Young women with breast cancer have age-specific concerns regarding changes in sexuality, fertility, and body image. However, the psychological impact of BC and its treatments is not exclusive to young patients and it also affects their social context, especially their partners, as they experience higher illness intrusiveness than the partners of older women. In young BC patients, relationships, body image, and sexual problems are related to most quality of life domains. While BC treatment is being planned, all women should be informed about the possible side-effects of treatment on sexuality, fertility, and body image. Inclusion of partners into decision making should be pursued to restore, improve, and maintain effective communication and positive relationships in young couples facing BC. The aim of this review is to describe the psychological impact of alterations in sexuality, fertility, and body image in young BC patients and their partners, and to recommend strategies to address such issues in a timely manner.

Objective To describe clinical and information needs, identify unmet support services and guide interventions for young breast cancer (BC) patients in Mexico. Methods Cross‐sectional, qualitative study, using interpretive description methodology. Patients with initial BC diagnosis within 6–12 months prior to enrolment, ≤40 years old and literate were included in focus groups. Results Twenty‐nine patients were included. Expressed needs were classified into the following categories: (a) understanding diagnosis and treatment; (b) treatment side effects; and (c) time, source and communication means. Patients felt their medical team did not provide enough information regarding diagnosis, treatment and relevant side effects related to fertility, menopause and sexuality. Lack of information fuelled uncertainty, distress, anxiety and fear, and could negatively influence treatment decisions. Patients wished that news be communicated considering their own attitude regarding the disease and providing psychological support when necessary, including partners, relatives and friends. They recommended that information should be delivered with an empathic and personalised approach, with take‐home educational material to help them recall, comprehend and/or expand verbal information received during medical appointments. Conclusions This study provides valuable insight to increase attention on unmet needs of young BC patients and to improve doctor–patient communication to ensure better care.

The aims of the study were: 1) to identify the psychological significance of the five stages of the grief process proposed by Kübler-Ross, and 2) to design a scale to measure the five stages of grief at the health loss from the obtained results. A test of free association of words from the natural semantic network technique was applied to a non-probabilistic intentional sample of 18 cancer patients and 12 primary caregivers. It was found that the word associations were consistent with the theoretical expectation. From these words and some theoretical considerations, 67 items were written. The items were subjected to the judgment of 9 experts. One item was removed and 19 were corrected. The results are discussed to clarify the content of the phases. Finally the 66-item Likert type Grief Stages Scale was presented for further psychometric study.Keywords: Meaning, grief, denial, anger, bargaining, depression, acceptance. ResumenLos objetivos del estudio fueron: 1) identificar el significado psicológico de las cinco fases del proceso del duelo propuestas por Kübler-Ross, y 2) diseñar una escala para medir las cinco fases del duelo ante la pérdida de la salud desde los resultados obtenidos. Se aplicó un test de asociación libre de palabras con la técnica de redes semánticas naturales a una muestra no probabilística intencional de 18 pacientes oncológicos y 12 cuidadores primarios. Se encontraron que las asociaciones de palabras eran congruentes con la expectativa teórica. A partir de estas palabras y algunas consideraciones teóricas se redactaron 67 ítems. Al ser sometidos al juicio de 9 expertos, un ítem fue eliminado y 19 corregidos. Se discuten los resultados para aclarar el contenido de las fases. Finalmente se presenta la Escala de la Fases del Duelo de 66 ítems tipo Likert para su posterior estudio psicométrico.

PURPOSE The pilot-phase report of the Joven & Fuerte prospective cohort broadly characterizes and assesses the needs of Mexican young women with breast cancer (YWBC). PATIENTS AND METHODS Women age ≤ 40 years with nonmetastatic primary breast cancer were consecutively accrued from 2 hospitals. Data were collected at the first/baseline oncology visit and 2 years later using a sociodemographic survey, European Organisation for Research and Treatment of Cancer Quality-of-Life (QOL) Questionnaire Core 30 (QLQ-C30) and Breast Cancer–Specific QOL Questionnaire (QLQ-BR23), Hospital Anxiety and Depression Scale (HADS), Female Sexual Functioning Index (FSFI), Sexual Satisfaction Inventory, and patients’ medical records. Pearson χ2 and 2-sided t tests were used for statistical analysis. An unadjusted P value < .05 was considered significant. RESULTS Ninety patients were included, all with government health care coverage. Most had low monthly household incomes (98%) and at least a high school education (59%). There was a considerable prevalence of unpartnered patients (36%) and unmet parity (25%). Patients’ most common initial symptom was a palpable mass (84%), and they were most frequently diagnosed with stage III disease (48%), with 51% having had a physician visit ≤ 3 months since detection but 39% receiving diagnosis > 12 months later. At baseline, 66% of patients were overweight/obese, and this proportion had significantly increased by 2 years ( P < .001). Compared with baseline, global QLQ-C30 had improved significantly by 2 years ( P = .004), as had HADS-Anxiety ( P < .001). However, both at baseline and at 2 years, nearly half of patients exhibited FSFI sexual dysfunction. CONCLUSION These preliminary findings demonstrate that YWBC in Mexico have particular sociodemographic and clinicopathologic characteristics, reinforcing the necessity to further describe and explore the needs of these young patients, because they may better represent the understudied and economically vulnerable population of YWBC in limited-resource settings.

