Impact of Race and Area Deprivation on Triple-Negative Metastatic Breast Cancer Outcomes.

OBJECTIVES: To describe area deprivation, anxiety, depression, relative dose intensity of first-line metastatic breast cancer (MBC) treatment, and survival in Black and White women who had died from triple-negative MBC, including interaction analysis. SAMPLE & SETTING: This cohort study drew from a database of women who had died from MBC (N = 53). METHODS & VARIABLES: Descriptive statistics, independent t tests, analysis of variance, and Mann-Whitney U tests were used, and effect sizes were calculated. RESULTS: Compared with White women, Black women reported higher anxiety and depression at MBC baseline. Black women living in areas of higher deprivation experienced shorter overall survival than White women living in similar areas (9.9 months versus 24.6 months). These results were not statistically significant, likely because of a small sample size, but were clinically meaningful. IMPLICATIONS FOR NURSING: Black and low-income women with breast cancer experience inferior survival as compared with White and higher-income women. Newer explanatory models for racial disparity in cancer outcomes include the assessment of neighborhood deprivation. White women may be less affected by their neighborhood, even when living in areas of greater deprivation influencing cancer outcomes. This merits further exploration.

Productivity Measures: Empowering Oncology Nurse Practitioners to Understand and Demonstrate Value in Practice.

Oncology nurse practitioners (ONPs) are essential providers of oncology care who work in a variety of practice settings. ONPs add to productivity in practice, but the way in which productivity is measured may not capture their full contributions and value. A greater understanding of productivity measures can empower ONPs to communicate and demonstrate their full value in practice.

Managing patients with high-risk breast lesions, precursors on the breast neoplasia pathway.

ABSTRACT: Breast cancer remains the most commonly diagnosed cancer among women. Imaging abnormalities may be noted on routine breast cancer screenings and require biopsy for further evaluation. Atypia and carcinoma in situ are nonmalignant lesions identified via breast biopsy and are associated with an increased risk of invasive carcinoma. Because of the lack of specialized breast cancer prevention and risk reduction programs, patients may not be able to access optimal management of the various subtypes of atypia and carcinoma in situ. By understanding the pathology of high-risk breast lesions and the resulting elevated cancer risk, healthcare providers, specifically primary care providers, can better counsel, manage, and treat patients to provide comprehensive quality care.

π donation and its effects on the excited-state lifetimes of luminescent platinum(II) terpyridine complexes in solution.

Introducing electron-donating groups extends the excited-state lifetimes of platinum(II)-terpyridine complexes in fluid solution. Such systems are of interest for a variety of applications, viz., as DNA-binding agents or as components in luminescence-based devices, especially sensors. The complexes investigated here are of the form [Pt(4'-X-T)Y](+), where 4'-X-T denotes a 4'-substituted 2,2':6',2″-terpyridine ligand and Y denotes the coligand. The π-donating abilities of -X and -Y increase systematically in the orders -NHMe < -NMe2 < -(pyrrolidin-1-yl) and -CN < -Cl < -CCPh, respectively. The results presented include crystal structures of two new 4'-NHMe-T complexes of platinum, as well as absorption, emission, and excited-state lifetime data for nine complexes. Excited-state lifetimes obtained in deoxygenated dichloromethane vary by a factor of 100, ranging from 24 µs for [Pt(4'-pyrr-T)CN](+) to 0.24 µs for [Pt(4'-ma-T)Cl](+), where ma-T denotes 4'-(methylamino)-2,2':6',2″-terpyridine and pyrr-T denotes 4'-(pyrrolidin-1-yl)-2,2':6',2″-terpyridine. Analysis of experimental and computational results shows that introducing a simple amine group on the terpyridine and/or a π-donating coligand engenders the emitting state with intraligand charge-transfer (ILCT) and/or ligand-ligand charge-transfer (LLCT) character. The excited-state lifetime increases when the change in orbital parentage lowers the emission energy, suppresses quenching via d-d states, and encourages delocalization of the excitation onto the ligand(s). At some point, however, the energy is low enough that direct vibronic coupling to the ground-state surface becomes important, and the lifetime begins to decrease again.