The psychological influence of the diagnosis of breast cancer on therapeutic options selection

Abstract

The therapeutic management decision-making process for breast cancer is complex, and is influenced by multiple factors including patient age, comorbidities, ethnicity, education, and availability of immediate or delayed reconstruction options. Our study analysed 276 patients diagnosed with breast cancer in the "Colțea" Clinical Hospital between 2014 and 2015. Mean patients age was 61.24, median 62, with a range of 31 to 89 years. Younger age was associated with a less advanced local disease and younger patients were more likely to choose and benefit from conservative surgery. Most patients (61.76%) came from rural areas. Place of origin had a significant influence on the tumor size at the time of diagnosis (3.9 cm vs. 1.8cm) as well as on the choice of surgical procedure. Personalized treatment management plans that include aesthetic satisfaction coupled with oncological safety should be the objectives of contemporary breast surgery. Patient age is so important to the decision making process that it has been proposed as a determinant of educational and counselling strategies. From our experience, young patients from urban areas were more proactive patients. They were diagnosed earlier and more involved in treatment decisions compared with patients from rural areas, who generally did not question the surgeon's opinion. Factors that influence the decision-making process likely include age, socioeconomic status, availability of radiotherapy, the necessity of periodic follow-up and the concern about recurrence. Acne conglobata is a rare, severe form of acne vulgaris characterized by the presence of comedones, papules, pustules, nodules and sometimes hematic or meliceric crusts, located on the face, trunk, neck, arms and buttocks.

Breast implant illness: a step forward in understanding this complex entity and the impact of social media

“…They also have a better progression and fewer complications. (19) When the patient decides on explantation surgery, the surgeon must restore her normal breast aspect. The goal is to achieve beautiful female features that increase the patient's confidence and improve emotional appearance.…”

Hypopharyngeal Cancer

“…Tumors located at this level can cause swallowing and breathing impairment, both by the mass effect (large tumors) and/or by edema caused by the lymphatic invasion. Tumor invasion of neural structures can cause pharyngeal muscle contraction impairment or intense pain with negative effects on the swallowing process and the quality of life of the patients [2].…”