Sandra Kereakoglow

Body image in recently diagnosed young women with early breast cancer

To assess body image concerns among young women following a breast cancer diagnosis.

Treatment-related amenorrhea and sexual functioning in young breast cancer survivors

Sexual dysfunction is a known complication of adjuvant therapy for breast cancer and an important determinant of quality of life. However, few studies have explored how treatment and other factors affect sexual functioning in young breast cancer survivors.

Patient Advocates' Role in Clinical Trials Perspectives From Cancer and Leukemia Group B Investigators and Advocates

Patient advocates are increasingly involved in cooperative group trials, single‐institution cancer programs, and peer‐review of research applications. The purpose of this study was to evaluate the role and value of patient advocates from the perspective of Cancer and Leukemia Group B (CALGB) advocates and investigators.

Quality of life and symptoms in male breast cancer survivors.

INTRODUCTION Little is known about quality of life and symptoms of male breast cancer survivors. PATIENTS AND METHODS We recruited men with stage 0-4 breast cancer for an on-line survey through www.outoftheshadowofpink.com, www.malebreastcancer.org, and www.malebreastcancer.ca. Surveys included expanded prostate cancer index composite (EPIC) hormonal/sexual scales, hospitalized anxiety and depression scale (HADS), Functional Assessment of Cancer Therapy-Breast (FACT-B), sociodemographic/disease-related, genetic, and fertility-related items. RESULTS Forty-two responded. Mean EPIC Sexual and Hormonal scores were 44.5 and 81.3, respectively, suggesting symptom burden. Mean FACT-B score was 111.1, consistent with impaired overall quality of life. CONCLUSIONS Male survivors experience substantial sexual and hormonal symptoms.

Pathologic Features and Biomarker Expression among Young Women with Breast Cancer: Results from the Young Women's Breast Cancer Study.

Background: Prior studies have suggested a higher prevalence of high grade, ER-negative and HER2-positive tumors as well as basal-like carcinomas in young women with breast cancer; features that are associated with a more aggressive phenotype and decreased survival. However, studies are limited by small numbers among the very young ( Design: The Young Women9s Breast Cancer Study is an ongoing multi-center prospective cohort enrolling women with newly diagnosed breast cancer at age ≤ 40 years old. Medical records are reviewed for clinical characteristics, tumor stage and receptor status. HER2 positivity is defined as IHC 3+ or FISH amplified. Pathologic features are examined by central review, with detailed evaluation of phenotypic features associated with basal-like carcinomas. Univariate logistic regression models were used to evaluate the relationship to age, as a continuous variable and each clinico-pathologic feature. Results: The first 248 women for whom pathology has been reviewed (71% of participants enrolled to date) are included in this analysis. The table below presents the distribution of pathologic features by age group. There are no statistically significant differences in ER expression, PR expression or HER2 overexpression by age at diagnosis. Nor are the youngest women more likely to have higher stage or higher grade tumors. However, the youngest women are more likely to have pushing tumor margins and zones of tumor necrosis (p=0.03 and p=0.01 respectively). Conclusion: We find no differences in the distribution of poor prognostic features such as higher tumor stage, high tumor grade, ER/PR negativity or HER2 positivity among the very young. However, our study does indicate that the youngest women are significantly more likely to have tumors with pushing margins and zones of tumor necrosis, which are some of the morphologic features associated with the basal-like phenotype. Further research is warranted to evaluate the implication of these findings with regard to the etiology, treatment and prognosis of breast cancer in young women. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 6007.

Using Students' Journals about Death Experiences as a Pedagological Tool.

ABSTRACT The purpose of this article is to evaluate a pedagological tool for students study of death and bereavement. Previous research suggests that students may be more willing to discuss issues associated with death through written correspondence rather than through oral communication. However, despite these efforts there are still students who experience great difficulty in expressing themselves fully in class—by no fault of the teacher—but merely due to the students own disposition. Based on the data, it appears as if journal writing may offer a way around this difficulty. Data were collected from two sites: a private college in New England and a Midwestern state university. Common themes that students stated effected their experiences with death included reactions of significant others to the death in question, the funeral services provided, and the familial events postfuneral. The limitations and benefits of using journaling as a pedagological tool for a bereavement course are discussed. Using projects such as this one may help students to accurately display their learning to the professor while still bringing in their own perceptions of death.

