فصلنامه بیماری های پستان ایران
سال چهاردهم شماره 3 (پیاپی 54، پاییز 1400)

Worldwide, breast cancer is the most common cancer-affecting women. The complexity of decision-making in the diagnosis and treatment of patients highlights the necessity for a team approach, mostly multidisciplinary team (MDT). The aim of this study was to compare the opinions of the MDT and the physician on the diagnosis and treatment of women with breast diseases at Motamed Cancer Institute.

This cross-sectional study was performed on 122 women with breast symptoms. Patients were enrolled in the study in diagnostic and therapeutic groups. After introducing patients’ complaints at the MDT meeting, each member expressed their suggestions and at the end of the meeting the final decision which was approved by the majority of members was acknowledged as the opinion of the MDT meeting. Then, the MDT decision was compared with the preliminary decision of the physician.

The final decision of the MDT in the diagnostic group was the same as the physician in 48.9% of the cases, and the MDT changed the diagnosis in 51.1% of patients (P<0.001). In the treatment group, the final decision of the MDT was the same as the physician in 28.6% of cases and in 71.4%, the MDT changed the treatment procedure (P <0.001).

Using an MDT approach in the management of breast diseases reduces the use of aggressive procedures, and helps the physician to make decisions precisely with more confidence in complicated cases.

The aim of this study was to compare the effect of delivering education via WhatsApp vs a compact disc on health literacy and behavior of middle-aged women about breast cancer.

This was a randomized controlled trial in which 154 middle-aged (40-59 years) women were recruited and randomly assigned into two groups of education (WhatsApp and compact disc [CD]). The CD training group was given a CD containing information, videos, and images about breast cancer screening methods. Women in the WhatsApp group received the same information on a daily basis for two weeks. The participants completed the Health Literacy Questionnaire (BCHL) before the intervention and after three months. The independent t test, the chi-square test, and the Wilcoxon test were used for analyzing the data.

The total score of health literacy was improved significantly in both groups after the intervention (from 79.1 ± 18.6 at baseline to 94.7 ± 11.9 in the CD group, and from 75.6 ± 17.7 to 85.5 ± 17 in the WhatsApp group; P < 0.0001). The improvement was observed in all domains of breast cancer health literacy including accessibility, reading, understanding, assessment, and decision making. Although using breast self-examination improved significantly in the two groups, there was little improvement in using clinical breast examination and mammography.

The results of this study showed that education could significantly improve the health literacy as well as the behavior of middle-aged women about breast cancer, but the comparison of the effects of the two methods showed a greater effect for education via CD.

Exercise has been proposed as a medicine for the control and treatment of cancer and its complications. The aim of the present study was to compare the effect of 12 weeks of high-intensity interval training and moderate continuous aerobic training on quality of life in women with breast cancer undergoing hormone therapy.

39 patients with breast cancer undergoing hormone therapy were randomly assigned to 3 groups: (1) high-intensity interval training (HIIT; n = 13), (2) moderate-intensity continuous training (MICT; n = 14), and (3) control group (n = 12). The intervention groups performed their exercises for 12 weeks, 3 sessions per week. Quality of life was measured using the Functional Assessment of Cancer Therapy-General (FACT-G) before and after the intervention. Data were analyzed using an ANCOVA test.

The physical well-being domain scores significantly improved in the MICT group compared with the control group (P = 0.010). The emotional dimension scores in both groups of HIIT (P = 0.010) and MCIT (P = 0.016) significantly improved compared with the control group. In the functional dimension, a significant difference was observed between the HIIT group and the control group (P = 0.050). Total quality of life scores for both the HIIT group (P = 0.001) and the MICT group (P = 0.005) were significantly increased compared with the control group.

The results of this study show that both interval and continuous exercise programs can improve quality of life in breast cancer patients, although a larger sample is needed to confirm the clinical significance of these initial findings.

Improving the quality of life in cancer patients requires holistic and community-based interventions. The aim of this study was to compare the effectiveness of spiritual counseling based on the sound heart model and mindfulness training in improving the quality of life of women with breast cancer.

