OBJECTIVETo explore the correlation between depressive disorder and breast cancer, and to study the features of depressive disorder in patients before and after suffering breast cancer.

METHODSWhether 40 breast cancer patients had depressive disorder and their degrees were assessed by filling in Hamilton Depression Rating Scale (HAM-D) at Department of Oncology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences. The correlation between depressive disorder and the occurrence and progression of breast cancer, as well as its features were studied.

RESULTSThe occurrence of general depressive disorder in breast cancer patients before they suffered from breast cancer was 72.5% (29/40 cases). The occurrence of confirmed depression was 2.5% (1/40 cases). The total depressive disorder rate was 75.0% (30/40 cases).They were 60. 0% (24/40 cases), 7.5% (3/40 cases), and 67. 5% (27/40 cases) in breast cancer patients after they suffered from breast cancer.

CONCLUSIONBreast cancer patients have depressive disorder to various levels before and after suffering from breast cancer, which should raise clinical attention and corresponding intervention.

Breast Neoplasms ; epidemiology ; pathology ; psychology ; Depressive Disorder ; epidemiology ; Female ; Humans ; Incidence

PURPOSE: The purpose of this study was to identify whether the couple perceived breast cancer as a traumatic event, to evaluate the association among posttraumatic growth, dyadic adjustment, and quality of life and to explore the predictors affecting quality of life of the couple. METHODS: A cross-sectional comparative survey design was utilized. Participants were 57 couples recruited from a national cancer center in Korea. Data were analyzed using paired t-test, McNemar test and independent t-test. On the basis of variables found to be significantly associated with quality of life, multiple regression was used to examine the simultaneous influence of multiple predictors. RESULTS: Breast cancers survivors and spouses perceived breast cancer as a traumatic event (43.9% and 24.6%, respectively). The global quality of life was explained by perception as trauma (beta= -19.79) and posttraumatic growth (beta=0.46) in survivors, and perception as trauma (beta= -18.81) and dyadic adjustment (beta=0.53) in spouses. CONCLUSION: Results suggest that future research should use qualitative methods to evaluate why contemplating reasons for cancer contributed to posttraumatic growth, examine other potential predictors of quality of life such as dyadic adjustment and intimacy, and identify links between posttraumatic growth and other psychological outcomes such as distress and well-being, using prospective analyses.
Adaptation, Psychological ; Adult ; Breast Neoplasms/pathology/*psychology ; Cross-Sectional Studies ; Female ; Humans ; Interpersonal Relations ; Male ; Marriage ; Middle Aged ; *Quality of Life ; Questionnaires ; Spouses/*psychology ; Survivors

PURPOSE: To develop a expressive writing program for women with breast cancer and to identify its effects on stress physical symptom, cancer symptom, anxiety, depression, and QOL. METHODS: A non-equivalent control pre-post design was used. Participants were recruited from self-help groups in six hospitals and were assigned to the experimental group (29) or control group (29). Data were collected before, after, and at four weeks after the intervention program. Changes in the variables were evaluated to test effects of the developed program, using chi2-test, Fisher's exact test, repeated measures ANOVA, and paired t-test. RESULTS: The expressive writing program was developed for women with breast cancer based on Pennebaker's expressive writing. Significant differences were found between the two groups for stress related to physical symptoms (p<.00) and quality of life (p=.024). No significant differences were found in cancer symptoms, anxiety, or depression between the two groups. CONCLUSION: The results indicate that the expressive writing program designed to express cancer-related deep thoughts and emotions helps in decreasing physical symptoms and improving QOL. Further studies are needed to identify the effect on emotions such as anxiety and depression for women with breast cancer with above average levels of anxiety and depression.
Adaptation, Psychological ; Adult ; Anxiety ; Breast Neoplasms/pathology/*psychology ; Demography ; Depression ; *Expressed Emotion ; Female ; Humans ; Intervention Studies ; Middle Aged ; Program Development ; Program Evaluation ; Quality of Life ; Republic of Korea ; Writing

PURPOSE: Purpose of this study was to examine the effects of the Mindfulness Meditation program on perceived stress, ways of coping, salivary cortisol level, and psychological stress response in patients with breast cancer. METHODS: This was a quasi-experimental study with a non-equivalent control group pre-post test design. Participants in this study were 50 patients who had completed breast cancer treatment (experimental group, 25, control group, 25). The experimental group received the Mindfulness Meditation program for 3 hours/session/ week for 8 weeks. Data were analyzed using chi2-test and t-test for subject homogeneity verification, and ANCOVA to examine the hypotheses. RESULTS: The experimental group had significantly lower scores for perceived stress, emotional focused coping, salivary cortisol level, and psychological stress response compared to the control group. However, no significant differences were found between two groups for the scores on problem focused stress coping. CONCLUSION: According to the results, the Mindfulness Meditation program was useful for decreasing perceived stress, emotional focused coping, salivary cortisol level, and psychological stress response. Therefore, this program is an effective nursing intervention to decrease stress in patients with breast cancer.
Adaptation, Psychological ; Adult ; Breast Neoplasms/metabolism/pathology/*psychology ; Emotions ; Female ; Humans ; Hydrocortisone/analysis ; Middle Aged ; Perception ; *Program Evaluation ; Questionnaires ; Salivary Glands/metabolism ; Stress, Psychological

