乳がん専門医による乳がん患者に対するうつ病診療の実態調査

Objective To investigate the nursing intervention focused on solving model on improvingthe anxiety and depression of perioperative breast cancer patients. Methods A total of 120 perioperative breast cancer patients randomly divided into control group （ n = 60） and observation group （ n = 60）. Control group received routine care, while observation group received the intervention based on focusing solving model. Anxiety Rating Scale （SAS） and Self- rating Depression Scale （SDS） were used to assess the results. Results Before the intervention, the differences of SAS and SDS scores between observation group and control group were not statistically significant （ P 〉 0. 05 ）. After nursing intervention, SAS and SDS scores in observation group were （41.64 ±6.32）, （42.61 ± 6.40） points, respectively, lower than that in control group （57.07 ± 7.32）, （59.42 ± 7.49） points, and the differences were statistically significant （ t = 11.29,10.28, respectively;P 〈 0.01 ）. Conclusions Focus solving model nursing intervention can significantly improve perioperative anxiety, depression and other negative emotions of breast cancer patients, help patients with treatment, increase surgical tolerance, improve surgical treatment, promote the body recovery. Key words: Breast cancer; Anxiety; Depression; Nursing; Focus solving model

Introduction: Breast cancer is not only the second most prevalent type of cancer but also most frequent cause of cancer deaths in women. Psychological problems like depression, anxiety, poor self image and use of unhealthy coping strategies affect quality of life of breast cancer patient. This article sought to review the available evidence regarding psychological problems in patients with breast cancer. Method: Literature was searched by using Google scholar database and articles from last 10 years, meeting inclusion criteria of this article were reviewed. Review of 36 articles was included. Results: For prevalence of depression and anxiety, 17 articles were review showing high prevalence of depression as well as anxiety in breast cancer patients. Poor self image was found in patients receiving any type of treatment for breast cancer. Avoidance coping was commonly used by most of patients with breast cancer. Poor quality of life has been highlighted by several studies and association was found between poor quality of life and depression in breast cancer patients. Conclusion: Majority of the studies reported high prevalence of depression and anxiety in breast cancer patients. Use of poor coping strategies is common in breast cancer patients at all stages even after treatment. Poor self image and quality of life is associated with all types of treatments.

BACKGROUND Depression represents a frequent comorbidity in breast cancer patients. However, many antidepressants have a certain degree of adverse reactions and decline patients’ compliance to conventional therapies. Chinese herbal formulas (CHF), with its long-standing application in mood disorders, offers a potential alternative. Nevertheless, comprehensive evidence regarding its effectiveness specifically for depression in breast cancer populations remains limited. AIM To systematically evaluate the efficacy of CHF interventions for depression in breast cancer patients and explore the potential mechanisms. METHODS We systematically searched four English databases (PubMed, EMBASE, the Cochrane Library, PsycINFO) and four Chinese databases (CNKI, CBM, VIP, Wanfang) from their inception through June 2024. The investigation focused on CHF’s effects on psychological outcomes [depression and quality of life (QOL)], neurochemical parameters (serotonin, norepinephrine, and dopamine levels) and immunological indicators (CD4+ and CD8+ T lymphocyte counts). Network pharmacology and experimental analysis of clinical samples were employed to elucidate the mechanisms of the core formula Si-Ni-San (SNS). RESULTS Pooled data from 20 randomized trials (n = 1607) demonstrated CHF’s superiority over antidepressants in reducing Hamilton Depression Rating Scale scores (mean difference = -5.33, 95% confidence interval: -6.93 to -3.73, P < 0.05) and enhancing QOL (mean difference = 9.13, 95% confidence interval: 6.69-11.57, P < 0.05). CHF significantly elevated monoamine neurotransmitter levels (all P < 0.05) and CD4+ T cell counts (P < 0.05), with no effect on CD8+ subsets. Subgroup analysis revealed enhanced efficacy with interventions ≥ 4 weeks. Safety profiles favored CHF, with fewer adverse events vs antidepressants. Network pharmacology analysis suggested that SNS may exert its effects by modulating immune responses and serotonergic synapse pathways. Experimental analysis of clinical samples further indicated that the antidepressant effects of SNS may be mediated through the regulation of CD4+ T cells and rebalancing of neurotransmitter, tryptophan metabolism. CONCLUSION This systematic review establishes CHF as an effective and safe intervention for depression in breast cancer patients, with benefits extending to QOL, monoamine neurotransmitter levels and immunological parameters. Moreover, SNS represents a promising complementary therapy with multi-pathway mechanisms of action, particularly involving immune and metabolic pathways.

