Evaluation of quality of life and socio-emotional impact of oncological treatment among patients with breast cancer.

Breast cancer is the most frequent cancer in women worldwide. Quality of life (QoL) is significantly affected by both surgical and oncological treatment. The aim of this study was to assess and compare QoL, resilience and depression scores among women who had breast cancer treatment. We assessed 170 patients diagnosed with breast cancer in a non-experimental, descriptive study through anonymized questionnaires from January to March 2024. Patients were invited to fill in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, Breast Cancer Module (EORTC QLQ-BR23) questionnaire, the Depression Anxiety Stress Scale, the CD-RISC 10 questionnaire, and the MOS Social Support Survey. Clinical information and demographical data were obtained and statistical analysis was conducted to evaluate factors that affect QoL, resilience and depression scores. QoL was significantly influenced by chemotherapy and surgery. Women with higher resilience scores had lower anxiety and depression scores and reported a better QoL. Women with strong social support and high resilience reported a better QoL during and after breast cancer treatment. The results of our study show that breast cancer surgery and chemotherapy have an important impact on patients' QoL. Moreover, the results reflect the importance of both medical treatment and social support as resilience-building strategies in managing and improving the QoL of patients.

The Psychological Impact on Romanian Women Infected with SARS-CoV-2 during Pregnancy.

BACKGROUND: It is well-known that the uncertainty about the COVID-19 pandemic has an indirect negative impact on pregnant women's mental health, given the fact that pregnant women are more vulnerable emotionally and psychologically than non-pregnant women. The aim of this study was to evaluate the maternal psychological impact on Romanian women who were infected with SARS-CoV-2 during pregnancy and their concerns and to determine which are the best measures to prevent negative outcomes. METHODS: A 40-item questionnaire was created for data collection and was shared on social platforms (Facebook and Instagram) and also with obstetric communities between February 2021 and January 2023. Our cross-sectional survey recruited 317 Romanian pregnant women who suffered from SARS-CoV-2 infection. Among general questions about their life and pregnancy during the pandemic, the survey included questions about their SARS-CoV-2 infection during pregnancy, their concerns and how they perceived this period in order to evaluate their emotional status. RESULTS: Of 317 women recruited, 91% of them had a mild to moderate form of COVID-19, and 2% had serious symptoms. Only 9% of women were hospitalized, 4% of women considered that the SARS-CoV-2 infection affected their physical condition to a great extent, and 8% considered to be affected in terms of mental state to a great extent. The main negative feelings of pregnant women during the COVID-19 disease were the fear regarding the possibility of affecting the pregnancy and the concern for their life (51.4%). These increase the risk of developing anxiety or depression. Pregnant women who contracted SARS-CoV-2 infection faced negative feelings, especially those with a severe form of the disease or who recovered with difficulty after the disease. Patients who required hospitalization reported an impairment of the mental state to a great extent and to a very great extent with a frequency of approximately two times and four times higher than non-hospitalized patients, respectively (p < 0.05 and p < 0.001, respectively). Also, giving birth during SARS-CoV-2 and the difficulty of accessing medical services represented a high level of stress. Also, 47% of patients who reported difficulty accessing medical services during the illness evaluated their mental state significantly less favorably. CONCLUSION: Preventive measures are essential to minimizing the negative psychological impact of COVID-19 disease during pregnancy among pregnant women. The medical treatment of COVID-19 disease during pregnancy should be prioritized, but emotional and mental health support must also be provided.

Sentinel Lymph Node Biopsy in Breast Cancer. Principle, Difficulties and Pitfalls.

Sentinel Lymph node biopsy (SLNB) represents the standard approach in a newly diagnosed breast cancer for axillary staging in cases of clinical node negative. This represents a major prognostic factor and the biopsy of sentinel lymph node for early breast cancer is used as guidance in surgical and oncological treatment. Although for many decades, axillary lymph node dissection was the standard approach for breast cancer treatment and staging, this pathway was abandoned due to significant risk of lymphedema, infection, nerve and vessels injury or dysfunction of the shoulder. Therefore, significant improvement in the quality of life was seen for patients diagnosed with early breast cancer after SLNB was introduced as standard. The principle of SLNB is based on the hypothesis that tumor drains in the lymphatic system in an orderly manner and if the first lymphatic station is clear of disease, it is highly unlike that the tumor has spread further above. We present in our paper the indications with principles and difficulties in identification of sentinel node.

Secondary Amenorrhea and Infertility Due to an Inhibin B Producing Granulosa Cell Tumor of the Ovary. A Rare Case Report and Literature Review.

