Emotional status of breast cancer patients: a qualitative study.

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192 Abstracts / Maturitas 81 (2015) 191–236 P128

The body image and sexual experiences in female patients receiving chemotherapy after mastectomy

Nurgül Bölükbas¸1,2,∗_{, Burc¸in Irmak}2_{, Züleyha} Ocak2

1_{Ordu University, Ordu, Turkey}

2_{Ordu University, Nursing Department, Ordu, Turkey}

The objective of this study was to determine the body image and sexual life of patients who treated with chemotherapy after mastectomy. The research was carried out between 5th September and 30th December 2014 at Ordu State Hospital in the chemother-apy unit as a cross-sectional and descriptive study. The data was collected with questionnaire including descriptive feature and The Medical Outcomes Body Image scale and Sexual Experiences scale. Statistical analyses were evaluated via Statistical Package for Social Sciences (SPSS) software program 15.0 for data entry and analysis. 33 female patients accepted participating in the study. The mean age of the women was 48.69, and all women married. 54.5% of women were primary school graduates. The mean age of the women husbands were 51.45% and 45.5% primary and secondary school graduates. Of women treated with chemotherapy were body image average 88.03, sexual experiences scale average 17.03.

These two results show that, in women receiving chemotherapy due to mastectomy had found to be in moderate (88.03± 23.80), and their about sexual experiences have proved to be a little reluc-tant (17.03± 10.40).

http://dx.doi.org/10.1016/j.maturitas.2015.02.269

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Prolactin promotes T47D cell motility through actin cytoskeleton

Vinicius Cestari do Amaral1,∗_{, Priscilla L. da Silva}2_, Tommaso Simoncini3

1_{University of Pisa, Postdoctoral Fellow, Pisa, Italy} 2_{Faculdade de Medicina da Universidade de Sao} Paulo – FMUSP, Disciplina de Ginecologia, Sao Paulo, Brazil

3_{University of Pisa, Gynecology, Pisa, Italy}

Objective: This study aimed at determining the effects of pro-lactin in the cell migration of the T47D breast cancer cells and analyse T47D actin rearrangement and modulation of cytoskeleton by prolactin.

Methods: For this purpose, the cells, cultured In 6 well dishes with supplemented medium, were divided in 4 differ-ent assays: Assay1 (T47D-control); Assay2 (T47D + 25 ng/ml of prolactin); Assay3 (T47D + 50 ng/ml of prolactin) and Assay4 (T47D + 100 ng/ml of prolactin). The migration analysis, as well the immunoblotting evaluation of Focal Adhesion Kinase (FAK) and Membrane-Organizing Extension Spike Protein (Moesin), were performed 24 hours after the treatment. The actins’ cytoskeleton modulation was analysed, by immunoﬂuorescence, 30 min after the treatment.

Results: The results showed that prolactin, in Assay3 (50 ng/ml) and Assay4 (100 ng/ml), enhanced the migration of T47D cells. Fur-thermore, the expression of FAK and Moesin as well as the cell membrane thickness were increased in those Assays (p < 0.001).

Conclusion: In summary, prolactin enhanced T47D breast cancer cell motility. This result is probably related to an activation of Actin adjustment on the cytoskeleton and formation of focal

adhesion complexes. Our ﬁndings may extend the knowledge about the physiological and pathological processes associated with prolactin and cell motility, nevertheless further studies are necessary to better understand these correlations.

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Systematic review: treatment of atrophic vaginitis in breast cancer patients treated with aromatase inhibitors

Aurelie Joris∗, Serge Rozenberg

Hospital Saint Pierre, Gynaecology, Brussels, Belgium

Background: It is estimated that about 60% of breast cancer patients (BRCA) using aromatase inhibitors (AI) suffer from atrophic vaginitis and consequently from dyspareunia. While topical estro-gen therapy has proven efﬁcacy, its safety remains questionable in such patients.

Aim: This systematic review analysis the safety of vaginal estro-gen and of alternative treatments for atrophic vaginitis in breast cancer patients (using AI).

Material and methods: We searched the literature and found 13 studies answering to the selection criteria.

Three retrospective studies evaluated the breast cancer risk recurrence, after using topical oestrogens. Between 869 and 10,933 patients were included and followed during 10–17 years. All were using oestradiol (E2). None of these studies observed an increased risk of breast cancer recurrence (hazard ratio and relative risks were respectively 0.46 (IC 95%: 0.21–1.01); 0.57 (IC 95% 0.2–1.58, p = 0.28) and 0.78 (IC 95%: 0.48–1.25).

Seven studies used sensitive dosages of serum concentration of oestradiol as a surrogate endpoint, in women using AI or Tamox-ifen and using concomitantly topical estrogen. In this case both oestradiol (E2) and estriol (E3) were used. These studies reported an increase in E2 or E3 during initial use of topic estrogen. Two studies evaluated topical testosterone. While they observed symp-tomatic improvement, they also reported some increase in serum testosterone and E2. Finally one study evaluated Replens® to a lubriﬁant. There was a transitory symptomatic improvement only using Replens.

Conclusion: Using vaginal oestradiol a transitory increase of serum estrogen can be observed. It is unknown whether this increase has clinical consequences.

