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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Women's Health".

Deadline for manuscript submissions: closed (31 March 2023) | Viewed by 24471

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Prof. Dr. Mosad Zineldin

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Department of Medicine and Optometry, Faculty of Health and Life Sciences, Linnaeus University, SE-35195 Växjö, Sweden
Interests: medical science; psychology; psychiatry; brain research; medical errors; medical and health care quality and patient safety
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Special Issue Information

Dear Colleagues,

Background

According to WHO (2020), globally, 19.3 million new cancer cases and almost 10.0 million cancer deaths were recorded in 2020. Female breast cancer has exceeded lung cancer as the most commonly diagnosed cancer, with an estimated 2.3 million new cases (11.7%) and 685,000 deaths (7%). Breast cancer has become a major public health problem around the world. Hereditary, genetic, and environmental factors predict BC development. It is well known that cancer grows when a cell’s DNA is damaged, yet it remains unknown why or how this DNA becomes damaged. The cause could be genetic, environmental and/or a combination of both. However, often, patients cannot be offered an accurate explanation as to the cause of their cancer.

Female breast cancer (FBC) is the most prevalent cancer in females in both the developed and the developing world. However, FBC is becoming more widespread in the developing world due to genetic and environmental factors such as lifestyle. Although there is evidence of some risk reduction with prevention strategies, these strategies cannot eliminate the majority of FBC, particularly in low- and middle-income countries, where breast cancer is diagnosed in its very late stages. Therefore, early detection of BC is the most critical factor in order to improve and control breast cancer outcome and survival.

Screening for breast cancer, which involves self-examination, mammography, and clinical breast examination, is crucial for early diagnosis. The mammography screening method is proven to be effective but is very costly. However, it is cost-effective and feasible in developed countries that have good health infrastructure because it can be incorporated into long-term, organized, population-based screening programmes. Low- and middle-income countries should implement combined cost-effective and affordable interventions to tackle BC.

Considerable research has examined how diagnosis and treatment influence health-related quality of life (HRQOL) among breast cancer survivors. There is still a lack of studies that explore the association between HRQOL, breast cancer recurrence, and overall mortality. Some HRQOL domains are mental health, psychiatric, physical health, and the sociological implications of the BC. These domains could be more important for prognosis, control, and mortality.

Aim of this special issue

This Special Issue aims to make a significant contribution to research in this field by focusing on encouraging researchers and practicians to make multidisciplinary, integrated, and holistic efforts to build a sustainable infrastructure for the dissemination of cancer prevention and control measures of cancer care. High-quality research in BC is one of the most essential infrastructure factors.

The ways in which researchers and professionals tackle these challenges now will determine the wellbeing of FBC patients in terms of their hope for successful recovery and better HRQOL. Thus, this Special Issue seeks to publish original, experimental, theoretical, and applied research about FBC health, presentation, and control. The issue presents interdisciplinary approaches combining medical, psychological, psychosocial, mental, social, and psychiatric perspectives in an attempt to improve the diagnosis, treatment, and prevention of FBC.

Prof. Dr. Mosad Zineldin
Guest Editor

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Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

Gene–environment interaction and risk of FBC
Hereditary and HER2-gene positive FBC
Sub-types of breast cancers
FBC and behavioural medicine
The sociology of FBC
Sexuality and FBC
DNA damage and FBC
Sociology of breast tissue
Physical health predicts and FBC
The effects of the BC illness on children, marriage, sex, and parent–child relationships
FBC, Depression, Anxiety, Insomnia, Stress (DAIS)
FBC and emotional intelligence
FBC, medicine, and social science
FBC, medical sociology, and the study of mental illness
Psychological, psychiatric, physical, and social effects of breast cancer
Medication and lifelong support of FBC patients
Impact of COVID-19 pandemic on clinical and surgical breast cancer
Impact of the locus of hope-related thinking concerning ongoing events and experience of FBC.

