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1.
Gen Dent ; 72(3): 74-77, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38640011

RESUMO

Human papillomavirus (HPV) is associated with both benign and malignant disorders, such as genital warts and a variety of cancers, including oropharyngeal squamous cell carcinomas (OPSCCs). The current 9-valent HPV vaccine (Gardasil 9) protects against high-risk strains that have been shown to cause OPSCC, and widespread vaccination should reduce the rate of all HPV-associated cancers. HPV-related OPSCCs differ from non-HPV-related OPSCCs in their clinical presentations and responsiveness to treatment. To provide oral healthcare providers with a basis for effective com-munication with patients, this article will examine the evolution of the HPV vaccination schedule and the role of the HPV vaccine in the prevention of OPSCCs.


Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Neoplasias Orofaríngeas , Infecções por Papillomavirus , Vacinas contra Papillomavirus , Humanos , Papillomavirus Humano , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/prevenção & controle , Carcinoma de Células Escamosas/prevenção & controle , Carcinoma de Células Escamosas/patologia , Neoplasias Orofaríngeas/prevenção & controle , Neoplasias Orofaríngeas/patologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/complicações , Neoplasias de Cabeça e Pescoço/complicações , Vacinas contra Papillomavirus/uso terapêutico
2.
Gen Dent ; 71(3): 57-61, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37083615

RESUMO

With the incidence of skin cancer increasing in the United States, the role of dental providers in noting suspicious skin lesions as well as advising patients in proper sun-protective strategies is more important than ever. However, the public conversation about proper sun protection is often laden with misunderstandings and pervasive myths. This article reviews the most common types of skin cancer, elucidates the differences among the types of UV radiation, and offers updated recommendations for proper sunscreen use along with adjunctive sun-protective strategies.


Assuntos
Neoplasias Cutâneas , Protetores Solares , Humanos , Estados Unidos , Protetores Solares/uso terapêutico , Neoplasias Cutâneas/prevenção & controle , Raios Ultravioleta/efeitos adversos
3.
IEEE Winter Conf Appl Comput Vis ; 2023: 1918-1927, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36865487

RESUMO

Detection of melanocytes serves as a critical prerequisite in assessing melanocytic growth patterns when diagnosing melanoma and its precursor lesions on skin biopsy specimens. However, this detection is challenging due to the visual similarity of melanocytes to other cells in routine Hematoxylin and Eosin (H&E) stained images, leading to the failure of current nuclei detection methods. Stains such as Sox10 can mark melanocytes, but they require an additional step and expense and thus are not regularly used in clinical practice. To address these limitations, we introduce VSGD-Net, a novel detection network that learns melanocyte identification through virtual staining from H&E to Sox10. The method takes only routine H&E images during inference, resulting in a promising approach to support pathologists in the diagnosis of melanoma. To the best of our knowledge, this is the first study that investigates the detection problem using image synthesis features between two distinct pathology stainings. Extensive experimental results show that our proposed model outperforms state-of-the-art nuclei detection methods for melanocyte detection. The source code and pre-trained model are available at: https://github.com/kechunl/VSGD-Net.

4.
J Pathol Inform ; 13: 100104, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36268085

RESUMO

Although pathologists have their own viewing habits while diagnosing, viewing behaviors leading to the most accurate diagnoses are under-investigated. Digital whole slide imaging has enabled investigators to analyze pathologists' visual interpretation of histopathological features using mouse and viewport tracking techniques. In this study, we provide definitions for basic viewing behavior variables and investigate the association of pathologists' characteristics and viewing behaviors, and how they relate to diagnostic accuracy when interpreting whole slide images. We use recordings of 32 pathologists' actions while interpreting a set of 36 digital whole slide skin biopsy images (5 sets of 36 cases; 180 cases total). These viewport tracking data include the coordinates of a viewport scene on pathologists' screens, the magnification level at which that viewport was viewed, as well as a timestamp. We define a set of variables to quantify pathologists' viewing behaviors such as zooming, panning, and interacting with a consensus reference panel's selected region of interest (ROI). We examine the association of these viewing behaviors with pathologists' demographics, clinical characteristics, and diagnostic accuracy using cross-classified multilevel models. Viewing behaviors differ based on clinical experience of the pathologists. Pathologists with a higher caseload of melanocytic skin biopsy cases and pathologists with board certification and/or fellowship training in dermatopathology have lower average zoom and lower variance of zoom levels. Viewing behaviors associated with higher diagnostic accuracy include higher average and variance of zoom levels, a lower magnification percentage (a measure of consecutive zooming behavior), higher total interpretation time, and higher amount of time spent viewing ROIs. Scanning behavior, which refers to panning with a fixed zoom level, has marginally significant positive association with accuracy. Pathologists' training, clinical experience, and their exposure to a range of cases are associated with their viewing behaviors, which may contribute to their diagnostic accuracy. Research in computational pathology integrating digital imaging and clinical informatics opens up new avenues for leveraging viewing behaviors in medical education and training, potentially improving patient care and the effectiveness of clinical workflow.

