乳腺微乳头状癌的临床病理特征分析

回顾性分析乳腺浸润性微乳头状癌(IMPC)的临床病理特征.选取河北医科大学第四医院乳腺中心手术切除并经病理证实的女性原发性乳腺癌共3 383例,筛选出符合IMPC为实验组,同期乳腺浸润性导管癌(IDC)为对照组.结果显示,本组IMPC 167例,占同期乳腺癌4.94％,年龄29岁～80岁,中位年龄54岁.淋巴结转移者共135例,占80.8％,淋巴结转移数目≥4个共105例,占62.9％,HER2阳性率58.7％,与IDC组相比差异均有统计学意义(P＜0.05).IMPC为一种少见类型的浸润性乳腺癌,具有淋巴管侵袭性强、淋巴结转移率高的生物学行为.应与其他类型肿瘤进行鉴别,明确诊断.     

Patient Motivation, Satisfaction, and Coping in Genetic Counseling and Testing for BRCA1 and BRCA2

Women with a strong family history of breast and/or ovarian cancer can now have genetic testing, that may identify mutations associated with increased cancer predisposition. Within the context of a clinical trial evaluating printed educational materials, we examined motivation, satisfaction, coping, and perceptions of genetic counseling and testing among 159 women who underwent pretest counseling and made a testing decision. Ninety-six percent of the participants elected to have BRCA1/2 testing. When making a decision about genetic testing, study participants were concerned less about the potential negative effects that could result from testing than the potential benefits. After counseling, participants said that they felt better able to make decisions that were right for them and that their questions and concerns were adequately addressed during the session. Ninety-five percent of the women were satisfied with their test decision. Participants used a range of strategies to cope with thoughts and feelings about cancer and/or genetic testing immediately following test decision. Results suggest that the genetic counseling session helped women make decisions about testing for BRCA1 and BRCA2, even in the setting of a trial in which all women also received detailed educational materials. Further, the results indicate that future research focusing on perceptions of risks and benefits of testing and of coping strategies immediately following test decision may be warranted.     

Posttraumatic Stress Symptoms and Stressful Life Events Predict the Long-term Adjustment of Survivors of Childhood Cancer and Their Mothers

Objectives: To examine prospectively the impact of posttraumatic stress symptoms (PTSS) in response to childhood cancer and treatment on general adjustment while accounting for the role of other stressful life events and appraisal of life threat and treatment intensity. Methods: As part of a larger study assessing PTSS, 56 childhood cancer survivors, aged 8 to 18, and 65 mothers completed self-report measures of PTSS and appraisal of the intensity and life threat associated with cancer treatment at time 1 and self-report measures of stressful life events and general adjustment at time 2 (approximately 18 months after time 1). Results: For child survivors and their mothers, posttraumatic stress at time 1 significantly predicted general adjustment at time 2, over and above the significant contribution of lifetime stressful events. The life events variable did not function as a mediator in the association of PTSS and general adjustment. Conclusions: Trauma responses to childhood cancer and its treatment have implications for the long-term adaptation of children and their families. Early signs and symptoms of posttraumatic stress and stressful life experiences require early assessment and intervention.     

Thinking Inside the Box: On Identity, Sexuality, Prostate Cancer, and Social Support

This fictional account results from three years of studying a social support group for prostate cancer patients and their loved ones. As a consequence, the story centers on the issue of identity and its relationship to illness, a significant cause of concern among group members. The story addresses the loss of sexual function and general agency that often accompany the disease, then considers the roles of social support and open communication in negotiating a new identity.     

Peer support for women with breast cancer: the role of empathy and self‐disclosure

This study examined how women with breast cancer perceived different styles of peer helping. Forty recently diagnosed breast cancer patients evaluated three audiotaped conversations between a breast cancer patient and an (ex‐patient) volunteer helper; the conversations differed in terms of the empathy and self‐disclosure offered by the helper. The findings supported the first hypothesis, that a helping style involving high self‐disclosure would be positively evaluated only in the presence of high empathy. However, the findings did not support the second hypothesis, that in conversations where high empathy is present, a helping style involving high self‐disclosure would be evaluated more positively than one involving low self‐disclosure. Qualitative data suggested that the helper's ability to listen to the patient and the helper's appropriate sharing of her own experience of breast cancer were both perceived as important components of effective helping. Implications for the training and practice of volunteer helpers are discussed. Copyright © 1999 John Wiley & Sons, Ltd.     

L’expertise médicale au temps des pandémies : l’exemple des cancers

Medical law suits were interrupted during the COVID-19 pandemia and judicial process will come shortly back to the normal. Pandemia induced delays in the cancer diagnosis and treatment. These modifications were validated by expert consensus from the medical societies. However in the coming years it is highly possible that patients think they were victims of a “loss of chance” and ask for a compensation. The various situations in which physicians can be involved are described and recommendations for the management of medical charts are discussed.     

Lifestyle differences between smokers,ex-smokers and non-smokers,and implications for their health

Abstract

Much evidence has been published in order to demonstrate that smoking cessation leads to a decrease in morbidity and mortality. Using data from the Health and Lifestyle Survey respondents were divided into three groups: smokers, ex-smokers and non-smokers and lifestyle characteristics such as diet and exercise were compared. Smokers were more likely to eat chips (French fries), fried food, butter and less likely to eat fresh fruit in winter, green vegetables and margarine high in polyunsaturated fats. Non-smokers were more likely than smokers and ex-smokers to take part in keepfit, jogging and swimming. Non-smokers in smoking households were more likely than non-smokers in non-smoking households to eat fried food, chips and butter and less likely to eat fruit in winter or margarine high in polyunsaturated fats. Results suggest that part of the assumed health benefits of smoking cessation are due to ex-smokers having a healthier diet than that of smokers.     

Risk-appraisal,outcome and self-efficacy expectancies: Cognitive factors in preventive behaviour related to cancer

Abstract

Health education often attempts to influence or persuade through risk-appraisal of impending danger or harm. Risk: appraisal implies cognitive processes concerning the severity of the threatening event and the probability of its occurrence. In two studies we investigated whether risk factors could adequately predict preventive behaviour with respect to cancer. The tint study concerned the health belief model. the second study the protection motivation theory. Protection motivation theory includes the health belief factors but also self-efficacy expectancy. The most important finding is that risk-appraisal does not predict preventive behaviour adequately: outcome expectancy and self-efficacy expectancy should be included in the prediction of preventive behaviour. In general, our findings suggest the superiority of the protection motivation theory to the health belief model in predicting preventive behaviour with respect to cancer.