- Email: [email protected]
PR118 COMPARISON OF INTEGRATIVE CARE EXPECTATIONS BETWEEN BREAST CANCER PATIENTS AND BREAST ONCOLOGY PHYSICIANS IN AN ETHNICALLY DIVERSE POPULATION
S62
Abstracts / The Breast 24 S3 (2015) S21–S75
place at the hospital, in the presence of family members and staff. The medical doctors who were invited to the wedding had chosen not to participate with the main purpose of keeping the emotional distance that would allow them to make a more rational decision. After the wedding some of the doctors would consider their presence at the ceremony from a different perspective. Conclusion: This case reflects the need of having well prepared and orientated teams, to approach the patient as a whole in her/his final life stage, not only to provide the pharmacological symptomatic relief, but also the emotional comfort, so many times considered as secondary.
PO117 CAN WE MAKE A PORTRAIT OF WOMEN WITH INOPERABLE LOCALLY ADVANCED BREAST CANCER? THE EXPERIENCE OF THE BREAST UNIT OF SOUTHERN SWITZERLAND (CSSI) Giacomo Montagna1,2, Gabriella Bianchi-Micheli2, Lorenzo Rossi2,3, Marzia Conti-Beltraminelli2,3, Roberta Decio2, Vilma Ratti3, Thomas Gyr1,2, Olivia Pagani2,3, Francesco Meani1,2 1 Ente Ospedaliero Cantonale, Department of Obstetrics and Gyneacology, Lugano, Switzerland; 2Ente Ospedaliero Cantonale, Breast Unit of Southern Switzerland (CSSI), Lugano, Switzerland; 3Ente Ospedaliero Cantonale, Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland Introduction: Breast cancer (BC) is the most common cancer in women. Early detection and treatment improvements have both led to a significant decrease in mortality over the last 25 years. Locally advanced BC (LABC) is defined as large operable primary BC (stage IIB, IIIA) and/or inoperable BC (i.e. involving the skin/chest wall and/or with extensive nodal involvement) (stage IIIB, IIIC). Despite the amount of information available through the media and advocacy groups (i.e. Europa Donna), repeated events to raise public awareness (i.e. the Pink Ribbon Campaign) and mammography screening programs, LABC still accounts for 5-10% of all new primary BC diagnoses. Overall, the prognosis of patients with LABC is relatively poor with a 5-year overall survival <50%. Materials and Methods: Between 2008-2014, >1300 patients with a newly diagnosed primary BC have been treated at CSSI. 114 patients (9%) had LABC at diagnosis. We planned to retrospectively investigate the demographic (i.e. age, social and marital status, education level, religious beliefs) and psychosocial characteristics (i.e. BC family history, somatic and psychiatric co-morbidities, use of psychiatric therapy, concomitant chronic diseases, timing of symptom detection and initial symptom interpretation, emotional reactions, family and social interactions) of these patients. A demographic survey and a semi-structured interview (28 items) was specifically developed and submitted by the treating team (gynecologist, psychologist, medical oncologist) to all consenting patients. Aims of the study: With this study we intend to assess the demographic and psychosocial features of women with LABC treated at our institution over the past 6 years and possibly identify factors which led them to delay seeking medical attention. Data are under collection and will be analyzed and ready to be presented by the end of October 2015. We aim at drawing a patient’s profile that could be potentially used to better identify those women who are at higher risk for developing LABC in our geographic area in order to build specific and targeted information and awareness tools. On the long term, we want to evaluate the impact of the mammographic screening program, recently introduced in our canton, on the incidence of LABC.
