Tor Vergata University-Hospital in the Beginning of COVID-19-Era: Experience and Recommendation for Breast Cancer Patients.

COVID-19 has been officially declared as a pandemic by the WHO. Italy was the first European country to be strongly affected by this outbreak. All elective and health promotion activities were reduced. Accordingly, Italian Breast Units and breast cancer (BC) screening programs scaled down significantly their activities. The aim of this study was to evaluate measures that could potentially reduce the clinical impact of COVID-19 on BC patients. Temporary recommendations are needed that could assist specialists in preventing COVID-19 infection and optimizing resources for diagnosis and treatment of BC patients.

Health-related quality of life associated with different cancer treatments in Chinese breast cancer survivors in Taiwan.

We assessed the quality of life (QoL) associated with patient's characteristics and different cancer treatments among Chinese breast cancer survivors in Taiwan. A cross-sectional survey was conducted in 2017 where 193 patients with hormone receptor-positive/human epidermal growth factor receptor-2-negative metastatic breast cancer were recruited. Three QoL questionnaires were administered: European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), its breast cancer supplementary measure (QLQ-BR23) and EQ-5D-5L. Multiple linear regression was performed to assess the association between QoL and cancer treatments, with adjustment for patient's characteristics. The mean age of study participants was 55.52 years. Simple linear regression showed that cancer stage and receiving chemotherapy were significantly associated with QoL scores (p < 0.05). Significant adverse effects of chemotherapy on QoL were found among early-stage cancer women (i.e., I or II), including poor cognitive and sexual functioning, and a higher symptom burden (i.e., dyspnoea, constipation, systematic therapy side effects). Multiple linear regression also revealed that receiving chemotherapy was significantly associated with poor QoL (e.g., lower functional health and higher symptom burden measured by the QLQ-BR23), compared to none chemotherapy (p < 0.05). Receiving chemotherapy was associated with poor QoL, especially among early-stage breast cancer patients.

Biopsychosocial Challenges and Needs of Young African American Women with Triple-Negative Breast Cancer.

Triple-negative breast cancer (TNBC) is a subtype of breast cancer known to have poorer prognoses and lower survival rates compared with other types of breast cancer. In addition, TNBC is overrepresented in premenopausal African American women. Using grounded theory as the qualitative methodological approach, the present article elucidates unique biopsychosocial challenges and needs of young African American women with TNBC. A study group of six women with TNBC and a comparison group of six women with estrogen receptor-positive breast cancer were interviewed longitudinally over three time points throughout the cancer treatment trajectory. Major themes that were unique to the study group of women with TNBC include (a) longer, more aggressive treatment trajectories; (b) more difficult struggles with feminine identity; (c) the presence of fertility and parenting issues; (d) higher burdens of care; (e) barriers to separation and individuation as a maturation milestone; and (f) feeling out of place compared with peers. These themes provide a foundation to inform how social workers care for this underserved group of women.

Differences in Coping Among African American Women With Breast Cancer and Triple-Negative Breast Cancer.

PURPOSE/OBJECTIVES: To determine differences in psychological distress, symptoms, coping capacity, and coping abilities among African American (AA) women with triple-negative breast cancer (TNBC) and non-TNBC and to explore differences in relationships among these variables.
. DESIGN: A prospective, descriptive, comparative, and correlational design.
. SETTING: Johns Hopkins Hospital in Baltimore, Maryland.
. SAMPLE: 30 AA women with breast cancer.
. METHODS: Patients completed questionnaires during chemotherapy. The Transactional Model of Stress and Coping was used to guide the research.
. MAIN RESEARCH VARIABLES: Psychological distress, symptoms, coping capacity, and coping ability.
. FINDINGS: Patients with non-TNBC reported more intense present total pain, nausea and vomiting, better emotional functioning, lower cognitive functioning, use of significantly more prayer and hope, and more coping self-statements. A lower coping capacity score was associated with psychological distress in the TNBC group at midpoint and in both groups at completion of chemotherapy treatment. Patients in both groups used a higher level of positive religious coping.
. CONCLUSIONS: AA women with TNBC and non-TNBC might benefit (reduced psychological distress and improved coping skills) from receiving a comprehensive psychological care program. The findings can be incorporated and tested in a comprehensive coping strategy program.
. IMPLICATIONS FOR NURSING: Nurses should work closely with AA women with breast cancer undergoing chemotherapy to help them identify and consciously use coping strategies associated with increased coping capacity.

Health-related quality of life in Black breast cancer survivors with and without triple-negative breast cancer (TNBC).