Granulosa cell tumor of the ovary (GCT) is a rare ovarian tumor with nonspecific symptoms. Studies reported that GCT are usually secreting estrogens and inhibins, especially inhibin B. It is considered that, in premenopausal women, irregular menses or secondary amenorrhea may be an early symptom of GCT and, in postmenopausal women, the most common manifestation is vaginal bleeding. Additionally, endometrial abnormalities can be associated due to estrogenic secretion. At reproductive age, high levels of inhibin, lead to low levels of FSH and secondary amenorrhea causing infertility. At times, increased levels of LH in women with GCT are observed and the pathogenesis is still unclear. Therefore, inhibin B level can differentiate GCT from other causes of secondary amenorrhea. We report the case of a 26-year-old nulliparous, women who presented in our clinic with secondary infertility lasting longer than 2 years, secondary amenorrhea, polycystic ovarian syndrome, and suspicion of right ovarian endometrioma on CT scan. The ultrasound examination revealed that the right ovary was transformed in an anechoic mass with increased peripheral vascularity having a volume of 10 cm3. This patient had high serum levels of inhibin B and LH but normal levels of FSH and estradiol. The preliminary diagnosis of granulosa cell tumor of the ovary was made. After counseling, the informed consent for treatment was obtained and the patient agreed to undergo surgery. An uneventful laparoscopy was performed with right oophorectomy and multiple peritoneal sampling. The histological diagnosis confirmed adult GCT limited to right ovary, with negative peritoneal biopsies (FIGO IA). After surgery the patient recovered fully and had normal menstrual cycles with normal serum levels of hormones. Two months later she conceived spontaneously and had an uneventful pregnancy. In conclusion, for cases with secondary amenorrhea, the evaluation of inhibin B level is essential. Elevated inhibin B level may be a sign for the presence of an unsuspected tumor. With early diagnosis and treatment, the prognosis is generally good and the fertility may be preserved, especially in young patients with GCT.

The Psychological Impact of the COVID-19 Pandemic on Pregnant Women.

BACKGROUND: The COVID-19 pandemic has meant significant precautions and changes in delivering healthcare services. The aim of the study was to explore the lifestyle changes of pregnant women during the COVID-19 pandemic in Romania, the changes in prenatal care and delivery during the pandemic and the psychological impact on women and to determine how healthcare providers can help them to overcome this period. METHODS: A cross-sectional survey was conducted anonymously and distributed among pregnancy-related groups from Romania, recruiting 559 study participants, between May and October 2020. A total of 559 pregnant women completed an online 26-item questionnaire but we only validated 557 responses for study. The survey included basic demographic questions, pregnancy-related questions, questions regarding the pregnant women's lifestyle changes during the pandemic and their perception of the COVID-19 pandemic and questions which evaluated the impact of the pandemic on prenatal care and delivery in Romania. RESULTS: The pandemic restrictions affected women's routine activities regarding professional, familial and social life. Therefore, for pregnant women who were emotionally vulnerable, these restrictions had a great impact on their mental health. The majority of the study participants (78.8%, N = 439) were emotionally affected by the pandemic. The fear related to the possibility of having their pregnancy affected by the virus was dominant in the group (45.8%). A high number of women (69.5%) felt safe when they accessed health services, but private hospitals were considered safer (53.1%) compared to public hospitals (14.4%). The majority of participants (53.7%) used to have prenatal care in a private healthcare system. During the pandemic, preventive measures were associated with low confidence in the healthcare system. Of the total group of participants, 123 women (22.1%) gave birth during the pandemic. Of these, a majority of the study participants considered that it was very difficult for them to cope without their partner during the hospitalization and labor period. CONCLUSIONS: The main anxiety of pregnant women were related to threats to their lives and their baby's health because of the uncertainty caused by pandemic. It is important to know that the restrictions and the changes in maternity care had a negative impact on them. This conclusion must be taken into account when preventive measures will be decided for helping them to get through such a period. Additionally, psychological support will be essential for improving the mental health of pregnant women and for preventing a negative outcome of the pregnancy. These feelings must be taken into account when preventive measures will be established during pandemic and a psychological support will be essential for improving their mental health for preventing negative outcome of pregnancy.

Cervical cancer in Eastern Europe: review and proceedings from the Cervical Cancer Research Conference.

Cervical cancer is the third most common cancer among women worldwide, with a disproportionately high burden of disease in less-developed regions of the world. The Cervix Cancer Research Network was founded by the Gynecologic Cancer InterGroup with a mission to improve outcomes in cervical cancer by enhancing international access to clinical trials, specifically in under-represented, underdeveloped areas. The Cervix Cancer Research Network held its third international educational symposium in Bucharest in 2018 and is the subject of this report. The purpose of this symposium was to advance the international understanding of cervical cancer treatment patterns, to foster recruitment to Cervix Cancer Research Network clinical trials, and identify key Cervix Cancer Research Network clinical trial concepts to improve cervical cancer care worldwide.