فصلنامه بیماری های پستان ایران
سال یازدهم شماره 4 (پیاپی 43، زمستان 1397)

Breast cancer is the most common cancer in women. Surgery is the main treatment, and patients may experience some complications after surgery, including pain and shoulder function limitation. The severity of these complications is greater in modified radical mastectomy. In various studies, Kinesio Tape (KT) has been introduced as a supporting and complementary method in rehabilitation after surgeries. The aim of the present study was to compare the effects of a rehabilitation program with or without KT on shoulder pain and function after mastectomy in women with breast cancer. This study was a double-blind randomized clinical trial (RCT). In this study, 20 participants were randomly assigned to 2 groups. The intervention started the first day after surgery. One of the groups (n = 10) received therapeutic exercise program, and the other group (n = 10) received therapeutic exercise program as well as lymphatic correction with fan-shaped KT over a four-week period. KT was attached to the upper limb of the surgical side, the effects of the interventions were examined from two aspects of shoulder pain and function (based on the SPADI questionnaire). The findings of the study indicated that both groups had significant improvements in pain and function after the four-week period of intervention. The improvement in shoulder function was significantly greater in the exercise + KT group (p < 0.05), although there was no significant difference between the two groups in shoulder pain (p > 0.05). The use of fan-shaped KT with therapeutic exercises is recommended for improving the shoulder function after a modified radical mastectomy.

Breast cancer is one of the most common cancers among women. Various studies have shown that taking medicinal herbs and physical activity can play an effective role in the prevention and treatment of cancer. The aim of this study was to investigate the synergistic effect of Aloe vera extract and aerobic exercise on levels of interleukin 6 (IL-6) and vascular endothelial growth factor (VEGF) in mice with breast cancer. In this experimental study, 35 female BALB/c mice were randomly assigned to 5 groups: (1) control (healthy), (2) control (cancer), (3) training (cancer), (4) extract (cancer), and (5) Exercise + Extract (Cancer). The induction of breast cancer in mice was done by tumor implantation. Aloe vera extract was injected subperitoneally at 300 mg/kg of body weight per day. Training (swimming) duration was 10 minutes on the first day, gradually increasing to 60 minutes per day through 5-minute increments. At the end of the study, tumor weight and volume and levels of IL-6 and VEGF were measured. After six weeks, the mean tumor volume and weight decreased in all cancer groups. IL-6 levels were significantly lower in the training group (p = 0.008) and the Exercise + Extract group (p = 0.006) compared with the cancer controls. In addition, the levels of VEGF were significantly lower in the training group (p = 0.006) and the Exercise + Extract group (p = 0.005). However, Aloe vera extract alone did not have a significant effect on the levels of IL-6 and VEGF (p = 0.224 and p = 0.012, respectively). It is likely that the combination of swimming exercises and consumption of Aloe vera extract can improve inflammatory status by reducing the levels of IL-6 and VEGF proinflammatory cytokines.

Being diagnosed with breast cancer is usually associated with stress, and the overflow of this stress in the form of marital stress affects the marital relationship of couples. The purpose of this study was to determine the effect of an education program based on rational emotive behavior therapy (REBT) on marital stress of couples coping with breast cancer in Qazvin. The method of this study was semi-experimental and its design was pretest and posttest with a control group. The population of the present study included all the couples with breast cancer who visited Velayat hospital in Qazvin province in October 2018. Sixty women were selected via available sampling and tested. Of them, 18 women, along with their husbands (18 couples), who had a score above average on the marital stress scale were selected and randomly assigned to two groups. The experimental group received 8 2-hour sessions of education based on REBT. The research instrument was the Stockholm-Tehran Marital Stress Scale (STMSS). Data were analyzed using covariance analysis. The experimental group had significantly lower marital stress compared with the control group (p < 0.001). Based on the findings of this research, it can be concluded that education based on REBT reduces marital stress of couples who are coping with breast cancer.