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Published Papers (8 papers)

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Research

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12 pages, 1204 KiB

Open AccessArticle

Safety of Combined Targeted and Helixor^® Viscum album L. Therapy in Breast and Gynecological Cancer Patients, a Real-World Data Study

by Friedemann Schad and Anja Thronicke

Int. J. Environ. Res. Public Health 2023, 20(3), 2565; https://doi.org/10.3390/ijerph20032565 - 31 Jan 2023

Cited by 8 | Viewed by 2907

Abstract

Background: Newer personalized medicines including targeted therapies such as PARP inhibitors and CDK 4/6 inhibitors have been shown to improve the survival of breast and gynaecological cancer patients. However, efficacy outcomes may be ham5pered by treatment discontinuation due to targeted therapy-related adverse drug reactions or resistance. Studies have suggested that add-on mistletoe (Viscum album L., VA) improves the quality of life and ameliorates the cytotoxic side effects of standard oncological therapy in cancer patients. The primary objective of this real-world data study was to determine the safety profile of targeted therapy in combination with add-on Helixor^® VA therapy compared to targeted therapy alone in breast and gynecological cancer patients. Methods: The present study is a real-world data observational cohort study utilizing demographic and treatment data from the accredited national Network Oncology (NO) registry. The study has received ethics approval. The safety profile of targeted therapies with or without Helixor^® VA therapy and safety—associated variables were evaluated by univariate and adjusted multivariable regression analyses. Results: All stages of breast and gynecological cancer patients (n = 242) were on average 54.5 ± 14.2 years old. One hundred and sixty patients (66.1%) were in the control (CTRL, targeted therapy) and 82 patients (33.9%) were in the combinational (COMB, targeted plus Helixor^® VA therapy) group. The addition of Helixor^® VA did not hamper the safety profile (χ² = 0.107, p-value = 0.99) of targeted therapy. Furthermore, no adverse events and a trend towards an improved targeted therapy adherence were observed in the COMB group. Conclusions: The present study is the first of its kind showing the applicability of Helixor^® VA in combination with targeted therapies. The results indicate that add-on Helixor^® VA does not negatively alter the safety profile of targeted therapies in breast and gynaecological cancer patients. Full article

(This article belongs to the Special Issue Female Breast Cancer (FBC) Health, Prevention and Control)

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11 pages, 4512 KiB

Open AccessArticle

Long-Term Skin Temperature Changes after Breast Cancer Radiotherapy

by Agnieszka Baic, Dominika Plaza, Barbara Lange, Łukasz Michalecki, Agata Stanek, Anna Kowalczyk, Krzysztof Ślosarek and Armand Cholewka

Int. J. Environ. Res. Public Health 2022, 19(11), 6891; https://doi.org/10.3390/ijerph19116891 - 4 Jun 2022

Cited by 2 | Viewed by 2120

Abstract

The aim of the study was to use thermal imaging to evaluate long-term chest temperature changes in patients who had previously been treated with radiotherapy. The examination with a thermal imaging camera involved 144 women—48 of them were patients after RT, 48 were females before breast cancer radiotherapy and the last group of participants were 48 healthy women. All patients (before and after radiotherapy) were divided into women after mastectomy and those after conservative surgery. In addition, the first group of women, those who had received radiotherapy, were divided into three other groups: up to 1 year after RT, over 1 year and up to 5 years after RT and over 5 years after RT. Due to this, it was possible to compare the results and analyse the differences between the temperature in the healthy and treated breasts. The comparison of obtained temperature results showed that the area treated by ionizing radiation is characterized by a higher temperature even a few years after the finished treatment. It is worth mentioning that despite the fact that the difference was visible on the thermograms, the patients had no observable skin lesion or change in color at the treatment site. For the results of the study provided for the group of healthy patients, there were no significant differences observed between the average temperatures in the breasts. The use of thermal imaging in the evaluation of skin temperature changes after radiotherapy showed that the average temperature in the treated breast area can change even a long time after treatment. Full article

(This article belongs to the Special Issue Female Breast Cancer (FBC) Health, Prevention and Control)

