Doreen L. Wiggins

Sex, Intimacy, and the Gynecologic Oncologist: Survey Results of the New England Association of Gynecologic Oncologists (NEAGO)

Abstract Sexuality is an important aspect of life and is often affected in patients diagnosed with cancer. For women, estimates of sexual dysfunction range from 40 to 100%. In light of these statistics, we were interested in determining the comfort level and practice of specialists in gynecologic oncology as it relates to taking a sexual history and addressing related concerns by conducting a survey of the New England Association of Gynecologic Oncologists (NEAGO). Our results show that although nearly all respondents felt comfortable addressing sexual problems in their patients, less than half took a sexual history in new patients and 80% did not feel there was sufficient time to devote to exploring sexual issues. The results of our survey suggest that aspects of sexual dysfunction in women with gynecologic cancer may be neglected by gynecologic oncology providers. This encourages cancer programs to develop formal resources for women with questions regarding sexuality following a diagnosis of cancer.

Trends in incidence and associated risk factors of suicide mortality among breast cancer patients

Breast cancer patients are associated with an increased risk for committing suicide. The purpose of this study was to study the trends in the incidence of suicide mortality and identify pertinent risk factors among patients with breast cancer.

Diffuse dermal angiomatosis mimicking inflammatory breast carcinoma

Diffuse dermal angiomatosis (DDA) is a rare pathologically distinct subtype of reactive angioendotheliomatosis. In the literature, few biopsy‐proven cases involving breast skin have been reported. We present a case of a 49‐year‐old female who presented with an indurated, erythematous, weeping, puckered and tender lesion with focal ulceration. Mammography demonstrated diffuse cutaneous and trabecular thickening concerning for inflammatory breast carcinoma. A punch biopsy demonstrated findings consistent with DDA. To our knowledge, this is the first reported case of DDA mimicking inflammatory carcinoma of the breast by clinical and radiologic examination.

BioZorb tissue marker as seen on multiple imaging modalities

by immunohistochemistry should also be performed. Traumatic neuromas are reactive proliferations of nerves commonly seen associated with prior biopsy sites. There are no specific imaging findings for schwannoma in the breast. Ultrasound typically shows a hypoechoic circumscribed solid mass which can lack homogeneity. Most patients have undergone excisional biopsy following a diagnosis of schwannoma in a core biopsy. However, schwannoma is a benign tumor and it is reasonable to follow patients with imaging rather than have the lesion excised in most cases, provided the lesion is not growing in size and there is good radiologic-pathologic correlation.

Transforming Cancer Survivorship Care

Population health efforts typically reach across subspecialties, ideally filling in healthcare management gaps from the patient’s or community’s perspective that should lower costs, improve access, and bolster quality. This case is a good example of the many differences between theory and practice. In 2012, Lifespan Healthcare System launched the Women’s Medicine Collaborative to address the gender-specific healthcare concerns of women. The aim was to develop an evidence-based, integrative cancer survivorship program to serve the needs of female cancer survivors and their families. This case examines the progress made, as well as the remaining development issues, as the program seeks to fulfill multiple stakeholder needs for improving gender-specific survivorship care. It is a classic case of more experimental initiatives that hold transformational promise, but must adjust to the realities of ongoing financial constraints and existing treatment paradigms.

The Impact of Reproductive Cancers on Women’s Mental Health

Today, one in three women in the USA will develop cancer in her lifetime. Women with breast and gynecologic cancers account for 30 % of all cancer survivors. Survivorship begins with a woman’s initial diagnosis and continues through her active treatment, its long-term side effects, and for the rest of her life. Because of advances in early detection and treatment, cancer is quickly becoming viewed as a chronic illness associated with long-term side effects of treatment, including decreased functional capacity, pain, fatigue, and decreased fertility and sexual function. The treatment itself, and even the diagnosis of cancer, leaves many women vulnerable to changes in their mental health, particularly anxiety and depression. The psychological impact of a cancer diagnosis varies with disease origin, age at diagnosis, physiologic alterations as a consequence of surgery, and the stage to which the disease has advanced. In this chapter, we discuss issues that often have a psychological impact on a woman after she receives a cancer diagnosis, specifically addressing the needs of reproductive cancer survivors. These issues are the physiologic, psychosocial, reproductive, and sexual changes experienced by female cancer survivors.