In order to fully understand the anxiety level of the patients who will have ultrasound-guided puncture biopsy, and the survey results will guide the future clinical care to reduce the anxiety score of the patients, and to im-prove the satisfaction of them, which reflects the quality of care, we used Zung Self-rating Anxiety Scale (SAS) to investigate outpatients who will have ultrasound-guided puncture biopsy in a upper first-class hospital by convenience sampling way. The results showed that the SAS standard score of the patients was higher than the Chinese normal population's, and there is significant difference between the patients and the normal population's score (t = 47.12, P < 0.001). So for reducing the patients' anxiety level we should give health education and care intervention to the patients before the operation. This reflects the Patient-centered Culture and Excellent-quality Care in China.
Adolescent ; Adult ; Aged ; Anxiety ; etiology ; prevention & control ; Biopsy, Needle ; methods ; psychology ; Breast Neoplasms ; diagnostic imaging ; pathology ; Female ; Humans ; Male ; Middle Aged ; Patient Education as Topic ; Patient Satisfaction ; Surveys and Questionnaires ; Thyroid Neoplasms ; diagnostic imaging ; pathology ; Ultrasonography ; Young Adult

PURPOSE: To validate and update a nomogram for predicting ductal carcinoma in situ (DCIS) upstaging in preoperative biopsy. MATERIALS AND METHODS: Medical records of 444 preoperative DCIS patients were evaluated and used to validate a previous version of the Severance nomogram for predicting DCIS upstaging in preoperative biopsy. Patients were divided into two groups according to the final postoperative pathology. Univariate and multivariate analyses with the chi-square test, Student's t-test, and binary logistic regression method identified new significant variables. The updated nomogram was evaluated with the C-index and Hosmer—Lemeshow goodness of fit test. RESULTS: The area under a receiver operating characteristic curve for comparison with the previous nomogram was 0.48. In postoperative pathology, the pure DCIS and invasive cancer groups comprised 345 and 99 cases, respectively. Approximately 22.3% of patients preoperatively diagnosed with DCIS were upstaged to invasive cancer. Significant variables in the univariate analysis were operation type, human epidermal growth factor receptor 2 overexpression, comedo necrosis, sonographic mass, mammographic mass, preoperative biopsy method, and suspicious microinvasion in preoperative biopsy. In multivariate analysis, operation type, sonographic mass, mammographic mass, and suspicious microinvasion were risk factors for upstaging. The updated model with these variables showed moderate discrimination and was appropriate in the calibration test. CONCLUSION: The previous nomogram did not effectively discriminate upstaging of preoperative DCIS in an independent cohort. An updated version of the nomogram appears to provide more accurate information for predicting preoperative DCIS upstaging.
Biopsy ; Breast Neoplasms ; Breast ; Calibration ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Cohort Studies ; Discrimination (Psychology) ; Humans ; Logistic Models ; Medical Records ; Methods ; Multivariate Analysis ; Necrosis ; Nomograms ; Pathology ; Receptor, Epidermal Growth Factor ; Risk Factors ; ROC Curve ; Ultrasonography

PURPOSE: This study was done to examine the difference in cancer screening with mammography and Papanicolaou smear according to Body Mass Index (BMI). METHODS: The participants in this study were 5,912 women ages 40 to 69 yr, selected from the Korean Genomic Regional Cohort in Kangwon province. Mammography and Papanicolaou smear were assessed by questionnaire and body weight (kg) and height (m) measured to calculate BMI. RESULTS: The distribution of BMI was as follows: low weight (1.5%), normal weight (31.1%), over weight (24.6%), mildly obese (36.4%) and severely obese (6.3%). After adjusting for age, education and monthly income, compared with normal weight women, overweight women (odds ratio [OR]=1.283, 95% confidence interval [CI]=1.089-1.513) and mildly obese women (OR=1.214, 95% CI=1.048-1.406) were less likely to have had mammography. In contrast to mammography, cancer screening with Papanicolaou smear was not significantly different by BMI. CONCLUSION: Obese women in rural areas are less likely to screen for breast cancer by using mammography than non obese women. To ensure regular screening for breast cancer, health care providers need to give scrupulous care to obese women and remove barriers originated from obesity. Also, educational and clinical implications are considered to increase the Papanicolaou smear rate.
Adult ; Aged ; *Body Mass Index ; Breast Neoplasms/prevention & control/*radiography ; Cohort Studies ; Demography ; Female ; Humans ; *Mammography ; Middle Aged ; Obesity/psychology ; Republic of Korea ; Rural Population ; Uterine Cervical Neoplasms/*pathology/prevention & control ; *Vaginal Smears ; Women's Health

By analyzing the data of 459 patients who completed the Supportive Care Needs Survey (SCNS), the prevalence, medical and non-medical predictors of unmet needs were investigated. Breast cancer patients in Korea experienced high levels of unmet needs across the needs domains, particularly in the health system and information domain (56.9%). Various medical and non-medical variables were identified as significant predictors of unmet needs in each domain. By multivariate analyses, several predictors were identified across the domains including; less education (< or = 9 years) in the psychologic, chemotherapy, short post-surgical interval, and less education in the physical and daily living, younger age (< 50 years) in the sexuality, larger tumor size (> 2cm) and younger age in the health system and information, and more education (> or = 13 years) in the care and support domain. The results of this study suggest medical professional should consider the complexity and dynamics of meeting patients' needs in providing supportive care services.
*Social Support ; Perception ; Needs Assessment ; Multivariate Analysis ; Middle Aged ; Korea ; Humans ; Health Services Needs and Demand ; Health Services Accessibility ; Female ; Breast Neoplasms/diagnosis/pathology/*psychology ; Attitude to Health ; Aged, 80 and over ; Aged ; Adult