Women's perceptions of events impeding or facilitating the detection, investigation and treatment of breast cancer.

Article Summary:An integrated network is currently being implemented in the province of Quebec in order to improve the cancer care continuum. In this context, formal trajectories for cancer patients through healthcare services are being established. The investigation of patients' perceptions of the healthcare continuum is essential as it allows us to identify the issue of continuity/discontinuity of health services. In addition, patients' perceptions of continuity of cancer care should be documented since they could influence the implementation of optimal trajectories through the healthcare services. An exploratory qualitative study was conducted in order to identify events, based on the perceptions of women with breast cancer, that made the patient progress more rapidly, facilitating events, or more slowly, impeding events, within the cancer care continuum. Two consecutive series of women receiving adjuvant radiation therapy in 2002 and 2003 at the University Hospital of Quebec City were recruited, for a total of 120 participants. A semi-structured interview was administered in order to identify women's perceptions regarding impeding and facilitating events during the detection, investigation and treatment periods of cancer, as well as the actors and reasons involved. Overall, 64% of women reported having at least one impeding event, while 68% reported at least one facilitating event. The periods most frequently affected by impeding or facilitating events were the investigation period, followed by the treatment period. The main stages affected by impeding or facilitating events were the scheduling of an appointment, during the investigation period, and the onset of treatment. Impeding events particularly affected the scheduling of mammography, the initial exam of the investigation for breast cancer, as well as the onset of radiation treatment. On the other hand, facilitating events mainly occurred at the time of the scheduling of medical consultations with specialists, during the investigation period, and of the onset of surgery. Finally, women generally perceived that impeding events were due to a lack in the availability of services and that facilitating events resulted from human intervention. Patients' perceptions, such as those regarding the importance of human intervention in the process of continuity of care, should be taken into account by healthcare authorities in charge of implementing cancer control programmes.

Article Authors:Bairati I, Fillion L, Meyer FA, Hery C, Larochelle M. Laval University Cancer Research Center and Direction regionale de Sante Publique de la Capitale nationale, Quebec City.

Article Source:European Journal of Cancer Care. 2006 May;15(2):183-93. PMID: 16643266

Birth weight and breast cancer risk.

Exploring whether the positive association between birth weight and breast cancer risk differs by other breast cancer risk factors may help inform speculation about biological mechanism. In these data, high birth weight was associated with breast cancer risk in younger and in more educated women, but was not associated overall.

Article Authors:Troisi R, Hatch EE, Titus-Ernstoff L, Palmer JR, Hyer M, Strohsnitter WC, Robboy SJ, Kaufman R, Herbst A, Adam E, Hoover RN. [1] 1Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892, USA [2] 2Department of Community and Family Medicine, Dartmouth Medical School, Hanover, NH 03755, USA.

Article Source:British Journal of Cancer,25 April 2006.PMID: 16641898.

Breast cancer stem cells: An overview.

Article Summary:The theory that cancer may be originated and sustained by a small proportion of stem-like, self-renewing cells (termed 'cancer stem cells') has gained support in recent years. Breast cancer stem cells have been identified as CD44(+)CD24(-) breast tumour cells and have recently been isolated and propagated in vitro. It has been demonstrated that these cells exclusively retain the ability to form new tumours in mouse models and that they display stem/progenitor cell properties. The ability to identify breast cancer stem cells in vivo and to propagate them in vitro provides the means to compare them with normal cells, in order to investigate from which cell they originate, which molecular alterations critically affect them, and how they interact with the microenvironment. Elucidation of these critical points is essential to develop new therapeutic strategies and to improve diagnosis and prognosis for breast cancer patients.

Article Authors:Ponti D, Zaffaroni N, Capelli C, Daidone MG.Translational Research Unit, Unit 10, Department of Experimental Oncology and Laboratories, Istituto Nazionale per lo Studio e la Cura dei Tumori, Via Venezian, 1, 20133 Milan, Italy.

Article Source:European Journal of Cancer Care, 2006 Apr 17. PMID: 16624548.

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