This clinical trial was performed with two experimental groups on women with breast cancer at Baqiyatallah Hospital, Tehran. Thirty eligible volunteer patients were enrolled in the study and randomly assigned to either spiritual counseling or mindfulness training. The interventions were performed in 8 sessions, 30 to 45 minutes, face to face. The quality of life questionnaire was completed by the subjects before and after the intervention. Data were entered in SPSS software (version 22.0). Because the normality of data distribution was not met, the Wilcoxon nonparametric test was used to compare the baseline and postintervention data in each group. In order to compare the effectiveness of the two methods of intervention, we calculated the mean difference in quality of life for each group and used the Mann-Whitney U test to compare the data.

The Wilcoxon test showed that both interventions were effective in improving quality of life (P < 0.001). The Mann-Whitney U test showed that spiritual counseling had a greater effect on quality of life than mindfulness training (P < 0.001).

Considering the greater effect of spiritual counseling on the patients’ quality of life, in comparison with mindfulness training, it is recommended that spiritual therapy be used in the treatment of cancer patients as a means of strengthening the adaptation ability, reducing spiritual distress, and increasing the quality of life of patients.

In recent decades, the significant role of angiogenesis in the growth and metastasis of cancer has led to much research in this field. The aim of this study was to investigate the interaction effect of 6 weeks of continuous aerobic training and quercetin on TIE-2 and VEGF-A expression in female mice with breast cancer.

Twenty-four female BALB/c mice with breast cancer were randomly divided into 3 groups: tumor (T), tumor+aerobic exercise (T+AE), and tumor+aerobic exercise+quercetin (T+AE+Q). The T+AE group and the T+AE+Q group performed endurance running exercise on a treadmill for 6 weeks, 5 days per week, 60 minutes per session, with a gradual increase in intensity over the training period. The T+AE +Q group was injected with 110 mg.kg-1 of quercetin solution for 6 weeks, /3 days per week/ in addition to exercise. Eventually, the mice were killed, and the tumor tissues were removed and frozen in liquid nitrogen. The expression of TIE-2 and VEGF-A genes was measured using real-time PCR. ΔCt, ΔΔCt, and the fold change were calculated, and one-way analyses of variance with Tukey post hoc tests were used to analyze the data at a significance level of 0.05. Data analysis was conducted using the GenEx software.

The results showed that T+AE+Q interaction significantly reduced VEGF-A expression (4.09 times decrease) compared with the T group (P< 0.05). Quercetin consumption in the T+AE+Q group significantly reduced VEGF-A expression (2.72 times) compared with the T+AE group (P< 0.05)., However, aerobic exercise alone had no effect on VEGF-A expression. Also, aerobic exercise alone or in combination with quercetin had no effect on TIE-2 expression.

The interaction of aerobic exercise and quercetin supplementation may be effective in inhibiting tumor angiogenesis.

Mastectomy causes psychological problems for women. Reducing their happiness and quality of life. The aim of this study was to determine the effect of narrative therapy on happiness and quality of life in women with breast surgery experience.

The study was semi-experimental with a pre-test-post-test and follow-up with the control group design. The study population included all mastectomized women in Esfahan who were undergoing radiation therapy in 2019. Thirty persons meeting the inclusion criteria were selected by cluster sampling. The subjects were randomly divided into the intervention (n=15) and control (n=15) groups. The intervention group received narrative therapy over 8 sessions of 1.5 hours (2 months, one session per week) as a group, according to the White and Epston treatment program. The control group did not receive any intervention. Members in both groups responded to the 29-item Oxford Happiness Questionnaire and the sf-36 before, after and 4 months after the intervention. Data were analyzed with repeated-measures analysis of variance.

The baseline mean ± SD scores for happiness and quality of life for the experimental group were 36.3±3.1 and 39.5±4.7 4.7, respectively, and those for the control group were 36.0±3.2 and 41.1±3.8 (P>0.05). Narrative therapy significantly increased happiness (44.2±2.4) and quality of life (50.2±5.3) of women with breast surgery experience compared with the control group (happiness: 37.8±4.3 and quality of life 41.2±3.8) (P<0.001). In the follow-up phase, the effect of narrative therapy on happiness (44.3±2.2) and quality of life (50.2±5.0) was lasting (P<0.001).

Based on the findings of this study, it can be concluded that narrative therapy has increased happiness and quality of life in women with breast surgery experience.