Iranian Journal of Breast Diseases
Year:2020 | Volume:13 | Issue:1 (48) |Papers Count:9

Introduction: Because of not applying analgesics in mastectomy candidates and the complications of analgesic therapy in these patients on the one hand and increased pain intensity in patients who undergo mastectomy following radiotherapy on the other hand, the present study aimed to evaluate foot reflexology massage on pain and the need for opioids in breast cancer patients undergoing mastectomy after radiotherapy. Methods: This randomized clinical trial was performed at Imam Reza Hospital, Tabriz, over the 10 months leading up to September 2019. Fifty-four patients (pilot-based estimation) were divided into two groups using a random-numbers table. The intervention group received foot massage every 6 hours (10 minutes per foot) for two days starting 4 hours after discharge. Patients’ demographic information was recorded and pain intensity was measured with a visual analog scale. Chi-square tests, Fisher’ s exact test, and an independent t test were used for data analysis on SPSS 21. P < 0. 05 was considered significant. Results: The control (51. 29 ± 9. 45) and the intervention (52. 03 ± 8. 96) groups were not different in pain intensity at baseline. However, after the intervention, a statistically significant difference was observed in pain intensity between the intervention and control groups (20. 12 ± 6. 75 vs 49. 88 ± 8. 95, respectively, P = 0. 003). Also, while there was no difference in pethidine consumption between the intervention (29. 99 ± 4. 49) and control (29. 18 ± 4. 50) groups before the intervention, the intervention group experienced a significant reduction in the medicine usage compared with the controls (10. 41 ± 4. 56 vs 32. 12 ± 5. 01, P = 0. 001). Conclusion: Foot reflexology massage reduced the severity of pain and the need for opioids in women who are candidates for mastectomy following radiation therapy.

Introduction: Hair loss (alopecia) is a common side effect of chemotherapy drugs, imposing further psychological stress on the patient. Scalp cooling is a common method used to prevent chemotherapy-induced alopecia; however, the results are not conclusive. The present study aimed to investigate the effectiveness of using a cold cap during chemotherapy in preventing alopecia in women with breast cancer. Methods: In a randomized Clinical Trial, 100 women with breast cancer were recruited and randomized into two equal-size groups of intervention (chemotherapy while wearing a cold cap) and control (chemotherapy without using a cold cap). Demographic data were collected using a questionnaire and alopecia was rated on a scale of 1(very low) to 4(very high). Results: The mean alopecia score was significantly lower in the intervention group compared with the control group (2. 25 ± 0. 49 vs 2. 49 ± 0. 34, p = 0. 005). The difference in alopecia score was not associated with any of the demographic or clinical variables including age, disease stage, type of surgery, menopausal status, education, marital status, employment, and income. Conclusion: Using a cold cap while receiving chemotherapy for breast cancer is effective in preventing hair loss.

Introduction: Cancer can negatively affect couples'’ intimate relationships, creating a need for psychological interventions. The purpose of this study was to determine the effectiveness of a group intervention based on acceptance and commitment therapy on quality of life and communication patterns in patients with breast cancer and their spouses. Methods: The study was a randomized controlled trial. The participating couples were randomly assigned to either the experimental or control groups. Each group consisted of 10 individuals (5 couples). Both groups completed quality of life questionnaires of cancer patients. the world health organization Quality of Life questionnaire and the Gottman distance and isolation Scale. Then, the experimental group participated in Acceptance and Commitment therapy– based intervention for eight sessions of two hours. Quality of life and communication patterns were evaluated immediately and 3 months after the intervention, Data were analyzed using independent t-tests and analysis of covariance. Results: The mean scores for communication pattern and quality of life for the experimental group (10. 40 ± 4. 50 and 54. 46 ± 11. 17, respectively) were significantly different compared with the control group (15/. 30 ± 3/. 40 and 45/. 34 ± 11/. 34, respectively) (both P < 0. 001). Conclusion: Based on the findings of the present study, acceptance and commitment therapy can improve quality of life and communication patterns of patients with cancer and their spouses and reduce couples'’ stress and communication challenges.