5.
Diagnostics (Basel) ; 12(7)2022 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-35885617

RESUMO

Invasive melanoma, a common type of skin cancer, is considered one of the deadliest. Pathologists routinely evaluate melanocytic lesions to determine the amount of atypia, and if the lesion represents an invasive melanoma, its stage. However, due to the complicated nature of these assessments, inter- and intra-observer variability among pathologists in their interpretation are very common. Machine-learning techniques have shown impressive and robust performance on various tasks including healthcare. In this work, we study the potential of including semantic segmentation of clinically important tissue structure in improving the diagnosis of skin biopsy images. Our experimental results show a 6% improvement in F-score when using whole slide images along with epidermal nests and cancerous dermal nest segmentation masks compared to using whole-slide images alone in training and testing the diagnosis pipeline.

6.
J Digit Imaging ; 35(5): 1238-1249, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35501416

RESUMO

The number of melanoma diagnoses has increased dramatically over the past three decades, outpacing almost all other cancers. Nearly 1 in 4 skin biopsies is of melanocytic lesions, highlighting the clinical and public health importance of correct diagnosis. Deep learning image analysis methods may improve and complement current diagnostic and prognostic capabilities. The histologic evaluation of melanocytic lesions, including melanoma and its precursors, involves determining whether the melanocytic population involves the epidermis, dermis, or both. Semantic segmentation of clinically important structures in skin biopsies is a crucial step towards an accurate diagnosis. While training a segmentation model requires ground-truth labels, annotation of large images is a labor-intensive task. This issue becomes especially pronounced in a medical image dataset in which expert annotation is the gold standard. In this paper, we propose a two-stage segmentation pipeline using coarse and sparse annotations on a small region of the whole slide image as the training set. Segmentation results on whole slide images show promising performance for the proposed pipeline.


Assuntos
Melanoma , Humanos , Melanoma/diagnóstico por imagem , Melanoma/patologia , Processamento de Imagem Assistida por Computador/métodos , Pele/diagnóstico por imagem , Pele/patologia , Epiderme/patologia , Biópsia
7.
J Cutan Pathol ; 49(2): 153-162, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34487353

RESUMO

BACKGROUND: Histopathologically ambiguous melanocytic lesions lead some pathologists to list multiple diagnostic considerations in the pathology report. The frequency and circumstance of multiple diagnostic considerations remain poorly characterized. METHODS: Two hundred and forty skin biopsy samples were interpreted by 187 pathologists (8976 independent diagnoses) and classified according to a diagnostic/treatment stratification (MPATH-Dx). RESULTS: Multiple diagnoses in different MPATH-Dx classes were used in n = 1320 (14.7%) interpretations, with 97% of pathologists and 91% of cases having at least one such interpretation. Multiple diagnoses were more common for intermediate risk lesions and are associated with greater subjective difficulty and lower confidence. We estimate that 6% of pathology reports for melanocytic lesions in the United States contain two diagnoses of different MPATH-Dx prognostic classes, and 2% of cases are given two diagnoses with significant treatment implications. CONCLUSIONS: Difficult melanocytic diagnoses in skin may necessitate multiple diagnostic considerations; however, as patients increasingly access their health records and retrieve pathology reports (as mandated by US law), uncertainty should be expressed unambiguously.


