Health disparities among breast cancer patients with/without disabilities in Germany

Groß, Sophie E.; Pfaff, Holger; Swora, Michael; Albert, Ute‐Susann; Groß-Kunkel, Anke

doi:10.1016/j.dhjo.2019.100873

Cited by 14 publications

(21 citation statements)

References 25 publications

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“…To the best of our knowledge there exists no literature on breast reconstruction in patients with TE or other physical impairments. In fact, patients with physical impairments are less likely to have breast conserving therapy and more likely to have a mastectomy without reconstruction compared to patients without disabilities (12). Our patient was known for a stable mental health and a good social background, which might have supported the decision to undergo breast reconstruction.…”

Section: Discussionmentioning

confidence: 81%

Autologous breast reconstruction in a patient with thalidomide embryopathy: case report

Grünherz¹,

Fertsch²,

Andree³

et al. 2022

AME Surg J

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Background: Thalidomide has caused thalidomide embryopathy (TE) in more than 10,000 live-born children and is typically associated with phocomelia as well as several other abnormalities such as eye or ear malformations and internal organ defects. Nowadays, thalidomide survivors entered middle age, an age that is susceptible to breast cancer in women.Case Description: Sixty years after the well-known "Contergan Scandal", we present a patient with thalidomide induced phocomelia receiving autologous free flap breast reconstruction. At the age of 49 the patient was diagnosed with multicentric breast cancer requiring neoadjuvant chemotherapy followed by mastectomy and right axillary sentinel lymph node biopsy. One year after mastectomy, an immediate-delayed autologous breast reconstruction using a deep inferior epigastric artery perforator flap was performed. The patient has been followed for 11 years now and still reports to be very satisfied with her reconstructed breast. Conclusions:We demonstrate that the deep inferior epigastric artery perforator flap is a feasible and safe technique to reconstruct the breast in a patient with TE. Given the well-known increased risk for mental disorders in that specific patient population, this case highlights the importance to restore body integrity by breast reconstruction. To the best of our knowledge there exists no literature on breast reconstruction in patients with TE or other physical impairments so far.

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Section: Discussionmentioning

confidence: 81%

Autologous breast reconstruction in a patient with thalidomide embryopathy: case report

Grünherz¹,

Fertsch²,

Andree³

et al. 2022

AME Surg J

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“…Two studies focused on cancer treatment adherence 19,26 . The rest explored differences in receipt of guideline recommended cancer treatment between cancer patients with PMHD and those without it 15–18,20,21,23–25,27–41,43 …”

Section: Resultsmentioning

confidence: 99%

“…Of the 29 studies included in the final analysis, 26 studies were conducted during 2012-2022, with only three studies identified prior to this period. 27,29,34 The main cancer types were breast (n = 11), [15][16][17][18][19][20][21][22][23][24][25]43 non-small cell lung (NSCLC) (n = 6), [30][31][32][33][34]43 colon (n = 6), [27][28][29][41][42][43] and rectal cancers (n = 6). 27,28,[40][41][42][43] Other cancer types included head/neck (n = 3), 36,42,43 prostate (n = 3), 38,39,43 bladder (n = 2), 15,43 cervical (n = 2), 26,43 gastric (n = 2), 41,43 esophageal (n = 2), 35,43 pancreatic (n = 2), 37,…”

Section: Resultsmentioning

confidence: 99%

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Impact of pre‐existing mental health disorders on the receipt of guideline recommended cancer treatments: A systematic review

et al. 2023

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Objective: Disparities in cancer outcomes for individuals with pre-existing mental health disorders have already been identified, particularly for cancer screening and mortality. We aimed to systematically review the influence on the time from cancer diagnosis to cancer treatment, treatment adherence, and differences in receipt of guideline recommended cancer treatment. Methods:We included international studies published in English from 1 January 1995 to 23 May 2022 by searching MEDLINE, Embase, and APA PsycInfo.Results: This review identified 29 studies with 27 being published in the past decade. Most studies focused on breast, non-small cell lung and colorectal cancer and were of high or medium quality as assessed by the Newcastle Ottawa Scale. All studies were from high-income countries, and mostly included patients enrolled in national health insurance systems. Five assessed the impact on treatment delay or adherence, and 25 focused on the receipt of guideline recommended treatment. 20/ 25 studies demonstrated evidence that patients with pre-existing mental health disorders were less likely to receive guideline recommended therapies such as surgery or radiotherapy. In addition, there was a greater likelihood of receiving less intensive or modified treatment including systemic therapy.Conclusions: Across different cancer types and treatment modalities there is evidence of a clear disparity in the receipt of guideline recommended cancer treatment for patients with pre-existing mental health disorders. The effect of pre-existing mental health disorders on treatment delay or adherence is under-researched.Future research needs to include low-and middle-income countries as well as qualitative investigations to understand the reasons for disparities in cancer treatment.

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“…Es zeichnen sich Hinweise auf Unterschiede in der Prävention, Inzidenz, Behandlung und Mortalität der Brustkrebspatientinnen ohne und mit vorbestehender Behinderung ab [5,6,9]. Gründe dafür könnten fehlende Informationen, mangelndes Verständnis für die Bedeutsamkeit des Mammographie-Screenings sowie Angst-und Schamgefühle sein, die bei Frauen mit Behinderung stärker ausgeprägt erscheinen als bei Frauen ohne Behinderung [4,5,9]. Die körperlich beeinträchtigten Teilnehmerinnen einer Studie berichteten zudem von baulichen Barrieren zu Versorgungseinrichtungen, die den Zugang erschweren [10].…”

Section: Stand Der Forschungunclassified

Die onkologische Versorgung von Brustkrebspatientinnen mit vorbestehender Behinderung – Ergebnisse einer qualitativen Studie über wahrgenommene Barrieren, kommunikative Schwierigkeiten und Bedarfe

et al. 2022

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ZusammenfassungMenschen mit Behinderung finden im Hinblick auf ihre individuellen Bedürfnisse bislang wenig Berücksichtigung in der Gesundheitsversorgung. Die Studie erhebt die Innenperspektive von Brustkrebspatientinnen mit einer vorbestehenden Behinderung in Bezug auf Bedarfe und Barrieren in der onkologischen Versorgung. Hierzu wurden qualitative, leitfadengestützte Interviews geführt und mittels qualitativer Inhaltsanalyse ausgewertet. Eingeschlossen wurden 23 Patientinnen mit körperlichen Behinderungen, chronischen körperlichen Erkrankungen, Sinnesbehinderungen, psychischen Erkrankungen und/oder geistiger Behinderung. In Abhängigkeit von der Art der Behinderung standen für Patientinnen unterschiedliche Barrieren im Vordergrund. Um die von Menschen mit Behinderung erlebten Barrieren in der Versorgung abzubauen, ist es notwendig, die Kooperation von Versorgenden aus verschiedenen Versorgungsbereichen zu fördern sowie Versorgende im Umgang mit Menschen mit Behinderung zu schulen.

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Health disparities among breast cancer patients with/without disabilities in Germany

Cited by 14 publications

References 25 publications

Autologous breast reconstruction in a patient with thalidomide embryopathy: case report

Autologous breast reconstruction in a patient with thalidomide embryopathy: case report

Impact of pre‐existing mental health disorders on the receipt of guideline recommended cancer treatments: A systematic review

Die onkologische Versorgung von Brustkrebspatientinnen mit vorbestehender Behinderung – Ergebnisse einer qualitativen Studie über wahrgenommene Barrieren, kommunikative Schwierigkeiten und Bedarfe

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