ABSTRACTyoung Mexican patients, as well as material for healthcare providers. As for research, a prospective cohort of young breast cancer patients was established to characterize clinicopathological features and psychosocial effects at baseline and during follow-up, as a guide for the development of specific cultural interventions addressing this vulnerable group. Eventually, it is intended that the program's organization and structure can reach national and international interactions and serve as a platform for other countries.

Resumen: Objetivo: Aunque en la clínica e investigación del cáncer de mama se considera las razones para hacerse la reconstrucción mamaria, no existe una escala validada para su evaluación. El objetivo del estudio fue crear una escala para medir los motivos a favor y en contra de la reconstrucción mamaria. Método: A través de la técnica de las redes semánticas naturales, se obtuvieron los ítems de la escala, y a través de un juicio de expertos estos fueron modificados. La técnica de las redes semánticas se aplicó a 65 mujeres mexicanas con cáncer de mama. El grupo de expertos quedó formado por 12 especialistas en cáncer de mama. Resultados: El núcleo central de los motivos para hacerse la reconstrucción mamaria se compuso de 16 motivos, los cuales se pueden agrupar en estéticos/imagen corporal, funcionales, emocionales/psicológicos y de relación con los hijos y la pareja. El núcleo central de los motivos en contra de hacerse la reconstrucción mamaria se compuso de 11 motivos, los cuales se pueden agrupar en miedos, aceptación/comodidad con la situación presente, costos y salud. Desde estos contenidos se redactaron 16 ítems sobre motivos para hacerse la reconstrucción y 11 en contra. Esta escala de 27 ítems fue evaluada en adecuación y comprensibilidad por el grupo de 12 expertos. Se conservaron los 27 ítems, pero siete ítems fueron modificados. Finalmente, se añadieron dos ítems sobre la falta de información señalada en estudios en México. Conclusiones: Se sugiere estudiar la confiabilidad, validez y distribución de la escala de 29 ítems.Abstract: Objective: Although the reasons for breast reconstruction are considered in clinics and research on breast cancer, there is not any validated scale for its evaluation. The objective of the study was to create a scale to measure the reasons for and against breast reconstruction. Method: Through the technique of natural semantic networks, the items of the scale were obtained, and through an expert judgment these were modified. The technique of semantic networks was applied to 65 Mexican women with breast cancer. The group of experts was formed by 12 specialists in breast cancer. ARTÍCULOS Miaja Ávila, M.; Moral de la Rubia, J.; Villarreal-Garza, C. Psicooncología 2018; 15(2): 327-344 328Results: The central core of the reasons in favor of breast reconstruction was composed of 16 reasons, which can be grouped into esthetic/body image, functional, emotional/psychological and relationship with children and the couple. The core of the motives against breast reconstruction was composed of 11 motives, which can be grouped into fears, acceptance/comfort with the present situation, costs and health. Based on these contents, 16 items were written about reasons for reconstruction and 11 against reconstruction. This 27-item scale was evaluated in adequacy and comprehensibility by the group of 12 experts. The 27 items were conserved, but seven items were modified. Finally, two items on the lack of information were added, which was marked in Mexican studies. Conclusions: It is suggest...

Resumen: Lo s objetivos de esta investigación fueron estudiar la consistencia interna, estructura factorial, distribución, diferencias sociodemográficas y validez criterial de la Escala de Ansiedad ante la Muerte (EAM; Osadolor, 2005). Se emplearon tres muestras: de seropositivos (n = 300) y población general (n = 300) donde sólo se aplicó la EAM, y una tercera de población general (n = 160) donde se aplicó adicionalmente la Death Anxiety Scale (DAS; Templer, 1970). Se sugiere reducir la escala EAM a 22 ítems, eliminando los del factor de miedo. Su estructura fue de 3 ó 4 factores correlacionados con consistencias altas, mostrando ambas ajuste adecuado a los datos. La solución de tres factores correspondió al original, pero en la de cuatro factores la ansiedad mostró consistir en dos factores separados. La escala EAM correlacionó con la DAS. Se cumplieron las expectativas de diferencias y relaciones sociodemográficas. Se recomienda usar en México y estudiar en otros países hispanohablantes.

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