This study aims to explore the effects of social support on stress and depression in patients with breast cancer. This study is a descriptive correlational research to provide basic data for a nursing intervention program with a social support system in order to reduce stress and depression in breast cancer patients. Subjects of this study are 75 women patients who have been diagnosed breast cancer and have undergone breast cancer surgery without a past history of other diseases and cancers. Frequency, 100percentile, mean, standard deviation, Pearson Correlation, t-test, ANOVA, Simple Linear Regression are estimated with SPSS. There is no statistical correlation among breast cancer patients’ stress and the support received from family members, medical staff, and fellow cancer patients. While there is no significant statistical correlation between breast cancer patients’ depression and the support received from medical workers and fellow cancer patients, there is a negative correlation between the patient’s depression and family support (r=-.436, p=.000). The more family support that a breast cancer patient receives, the less likely they are to become depressed. This result suggests that family support should be considered as a key parameter in developing a nursing intervention program. Therefore, in order to reduce depression of breast cancer patients, nurses need to offer comprehensive and integrated nursing interventions encouraging family support.

The aim of this study was to explore the effects of exercise on angiogenesis and apoptosis-related molecules, quality of life, fatigue and depression in patients who completed breast cancer treatment. Sixty breast cancer patients were randomised into three groups, as supervised exercise group, home exercise group and education group. Angiogenesis and apoptosis-related cytokine levels and quality of life (EORTC QOL-C30: European Organisation for Research and Treatment of Cancer Quality of Life C30), fatigue (Brief Fatigue Inventory) and depression (BDI: Beck Depression Inventory) scores were compared before and after a 12-week exercise programme. After the exercise programme, statistically significant decreases were found in interleukin-8 and neutrophil activating protein-78 levels in the home exercise group (P < 0.05). The education group showed a statistically significant increase in monocyte chemoattractant protein-1 level (P < 0.05). Functional score and global health score of EORTC QOL-C30 in the supervised exercise group and functional score of EORTC QOL-C30 in the home exercise group increased significantly after exercise programme (P < 0.05). BDI score was significantly lower in the supervised exercise group after the exercise programme (P < 0.05). Changes in angiogenesis and apoptosis-related molecules in the study groups suggest a possible effect of exercise on these parameters. Exercise programmes are safe and effective on quality of life and depression in breast cancer patients whose treatments are complete.