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15 pages, 792 KiB

Open AccessArticle

Factors Associated with Screening Mammogram Uptake among Women Attending an Urban University Primary Care Clinic in Malaysia

by Nasturah Abdullah, Noorhida Baharudin, Mariam Mohamad and Mohamed-Syarif Mohamed-Yassin

Int. J. Environ. Res. Public Health 2022, 19(10), 6103; https://doi.org/10.3390/ijerph19106103 - 17 May 2022

Cited by 5 | Viewed by 2687

Abstract

Screening mammograms have resulted in a reduction in breast cancer mortality, yet the uptake in Malaysia was low. This study aimed to determine the prevalence and factors associated with screening mammogram uptake among women attending a Malaysian primary care clinic. A cross-sectional study was conducted among 200 women aged 40 to 74 attending the clinic. The data was collected using questionnaires assessing sociodemographic, clinical characteristics, knowledge and health beliefs. Multiple logistic regression was used to identify factors associated with mammogram uptake. The prevalence of screening mammograms was 46.0%. About 45.5% of women with high breast cancer risk had never undergone a mammogram. Older participants, aged 50 to 74 (OR = 2.57, 95% CI: 1.05, 6.29, p-value = 0.039) and those who received a physician’s recommendation (OR = 7.61, 95% CI: 3.81, 15.20, p-value < 0.001) were more likely to undergo screening mammography. Significant health beliefs associated with mammogram uptake were perceived barriers (OR = 0.81, 95% CI: 0.67, 0.97, p-value = 0.019) and cues to action (OR = 1.30, 95% CI: 1.06, 1.59, p-value = 0.012). Approximately half of the participants and those in the high-risk group had never undergone a mammogram. Older age, physician recommendation, perceived barriers and cues to action were significantly associated with mammogram uptake. Physicians need to play an active role in promoting breast cancer screening and addressing the barriers. Full article

(This article belongs to the Special Issue Female Breast Cancer (FBC) Health, Prevention and Control)

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11 pages, 360 KiB

Open AccessArticle

Impact of High-Intensity Circuit Resistance Exercise on Physical Fitness, Inflammation, and Immune Cells in Female Breast Cancer Survivors: A Randomized Control Trial

by Kwang-Jin Lee and Keun-Ok An

Int. J. Environ. Res. Public Health 2022, 19(9), 5463; https://doi.org/10.3390/ijerph19095463 - 29 Apr 2022

Cited by 8 | Viewed by 3057

Abstract

Questions remain about whether resistance exercise has a positive effect on immune and inflammatory cells. The purpose of this study was to evaluate the effect of 12 weeks of high-intensity circuit resistance exercise (HCRE) on inflammation and immune cells, and physical fitness, of female breast cancer survivors (FBCSs). Thirty FBCSs were randomly assigned to the HCRE (n = 15) and control (n = 15) groups. HRCE was administered for 50 min a day, 2–3 times a week, for 12 weeks. The control group only performed activities of daily living during the study period. Baseline and post-intervention measures included body composition, muscular strength, muscular endurance, flexibility, reaction time, balance, inflammation, and immune cell measurements. The results showed that HCRE improved body mass index, body fat, muscle mass, grip strength, back muscle strength, sit-up, whole-body reaction, standing on one leg with eyes closed, Y-balance test, and NKCA in FBCSs. The improvement of physical strength and immune cells of FBCSs was achieved using the 12-week HRCE program. Future studies must analyze various exercise intensities and types, and should be conducted on other cancer survivors. In addition, strategies should be developed to allow FBCSs to participate in resistance training. Full article

(This article belongs to the Special Issue Female Breast Cancer (FBC) Health, Prevention and Control)

13 pages, 503 KiB

Open AccessArticle

The DAMA25 Study: Feasibility of a Lifestyle Intervention Programme for Cancer Risk Reduction in Young Italian Women with Breast Cancer Family History

by Giovanna Masala, Domenico Palli, Ilaria Ermini, Daniela Occhini, Luigi Facchini, Lisa Sequi, Maria Castaldo, Saverio Caini, Benedetta Bendinelli, Calogero Saieva, Melania Assedi and Ines Zanna