Assuntos
Patologistas , Neoplasias Cutâneas/classificação , Neoplasias Cutâneas/diagnóstico , Pele/patologia , Adulto , Idoso , Biópsia , Feminino , Humanos , Masculino , Melanócitos/patologia , Pessoa de Meia-Idade , Terminologia como Assunto
8.
J Cutan Pathol ; 48(7): 842-846, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33326119

RESUMO

BACKGROUND: The histopathological diagnosis of MF is challenging, and there is significant overlap with benign inflammatory processes. Clinical features may be relevant in the assessment of skin biopsies. METHODS: We provided photomicrographs to board-certified dermatopathologists and one hematopathologist with and without accompanying clinical photographs and assessed accuracy and confidence in diagnosing MF. RESULTS: We found that access to clinical photographs improved diagnostic accuracy in both MF and non-MF (distractors); the degree of improvement was significantly higher in the non-MF/distractor category. Across all categories, diagnostic confidence level was higher when clinical images were available. CONCLUSION: These findings suggest that clinical images are useful in making an accurate diagnosis of MF, and may be particularly helpful in ruling it out when an inflammatory disorder is clinically suspected.


Assuntos
Inflamação/patologia , Micose Fungoide/diagnóstico , Fotomicrografia/métodos , Neoplasias Cutâneas/patologia , Adulto , Biópsia/métodos , Dermatologistas/psicologia , Diagnóstico Diferencial , Hematologia/estatística & dados numéricos , Humanos , Pessoa de Meia-Idade , Micose Fungoide/patologia , Micose Fungoide/ultraestrutura , Variações Dependentes do Observador , Patologistas/psicologia , Competência Profissional/estatística & dados numéricos , Reprodutibilidade dos Testes , Autoimagem , Pele/patologia
9.
IEEE Access ; 9: 163526-163541, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-35211363

RESUMO

Diagnosing melanocytic lesions is one of the most challenging areas of pathology with extensive intra- and inter-observer variability. The gold standard for a diagnosis of invasive melanoma is the examination of histopathological whole slide skin biopsy images by an experienced dermatopathologist. Digitized whole slide images offer novel opportunities for computer programs to improve the diagnostic performance of pathologists. In order to automatically classify such images, representations that reflect the content and context of the input images are needed. In this paper, we introduce a novel self-attention-based network to learn representations from digital whole slide images of melanocytic skin lesions at multiple scales. Our model softly weighs representations from multiple scales, allowing it to discriminate between diagnosis-relevant and -irrelevant information automatically. Our experiments show that our method outperforms five other state-of-the-art whole slide image classification methods by a significant margin. Our method also achieves comparable performance to 187 practicing U.S. pathologists who interpreted the same cases in an independent study. To facilitate relevant research, full training and inference code is made publicly available at https://github.com/meredith-wenjunwu/ScATNet.

10.
Chest ; 158(1): e33-e36, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32654736

RESUMO

CASE PRESENTATION: A 68-year-old man developed an erythematous, papular, pruritic rash on his right thigh 1 month prior to presentation. It subsequently spread to his other extremities and trunk. He also endorsed fevers of > 38.3°C, night sweats, fatigue, shortness of breath, and a dry cough. He was prescribed triamcinolone 0.1% cream for his rash and azithromycin for presumed community-acquired pneumonia, with no improvement in symptoms. He had a history of relapsing polychondritis for which he was prescribed infliximab and low-dose prednisone. He had never smoked tobacco, did not use alcohol or illicit substances, and had no significant travel history.


Assuntos
Exantema/etiologia , Derrame Pleural/etiologia , Policondrite Recidivante/complicações , Policondrite Recidivante/diagnóstico , Síndrome de Sweet/complicações , Síndrome de Sweet/diagnóstico , Idoso , Exantema/diagnóstico , Exantema/terapia , Humanos , Masculino , Derrame Pleural/diagnóstico , Derrame Pleural/terapia , Policondrite Recidivante/terapia , Síndrome de Sweet/terapia
11.
Gen Dent ; 68(3): 41-44, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32348242

RESUMO

Metastatic disease to the oral cavity is rare. Patients with metastasis to the oral cavity may present with swelling, pain, and paresthesia and require evaluation by providers trained in managing pathoses of the oral cavity and surrounding structures. This report describes the case of a 78-year-old man with painful enlargement of the right posterior mandible that caused paresthesia. An open biopsy procedure resulted in significant blood loss and the need for percutaneous needle biopsy. Immunohistochemical analysis was used to make the diagnosis of metastatic clear cell renal cell carcinoma in this patient, whose primary malignancy was previously unknown. Composite resection of the metastatic lesion and reconstruction were performed with the use of virtual surgical planning, an osteomyocutaneous free tissue transfer, and a custom reconstruction plate. This case highlights the importance of dental professionals in the diagnosis and management of lesions of the head and neck and adds to the literature on metastatic lesions to the region.


