(Press-News.org) SAN DIEGO -- A third of breast cancer survivors who received the breast-conserving treatments lumpectomy and radiation rate the appearance of their post-treatment breast as only "fair" or "poor" in comparison to their untreated breast, according to a new University of Pennsylvania School of Medicine study that will be presented today at the 52nd Annual Meeting of the American Society for Radiation Oncology (ASTRO) in San Diego. In addition, one fifth of patients report complications including chronic pain in their breast or arm and loss of arm or shoulder flexibility following their treatment, the study authors found.
The findings, which are the first to examine patients' own impressions of the cosmetic appearance of their breast following treatment, contrast with previous studies in which clinicians were more likely to label post-treatment breasts as "good" or "excellent" in appearance. The authors say that the findings shed light on how patients' treatment expectations may differ from their physicians', and reveal a need for additional patient education about potential outcomes.
"Most patients are ultimately happy they were able to preserve their breast, but our study shows that often, how they feel about the way they look after treatment is not as good as doctors would have predicted," says lead author Christine Hill-Kayser, MD, an assistant professor of Radiation Oncology at Penn's Abramson Cancer Center.
Among 503 patients surveyed who had a lumpectomy followed by radiotherapy, the findings showed that 16 percent reported "excellent" cosmesis, 52 percent "good," 30 percent "fair," and 2 percent "poor." Forty-three percent of women who had these breast-conserving treatments reported chronic skin or soft tissue changes, 22 percent said they had chronic pain in the breast or arm, 21 percent had suffered a loss of arm or shoulder flexibility, and 8 percent had chronic swelling. The study data was collected from patients who voluntarily created an online survivorship care plan using the LIVESTRONG Care Plan Powered by Penn Medicine's Oncolink (http://www.livestrongcareplan.org). This easy-to-use tool, developed by physicians and nurses from the Abramson Cancer Center, provides users with an easy-to-follow roadmap for managing their health as they finish treatment and transition to life as a cancer survivor.
"It's very important that cancer survivors be empowered by information – they should be aware not only of the possible complications associated with their treatment, but also that there are things that they can do about many of them," Hill-Kayer says.
Currently, more than half of breast cancer patients undergo both lumpectomy and radiation, a combination of treatments which offer the best chance of cure while avoiding complete removal of the breast among women with Stage I or II cancer. Cosmetic issues that these patients may report include scarring, skin puckering, changes in the color or texture of skin, size or shape asymmetry between the treated and untreated breast, and nipple distortion. Although it may not be possible to correct all of those problems, Hill-Kayser notes there are a variety of therapies available for women with treatment complications, including physical therapy and weight training regimens for patients who experience the painful arm-swelling condition called lymphedema, and shoulder pain and/or stiffening.
"As cure rates for breast and other cancers continue to improve, attention to survivorship issues is more important than ever before," Hill-Kayer says. "Understanding more about the way that survivors feel after their treatment is one step towards helping patients live as well as possible after cancer."
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Penn Medicine is one of the world's leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the University of Pennsylvania School of Medicine (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System, which together form a $3.6 billion enterprise.
Penn's School of Medicine is currently ranked #2 in U.S. News & World Report's survey of research-oriented medical schools, and is consistently among the nation's top recipients of funding from the National Institutes of Health, with $367.2 million awarded in the 2008 fiscal year.
Penn Medicine's patient care facilities include:
The Hospital of the University of Pennsylvania – the nation's first teaching hospital, recognized as one of the nation's top 10 hospitals by U.S. News & World Report.
Penn Presbyterian Medical Center – named one of the top 100 hospitals for cardiovascular care by Thomson Reuters for six years.
Pennsylvania Hospital – the nation's first hospital, founded in 1751, nationally recognized for excellence in orthopaedics, obstetrics & gynecology, and psychiatry & behavioral health.
Additional patient care facilities and services include Penn Medicine at Rittenhouse, a Philadelphia campus offering inpatient rehabilitation and outpatient care in many specialties; as well as a primary care provider network; a faculty practice plan; home care and hospice services; and several multispecialty outpatient facilities across the Philadelphia region.
Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2009, Penn Medicine provided $733.5 million to benefit our community.
A pre-school language intervention programme can significantly improve the educational lives of children with poorly developed speech and language skills, according to new research by psychologists at the University of York.
In the Language 4 Reading project, a team from the University's Department of Psychology at the University of York have evaluated the benefits of a pre-school language intervention programme for children who enter school with poorly developed speech and language skills.
The project, which involved 15 schools and feeder-nurseries across Yorkshire, ...
The report by Jeanne Lenzer, a medical investigative journalist in New York, and Shannon Brownlee from the Dartmouth Institute for Health Policy and Clinical Practice in New Hampshire, looks at the FDA's approval of a device to prevent or reduce seizures in patients with epilepsy who do not respond to drug treatment.
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In the UK, medical students are 4.5 to 7.2 times more likely to come from the wealthier socio-economic groups 1-3 than 4-7, write Professor Terence Stephenson, president of the Royal College of Paediatrics and Child Health, and Lucy Stephenson, a medical student.
Selection to a medical course should not depend on the applicants' financial status. However, with "grade inflation" at A level, choosing between applicants can involve other criteria that may depend on ability to pay, they say.
They calculate that the activities required as part of the selection process ...
Ann Arbor, Mich. — Value-Based Insurance Design — a concept created at the University of Michigan and incorporated in the nation's new health care reform law — is the focus of an upcoming national policy journal.
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Strengthening routine influenza vaccination and health programs may help states improve their vaccination coverage against future pandemics or other health emergencies, a new study suggests.
The study -- conducted by researchers at the Georgia Institute of Technology in collaboration with the Centers for Disease Control and Prevention (CDC) -- examined factors that may have contributed to the striking state-by-state variation in U.S. H1N1 flu vaccination rates. The results of the study were revealed on Oct. 26 at the 32nd Annual Meeting of the Society for Medical Decision ...
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The Geostationary Operational Environmental Satellites like GOES-13 are managed by NOAA. The NASA GOES Project at NASA's Goddard Space Flight Center in Greenbelt, Md. creates images and animations from the GOES satellite data. When GOES-13 provided an infrared image (because it was taken at night) today, Nov. 2 at 0845 UTC (4:45 a.m. EDT), Tropical Storm Tomas ...
NJIT Associate Professor Victor Matveev, PhD, in the department of mathematical sciences, was part of a research team that published "N-type Ca2+ channels carry the largest current: Implications for nanodomains and transmitter release," in Nature Neuroscience on Oct. 17, 2010. http://www.nature.com/neuro/journal/v13/n11/abs/nn.2657.html
Leading the project, Elise Stanley, PhD, a senior scientist at the Toronto Western Research Institute, said that Matveev's mathematical modeling showed that calcium influx through a single N-type calcium channel is sufficient to trigger ...
Faster and more widely available internet access has improved our lives in many ways but healthcare is lagging behind, according to researchers writing in the International Journal of Medical Engineering and Informatics.
The US team suggests that there is immense potential for the utilization of digitized personal health records (PHR) in chronic disease management. They have reviewed the state of the art in healthcare portals, assessed the standardization and the legality of health record s and point to a need to improve interoperability, which still represents a major ...
WHAT:
Secondary infections with bacteria such as Streptococcus pneumoniae, which causes pneumonia, were a major cause of death during the 1918 flu pandemic and may be important in modern pandemics as well, according to a new article in the Journal of Infectious Diseases co-authored by David M. Morens, M.D., senior advisor to the director of the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health.
The researchers examined 13 studies published between 1918 and 1920. During this time, many scientists erroneously believed that ...
Gastric bypass surgery decreases the preference for sweet-tasting substances in obese rats, a study finding that could help in developing safer treatments for the morbidly obese, according to Penn State College of Medicine researchers.
"Roux-en-Y gastric bypass surgery is the most common effective treatment for morbid obesity," said Andras Hajnal, M.D., Ph.D., associate professor, Department of Neural and Behavioral Science and Surgery. "Many patients report altered taste preferences after having the procedure."
This surgery involves the creation of a small gastric ...
