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Quantifying cosmetic results after breast-conserving therapy. We’re talking about the same thing?
15th St.Gallen International Breast Cancer Conference / The Breast 32S1 (2017) S78–S132
this was 1.7% (95% CI, 0.9–3.1) in those who did not receive and 3.2% (95% CI, 1.8–5.4) amongst those who did receive aCT. Table 1 describes the patients who did not receive and who did receive aCT. Conclusion: Omission of aCT based on clinicopathological results, in “MINDACT clinical high risk”, ER positive, grade 1–2 tumors, resulted in a low 5-year cumulative DRFI (1.7%). Clinicopathological factors may contribute to the most cost-effective use of gene expression profiles. Disclosure of Interest: No significant relationships. Table 1 Description of patients with and without adjuvant chemotherapy (aCT) Variable
Age (years), median (IQR) Size (mm), median (IQR) Grade 1, N (%) pN1, N (%)
With aCT (n = 392) 50(45–54) 30(22–45) 20(5%) 318(81%)
Without aCT (n = 550) 60(53–65) 26(22–35) 44(8%) 260(47%)
P328 Effectiveness of music intervention on the anxiety and salivary physiological indicators of patients with breast cancer undergoing chemotherapy H. Tsai1 *, K. Chou2. 1New Taipei, Taiwan (R.O.C), 2Taipei, Taiwan (R.O.C) Aims: This study investigated the effectiveness of music intervention on the anxiety and salivary physiological indicators of patients with breast cancer who are undergoing chemotherapy. Methods: This study used a randomized, double blind, parallelgroup, controlled trial design. A total of 36 patients with breast cancer who were undergoing chemotherapy were recruited at a teaching hospital in New Taipei City. The experimental group and the control group were each assigned 18 participants. The participants in the experimental group listened to music for 30 minutes, whereas the control group participants listened to ambient sounds for the same interval. The research instruments employed were the state anxiety inventory (SAI) and a handheld salivary α-amylase (SAA) analyzer. The Mann–Whitney U test and the Wilcoxon signed-rank test were used for inferential statistical analysis. Results: The results showed that the experimental group participants presented a significant decline in state anxiety level from 40.1 to 36.8 ( p = .03) after undergoing music intervention. Significant difference in state anxiety level was found between the experimental and control groups ( p < .01). Similarly, concerning the salivary indicator, the SAA level of the experimental group declined significantly from 203.6 U/mL to 131.6 U/mL ( p = .02). Significant difference in SAA level between the experimental and control groups was also found ( p = .001), indicating a clear post intervention decline and rise of SAA level in the experimental group and the control group, respectively. Conclusion: Music intervention is nonthreatening and non-invasive, and is thus suitable for patients with breast cancer, who are experiencing physical and mental distress. Clinical nurses are suggested to incorporate music listening into routine care programs as anxiety-reduction and stress-relief measures, which could improve nursing quality during chemotherapy and thereby increase patient satisfaction. Disclosure of Interest: No significant relationships.