PR118 COMPARISON OF INTEGRATIVE CARE EXPECTATIONS BETWEEN BREAST CANCER PATIENTS AND BREAST ONCOLOGY PHYSICIANS IN AN ETHNICALLY DIVERSE POPULATION Damien Hansra3,4, Jeremy Ramdial1, David Ruiz2,3, Ashwin Mehta4, Eugene Ahn4, Jorge Antunez de Mayolo3 1 Jackson Memorial Hospital, Oncology, Miami, USA; 2Mast Academy, Oncology Clinical Research, Miami, USA; 3Mercy Hospital/Oncology and Radiation Associates, Hematology & Oncology, Miami, USA; 4Sylvester Comprehensive Cancer Center at the University of Miami, Oncology, Miami, USA Purpose: Evidence shows increased patient utilization of various integrative care modalities to manage symptoms and improve quality of life. Measurements of breast cancer patients and physicians’ opinions regarding the importance of integrative care are lacking. We aim to compare how integrative care modalities are values between physicians and patients. Methods: University of Miami IRB obtained. Adult breast cancer patients (pts) and physicians who specialize in breast cancer (MDs) at an academic tertiary care medical center in Miami, Florida were enrolled to complete a survey. Inclusion criteria: adult cancer pts and treating hem/ onc MDs. Exclusion criteria: Pts without breast cancer and non-breast cancer specialist MDs. Demographics include: age, gender, race, and ethnicity. Clinical info included cancer subtype and MD name. Survey had 7 questions assessing opinions on “comprehensive care”, asking “In addition to standard care, it’s important to incorporate/provide” nutrition services, exercise therapy, spiritual/religious counseling, supplement/herbal advice, support groups, music therapy, or other complimentary medicine services (acupuncture, massage, relaxation therapy). Data recorded on a 5 point Likert scale (1 = highly disagree, 2 = disagree, 3 = neutral, 4 = agree, 5 = highly agree) and made into 2 categories (1, 2, 3 = neutral/disagree vs. 4, 5 = agree). Fisher’s exact test with 2 sided p-value used to compare responses between MDs and pts. Results: 909 pts and 55 MDs enrolled from 06/2013-01/2015 with 144 pts and 11 MDs meeting criteria. Mean pts age = 50 with range 26-88 with 2% male and 98% female. 65% of pts were Hispanic vs. 35% non-Hispanic. 78% were white, 6% black, 0% Asian/Pacific Islander, and 16% other. 71% of pts agree spiritual/religious counseling is important to incorporate into cancer care compared to 25% of MDs, p=0.01. Disparities were also seen for supplement/herbal therapies (90% vs. 36% resp., p=0.001), music therapy (63% vs. 11% resp., p=0.003), and “other complementary services” (84% vs. 44% resp., p=0.01). No differences were found for nutritional advice (88% pts vs. 82% MDs, p=0.63), exercise therapy (90% vs. 82% resp., p=0.31), and support groups (75% vs. 75% resp., p=1.00). Conclusion: The majority of adult breast cancer pts seen at a major academic institution feel that it is important to incorporate nutrition advice, exercise therapy, spiritual/religious counseling, supplement/ herbal advice, support groups, music therapy, and other complimentary services as part of their treatment plan. With the exception of support groups, exercise therapies, and nutritional advice, MDs tend to value integrative modalities significantly less than pts. Increased availability and utilization of integrative modalities could improve pts quality of life, and other clinical endpoints.
PR119 SENSITIZING PRIMARY HEALTHCARE WORKERS TOWARDS PSYCHOSOCIAL ISSUES OF BREAST-CANCER PATIENTS S. Pramod Health Alert Organisation of India, Health Dpt., Garud colony, Deopur, Dhule, India Introduction: Primary healthcare workers are backbone of rural/tribal areas healthcare-sector must be trained for psycho-social needs of young breast-cancer patients.
Abstracts / The Breast 24 S3 (2015) S21–S75
place at the hospital, in the presence of family members and staff. The medical doctors who were invited to the wedding had chosen not to participate with the main purpose of keeping the emotional distance that would allow them to make a more rational decision. After the wedding some of the doctors would consider their presence at the ceremony from a different perspective. Conclusion: This case reflects the need of having well prepared and orientated teams, to approach the patient as a whole in her/his final life stage, not only to provide the pharmacological symptomatic relief, but also the emotional comfort, so many times considered as secondary.
PO117 CAN WE MAKE A PORTRAIT OF WOMEN WITH INOPERABLE LOCALLY ADVANCED BREAST CANCER? THE EXPERIENCE OF THE BREAST UNIT OF SOUTHERN SWITZERLAND (CSSI) Giacomo Montagna1,2, Gabriella Bianchi-Micheli2, Lorenzo Rossi2,3, Marzia Conti-Beltraminelli2,3, Roberta Decio2, Vilma Ratti3, Thomas Gyr1,2, Olivia Pagani2,3, Francesco Meani1,2 1 Ente Ospedaliero Cantonale, Department of Obstetrics and Gyneacology, Lugano, Switzerland; 2Ente Ospedaliero Cantonale, Breast Unit of Southern Switzerland (CSSI), Lugano, Switzerland; 3Ente Ospedaliero Cantonale, Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland Introduction: Breast cancer (BC) is the most common cancer in women. Early detection and treatment improvements have both led to a significant decrease in mortality over the last 25 years. Locally advanced BC (LABC) is defined as large operable primary BC (stage IIB, IIIA) and/or inoperable BC (i.e. involving the skin/chest wall and/or with extensive nodal involvement) (stage IIIB, IIIC). Despite the amount of information available through the media and advocacy groups (i.e. Europa Donna), repeated events to raise public awareness (i.e. the Pink Ribbon Campaign) and mammography screening programs, LABC still accounts for 5-10% of all new primary BC diagnoses. Overall, the prognosis of patients with LABC is relatively poor with a 5-year overall survival <50%. Materials and Methods: Between 2008-2014, >1300 patients with a newly diagnosed primary BC have been treated at CSSI. 114 patients (9%) had LABC at diagnosis. We planned to retrospectively investigate the demographic (i.e. age, social and marital status, education level, religious beliefs) and psychosocial characteristics (i.e. BC family history, somatic and psychiatric co-morbidities, use of psychiatric therapy, concomitant chronic diseases, timing of symptom detection and initial symptom interpretation, emotional reactions, family and social interactions) of these patients. A demographic survey and a semi-structured interview (28 items) was specifically developed and submitted by the treating team (gynecologist, psychologist, medical oncologist) to all consenting patients. Aims of the study: With this study we intend to assess the demographic and psychosocial features of women with LABC treated at our institution over the past 6 years and possibly identify factors which led them to delay seeking medical attention. Data are under collection and will be analyzed and ready to be presented by the end of October 2015. We aim at drawing a patient’s profile that could be potentially used to better identify those women who are at higher risk for developing LABC in our geographic area in order to build specific and targeted information and awareness tools. On the long term, we want to evaluate the impact of the mammographic screening program, recently introduced in our canton, on the incidence of LABC.