The aim of the current research was to compare the effectiveness of neurofeedback therapy and reality therapy in improving the psychological symptoms of depression and state-trait anxiety in women with breast cancer. In a clinical trial with a pretest-posttest and follow-up design, 45 of 135 breast cancer patients in Amol city in 2017 were enrolled after controlling for inclusion/exclusion criteria. Subjects were randomly divided into 3 groups: reality therapy, neurofeedback therapy, and control. All participants completed the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI) at 3 time points. Data were analyzed using a MANCOVA test. Significant differences were observed in the mean DPI and STAI scores among the three groups at posttreatment. Lower mean posttest depression scores were obtained for the two therapy groups compared with the control group, with better results for the reality therapy (p < 0.05). The mean STAI score was significantly lower for the reality therapy group than for the control group (p < 0.05), while only a positive trend was observed for the neurofeedback. In sum, a significant improvement of 2.28 to 6.64 points relative to baseline was observed in the mean depression and anxiety scores after the psychological therapies. These therapeutic effects even increased over the 4 months of follow-up, indicating the consistency of therapeutic effects for both treatments (p < 0.05). The reality therapy and neurofeedback therapy could effectively decrease state-trait anxiety and depression symptoms in breast cancer patients, with robust effects for reality therapy, and are recommended to these patients. Given the economy and availability of reality therapy, we recommend reality therapy as an adjunct treatment for breast cancer patients.

Lifestyle improvement is one of the main strategies to increase treatment persistence in breast cancer survivors. The purpose of the present study was to determine the effect of a light-intensity physical activity program on Socio-cognitive factors that affect sedentary behavior and lifestyle in breast cancer survivors in Isfahan city. Twenty-four female breast cancer survivors were recruited via convenience sampling and randomly assigned to experiment and control groups (12 subjects for each group). Both groups were assessed using Busschaert’s context-specific sedentary behavior questionnaire and the Miller-Smith Lifestyle Assessment Inventory before and after the intervention. The light-intensity physical activity program was conducted for one month in the experimental group based on Australia’s Physical Activity and Sedentary Behavior Guidelines for Adults. Data were analyzed using descriptive statistics including mean and standard deviation and inferential statistics including ANCOVA and MANCOVA with a significance level of 0.05. There was a significant difference between the two groups in lifestyle and Socio-cognitive factors affecting sedentary behavior (except for the sedentary behavior modelling) (p = 0.001). It seems that performing light physical exercises may improve the lifestyle and Socio-cognitive factors affecting sedentary behavior by changing key factors such as motivation and intrapersonal relationship in breast cancer survivors.

Breast cancer can be considered as the most common cancer among women in the world. Hence, finding appropriate diagnosis methods is a critical and sensitive challenge in the health of the human community. Various methods have been proposed for breast screening in women, and one of the safest methods is magnetic resonance imaging. Tumors do not have morphological features of their own. Therefore, differentiating between benign and malignant lesions is normally very time-consuming and difficult. In this study, a computer-aided autodiagnosis system is developed for diagnosis and classification of axial magnetic resonance images of the breast in two classes of benign and malignant. Initially, suspected parts of the lesion were separated as a rectangular box around the lesion by an experienced radiologist. Then, we used, for the first time, a level set–based algorithm to precisely separate the lesion considering the unevenness of the images and to remove false positive regions using morphological operations and removing veins. In the next stage, four groups of features expressing particular states of the lesion structure are extracted from the separated parts of the lesions. These four groups are textural, kinetic, frequency, and morphological features. Here a new group of features called the Gabor-Haralik features, which present a particular efficiency, was extracted for each lesion. Finally, MLP classification was used to classify the lesions. The proposed method was tested on 46 lesions. By utilizing Gabor-Haralik features, we achieved mean sensitivity, specificity, accuracy, and F-measure of 95.41, 90.70, 92.76, and 92.19%, respectively. The performance measures indicate the efficiency of the proposed diagnosis system for classification of benign and malignant breast lesions in magnetic resonance imaging.