Assuntos
Carcinoma de Células Renais/diagnóstico , Carcinoma de Células Renais/cirurgia , Neoplasias Renais , Neoplasias Mandibulares/diagnóstico , Idoso , Biópsia , Humanos , Masculino , Mandíbula/cirurgia
12.
Am J Dermatopathol ; 42(3): 186-190, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31592864

RESUMO

Significant communication occurs between pathologists and clinicians through the dermatopathology report. Our objective was to describe clinician preference about reporting of the margin status of skin biopsies of nonmelanoma skin cancers. An anonymous survey was sent to 243 medical providers who submitted specimens to a single institution university medical center; 50 complete responses from attending-level providers and advance practice providers were received. The majority (96%) of those surveyed indicated margins should be reported on skin biopsies of neoplasms, particularly nonmelanoma skin cancers (basal cell carcinoma 96% and squamous cell carcinoma 92%) and atypical nevi (96%). When asked about particular language used to describe the margin status, some phrasing led to more variance in respondents' clinical management decisions, with 96%-98% of respondents making the same decision when presented with "unambiguous" terms and 58%-84% of respondents making the same decision when presented with "ambiguous" language (P < 0.001). Respondents generally preferred "unambiguous" margin descriptions when shown an involved margin (70% vs. 30%, P < 0.001) but accepted "ambiguous" language when the margin was clearly uninvolved (68% vs. 32%, P = 0.015). Most respondents (88%) desire inclusion of treatment recommendations in dermatopathology reports. Microscopic descriptions were highly utilized, particularly by nondermatology trained clinicians (97% vs. 80%, P = 0.09). Clinicians desire inclusion of margins for skin biopsies in dermatopathology reports, at least in some circumstances. The choice of language used to describe the margin status in dermatopathology reports has important implications for patient care. Margin descriptors that are unclear or ambiguous may lead to more variance in clinical management.


Assuntos
Dermatologia , Margens de Excisão , Patologia Cirúrgica , Neoplasias Cutâneas/diagnóstico , Terminologia como Assunto , Adulto , Biópsia , Feminino , Humanos , Idioma , Masculino , Pessoa de Meia-Idade
13.
Appl Immunohistochem Mol Morphol ; 25(8): 543-547, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-28885232

RESUMO

Proliferative index is a prognostic feature of invasive ductal carcinoma of the breast, and has more recently emerged as a predictor of ductal carcinoma in situ (DCIS) local recurrence and progression when used in combination with other predictive markers. Ki67 is the most commonly used immunohistochemical marker of proliferative index. However, high interobserver and interlaboratory variability has been reported, in part due to differences in staining methodologies, positivity thresholds, and approaches to quantification. Phosphohistone-H3 (pHH3) is a marker of mitotic activity that has emerged as a more reliable indicator of proliferation in other neoplasms. Quantification of proliferative index was compared in 48 cases of DCIS using Ki67 and pHH3 immunohistochemistry. A strong linear relationship between Ki67 and pHH3 quantification was observed (P<0.0001, R=0.75). Interobserver concordance was modestly higher for pHH3 than Ki67 proliferative indices. However, positive pHH3 staining was more dichotomous (either negative or uniformly positive) and specific for mitotic activity, and interpretation of pHH3 proliferative indices was significantly faster than that of Ki67. The strong correlation between pHH3 and Ki67 supports the use of this marker as a measure of proliferative activity in DCIS.


Assuntos
Biomarcadores Tumorais/metabolismo , Neoplasias da Mama/metabolismo , Carcinoma Intraductal não Infiltrante/metabolismo , Proliferação de Células , Histonas/metabolismo , Antígeno Ki-67/metabolismo , Fosfoproteínas/metabolismo , Neoplasias da Mama/patologia , Carcinoma Intraductal não Infiltrante/patologia , Feminino , Humanos , Imuno-Histoquímica
15.
Dermatol Online J ; 23(9)2017 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-29469730

RESUMO

Hidrocystomas are benign cysts that typically present as translucent, bluish dermal nodules on the face and are rarely > 1 cm in size. They are classically categorized as eccrine or apocrine based on histologic features. We present a rare case of a giant apocrine hidrocystoma of the trunk, demonstrating that, although a rare variant, apocrine hidrocystomas can present both off the head and neck, and can be significantly larger in size than previously reported.


