients who have survived cancer and have lower socio-economic status, are more likely to leave the workforce. Financial problems are widespread among many of the breast cancer survivors, but their effect on the quality of life are not sufficiently explored. The aim of this study is to assess the effect of low income onto quality of life in early breast cancer survivors.MethodsIn this study, 214 consecutive early female breast cancer patients, with mean age of 60 years (range 30–90), were interviewed for psycho-social aspects, depression (MINI) and quality of life (EORTC QLQ-Core 30 and BR-23). All patients were cancer free at the moment of interview and all initial oncological treatments were completed. Monthly net family income distribution was: ≤150 euro 58 patients (27.1%); income between 150–500 euro 116 patients (54.2%); ≥500 euro 40 patients (18.7%).ResultsPatients with income ≤150 euro, compared to patients with income ≥500 euro, had statistically significant worse global health status (60.2 ± 27.9 vs. 80.2 ± 19.2; P = 0.0007); worse physical functioning (80.3 vs. 69.1; P &lt; 0.001); worse role functioning (92.9 vs. 78.7; P = 0.009); worse sexual functioning (P = 0.019); more severe fatigue (38 vs. 23; P = 0.01), nausea/vomitus (P = 0.041), appetite loss (18.4 ± 7.5). Major depression was diagnosed in 35 patients. Depressed patients have less income than not depressed patients (23.3% vs. 14.41%), but the difference did not reach statistical significance.ConclusionsLower income negatively affects many aspects of quality of life. Specific interventions are needed for cancer survivors with lower socio-economic status to preserve and improve the quality of life.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Objectively measured sedentary behavior and quality of life among survivors of early stage breast cancer.

This study examined relationships between sedentary behavior accumulated in different bout durations and quality of life (QoL) among breast cancer survivors. Postmenopausal breast cancer survivors completed the Short Form Health Survey to assess QoL and wore an accelerometer to measure sedentary behavior and physical activity between August 2011 and May 2013. Participants (n=134) averaged 509.7min/day in sedentary time with 285.2min/day in short bouts (<20min) and 224.5 min/day long bouts (≥20min). Linear regression models indicated that greater total sedentary time was significantly associated with worse physical QoL (b=-0.70, p=0.02) but not mental QoL (p=0.92). Models that examined the accumulation of sedentary time in short bouts and long bouts together showed that time in long sedentary bouts was significantly related to physical QoL (b=-0.72, p=0.02), while time in short bouts was not (p=0.63). Moderate-to-vigorous intensity physical activity (MVPA) was a significant effect modifier of the relation between time spent in long sedentary bouts and physical QoL (p=0.028) such that greater time in long bouts was associated with worse physical QoL only among women with lower levels of MVPA. Findings indicate that time spent in long sedentary bouts is associated with worse physical QoL among breast cancer survivors who do not engage in high levels of MVPA. Future research should examine reducing sedentary time as a potential strategy to improve physical QoL.

Partners of young breast cancer survivors: A cross-sectional evaluation of psychosocial issues and mental health.

184 Background: While evidence of the challenges of cancer caregiving has been growing, scant research addresses the experience of partners of young adults with cancer. These individuals and their relationships may be particularly vulnerable to stress, especially when managing the complexity of cancer care and survivorship with their partner. We sought to evaluate psychosocial concerns and mental health in the partners of young survivors of early stage breast cancer (BC). Methods: We invited partners of young women w/BC diagnosed at age ≤ 40 yrs enrolled in a prospective cohort study to participate in a one-time survey evaluating psychosocial concerns including quality of life, coping, social support, financial insecurity, partnership concerns, parenting concerns, anxiety and depression. Logistic regression was used to explore predictors of anxiety (score &gt; 8 on Hospital Anxiety and Depression Scale (HADS)). Results: Most respondents (284/289) were male, with median age 43 yrs (range 27-65). The median time of survey completion was 62 months (range 16 -114) after their partner’s dx. Respondents were mostly white (93%), working full time (94%), and college educated (78%); 29% reported some financial stress, 74% were parenting children &lt; 18 yrs, and 32% reported at least a fair amount of relationship concern. 42% (106/250) had anxiety (39/289 respondents (13%) had incomplete/missing HADS). In univariable analyses, lower education, working full time, parenting concerns, insufficient social support and maladaptive coping were associated (p &lt; .05) with anxiety. In the multivariable model, only maladaptive coping remained significantly associated with anxiety (p &lt; .01, OR = 2.32 (95% CI: 1.22, 4.39)). Conclusions: Partners of young BC survivors who used less constructive/more maladaptive coping strategies experience negative mental health outcomes after tx has ended. Caregivers’ anxiety may have implications for both their own and survivors’ health and QOL. Future interventions might focus on the development of constructive coping strategies to enhance adjustment and role effectiveness in dealing with the impact of cancer.

Effect of Long-term Yoga Practice on Psychological outcomes in Breast Cancer Survivors.

Aim:Breast cancer has become a pandemic with an ever-increasing incidence. Although better diagnostics and treatment modalities have reduced mortality, a large number of survivors face cancer and treatment-related long-term symptoms. Many survivors are taking up yoga for improving the quality of life (QoL). The present study attempts to evaluate predictors of psychological states in breast cancer survivors with long-term yoga experience.Materials and Methods:A case–control study recruited early breast cancer survivors, 30–65 years, completing treatment > 6 months before recruitment, and grouped them based on prior yoga experience (BCY, n = 27) or naïve (BCN, n = 25). Demography, cancer history, diet, exercise habits, and yoga schedule were collected and tools to assess stress, anxiety, depression, general health, and QoL were administered. Multivariate linear regression was done to identify predictors of psychological variables.Results:BCY had significantly lower stress, anxiety, depression, better general health, and QoL (P < 0.001). Global QoL and trait anxiety were significantly predicted by Yoga practice; depression was predicted by yoga practice, annual income, and sleep quality; state anxiety was predicted by Yoga practice and income; and stress was predicted by Yoga practice and sleep quality.Conclusion:Results indicate that breast cancer survivors, doing yoga, have better psychological profiles and are able to deal with demanding situations better. The psycho-oncogenic model of cancer etiology suggests that a better psychological state in survival has the potential to improve prognosis and survival outcomes and Yoga may be a suitable practice for staying cancer-free for a longer time.

P.2.b.038 - Diagnostic challenges for major depression in early breast cancer survivors

P.2.b.038 - Diagnostic challenges for major depression in early breast cancer survivors