Factors influencing older women's decision-making related to treatment of operable breast cancer: A qualitative systematic review.

Objective: There is variation in practice in the treatment of older women with breast cancer. International guidelines highlight the importance of patient autonomy in treatment decision-making. The aim of this study is to identify factors which influence decision-making in older women with operable breast cancer, which will enable us to further understand how to support these patients.

Treatment and outcomes in breast cancer patients: A cross section study from the EUSOMA breast centre network.

Introduction: The present study was designed to describe tumour features and treatments for patients with breast cancer. It also aimed at assessing the risk of distant metastases in relation to biological profiles, disease stages and treatment.

Methods: Data were analysed from 81,882 patients in the EUSOMA database (disease stages at diagnosis 0-IV; median age 61 years; range 20-100 years).

Outcomes of complex oncoplastic breast surgery in older women. Analysis of data from the Age Gap cohort study.

Breast cancer, mastectomy, breast conserving surgery, post-mastectomy reconstruction, older women, quality of life.

Oncoplastic breast surgery in older women with primary breast cancer: systematic review.

Background: Oncoplastic procedures allow excision of larger breast tumours, or unfavourable tumour/breast ratio lesions while achieving a good cosmetic outcome. This increases the pool of patients eligible for breast conservation over mastectomy, reducing the need for more extensive surgery in older women and potentially improving their quality of life. Nonetheless, studies to date suggest a poor uptake of oncoplastic breast surgery in the older group.

Revisiting primary endocrine therapy versus surgery in older women with breast cancer: meta-analysis.

Background: Old age is associated with increased co-morbidities, resulting in reduced life expectancy. Primary endocrine therapy is an alternative to primary surgical therapy for patients with breast cancer and increased co-morbidities. The aim was to review outcomes of primary endocrine therapy versus primary surgical therapy in older women with breast cancer.

The impact of the SARS-COV-2 pandemic on the quality of breast cancer care in EUSOMA-certified breast centres.

Aims: We analysed the impact of the SARS-CoV-2 pandemic (COVID-19) on the quality of breast cancer care in certified EUSOMA (European Society of Breast Cancer Specialists) breast centres.

Materials And Methods: The results of the EUSOMA quality indicators were compared, based on pseudonymised individual records, for the periods 1 March 2020 till 30 June 2020 (first COVID-19 peak in most countries in Europe) and 1 March 2019 till 30 June 2019. In addition, a questionnaire was sent to the participating Centres for investigating the impact of the COVID-19 pandemic on the organisation and the quality of breast cancer care.

Immediate breast reconstruction uptake in older women with primary breast cancer: systematic review.

Background: Postmastectomy immediate breast reconstruction (PMIBR) may improve the quality of life of patients with breast cancer, of whom older women (aged 65 years or more) are a growing proportion. This study aimed to assess PMIBR in older women with regard to underlying impediments (if any).

Methods: MEDLINE, Embase, and PubMed were searched by two independent researchers up to June 2022.

Bridging The Age Gap: observational cohort study of effects of chemotherapy and trastuzumab on recurrence, survival and quality of life in older women with early breast cancer.

Background: Chemotherapy improves outcomes for high risk early breast cancer (EBC) patients but is infrequently offered to older individuals. This study determined if there are fit older patients with high-risk disease who may benefit from chemotherapy.

Methods: A multicentre, prospective, observational study was performed to determine chemotherapy (±trastuzumab) usage and survival and quality-of-life outcomes in EBC patients aged ≥70 years.

Bridging the Age Gap in breast cancer: Impact of chemotherapy on quality of life in older women with early breast cancer.

Introduction: Older patients with early breast cancer (EBC) derive modest survival benefit from chemotherapy but have increased toxicity risk. Data on the impact of chemotherapy for EBC on quality of life in older patients are limited, but this is a key determinant of treatment acceptance. We aimed to investigate its effect on quality of life in older patients enrolled in the Bridging the Age Gap study.

Bridging the age gap in breast cancer. Impacts of omission of breast cancer surgery in older women with oestrogen receptor positive early breast cancer. A risk stratified analysis of survival outcomes and quality of life.

Background: Age-related breast cancer treatment variance is widespread with many older women having primary endocrine therapy (PET), which may contribute to inferior survival and local control. This propensity-matched study determined if a subgroup of older women may safely be offered PET.

Methods: Multicentre, prospective, UK, observational cohort study with propensity-matched analysis to determine optimal allocation of surgery plus ET (S+ET) or PET in women aged ≥70 with breast cancer.

Age specific recruitment and retention to a large multicentre observational breast cancer trial in older women: The Age Gap Trial.

Introduction: Recruitment and retention are two of the most important factors in successfully running clinical trials. Many trials encounter problems with both, causing delays or preventing study progress. These issues are greater in older adults and patients with cancer.

Observational cohort study to determine the degree and causes of variation in the rate of surgery or primary endocrine therapy in older women with operable breast cancer.

Background: In the UK there is variation in the treatment of older women with breast cancer, with up to 40% receiving primary endocrine therapy (PET), which is associated with inferior survival. Case mix and patient choice may explain some variation in practice but clinician preference may also be important.

Methods: A multicentre prospective cohort study of women aged >70 with operable breast cancer.

Exploring the gender difference in relationships between narcissism, competitiveness, and mental health problems among college students.

The current research examined the gender difference in relationships in terms of overt and covert narcissism, hypercompetitiveness, personal development competitiveness, and mental health problems, such as anxiety, depression, and stress symptoms among college students. 195 college students (mean age = 21.55 years) in Hong Kong.