Introduction: Given the high comorbidity of mental conditions and chronic pain in cancer, there is a need for development and administration of interventions for this population. This study aimed to investigate the effectiveness of mindfulness-integrated cognitive-behavioral therapy (MiCBT) in breast cancer pain management. Methods: In this clinical trial, 24 patients with breast cancer from Omid Hospital in Mashhad were selected via a purposive sampling method and randomly assigned to two groups of intervention (N = 12) and control (N = 12). The participants were assessed using the Short Cancer Pain Scale, Pain Self-Efficacy Questionnaire, and Pain Catastrophizing Scale before, immediately after, and one month after the intervention. The participants in the intervention group received MiCBT for 8 weeks. The control group did not receive any intervention from the research team during the research period. Descriptive statistics (percentage, frequency, mean and standard deviation), chi-square tests, t-tests, and multivariate analysis of covariance were used for data analysis. Results: After controlling for the pretest scores, there were significant differences between control and intervention groups in perceived pain, pain catastrophizing, and pain self-efficacy immediately and one month after the intervention (P > 0. 001). The perceived pain, pain catastrophizing decreased and pain self-efficacy increased immediately and one month after the intervention (P > 0. 001). Eta square showed 0. 85, 0. 78 and 0. 70 change in perceived pain, pain catastrophizing, and pain self-efficacy immediately and one month. In the follow-up phase, Eta squre were 0. 87, 0. 75 and 0. 79 for perceived pain, pain catastrophizing, and pain self-efficacy respectively. Conclusion: MiCBT is effective in improving pain, pain self-efficacy, and pain catastrophe in patients with breast cancer. Therefore, considering the cost-effectiveness and availability, this program is recommended as a complementary treatment for breast cancer patients.

Introduction: Regular exercise training inhibits tumor growth and prevents cardiomyopathy in breast cancer patients by activating signaling pathways leading to changes in gene expression. The purpose of the present study was to investigate the effects of 10 weeks of continuous aerobic training on tumor volume and expression of IGF-1, Akt, mTORC1 genes in the myocardium of mice with breast cancer. Methods: Twelve female BALB/c mice were divided into 2 groups of 6: Continuous Aerobic Exercise and Control. The tumor was induced by the injection of MC4-L2 cells. The aerobic exercise included 75 minutes of steady running at 60% to 65% of VO2 peak, 5 days a week for 10 weeks. Tumor volume was measured by a caliper weekly. Twenty-four hours after the last training session, the mice were killed and their left ventricles were harvested. IGF-1 protein levels were measured with western blotting analysis, and real-time PCR was used to determine the expression of Akt and mTORC1 genes. The comparison of the groups was made using t tests at a significance level of 5%. Results: IGF-1 did not show significant changes in the Aerobic Exercise group compared with the Control group (P = 0. 08). The expression of Akt was significantly higher in the Aerobic Exercise group than in the controls (P = 0. 016). The Aerobic Exercise group had also a significantly higher mTORC1 gene expression compared with the Control group (P = 0. 022). Tumor volume also showed a significant decrease in the Aerobic Exercise group compared with the Control group (P = 0. 03). Conclusion: It can be concluded that 10 weeks of aerobic exercise training may reduce tumor volume and, possibly, improve heart function in breast cancer patients by increasing the expression of genes.

Introduction: In patients with breast cancer, low serum brain-derived neurotrophic factor (BDNF) levels and high serum tumor necrosis factor (TNF)-α level have been reported. Therefore, the present study aimed to investigate the effect of eight weeks of high-intensity circuit training on serum levels of BDNF and TNFα and aerobic power in breast cancer survivors. Methods: This randomized controlled trial was conducted at Shahid Rahimi Hospital Oncology Center in Khorramabad in 2018. Seventeen breast cancer survivors were selected from a group of 55 women who had undergone chemotherapy and radiation therapy and randomly divided into an exercise (n = 9) or a control (n = 8) group. The exercise group performed high-intensity circuit training (HICT) three sessions per week for eight weeks. Data were analyzed using a paired-samples t test and an analysis of covariance. Results: The results of the t test showed that after eight weeks, serum levels of BDNF and TNF-α were significantly increased in both groups (p ˂ 0. 05), although the difference between the groups was not significant. Aerobic power significantly increased only in the exercise group (p = 0. 0005). In addition, the results of the analysis of covariance showed only a significant difference in aerobic power between the two groups (p ˂ 0. 05). Conclusion: Eight weeks of HICT training in breast cancer survivors can increase aerobic capacity without affecting serum levels of BDNF and TNFα .