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Emotional status of breast cancer patients: a qualitative study

Güls¸ah Tanrıverdi1,∗_{, Zehra Eskimez}1_{, Pınar} Yes¸il1_{, Gürsel Öztunc¸}1_{, Ahmet T. Tanrıverdi}2_, ˙Ipek Köse1

1_{Cukurova University Adana School Health, Nursing,} Adana, Turkey

2_{C¸ukurova University, Sociology of Religion, Adana,} Turkey

Breast cancer is the most frequent female cancer worldwide. People who have breast cancer may ﬁnd the physical, emotional, and social effects of the disease stressful. The purpose of this study is to identify the emotional status of patients with breast cancer after prognosis. Target population of the study which is descriptive

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Abstracts / Maturitas 81 (2015) 191–236 193 in nature was all breast cancer patients (n = 15) who had treatment

in the oncology clinics of various hospitals located in Adana/Turkey. Average age of the 15 women with breast CA participating in the study was 47.67± 2.36. Of all the patients, 12 of them were mar-ried and average number of children was 2.46± 0.49. Besides, 8 participants (53.3%) graduated from primary school, 100% knew their diagnosis, 80% learned the diagnosis from their doctors, and all of them had both surgery and chemotherapy. Most of the par-ticipants stated that they were shocked and tried to deny the diagnosis at ﬁrst, they were angry with themselves, some of them isolated themselves from the people around and made promises to themselves to be conducted upon getting better. They also stated that they regretted for not having treated themselves better in the past, they did not quit treatment and they did not have the feelings of social exclusion. Seven participants stated that having breast cancer did not change their strong beliefs, four participants began to have stronger beliefs, and three participants ﬁrst revolted but then returned to normal. One patient said her beliefs became weaker and she revolted against the disease. Three patients indi-cated that they fought against the disease all by themselves while the others expressed that the strongest support they had came from their husbands and children. Average age of the participants was found 47.67± 2.36. Social support can be an important source in decreasing the negative psychological reactions of patients with breast cancer who have had surgical operation and who are under-going chemotherapy and radiotherapy.

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Usefullness of menstruation or serum hormone levels as markers for protection using

gonadotropin-releasing hormone agonist against chemotherapy-induced ovarian damage in young breast cancer patients

Dong-Yun Lee∗, Byung-Koo Yoon, Doo Seok Choi Samsung Medical Center, Seoul, Republic of Korea

Objective: To investigate whether changes in menstruation or hormones are adequate parameters to assess the efﬁcacy of gonadotropin-releasing hormone (GnRH) agonist co-treatment with chemotherapy.

Methods: This retrospective cohort study included reproductive-aged women between the ages of 18 and 40 years who were diagnosed with stage I–III breast cancer and received GnRH agonist during chemotherapy for ovarian protec-tion. Women with treatment failure (deﬁned as follicle-stimulating hormone (FSH) level > 20 mIU/mL and estradiol < 10 pg/mL after a long-term follow-up period of at least 12 months from the end of chemotherapy and failure for becoming pregnant) or with treatment success (becoming pregnant spontaneously and having a live birth) were selected, and clinical characteristics, resumption of menstruation, and changes in hormone proﬁles were compared between the two groups.

Results: Resumption of menstruation, regardless of hormone levels, was observed in five women in the treatment failure group. In addition, levels of luteinizing hormone (LH) and FSH at 3 and 6 months after chemotherapy did not differ between the groups. Although serum FSH levels were significantly different between the groups at 12 months, the median values were similar to those at 6 months. Levels of FSH and LH were significantly higher and the level of estradiol was significantly lower in the treatment failure group only after long-term follow-up.

Conclusion: Changes in menstruation or hormones may not be adequate parameters to assess the efﬁcacy of GnRH agonist co-treatment for ovarian protection in young breast cancer patients who undergo chemotherapy.

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Can estradiol metabolites be used as predictor for breast cancer risk in pre- and

postmenopausal women?

Xiangyan Ruan1,∗_{, Harald Seeger}2_{, Alfred O.} Mueck2

1_{Beijing OB/GYN Hospital, Capital Medical} University, Department of Gynecological Endocrinology, Beijing, China

2_{University Women’s Hospital, Tübingen, Germany}

Objectives: Two main estradiol metabolites have different biological behavior with tumorigenic features of 16OHE1 and antiproliferative characteristics of 2OHE1. The ratio of these estra-diol metabolites in patients with breast cancer (BC) and with benign diseases was investigated.

Patients and methods: 41 premenopausal pts. with (cases) and without (controls n = 211) BC and 207 postmenopausal pts with and without BC (n = 206). The control group comprised follow-ing diagnoses: ﬁbroadenoma, mastopathy, hysteromyoma, urinary incontinence, benign ovarian cysts. Urine samples were collected prior to surgery. 2OHE1 and 16OHE1 were measured by ELISA. Absolute values expressed in␮g steroid hormone/mg creatinine were compared after logarithmic transformation (log ratio 2OHE1 to 16OHE1) by t-test. The multiple linear regression test with two interactions was performed to evaluate the inﬂuence of different factors on the metabolic ratio.

Results: In premenopausal pts. log ratio was 0.25 (CI 0.20;0.29) and 0.21 (CI 0.11;0.31) for controls and cases without significant difference. In postmenopausal pts log ratio was 0.22 (CI 0.17;0.26) and 0.11 (CI 0.07;0.15) in controls and cases respectively and was statistically significant lower (p = 0.0002). In multiple linear regres-sion test log ratio was significantly influenced by BMI, but only in postmenopausal pts. In these pts an increased BMI resulted in a significantly (p < 0.042) decreased ratio of 2OHE1 to 16OHE1.

Conclusions: The data of our case control study suggest that in postmenopausal women a different metabolism of estrogens may play an important role in the tumorigenesis of breast can-cer. This genetically determined metabolism could be influenced by the exogenic factor BMI. In premenopausal women different hor-mone levels at different time points of the menstrual cycle may be an explanation that we could not find an influence of estrogen metabolism in this population.