IntroductionThe aim of the study was to examine the impact of different exercise interventions on anxiety and depression in breast cancer patients through 1-year outpatient rehabilitation.MethodsOverall, 138 breast cancer patients were assessed for eligibility. After excluding 14 women, 124 patients were randomly allocated to water exercise interventions (group A, &lt;i&gt;n&lt;/i&gt; = 50), Pilates exercise interventions (group B, &lt;i&gt;n&lt;/i&gt; = 44), and yoga exercise interventions (group C, &lt;i&gt;n&lt;/i&gt; = 30). Finally, 115 patients completed relevant interventions and were analysed. The participants reported anxiety and depression using the Hospital Anxiety and Depression Scale at baseline and after 6 and 12 months of the interventions.ResultsAfter 12 months, a decrease in anxiety and depression was observed by 5.64 (&lt;i&gt;p&lt;/i&gt; &lt; 0.001) and 4.09 (&lt;i&gt;p&lt;/i&gt; &lt; 0.001) points in group A, by 5.75 (&lt;i&gt;p&lt;/i&gt; &lt; 0.001) and 4.60 (&lt;i&gt;p&lt;/i&gt; &lt; 0.001) points in group B, and by 4.07 (&lt;i&gt;p&lt;/i&gt; &lt; 0.001) and 3.14 (&lt;i&gt;p&lt;/i&gt; &lt; 0.001) points in group C, respectively. Group A showed significantly better results than group C in anxiety (by 1.54 points; p &lt; 0.01) and depression (by 1.40 points; &lt;i&gt;p&lt;/i&gt; &lt; 0.05). Group B obtained significantly better results than group C in anxiety (by 1.61 points; &lt;i&gt;p&lt;/i&gt; &lt; 0.01) and depression (by 1.81 points; &lt;i&gt;p&lt;/i&gt; &lt; 0.01).ConclusionsPractising a water exercise program resulted in a better decrease of anxiety and depression levels compared with Pilates and yoga interventions.

BackgroundDepression increases the risk of breast cancer recurrence and metastasis. However, there lacks potential biomarkers for predicting prognosis in breast cancer. 5-hydroxytryptamine (5-HT) plays a key role in the pathogenesis and treatment of depression. In this study, we developed a prognostic signature based on 5-HT receptors (5-HTRs) and elucidated its potential immune regulatory mechanisms for breast cancer prognosis.MethodsOncomine, GEPIA, UALCAN, cBioPortal, Kaplan-Meier plotter, and TIMER were used to analyze differential expression, prognostic value, genetic alteration, and immune cell infiltration of HTRs in breast cancer patients. The model training and validation assays were based on the analyses of GSE1456 and GSE86166. A risk signature was established by univariate and multivariate Cox regression analyses. The transwell assay was utilized to verify the effect of the 5-HTRs expression on breast cancer invasion. Effects of HTR2A/2B inhibitor on CD8+ T cell proliferation and infiltration as well as apoptosis of 4T1 cells in the tumor microenvironment were detected by flow cytometry and TUNEL assay. Zebrafish and mouse breast cancer xenografts were used to determine the effect of HTR2A/2B inhibitor on breast cancer metastasis.ResultsThe expression levels of HTR1A, HTR1B, HTR2A, HTR2B, HTR2C, HTR4, and HTR7 were significantly downregulated in highly malignant breast cancer types. 5-HTRs were significantly associated with recurrence-free survival (RFS) in breast cancer patients. The genetic alteration of HTR1D, HTR3A, HTR3B, and HTR6 in breast cancer patients was significantly associated with shorter overall survival (OS). Finally, HTR2A and HTR2B were determined to construct the risk signature. The expression of HTR2A/2B was positively correlated with the infiltration of immune cells such as CD8+ T cells and macrophages. Furthermore, inhibition of HTR2A expression could suppress CD8+ T cell proliferation and enhance invasion and metastasis of breast cancer cells in both zebrafish and mice model.ConclusionsThe HTR2A/2B risk signature not only highlights the significance of HTRs in breast cancer prognosis by modulating cancer immune microenvironment, but also provides a novel gene-testing tool for early prevention of depression in breast cancer patients and lead to an improved prognosis and quality of life.

The aim of the present study is to investigate anxiety and depression levels and quality of life of Turkish breast cancer patients and their husbands with Beck depression, STAI scoring system, and EORTC-QLQ-C30 quality of life scale. Fifty-five patients with breast cancer undergoing chemotherapy who applied to Dokuz Eylul University Faculty of Medicine, Department of Oncology, and their husbands were included in this study. The series of forms including the questions regarding the demographic characteristics of the patient, Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), and EORTC-QLQ-C30 (version 3) were completed during face-to-face interviews by trained interviewers for determination of the psychological status and quality of life of the patients. The mean Beck depression scores of patients and their husbands were 13 +/- 9.3 (range 2-46) and 7.9 +/- 5.7 (range 0-27) (P = 0.001). The mean STAI scores of patients and their husbands were 44.9 +/- 8.7 (range 20-58) and 41.7 +/- 8.0 (range 26-59) (P = 0.09).Twenty-nine percent of the patients and 5.4% of the husbands (Beck Depression scores > or = 17 points) were determined as depressive. It was determined that the EORTC-QLQ C30 physical and social function scales of the patients were significantly lower than their husbands. The difference of global quality of life scores and other function scales (role, cognitive, emotional function scales) between patients and their husbands were not significant. It was found that depression of breast cancer patients were significantly higher than their husbands. But there was no significant difference between the EORTC-QLQ C30 global quality of life scores and STAI scores of the breast cancer patients and their husbands.