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P329 Aesthetic and functional results of quality of life after breast conserving surgery evaluated by Portuguese/Brazil version of breast cancer treatment outcome scale (BCTOS) R. Costa Vieira*, F. Brandini Silva, J. da Silva, L. Ferreira, J. Santos Paulista, M. Alves de Lima, A. Sarri, C. Paiva. Hospital de Câncer de Barretos, Barretos, Brazil Aims: Validate for Portuguese/Brazil language and evaluate the quality of life questionnaire BCTOS. Methods: A prospective cohort study was performed evaluating 300 breast cancer patients, submitted to breast conservative surgery (BCS) and radiotherapy. The inclusion criteria were the end of radiotherapy at last one year and absence of recurrence or metastatic disease. The quality of life questionnaire (QLQ) BCTOS had been initially translated for Portuguese/Brazil using Beaton’s methodology. It has 22 questions and four domains (functional, cosmetic, pain and edema). The patients completed the QLQ BCTOS, EORTC QLQ-C30 and QLQ-BR23. We evaluated the internal consistency, reliability, factorial analysis, and convergent/divergent validation. For questionnaire and domain evaluation the Cronback’s α was used. For reliability the index of interclass correlation was used. For validation convergent and divergent process a Spearman’s analysis was performed. Ethics committee approval was performed (782/2014). Results: The mean elapsed time of the end of treatment was 7.4 years (1.2 to 20.6). Evaluating the QLQ BCTOS answers we observed missing information lower than 1%. The item Cronback’s α were higher than 0.4 in all questions, and after the item exclusion it was higher than 0.90. The Cronback’s α was excellent, as it was higher than 0.785 for all domains, and after domain exclusion it was higher than 0.776. Evaluating the item reliability we observed an excellent correlation (0.825 to 0.879). Exploratory factorial analysis also selected four main domains. Convergent and divergent validations between different QLQ’s were regular to moderate (Table 1). Conclusion: The QLQ BCTOS seems to be related to the quality of life for Brazilian women, independent of the time after BCS. Disclosure of Interest: No significant relationships. Grant: FAPESP 2014/08197-0. Table 1 Convergent and Divergent validation with QLQ BCTOS between EORTC QLQ C30 and QLQ BR23 in Brazilian women BCTOS
Functional
Cosmetic
EORTC C30 global health C30 functional scale C30 symptom scale BR23 functional scale BR23 symptom scale
−0.429 −0.628 0.612 −0.343 0.714
−0.379 −0.458 0.382 −0.417 0.397
Pain
Edema
0.292 −0.540 0.532 −0.353 0.618
−0.298 −0.435 0.409 −0.308 0.490
P330 Quantifying cosmetic results after breast-conserving therapy. We’re talking about the same thing? R. Costa Vieira1 *, V. Andrade1, F. Brandini da Silva1, G. Zucca-Matthes1, G. Uemura2, M. do Socorro Silva Maciel3, F. Nazima4, G. Biller1, J. da Silva1, C. Paiva1. 1Hospital de Câncer de Barretos, Barretos, Brazil, 2 Faculdade de Medicina de Botucatu/ UNESP, Botucatu, Brazil, 3 Hospital Alemão Oswaldo Cruz, São Paulo, Brazil, 4Clínica Plastiki, Londrina, Brazil Aims: Evaluate and compare multiple quantitative methodologies of cosmetic evaluation of breast-conserving therapy. Methods: 300 breast cancer patients, submitted to conservative treatment and radiotherapy were evaluated. The inclusion criteria were the end of radiotherapy at last one year and the absence of recurrence or metastatic disease. Photographs were performed for BCCT.core cosmetic evaluation.
S132
Poster Abstracts II / The Breast 32S1 (2017) S78–S132
The cosmetic quality of life questionnaire (QLQ) was evaluated using EORTC QLQ-BR23 body image, cosmetic BCTOS item and a selfevaluation. Four surgeons with evaluated the photos ( plastic, oncologic, oncoplastic surgeon and mastologist) and performed the Garbay’s classification. For comparison between the different methodologies, we used the interclass correlation index and the Kappa (k) index. To compare the items of the QLQ a Spearman’s rank correlation (rs) analysis was performed. Ethics Committee: 782/2014. Results: The mean elapsed time of the end of treatment was 7.4 years. Considering the sequence of results in excellent, good, reasonable and bad, the BCCT.core observed 6.0%, 23.7%, 45.0% and 24.3%; but the self-evaluation showed 27.3%, 49.0%, 16.3% and 6.7%, respectively. Comparing the BCCT.core with the patient’s finding, there was a slight agreement (k = 0.08), with a concordance of findings at 28.3%. The patients considered the results better at 61.2% and the software it at 9.4%. BCCT.core results had a slight to moderate correlation with the surgeons (k from 0.135 to 0.276). Comparing Garbay’s classification among the different surgeons, a satisfactory to excellent correlation was observed between them (ICC from 0.674 to 0.776). Comparing the patient’s findings with the professionals, there was no correlation between the surgeons. Evaluating QLQ there were a regular correlation between them (rs from −0.436 to 0.408) and only BCTOS had a correlation with BCCT.core (rs = 0.267). Conclusion: Patients tend to have a better self-evaluation of the cosmetic results. There was a correlation between the findings of the different types of surgeons, but no correlation between patients and surgeons, and a limited correlation between QLQ and BCCT.core. Despite a concordance among the health professionals’ findings, we observed a limitation of instruments that adequately assess patients’ expectations. Disclosure of Interest: No significant relationships. Grant: FAPESP 2014/08197-0.