Assuntos
Hidrocistoma/diagnóstico , Hidrocistoma/patologia , Neoplasias das Glândulas Sudoríparas/diagnóstico , Neoplasias das Glândulas Sudoríparas/patologia , Idoso , Glândulas Apócrinas , Humanos , Masculino
16.
Am J Dermatopathol ; 39(10): 760-763, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27759690

RESUMO

Although malignant melanomas exhibit a wide range of immunophenotypes, concurrent loss of all 3 conventional melanocytic markers (S-100, Melan-A, and HMB-45) is relatively rare. We report a case of primary malignant melanoma with lymph node metastasis, both exhibiting loss of immunoreactivity for conventional melanocytic markers, while aberrantly expressing epithelial antigenicity (pancytokeratin, CAM 5.2).


Assuntos
Biomarcadores Tumorais/análise , Metástase Linfática/diagnóstico , Melanoma/diagnóstico , Neoplasias Cutâneas/diagnóstico , Humanos , Antígeno MART-1/biossíntese , Masculino , Melanoma/metabolismo , Melanoma/patologia , Antígenos Específicos de Melanoma/biossíntese , Pessoa de Meia-Idade , Proteínas S100/biossíntese , Neoplasias Cutâneas/metabolismo , Neoplasias Cutâneas/patologia , Antígeno gp100 de Melanoma , Melanoma Maligno Cutâneo
17.
J Invest Dermatol ; 137(4): 819-827, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-27815175

RESUMO

Previous studies have reached conflicting conclusions regarding the proportion of Merkel cell carcinomas (MCCs) that contain the Merkel cell polyomavirus (MCPyV) and the clinical significance of tumor viral status. To address these controversies, we detected MCPyV large T antigen using immunohistochemistry with two distinct antibodies and MCPyV DNA using quantitative PCR. Tumors were called MCPyV-positive if two or more of these three assays indicated presence of this virus. A total of 53 of 282 (19%) MCC tumors in this cohort were virus-negative using this multimodal system. Immunohistochemistry with the CM2B4 antibody had the best overall performance (sensitivity = 0.882, specificity = 0.943) compared with the multimodal classification. Multivariate analysis including age, sex, and immunosuppression showed that, relative to MCC patients with virus-positive tumors, virus-negative MCC patients had significantly increased risk of disease progression (hazard ratio = 1.77, 95% confidence interval = 1.20-2.62) and death from MCC (hazard ratio = 1.85, 95% confidence interval = 1.19-2.89). We confirm that approximately 20% of MCCs are not driven by MCPyV and that such virus-negative MCCs, which can be quite reliably identified by immunohistochemistry using the CM2B4 antibody alone, represent a more aggressive subtype that warrants closer clinical follow-up.


Assuntos
Carcinoma de Célula de Merkel/virologia , Poliomavírus das Células de Merkel/isolamento & purificação , Neoplasias Cutâneas/virologia , Infecções Tumorais por Vírus/patologia , Idoso , Biópsia por Agulha , Carcinoma de Célula de Merkel/mortalidade , Carcinoma de Célula de Merkel/patologia , Estudos de Coortes , Intervalos de Confiança , Progressão da Doença , Feminino , Humanos , Imuno-Histoquímica , Masculino , Poliomavírus das Células de Merkel/genética , Pessoa de Meia-Idade , Análise Multivariada , Invasividade Neoplásica/patologia , Estadiamento de Neoplasias , Prognóstico , Modelos de Riscos Proporcionais , Reação em Cadeia da Polimerase em Tempo Real/métodos , Valores de Referência , Estudos Retrospectivos , Medição de Risco , Neoplasias Cutâneas/mortalidade , Neoplasias Cutâneas/patologia , Análise de Sobrevida , Infecções Tumorais por Vírus/mortalidade , Infecções Tumorais por Vírus/virologia
18.
J Cutan Pathol ; 43(10): 892-7, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27251900