Correlation between breast cancer and lifestyle within the Gulf Cooperation Council countries: A systematic review.

Background: In the six Gulf Cooperation Council countries (GCCCs), Bahrain, Saudi Arabia, Kuwait, Oman, Qatar and the United Arab Emirates, breast cancer (BC) is the greatest cause of cancer incidence and mortality. Obesity and physical inactivity are established risk factors for BC globally and appear to be more of a problem in high income countries like the GCCCs.

Aim: To determine whether obesity and physical inactivity are associated with BC incidence in the GCCCs using the United Kingdom as a comparator.

Personalising Care in the Older Woman with Primary Breast Cancer.

The incidence of breast cancer increases with age. Despite this, most research in the field is targeted at younger patients. Age-specific guidelines are not widely referred to and guidelines which allude to the older woman as an individual are based solely on conventional factors.

Bridging the age gap in breast cancer: evaluation of decision support interventions for older women with operable breast cancer: protocol for a cluster randomised controlled trial.

Introduction: While breast cancer outcomes are improving steadily in younger women due to advances in screening and improved therapies, there has been little change in outcomes among the older age group. It is inevitable that comorbidities/frailty rates are higher, which may increase the risks of some breast cancer treatments such as surgery and chemotherapy, many older women are healthy and may benefit from their use. Adjusting treatment regimens appropriately for age/comorbidity/frailty is variable and largely non-evidence based, specifically with regard to rates of surgery for operable oestrogen receptor-positive disease and rates of chemotherapy for high-risk disease.

Cyclin E overexpression as a biomarker for combination treatment strategies in inflammatory breast cancer.

Inflammatory breast cancer (IBC) is a virulent form of breast cancer, and novel treatment strategies are urgently needed. Immunohistochemical analysis of tumors from women with a clinical diagnosis of IBC (n = 147) and those with non-IBC breast cancer (n = 2510) revealed that, whereas in non-IBC cases cytoplasmic cyclin E was highly correlated with poor prognosis (P < 0.001), in IBC cases both nuclear and cytoplasmic cyclin E were indicative of poor prognosis.

Cytoplasmic Cyclin E Predicts Recurrence in Patients with Breast Cancer.

Low molecular weight cyclin E (LMW-E) detected by Western blot analysis predicts for reduced breast cancer survival; however, it is impractical for clinical use. LMW-E lacks a nuclear localization signal that leads to accumulation in the cytoplasm that can be detected by IHC. We tested the hypothesis that cytoplasmic staining of cyclin E can be used as a predictor of poor outcome in different subtypes of breast cancer using patient cohorts with distinct clinical and pathologic features.

Biological effects of fulvestrant on estrogen receptor positive human breast cancer: short, medium and long-term effects based on sequential biopsies.

We report the first study of the biological effect of fulvestrant on ER positive clinical breast cancer using sequential biopsies through to progression. Thirty-two locally/systemically advanced breast cancers treated with first-line fulvestrant (250 mg/month) were biopsied at therapy initiation, 6 weeks, 6 months and progression and immunohistochemically-analyzed for Ki67, ER, EGFR and HER2 expression/signaling activity. This series showed good fulvestrant responses (duration of response [DoR] = 25.

Primary breast cancer in the elderly: a systematic literature review on histological type and clinical outcome.

The objective was to determine whether histological types of breast cancer in elderly women influence clinical outcome. Four major databases were searched. All relevant articles, from January 1990 to December 2013, were screened.

Progression from impaired fasting glucose to type 2 diabetes mellitus among Chinese subjects with and without hypertension in a primary care setting.

Background: The progression from impaired fasting glucose (IFG) to type 2 diabetes mellitus (T2DM) in Chinese subjects, with and without hypertension, in a primary care setting was unknown.

Methods: The present retrospective multicenter 5-year (2002-2007) cohort study was performed on IFG subjects attending 23 general outpatient clinics who were identified by their elevated fasting blood glucose laboratory results. Development of T2DM was determined by physician diagnosis of T2DM or starting of oral antidiabetic drugs within 5 years.

Breast nurse practitioner training and assessment: a proposed model.

The role of the breast nurse practitioner has been expanding in recent years and many breast units in the UK employ nurse practitioners to carry out a variety of clinical duties. Most of these involve diagnostic assessment of breast diseases and clinical breast examination. While most nurse practitioners have been trained by shadowing breast surgeons, working under supervision, and demonstrating a satisfactory concordance, in terms of clinical opinion with their clinical supervisors, there is a lack of literature describing a training programme that includes assessment.

Strength of ER-positivity in relation to survival in ER-positive breast cancer treated by adjuvant tamoxifen as sole systemic therapy.

Aims: Oestrogen receptor (ER) positivity has been shown to be a predictive factor for response to endocrine treatment in breast cancer patients. Following breast surgery, adjuvant treatment is allocated according to various parameters (including Nottingham Prognostic Index (NPI), menopausal status and ER status). Patients whose cancer falls in the same NPI range may receive different adjuvant treatment according to ER status.

Primary Endocrine Therapy for Locally Advanced Breast Cancer-Is it an Inferior Approach? Experience from Nottingham.

Treatment strategy for locally advanced primary breast cancer(LAPC) remains mainly multimodal involving neoadjuvant chemotherapy, surgery followed by radiotherapy and endocrine therapy, all given upfront. There have been few studies comparing this with a sequential treatment approach, for instance, using endocrine therapy as initial treatment. Based on small randomised clinical trials and local experience in Nottingham, primary endocrine therapy has been shown to produce very good early (response) and late (survival) outcome when used in ER positive, noninflammatory LAPC.