Factors Associated with Body Image and Self-Esteem in Mastectomized Breast Cancer Survivors.

Body image (BI) and self-esteem (SE) are two fundamental aspects in the evolution of breast cancer (BC), mainly due to surgery, treatment, and the patient's conception of BI. A dissatisfaction with BI and low SE decreases the subject's quality of life and increases the risk of recurrence and mortality by BC. The aim of this study is to find out if there is any degree of association between the sociodemographic data of the sample and their BI and SE. A cross-sectional, descriptive study was conducted with 198 women diagnosed with BC, aged 30-80 years, in Mexico. Women's BI and SE were assessed using two questionnaires, Hopwood Body Image Scale (S-BIS) and Rosenberg Self-Esteem Scale (RSES). The results show significant differences in several items when the variable sense of humor is taken into account, indicating that women with a sense of humor report higher satisfaction with their BI and higher SE. The age also indicates a significantly better BI in women over 50 years of age, as well as the education level variable, where those women who had studied up to secondary reported higher satisfaction with their BI; the family history shows that those women without a family history report better SE. All these data are supported by stepwise regression, which shows that educational level and sense of humor are predictors of BI, and family history along with breast reconstruction and sense of humor are predictors as of SE. In conclusion, it is important to take into account the characteristics of women with BC, particularly age and sense of humor, in order to reduce the impact of the disease on their BI and SE with the help of a multidisciplinary team.

Muscle Quality of Knee Extensors Based on Several Types of Force in Multiple Sclerosis Patients with Varying Degrees of Disability.

Background and Objectives: Multiple sclerosis (MS) tends to affect muscle performance, mainly in the lower extremities. The degree of disability is associated with the loss of strength and muscle mass, to varying extents. Muscle quality (MQ) expresses the amount of force produced relative to the activated muscle mass. The purpose of this study was to compare the MQ of the knee extensors in the main manifestations of strength (isometric, dynamic strength, and power) among patients with differing degrees of neurological disability and evolutionary forms of the disease. We also establish reference values for MQ in MS patients (pwMS). Materials and Methods: In total, 250 pwMS were evaluated according to the Expanded Disability Status Scale (EDSS). The maximum dynamic and isometric forces and muscle power manifested a load of 60% of the maximum dynamics of the knee extensors. The lean mass of the thigh and hip was determined by densitometry, and the MQ was calculated for the three types of force evaluated. Results: The pwMS with relapsing remitting MS (RRMS) presented isometric MQ values that were 15.8% better than those of pwMS with primary progressive MS (PPMS) and 13.8% better than those of pwMS with secondary progressive MS (SPMS). For pwMS with SPMS, the dynamic MQ was 16.7% worse than that of patients with RRMS, while the power MQ was 29.5% worse. By degree of disability (<4 >7.5 EDSS score), patients with better MQ had mild EDSS scores, and patients with severe EDSS scores had 24.8%, 25.9%, and 40.3% worse isometric, dynamic, and power MQ scores, respectively, than those with RRMS. Based on these results, reference values for MQ in pwMS were established. Conclusions: The pwMS with different types of MS do not show differences in lean mass or strength but do show differences in MQ. In pwMS with different EDSS grades, there are no differences in lean mass, but there are differences in strength based on MQ, especially power MQ.

Determination of the Minimum Detectable Change in the Total and Segmental Volumes of the Upper Limb, Evaluated by Perimeter Measurements.

Among female breast cancer survivors, there is a high prevalence of lymphedema subsequent to axillary lymph node dissection and axillary radiation therapy. There are many methodologies available for the screening, diagnosis and follow-up of breast cancer survivors with or without lymphedema, the most common of which is the measurement of patients' arm circumference. The purpose of this study was to determine the intra-rater minimal detectable change (MDC) in the volume of the upper limb, both segmentally and globally, using circumference measurements for the evaluation of upper limb volume. In this study, 25 women who had received a unilateral mastectomy for breast cancer stage II or III participated. On two occasions separated by 15 min, the same researcher determined 11 perimeters for each arm at 4 cm intervals from the distal crease of the wrist in the direction of the armpit. The MDC at the segmental level ranged from 3.37% to 7.57% (2.7 to 14.6 mL, respectively) and was 2.39% (42.9 mL) at the global level of the arm; thus, minor changes in this value result in a high level of uncertainty in the interpretation of the results associated with the diagnosis of lymphedema and follow-up for presenting patients.