RESUMO

Free-living amebae are ubiquitous in our environment, but rarely cause cutaneous infection. Balamuthia mandrillaris has a predilection for infecting skin of the central face. Infection may be restricted to the skin or associated with life-threatening central nervous system (CNS) involvement. We report a case of a 91-year-old woman, who presented with a non-healing red plaque over her right cheek. Several punch biopsies exhibited non-specific granulomatous inflammation without demonstrable fungi or mycobacteria in histochemical stains. She was treated empirically for granulomatous rosacea, but the lesion continued to progress. A larger incisional biopsy was performed in which amebae were observed in hematoxylin-eosin stained sections. These were retrospectively apparent in the prior punch biopsy specimens. Immunohistochemistry and polymerase chain reaction studies identified the organisms as Balamuthia mandrillaris. Cutaneous infection by B. mandrillaris is a rare condition that is sometimes complicated by life-threatening CNS involvement and which often evades timely diagnosis due to its rarity and nonspecific clinical manifestations. Moreover, these amebae are easily overlooked in histopathologic sections because of their small number and their resemblance to histiocytes. Dermatopathologists should be familiar with the histopathologic appearance of these organisms and include balamuthiasis and other amebic infections in the differential diagnosis of granulomatous dermatitis.


Assuntos
Amebíase , Balamuthia mandrillaris , Bochecha , Dermatopatias Parasitárias , Idoso de 80 Anos ou mais , Amebíase/metabolismo , Amebíase/patologia , Bochecha/parasitologia , Bochecha/patologia , Feminino , Humanos , Imuno-Histoquímica , Dermatopatias Parasitárias/metabolismo , Dermatopatias Parasitárias/patologia
20.
Asian Pac J Cancer Prev ; 15(20): 8607-12, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25374176

RESUMO

BACKGROUND: Breast cancer patients experience a variety of altered appearance--such as loss or disfigurement of breasts, discolored skin, and hair loss--which result in psychological distress that affect their quality of life. This study aims to evaluate the impact of socioeconomic status on the altered appearance distress, body image, and quality of life among Korean breast cancer patients. MATERIALS AND METHODS: A cross-sectional survey was conducted at advocacy events held at 16 different hospitals in Korea. Subjects were eligible to participate if they were 18 years of age or older, had a histologically confirmed diagnosis of breast cancer, had no evidence of recurrence or metastasis, and had no psychological problems at the time of the survey. Employment status, marital status, education, and income were assessed for patient socioeconomic status. Altered appearance distress was measured using the NCI's cancer treatment side effects scale; body image and quality of life were measured by the EORTC QLC-C30 and BR23. Means and standard deviations of each outcome were compared by socioeconomic status and multivariate linear regression models for evaluating the association between socioeconomic status and altered appearance distress, body image, and quality of life. RESULTS: A total of 126 breast cancer patients participated in the study; the mean age of participants was 47.7 (SD=8.4). Of the total, 83.2% were married, 85.6% received more than high school education, 35.2% were employed, and 41% had more than $3000 in monthly household income. About 46% had mastectomy, and over 30% were receiving either chemotherapy or radiation therapy at the time of the survey. With fully adjusted models, the employed patients had significantly higher altered appearance distress (1.80 vs 1.48; p<0.05) and poorer body image (36.63 vs 51.69; p<0.05) compared to the patients who were unemployed. Higher education (10.58, standard error (SE)=7.63) and family income (12.88, SE=5.08) was positively associated with better body image after adjusting for age, disease stage at diagnosis, current treatment status, and breast surgery type. Similarly, patients who were married and who had higher education had better quality of life were statistically significant in the multivariate models. CONCLUSIONS: Socioeconomic status is significantly associated with altered appearance distress, body image, and quality of life in Korean women with breast cancer. Patients who suffer from altered appearance distress or lower body image are much more likely to experience psychosocial, physical, and functional problems than women who do not, therefore health care providers should be aware of the changes and distresses that these breast cancer patients go through and provide specific information and psychosocial support to socioeconomically more vulnerable patients.


Assuntos
Imagem Corporal/psicologia , Neoplasias da Mama/psicologia , Qualidade de Vida , Autoimagem , Adaptação Psicológica , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/patologia , Neoplasias da Mama/terapia , Quimioterapia Adjuvante/métodos , Quimioterapia Adjuvante/psicologia , Terapia Combinada , Estudos Transversais , Feminino , Seguimentos , Humanos , Mastectomia Segmentar/métodos , Mastectomia Segmentar/psicologia , Pessoa de Meia-Idade , Radioterapia Adjuvante/métodos , Radioterapia Adjuvante/psicologia , República da Coreia , Medição de Risco , Fatores Socioeconômicos , Estresse Psicológico , Sobreviventes
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