PURPOSE: Black women are more likely to develop early-onset (≤50 years) breast cancer (BC) and have the lowest five-year, cause-specific survival rate of any United States (U.S.) racial or ethnic group. These disparities can be attributed partially to the higher rate of triple-negative BC (TNBC) in Blacks. Yet, little is known about health-related quality of life (HRQOL) among Black women with TNBC. METHODS: Black women with invasive BC ≤ 50 years were recruited via the Florida Cancer Data System as part of a population-based case-only study of etiology and outcomes of early-onset invasive BC. Of 460 consented participants, a subset of 355 self-reported sociodemographic, clinical, and psychosocial variables. Descriptive analyses included participants with known TNBC (n = 85) or non-TNBC (n = 245) disease. Univariable and multivariable analyses were conducted to examine differences in factors associated with HRQOL. RESULTS: In unadjusted analyses, TNBC participants had significantly lower FACT-B total scores (90.1 ± 27.9) compared to non-TNBC (98.5 ± 27.6) participants (p < 0.05). For the TNBC group, multivariable analyses indicated five individual-level, and three systemic-level factors explain 80% of the response variation in HRQOL. For the non-TNBC group, seven individual-level factors and three systemic-level factors account for 76% of the variation in HRQOL scores. CONCLUSIONS: Compared to Black women with non-TNBC, TNBC women have worse HRQOL. There are key individual and systemic-level factors that are unique to both groups. Findings can inform future HRQOL interventions to support young Black BC survivors.

"An addendum to breast cancer": the triple negative experience.

PURPOSE: The triple negative breast cancer (TNBC) subtype, known to be aggressive with high recurrence and mortality rates, disproportionately affects African-Americans, young women, and BRCA1 carriers. TNBC does not respond to hormonal or biologic agents, limiting treatment options. The unique characteristics of the disease and the populations disproportionately affected indicate a need to examine the responses of this group. No known studies describe the psychosocial experiences of women with TNBC. The purpose of this study is to begin to fill that gap and to explore participants' psychosocial needs. METHOD: An interpretive descriptive qualitative approach was used with in-depth interviews. A purposive sample of adult women with TNBC was recruited. Dominant themes were extracted through iterative and constant comparative analysis. RESULTS: Of the 22 participants, nearly half were women of color, and the majority was under the age of 60 years and within 5 years of diagnosis. The central theme was a perception of TNBC as "an addendum" to breast cancer. There were four subthemes: TNBC is Different: "Bottom line, it's not good"; Feeling Insecure: "Flying without a net"; Decision-Making and Understanding: "A steep learning curve"; and Looking Back: "Coulda, shoulda, woulda." Participants expressed a need for support in managing intense uncertainty with a TNBC diagnosis and in decision-making. CONCLUSIONS: Women with all subtypes of breast cancer have typically been studied together. This is the first study on the psychosocial needs specifically of women with TNBC. The findings suggest that women with TNBC may have unique experiences and unmet psychosocial needs.

Elderly woman with triple-negative metastatic breast cancer successfully treated with metronomic capecitabine.

Triple-negative breast cancer phenotype (estrogen receptor-, progesterone receptor- and human epidermal growth receptor 2-negative) is one of the most aggressive molecular subtypes, accounting for 15-20% of all breast tumors. There is no standard treatment for this setting of patients except anthracyclines and taxanes, but not all elderly patients can tolerate these kinds of agents. We describe the case of an elderly woman affected by triple-negative breast cancer with bone and brain metastases who has been treated for five years with metronomic capecitabine. At the moment, the patient has stable disease and enjoys good quality of life. She had initially been diagnosed with a poor Karnofsky index, which has actually improved from 50 to 90. Metronomic capecitabine treatment has clearly improved her quality of life, as documented by the results of the Functional Assessment of Cancer Therapy Breast.

Triple-negative breast cancer: what is known about it?

Triple-negative breast cancer (TNBC) is considered a rare diagnosis. This malignancy targets a specific population of women and has risk factors differing from those of other breast cancers. TNBC exhibits distinct pathologic features that result in aggressive metastasis and poor prognosis. Pathologically, TNBC cancer cells are characterized by negative receptors for progesterone and estrogen and by the lack of over-expression of human epidermal growth factor receptor 2, which limits chemotherapeutic treatment options for women with TNBC. Nurses can assist in early detection by offering patient education about the little known risk factors for TNBC. Psychosocial issues can overwhelm patients diagnosed with breast cancer. This article provides suggestions for nurses as they guide women who are experiencing an atypical breast cancer diagnosis with an uncertain prognosis and limited treatment options.