The aim of this study is to investigate activity and functional connectivity (FC) of Papez circuit networks associated with music processing using functional magnetic resonance imaging (fMRI) in depressed breast cancer patients. Twenty-three breast cancer patients listened to four different Iranian/Persian music paradigms during the resting-state fMRI scanning session: negative stimulation of traditional music, negative stimulation of pop music, positive stimulation of traditional music and positive stimulation of pop music. The amplitude of low-frequency fluctuation (ALFF) was used to evaluate the local characteristics of spontaneous brain activity. FC maps were created using multivariate ROI-to-ROI connectivity (mRRC) and Papez circuit-based regions of interest (ROIs) selection. We found that music increases FC within various brain networks which are involved in memory, emotion, and cognitive function, including the limbic system, the default mode network (DMN), salience network (SN), and central executive network (CEN). Moreover, it seems that the traditional types (both positive and negative) of Iranian music may be more effective to affect brain activity in the patients with breast cancer, than the Iranian pop music. These findings demonstrate that music therapy, as an effective and easily applicable approach, supports the neuropsychological recovery and can contribute to standard treatment protocols in patients with breast cancer.

The monoamine oxidase-A inhibitor clorgyline promotes a mesenchymal-to-epithelial transition in the MDA-MB-231 breast cancer cell line

Risk and severity of SARS-CoV-2 infection in breast cancer patients undergoing a structured infection screening program at the University and Hospital Trust of Verona

e20567 Background: Women with a history of childhood abuse and/or neglect are at increased risk for psychological distress when confronted with new traumatic experiences including a diagnosis and t...

Background: Mastectomy leads to moderate to severe degrees of depression and anxiety. Objectives: This study aimed to evaluate the outcome of breast conservative surgery with breast reconstruction on the quality of life (QOL). The current retrospective study included 62 patients with T1, and T2 breast cancer who underwent modified radical mastectomy (MRM) or breast conservative surgery (BCS) with reconstruction. Evaluation of the quality of life, depression as well as post-operative complications was reported and compared. Results: The current study included 62 female patients with mean age of 43.20 ± 4.49 and 44.36 ± 5.16 in groups A and B respectively. There was a significantly lower mean operative time (P value =0.001) in patients who underwent MRM. There was statistically significant beck depression inventory (BDI) scores in both groups with more improvement in BCS group. Both groups reported statistically significant improvement of psychological well-being, social well-being, and spiritual well-being after 6 months with significant improvement in group A. Conclusion: Conservative breast surgery with reconstruction offers an oncologically safe alternative for modified radical mastectomy with less impact on the QOL and associated with less depression