Int. J. Environ. Res. Public Health 2021, 18(23), 12287; https://doi.org/10.3390/ijerph182312287 - 23 Nov 2021

Cited by 3 | Viewed by 2196

Abstract

Background: Diet and physical activity (PA) can modulate sporadic and possibly familial breast cancer (BC) risk. The DAMA25 study is a single-arm 12-month intervention aimed to modify dietary and PA habits in healthy young Italian women with a positive BC family history, categorized as having intermediate or high genetic risk according to NICE (National Institute for Health and Cancer Excellence) guidelines. Methods: Participants, aged 25–49 years, were asked to adopt a diet mainly based on plant-based foods and to increase moderate daily activities combined with 1 h/week of more intense activity. Cooking lessons, collective walks, educational sessions, brochures, booklets and online materials were implemented. Dietary, PA habits and anthropometry were collected at baseline and at the end of the intervention. Changes on dietary, lifestyle habits and anthropometry were evaluated by GLM adjusted for weight reduction counselling aimed to participant with a BMI ≥ 25, age and baseline values of each variable. Results: Out of 237 eligible women 107 (45.2%) agreed to participate and among them 98 (91.6%) completed the intervention. The adherence rate of the intervention was 77.8%. We observed a reduction in red and processed meat (p < 0.0001) and cakes consumption (p < 0.0001). Consumption of whole grain bread (p < 0.001), leafy vegetables (p = 0.01) and olive oil (p = 0.04) increased. We observed an increase in moderate (p < 0.0001) and more intense (p < 0.0001) recreational activities, an average 1.4 kg weight loss (p = 0.005), a reduction of waist circumference (p < 0.001) and fat mass (p = 0.015). Conclusions: The DAMA25 study shows that it is feasible an intervention to improve in the short-term dietary and PA habits and anthropometry in women with high BC familial risk. Full article

(This article belongs to the Special Issue Female Breast Cancer (FBC) Health, Prevention and Control)

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13 pages, 361 KiB

Open AccessArticle

Well-Being, Depression, and Anxiety following Oncoplastic Breast Conserving Surgery versus Modified Radical Mastectomy Followed by Late Breast Reconstruction

by Daciana Grujic, Cătălina Giurgi-Oncu, Cristina Oprean, Zorin Crăiniceanu, Ica Secoșan, Ioana Riviș, Ion Papavă, Corina Vernic and Cristina Bredicean

Int. J. Environ. Res. Public Health 2021, 18(17), 9320; https://doi.org/10.3390/ijerph18179320 - 3 Sep 2021

Cited by 7 | Viewed by 2986

Abstract

Breast cancer requires complex clinical care. Well-being is an intricate concept, encompassing physical, functional, emotional, and social aspects. Background: This study aims to evaluate the relationship between the type of surgery our patients underwent and the timing of the reconstructive surgery with physical, emotional, social, and functional well-being. Furthermore, through our research we tried to identify potential mental health comorbidities in patients with breast cancer, clinical symptoms, and well-being in women with breast cancer, depending on the type of required surgery. Methods: The study included 69 women diagnosed with breast cancer, in stages I to III, divided in two groups: I—patients with oncoplastic breast-conserving surgery and contralateral correction surgery, for symmetry reasons; II—patients who underwent modified radical mastectomy and late breast reconstruction with contralateral symmetrisation. We evaluated socio-demographic aspects, alongside depression, anxiety, stress (DASS 21), and well-being (FACT-B). Data were statistically processed; statistical significance was set at p < 0.05. Results: Clinical elements of depression, anxiety, and stress were noted in both groups, without statistical significance (p > 0.05). Significant differences were found regarding psycho-emotional (p = 0.035) and functional well-being (p = 0.001), with higher scores for group I. The chi-square test indicated statistically significant differences (at p < 0.01) between the groups, regarding the frequency of scores on items B4 and B9 (FACT-B items, related to feminine aesthetics and desirability), with evidently higher scores in group I than in group II. Conclusions: The state of well-being, as well as the items related to femininity and sexuality had higher values in the group of women treated by oncoplastic conservative surgery compared to late reconstruction after modified radical mastectomy. Full article

