2 results
Screening for psychological distress in two French cancer centers: Feasibility and performance of the adapted distress thermometer
- Sylvie Dolbeault, Anne Bredart, Véronique Mignot, Patrick Hardy, Annie Gauvain-Piquard, Laurence Mandereau, Bernard Asselain, Jacques Medioni
-
- Journal:
- Palliative & Supportive Care / Volume 6 / Issue 2 / June 2008
- Published online by Cambridge University Press:
- 23 May 2008, pp. 107-117
-
- Article
- Export citation
-
Objective:
Little is known about the prevalence of psychiatric disorders in French cancer patients. This study aimed to assess the feasibility of a screening procedure using the Psychological Distress Scale (PDS). The PDS is a French adaptation of the National Comprehensive Cancer Network Distress Thermometer. The screening performance of the PDS was assessed by comparison with the established clinical case threshold on the Hospital Anxiety and Depression Scale (HADS).
Methods:Among 598 consecutive cancer outpatients recruited in two cancer centers in Paris, 561 (94%) agreed to complete the PDS, the HADS, the European Organisation for Research and Treatment of Cancer core quality of life questionnaire (EORTC QLQ-C30), and study-specific psychosocial questions.
Results:A receiver operating characteristic (ROC) analysis was performed, using a HADS cutoff score of 15 or greater to identify patients with psychological distress. This yielded a PDS cutoff score of 3, giving 76% sensitivity and 82% specificity. With this cutoff score, the prevalence of psychological distress was 38%. PDS scores were significantly related to scores from the HAD total scale (r = .64), HAD anxiety (r = .61) and HAD depression (r = .39) subscales, and EORTC QLQ-C30 emotional functioning (r = .56) and global health state (r = .44). In multivariate analyses, factors associated with psychological distress were female gender, taking analgesics, receiving professional psychological help, perceived psychosocial difficulties and lack of social support.
Significance of results:Using the PDS appeared feasible, acceptable and effective for psychological distress screening in French ambulatory cancer care settings.
6 - The natural history of hereditary breast cancer
-
- By Pierre O. Chappuis, McGill University Health Centre, Montreal, QC, Canada, Dominique Stoppa-Lyonnet, Institut Curie, Paris, France, Bernard Asselain, Institut Curie, Paris, France, William D. Foulkes, McGill University Health Centre, Montreal, QC, Canada; Sir M. B. Davis-Jewish General Hospital, McGill University, Montreal, QC, Canada; McGill University, Montreal, QC, Canada
- Edited by Patrick J. Morrison, Belfast City Hospital, Belfast, Shirley V. Hodgson, Guy's Hospital, London, Neva E. Haites, University of Aberdeen
-
- Book:
- Familial Breast and Ovarian Cancer
- Published online:
- 24 August 2009
- Print publication:
- 07 November 2002, pp 81-107
-
- Chapter
- Export citation
-
Summary
Summary
Determining the outcome following hereditary breast cancer is one of the key questions in clinical breast cancer genetics. There is increasing evidence that BRCA1- and BRCA2-related breast cancers are distinguishable from non-hereditary breast cancers: hereditary cancers demonstrate gene expression profiles and somatic genetic changes that are distinct from those seen in sporadic breast cancers and feature histopathological and immunohistochemical characteristics usually associated with a worse prognosis. Despite these findings, conflicting data exist as to whether the prognosis of hereditary breast cancer differs from that of sporadic cases. Some of the discrepancies may be explained by methodological differences or biases. However, no mutation-based studies have shown a survival advantage for BRCA1/2 mutation carriers and several unrelated studies have recently found that the presence of a BRCA1/2 mutation was an independent poor prognostic factor. Regarding the risk of further or recurrent breast cancer, it is established that the risk of contralateral breast cancer is significantly increased in breast cancer patients harbouring BRCA1/2 germline mutations, but surprisingly, during the first 5 years after diagnosis, an increase in the rate of ipsilateral breast recurrences has not been found. These data suggest that radiation may protect against, or at least delay, ipsilateral recurrences.
Introduction
Up to five per cent of breast cancer cases are hereditary and germline mutations in the breast cancer predisposing genes BRCA1 and BRCA2 may account for 65–80% of the hereditary cases (Ford et al., 1998; Rahman and Stratton, 1998).