This study aimed to use non-invasive methods to assess and compare the levels of oxidative indices and non-enzymatic antioxidants in breast and colorectal cancer (CRC) patients. Various studies have reported on lipid peroxidation, hydrogen peroxide (H(2)O(2)) and ferric-reducing antioxidant power (FRAP) levels in the serum of cancer patients but this is the first report that highlights the significance of urinary-advanced oxidative protein product (AOPP) in cancer patients. The levels of advanced oxidative protein product (AOPP), hydrogen peroxide (H(2)O(2)), malondialdehyde (MDA) which is a marker for lipid peroxidation and ferric-reducing antioxidant power (FRAP) were measured in urine samples of breast (n = 101) and colorectal cancer (n = 49) patients attending the Oncology Clinic, University Malaya Medical Centre, Kuala Lumpur and were compared with 95 age-matched healthy individuals. AOPP, H(2)O(2) and MDA levels in the urine were significantly higher in the CRC patients compared to the control subjects and breast cancer patients. In breast cancer patients, only AOPP level was elevated. FRAP level did not differ between breast and colorectal cancer patients but the levels were significantly lower compared to control subjects. Urinary oxidative indices such as AOPP, H(2)O(2), and MDA as well as FRAP could serve as useful non-invasive oxidative stress markers in colorectal cancer but only AOPP serves as a useful urinary oxidative biomarker in breast cancer.

FAM64A is a mitotic regulator which promotes cell metaphase-anaphase transition and is highly expressed in a cell-cycle-dependent manner. In this study, we examined the clinicopathological and prognostic significance of FAM64A mRNA expression in gynecological cancers. We conducted a bioinformatics analysis of FAM64A mRNA expression using Gene Expression Omnibus (GEO), The Cancer Genome Atlas (TCGA), xiantao, The University of ALabama at Birmingham CANcer data analysis Portal (UALCAN), and Kaplan-Meier (KM) plotter databases. FAM64A expression was elevated in breast, cervical, endometrial, and ovarian cancers when compared with normal tissue. Expression was positively correlated with white race, low T stages, infiltrating ductal carcinoma, or favourable PAM50 classification in breast cancer patients, and with clinical stage, histological grade and TP53 mutation, and endometrial cancer serous subtype. FAM64A expression was negatively associated with overall and/or recurrence-free survival rates in breast and endometrial cancer patients, while the opposite was observed in cervical and ovarian cancer patients. FAM64A functioned as an independent predictor of overall and disease-specific survival in breast cancer patients. FAM64A-correlated genes were involved in ligand-receptor interactions, and chromosomal, cell cycle, and DNA replication processes in breast, cervical, endometrial and ovarian cancers. Top hub genes primarily included cell cycle-related proteins in breast cancer, mucins and acetylgalactosaminyl transferases in cervical cancer, kinesin family members in endometrial cancer, and synovial sarcoma X and the cancer/testis antigen in ovarian cancer. FAM64A mRNA expression was positively related to Th2 cell infiltration, but negatively associated with neutrophil and Th17 cell infiltration in breast, cervical, endometrial, and ovarian cancers. FAM64A expression may be considered a potential biomarker reflecting carcinogenesis, histogenesis, aggressive behaviour, and prognosis in gynecological cancers. Impact statement What is already known on this subject? FAM64A is located in cell nucleolar and nucleoplasmic regions, and during mitosis it putatively controls metaphase-to-anaphase transition. FAM64A appears to regulate different physiological processes, including apoptosis, tumorigenesis, neural differentiation, stress responses, and the cell cycle. What the results of this study add? FAM64A expression was up-regulated in breast, cervical, endometrial, and ovarian cancers, and positively correlated with white race, low T stages, infiltrating ductal carcinoma, or favourable PAM50 classification in breast cancer patients, and with clinical stage, histological grade, and TP53 mutation, and a serous subtype in endometrial cancer. FAM64A expression was negatively associated with overall and/or recurrence-free survival rates in breast and endometrial cancer patients, while the opposite was observed in cervical and ovarian cancer patients. FAM64A functioned as an independent predictor of overall and disease-specific survival in breast cancer. FAM64A-correlated genes were involved in ligand-receptor interactions, chromosomal, cell cycle, and DNA replication processes, while FAM64A mRNA expression was positively related to Th2 cell infiltration but negatively correlated with neutrophil and Th17 cell infiltration in four gynecological cancers. What the implications of these findings for clinical practice and/or further research? In the future, abnormal FAM64A mRNA expression may serve as a biomarker of carcinogenesis, histogenesis, aggressiveness, and prognosis in gynecological malignancies.