Aims: Complementary treatment methods are increasingly integrated into the therapy concept of breast cancer patients. The data on utilization, compliance, compatibility and the quality of life is thereby still limited. Methods: 343 breast cancer patients presented to the integrative clinic during the years 2012–2015. The files of these patients were evaluated with regard to their socioeconomic status, their tumor situation, their conventional medical therapy, their prescribed CAM and their behavior regarding to the complementary therapy. Results: 74.3% (n = 255) of the patients showed up in an adjuvant situation, 7.6% (n = 26) after the first relaps and 20.1% (n = 69) in a palliative situation. Chemotherapy with 37.9% (n = 130) and antihormonal therapy with 33.5% (n = 115) were the two most frequently used therapies at the moment of consultation. 54.5% (n = 187) of the patients came to the consultation hour for an extended period (median of 16 months) and were therefore compliant. 37.3% (n = 128) of the patients were incompliant, including 27 patients (21.1%) who were also incompliant according to conventional medicine. 8.2% (n = 28) asked for a second opinion. Mistletoe therapy was the most frequently prescribed CAM (79.3%). 72 of 75 patients (96%) indicated good tolerability. 76 patients provided data on the quality of life. 44.7% (n = 34) showed an increase in well-being. A reduction of hot flushes (n = 17), a better tolerability of the conventional medicine therapy (n = 17) and more strength and energy (n = 17) were documented. The consultation was rather requested by younger patients (median of 52 years). Conclusions: Over 74% of the patients with breast cancer desiring complementary cancer treatment presented to the integrative clinic in an adjuvant situation. The compliance rate is 54.5%. Complementary therapy is mostly well-tolerated with a low incidence of undesirable effects. 22.2% of the patients expressed a subjective improvement in their quality of life. Disclosure of Interest: No significant relationships.
P331 Retrospective analysis of utilization, compliance, tolerability and quality of life of breast cancer patients under complementary treatment (CAM) B. Welz1 *, A. Hapfelmeier2, M. Kiechle1, D. Paepke1. 1Department of Obstetrics and Gynecology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany, 2Institute of Medical Statistics and Epidemiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
this was 1.7% (95% CI, 0.9–3.1) in those who did not receive and 3.2% (95% CI, 1.8–5.4) amongst those who did receive aCT. Table 1 describes the patients who did not receive and who did receive aCT. Conclusion: Omission of aCT based on clinicopathological results, in “MINDACT clinical high risk”, ER positive, grade 1–2 tumors, resulted in a low 5-year cumulative DRFI (1.7%). Clinicopathological factors may contribute to the most cost-effective use of gene expression profiles. Disclosure of Interest: No significant relationships. Table 1 Description of patients with and without adjuvant chemotherapy (aCT) Variable
Age (years), median (IQR) Size (mm), median (IQR) Grade 1, N (%) pN1, N (%)
With aCT (n = 392) 50(45–54) 30(22–45) 20(5%) 318(81%)
Without aCT (n = 550) 60(53–65) 26(22–35) 44(8%) 260(47%)
P328 Effectiveness of music intervention on the anxiety and salivary physiological indicators of patients with breast cancer undergoing chemotherapy H. Tsai1 *, K. Chou2. 1New Taipei, Taiwan (R.O.C), 2Taipei, Taiwan (R.O.C) Aims: This study investigated the effectiveness of music intervention on the anxiety and salivary physiological indicators of patients with breast cancer who are undergoing chemotherapy. Methods: This study used a randomized, double blind, parallelgroup, controlled trial design. A total of 36 patients with breast cancer who were undergoing chemotherapy were recruited at a teaching hospital in New Taipei City. The experimental group and the control group were each assigned 18 participants. The participants in the experimental group listened to music for 30 minutes, whereas the control group participants listened to ambient sounds for the same interval. The research instruments employed were the state anxiety inventory (SAI) and a handheld salivary α-amylase (SAA) analyzer. The Mann–Whitney U test and the Wilcoxon signed-rank test were used for inferential statistical analysis. Results: The results showed that the experimental group participants presented a significant decline in state anxiety level from 40.1 to 36.8 ( p = .03) after undergoing music intervention. Significant difference in state anxiety level was found between the experimental and control groups ( p < .01). Similarly, concerning the salivary indicator, the SAA level of the experimental group declined significantly from 203.6 U/mL to 131.6 U/mL ( p = .02). Significant difference in SAA level between the experimental and control groups was also found ( p = .001), indicating a clear post intervention decline and rise of SAA level in the experimental group and the control group, respectively. Conclusion: Music intervention is nonthreatening and non-invasive, and is thus suitable for patients with breast cancer, who are experiencing physical and mental distress. Clinical nurses are suggested to incorporate music listening into routine care programs as anxiety-reduction and stress-relief measures, which could improve nursing quality during chemotherapy and thereby increase patient satisfaction. Disclosure of Interest: No significant relationships.