PR118 COMPARISON OF INTEGRATIVE CARE EXPECTATIONS BETWEEN BREAST CANCER PATIENTS AND BREAST ONCOLOGY PHYSICIANS IN AN ETHNICALLY DIVERSE POPULATION Damien Hansra3,4, Jeremy Ramdial1, David Ruiz2,3, Ashwin Mehta4, Eugene Ahn4, Jorge Antunez de Mayolo3 1 Jackson Memorial Hospital, Oncology, Miami, USA; 2Mast Academy, Oncology Clinical Research, Miami, USA; 3Mercy Hospital/Oncology and Radiation Associates, Hematology & Oncology, Miami, USA; 4Sylvester Comprehensive Cancer Center at the University of Miami, Oncology, Miami, USA Purpose: Evidence shows increased patient utilization of various integrative care modalities to manage symptoms and improve quality of life. Measurements of breast cancer patients and physicians’ opinions regarding the importance of integrative care are lacking. We aim to compare how integrative care modalities are values between physicians and patients. Methods: University of Miami IRB obtained. Adult breast cancer patients (pts) and physicians who specialize in breast cancer (MDs) at an academic tertiary care medical center in Miami, Florida were enrolled to complete a survey. Inclusion criteria: adult cancer pts and treating hem/ onc MDs. Exclusion criteria: Pts without breast cancer and non-breast cancer specialist MDs. Demographics include: age, gender, race, and ethnicity. Clinical info included cancer subtype and MD name. Survey had 7 questions assessing opinions on “comprehensive care”, asking “In addition to standard care, it’s important to incorporate/provide” nutrition services, exercise therapy, spiritual/religious counseling, supplement/herbal advice, support groups, music therapy, or other complimentary medicine services (acupuncture, massage, relaxation therapy). Data recorded on a 5 point Likert scale (1 = highly disagree, 2 = disagree, 3 = neutral, 4 = agree, 5 = highly agree) and made into 2 categories (1, 2, 3 = neutral/disagree vs. 4, 5 = agree). Fisher’s exact test with 2 sided p-value used to compare responses between MDs and pts. Results: 909 pts and 55 MDs enrolled from 06/2013-01/2015 with 144 pts and 11 MDs meeting criteria. Mean pts age = 50 with range 26-88 with 2% male and 98% female. 65% of pts were Hispanic vs. 35% non-Hispanic. 78% were white, 6% black, 0% Asian/Pacific Islander, and 16% other. 71% of pts agree spiritual/religious counseling is important to incorporate into cancer care compared to 25% of MDs, p=0.01. Disparities were also seen for supplement/herbal therapies (90% vs. 36% resp., p=0.001), music therapy (63% vs. 11% resp., p=0.003), and “other complementary services” (84% vs. 44% resp., p=0.01). No differences were found for nutritional advice (88% pts vs. 82% MDs, p=0.63), exercise therapy (90% vs. 82% resp., p=0.31), and support groups (75% vs. 75% resp., p=1.00). Conclusion: The majority of adult breast cancer pts seen at a major academic institution feel that it is important to incorporate nutrition advice, exercise therapy, spiritual/religious counseling, supplement/ herbal advice, support groups, music therapy, and other complimentary services as part of their treatment plan. With the exception of support groups, exercise therapies, and nutritional advice, MDs tend to value integrative modalities significantly less than pts. Increased availability and utilization of integrative modalities could improve pts quality of life, and other clinical endpoints.
PR119 SENSITIZING PRIMARY HEALTHCARE WORKERS TOWARDS PSYCHOSOCIAL ISSUES OF BREAST-CANCER PATIENTS S. Pramod Health Alert Organisation of India, Health Dpt., Garud colony, Deopur, Dhule, India Introduction: Primary healthcare workers are backbone of rural/tribal areas healthcare-sector must be trained for psycho-social needs of young breast-cancer patients.