(This article belongs to the Special Issue Female Breast Cancer (FBC) Health, Prevention and Control)

16 pages, 356 KiB

Open AccessArticle

Factors Associated with Breast Cancer Screening Adherence among Church-Going African American Women

by Pooja Agrawal, Tzuan A. Chen, Lorna H. McNeill, Chiara Acquati, Shahnjayla K. Connors, Vijay Nitturi, Angelica S. Robinson, Isabel Martinez Leal and Lorraine R. Reitzel

Int. J. Environ. Res. Public Health 2021, 18(16), 8494; https://doi.org/10.3390/ijerph18168494 - 11 Aug 2021

Cited by 15 | Viewed by 3879

Abstract

Relative to White women, African American/Black women are at an increased risk of breast cancer mortality. Early detection of breast cancer through mammography screening can mitigate mortality risks; however, screening rates are not ideal. Consequently, there is a need to better understand factors associated with adherence to breast cancer screening guidelines to inform interventions to increase mammography use, particularly for groups at elevated mortality risk. This study used the Andersen Behavioral Model of Health Services Use to examine factors associated with adherence to National Comprehensive Cancer Network breast cancer screening guidelines amongst 919 African American, church-going women from Houston, Texas. Logistic regression analyses measured associations between breast cancer screening adherence over the preceding 12 months (adherent or non-adherent) and predisposing (i.e., age, education, and partner status), enabling (i.e., health insurance status, annual household income, employment status, patient-provider communication, and social support), and need (i.e., personal diagnosis of cancer, family history of cancer, and risk perception) factors, separately and conjointly. Older age (predisposing: OR = 1.015 (1.007–1.023)), having health insurance and ideal patient–provider communication (enabling: OR = 2.388 (1.597–3.570) and OR = 1.485 (1.080–2.041)), and having a personal diagnosis of cancer (need: OR = 2.244 (1.058–4.758)) were each associated with greater odds of screening adherence. Only having health insurance and ideal patient-provider communication remained significantly associated with screening adherence in a conjoint model; cancer survivorship did not moderate associations between predisposing/enabling factors and screening adherence. Overall, results suggest that interventions which are designed to improve mammography screening rates amongst African American women might focus on broadening health insurance coverage and working to improve patient–provider communication. Implications for multi-level intervention approaches, including the role of churches in their dissemination, are proposed. Full article

(This article belongs to the Special Issue Female Breast Cancer (FBC) Health, Prevention and Control)

Review

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12 pages, 2655 KiB

Open AccessReview

Health Care Accessibility and Breast Cancer Mortality in Europe

by Agata Ciuba, Katarzyna Wnuk, Aneta Nitsch-Osuch and Marta Kulpa

Int. J. Environ. Res. Public Health 2022, 19(20), 13605; https://doi.org/10.3390/ijerph192013605 - 20 Oct 2022

Cited by 12 | Viewed by 2708

Abstract

Background: Breast cancer is the most common cause of death, due to malignant neoplasms in women worldwide. The nature of the symptoms associated with breast cancer depends on the stage of the disease. In this case, any cancerous changes in the initial phase of the disease can only be detected during imaging tests. Participation in mammography screening can reduce breast cancer mortality by up to 40%, if only 70% of the eligible population participates in preventive programs. The purpose of the study was to assess the impact of accessibility to health care resources on breast cancer mortality. Methods: Eurostat aggregated health care data was extracted. Hierarchical cluster analysis of average breast cancer mortality identified four groups of countries with similar mortality rates and trends. The data was then analyzed, in terms of access to health care. Results: It was observed that the higher the financial expenditure on health care and the better the health care accessibility, the lower the mortality rates of breast cancer. Conclusions: There are examples indicating that the studied elements are not the only factors affecting the improvement of population health. The authors would like to emphasize the need to influence lifestyle factors, direct cancer risk, and introduce a multidisciplinary approach to breast cancer prevention. Full article

(This article belongs to the Special Issue Female Breast Cancer (FBC) Health, Prevention and Control)

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