S131
P329 Aesthetic and functional results of quality of life after breast conserving surgery evaluated by Portuguese/Brazil version of breast cancer treatment outcome scale (BCTOS) R. Costa Vieira*, F. Brandini Silva, J. da Silva, L. Ferreira, J. Santos Paulista, M. Alves de Lima, A. Sarri, C. Paiva. Hospital de Câncer de Barretos, Barretos, Brazil Aims: Validate for Portuguese/Brazil language and evaluate the quality of life questionnaire BCTOS. Methods: A prospective cohort study was performed evaluating 300 breast cancer patients, submitted to breast conservative surgery (BCS) and radiotherapy. The inclusion criteria were the end of radiotherapy at last one year and absence of recurrence or metastatic disease. The quality of life questionnaire (QLQ) BCTOS had been initially translated for Portuguese/Brazil using Beaton’s methodology. It has 22 questions and four domains (functional, cosmetic, pain and edema). The patients completed the QLQ BCTOS, EORTC QLQ-C30 and QLQ-BR23. We evaluated the internal consistency, reliability, factorial analysis, and convergent/divergent validation. For questionnaire and domain evaluation the Cronback’s α was used. For reliability the index of interclass correlation was used. For validation convergent and divergent process a Spearman’s analysis was performed. Ethics committee approval was performed (782/2014). Results: The mean elapsed time of the end of treatment was 7.4 years (1.2 to 20.6). Evaluating the QLQ BCTOS answers we observed missing information lower than 1%. The item Cronback’s α were higher than 0.4 in all questions, and after the item exclusion it was higher than 0.90. The Cronback’s α was excellent, as it was higher than 0.785 for all domains, and after domain exclusion it was higher than 0.776. Evaluating the item reliability we observed an excellent correlation (0.825 to 0.879). Exploratory factorial analysis also selected four main domains. Convergent and divergent validations between different QLQ’s were regular to moderate (Table 1). Conclusion: The QLQ BCTOS seems to be related to the quality of life for Brazilian women, independent of the time after BCS. Disclosure of Interest: No significant relationships. Grant: FAPESP 2014/08197-0. Table 1 Convergent and Divergent validation with QLQ BCTOS between EORTC QLQ C30 and QLQ BR23 in Brazilian women BCTOS
Functional
Cosmetic
EORTC C30 global health C30 functional scale C30 symptom scale BR23 functional scale BR23 symptom scale
−0.429 −0.628 0.612 −0.343 0.714
−0.379 −0.458 0.382 −0.417 0.397
Pain
Edema
0.292 −0.540 0.532 −0.353 0.618
−0.298 −0.435 0.409 −0.308 0.490
P330 Quantifying cosmetic results after breast-conserving therapy. We’re talking about the same thing? R. Costa Vieira1 *, V. Andrade1, F. Brandini da Silva1, G. Zucca-Matthes1, G. Uemura2, M. do Socorro Silva Maciel3, F. Nazima4, G. Biller1, J. da Silva1, C. Paiva1. 1Hospital de Câncer de Barretos, Barretos, Brazil, 2 Faculdade de Medicina de Botucatu/ UNESP, Botucatu, Brazil, 3 Hospital Alemão Oswaldo Cruz, São Paulo, Brazil, 4Clínica Plastiki, Londrina, Brazil Aims: Evaluate and compare multiple quantitative methodologies of cosmetic evaluation of breast-conserving therapy. Methods: 300 breast cancer patients, submitted to conservative treatment and radiotherapy were evaluated. The inclusion criteria were the end of radiotherapy at last one year and the absence of recurrence or metastatic disease. Photographs were performed for BCCT.core cosmetic evaluation.