Evaluating the effect of esthetically enhanced materials compared to standard materials on clinician response rates to a mailed survey

Evidence suggests that physicians have lower response rates than nonphysicians to mailed surveys. It is important to identify methods that can increase physician and nurse participation in health-related survey research. In an effort to improve response rates among clinicians, we developed esthetically enhanced survey materials (booklets printed on glossy paper with color and graphic designs) as part of a large mailed-survey study of oncology doctors and nurses who were listed as members of a North American cooperative oncology group. We randomized these clinicians to receive either an enhanced (90%) or standard (10%) paper survey (standard white paper with no color nor graphic designs, stapled together) about offering results of clinical trials to trial participants. Overall, 34% (793/2333) of the surveys were returned. There was no significant difference between the two groups; 33.7% (707/2300) responded to the enhanced materials and 36.9% (86/233) responded to the standard materials (p = .34). These results suggest that esthetically enhanced materials do not increase clinician response rates to mailed surveys, although further research is warranted in this area.

OR34 Sexual functioning in young women with breast cancer

OR34 Sexual functioning in young women with breast cancer S. Rosenberg *, R. Tamimi, S. Gelber, K. Ruddy, S. Kereakoglow, V. Borges, S. Come, L. Schapira, E. Winer, A. Partridge. Harvard School of Public Health, Department of Epidemiology, Boston, USA, Dana-Farber Cancer Institute, Department of Medical Oncology, Boston, USA, University of Colorado-Denver, Department of Medical Oncology, Denver, USA, Beth Israel Deaconess Medical Center, Department of Medical Oncology, Boston, USA, Massachusetts General Hospital, Department of Medical Oncology, Boston, USA

P4-19-03: Physical and Psychological Sequelae of Breast Cancer in Men.

Introduction : Little is known about the physical and emotional health of men with breast cancer. Information is also lacking regarding whether their informational and supportive care needs are being met regarding fertility and genetic concerns. Methods : In an online pilot study recruiting participants through three websites focused on male breast cancer, www.outoftheshadowofpink.com, www.malebreastcancer.org, and www.malebreastcancer.ca, we surveyed men with breast cancer about their attitudes, symptoms, experiences, and health perceptions. We measured anxiety and depression using the Hospitalized Anxiety and Depression Scale (HADS), health-related quality of life (QOL) using Functional Assessment of Cancer Therapy-Breast (FACT-B), and hormonal and sexual symptoms using the Expanded Prostate Cancer Index Composite (EPIC) Hormonal and Sexual Scales. We assessed select toxicities from therapy and history of genetic and fertility counseling. Results : Forty-two men responded to this online survey at least in part. Conclusions : Men with breast cancer experience substantial symptoms in follow-up. Sexual functioning, in particular, may be impaired (in men without cancer, mean EPIC Sexual Score is 61.4 with SD 23.6). Hormonal symptoms are also prevalent (in men without cancer, mean EPIC Hormonal Score is 91.7 with SD 9.7). We plan to use data from this pilot study to inform a larger study and develop targeted interventions to improve sexual functioning and reduce symptoms in male breast cancer survivors. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P4-19-03.

PD04-05: Body Image Issues in Young Breast Cancer Patients: The Impact of Chemotherapy, Hormone Treatment, and Surgery.

Background: While there is evidence that younger women with breast cancer are more likely to experience compromised quality of life compared to older women, few studies have prospectively explored the impact of treatment, including surgery, chemotherapy, and hormone therapy, on body image, in particular, in very young women (≤40 years old). This analysis examined treatment-associated differences in self-reported body image among a large cohort of young women diagnosed with breast cancer. Methods: 431 women enrolled in an ongoing multi-center prospective cohort study with Stage 0-Stage III breast cancer were included in this analysis. Body image was measured at baseline (1-12 months following diagnosis) using three items from the Cancer Rehabilitation Evaluation System (CARES) survey. CARES scores range from 0–4, with higher scores indicative of greater image concerns. Mean differences in CARES scores between treatment groups (chemotherapy within the last month vs. none; hormone therapy vs. none; lumpectomy vs. mastectomy alone vs. mastectomy + reconstruction) were estimated using T-tests and one-way ANOVA. To control for concurrent treatment, stage, and time since diagnosis, multiple linear regression models were fit and least squares means estimated and compared between treatment groups. Multiple comparisons were adjusted for using the Bonferroni correction. Results: Median age at diagnosis was 37 (range: 17–40) and median time from diagnosis to study enrollment was 5 months (range: 1–12 months). In the unadjusted analysis, there were no significant differences in scores between women who had received chemotherapy within the last month and those who did not (p=0.80), while women who reported hormone treatment had higher mean CARES scores compared to women who did not (p=0.04). Among women who had undergone surgery (n=370), women who had lumpectomies had a mean CARES score of 0.95, which was significantly lower (p Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr PD04-05.