S132
Poster Abstracts II / The Breast 32S1 (2017) S78–S132
The cosmetic quality of life questionnaire (QLQ) was evaluated using EORTC QLQ-BR23 body image, cosmetic BCTOS item and a selfevaluation. Four surgeons with evaluated the photos ( plastic, oncologic, oncoplastic surgeon and mastologist) and performed the Garbay’s classification. For comparison between the different methodologies, we used the interclass correlation index and the Kappa (k) index. To compare the items of the QLQ a Spearman’s rank correlation (rs) analysis was performed. Ethics Committee: 782/2014. Results: The mean elapsed time of the end of treatment was 7.4 years. Considering the sequence of results in excellent, good, reasonable and bad, the BCCT.core observed 6.0%, 23.7%, 45.0% and 24.3%; but the self-evaluation showed 27.3%, 49.0%, 16.3% and 6.7%, respectively. Comparing the BCCT.core with the patient’s finding, there was a slight agreement (k = 0.08), with a concordance of findings at 28.3%. The patients considered the results better at 61.2% and the software it at 9.4%. BCCT.core results had a slight to moderate correlation with the surgeons (k from 0.135 to 0.276). Comparing Garbay’s classification among the different surgeons, a satisfactory to excellent correlation was observed between them (ICC from 0.674 to 0.776). Comparing the patient’s findings with the professionals, there was no correlation between the surgeons. Evaluating QLQ there were a regular correlation between them (rs from −0.436 to 0.408) and only BCTOS had a correlation with BCCT.core (rs = 0.267). Conclusion: Patients tend to have a better self-evaluation of the cosmetic results. There was a correlation between the findings of the different types of surgeons, but no correlation between patients and surgeons, and a limited correlation between QLQ and BCCT.core. Despite a concordance among the health professionals’ findings, we observed a limitation of instruments that adequately assess patients’ expectations. Disclosure of Interest: No significant relationships. Grant: FAPESP 2014/08197-0.
Aims: Complementary treatment methods are increasingly integrated into the therapy concept of breast cancer patients. The data on utilization, compliance, compatibility and the quality of life is thereby still limited. Methods: 343 breast cancer patients presented to the integrative clinic during the years 2012–2015. The files of these patients were evaluated with regard to their socioeconomic status, their tumor situation, their conventional medical therapy, their prescribed CAM and their behavior regarding to the complementary therapy. Results: 74.3% (n = 255) of the patients showed up in an adjuvant situation, 7.6% (n = 26) after the first relaps and 20.1% (n = 69) in a palliative situation. Chemotherapy with 37.9% (n = 130) and antihormonal therapy with 33.5% (n = 115) were the two most frequently used therapies at the moment of consultation. 54.5% (n = 187) of the patients came to the consultation hour for an extended period (median of 16 months) and were therefore compliant. 37.3% (n = 128) of the patients were incompliant, including 27 patients (21.1%) who were also incompliant according to conventional medicine. 8.2% (n = 28) asked for a second opinion. Mistletoe therapy was the most frequently prescribed CAM (79.3%). 72 of 75 patients (96%) indicated good tolerability. 76 patients provided data on the quality of life. 44.7% (n = 34) showed an increase in well-being. A reduction of hot flushes (n = 17), a better tolerability of the conventional medicine therapy (n = 17) and more strength and energy (n = 17) were documented. The consultation was rather requested by younger patients (median of 52 years). Conclusions: Over 74% of the patients with breast cancer desiring complementary cancer treatment presented to the integrative clinic in an adjuvant situation. The compliance rate is 54.5%. Complementary therapy is mostly well-tolerated with a low incidence of undesirable effects. 22.2% of the patients expressed a subjective improvement in their quality of life. Disclosure of Interest: No significant relationships.
P331 Retrospective analysis of utilization, compliance, tolerability and quality of life of breast cancer patients under complementary treatment (CAM) B. Welz1 *, A. Hapfelmeier2, M. Kiechle1, D. Paepke1. 1Department of Obstetrics and Gynecology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany, 2Institute of Medical Statistics and Epidemiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany