Search

Abstract accepted at SABCS 2023, poster presented at SABCS 2023 We report the efficacy of trastuzumab deruxtecan (T-DXd) in treating human epidermal growth factor receptor 2 (HER2) low, type ID leptomeningeal breast cancer (LMD) (with positive cerebrospinal fluid [CSF] cytology and hydrocephalus as the only abnormal imaging finding) and the diagnostic and monitoring utilization of a novel microfluidic platform called CNSide™. Breast cancer LMD is associated with poor prognosis, and effective treatments are lacking. Our case highlights two crucial aspects related to the treatment and monitoring of breast cancer LMD. First, T-DXd was chosen based on immunocytochemistry (IHC) data from CSF malignant cells and follow-up revealed effectiveness of T-DXd in treating HER2-low LMD. While the efficacy of T-DXd has been established in treating metastatic HER2-low breast cancer, our case represents, to our knowledge, the first demonstration of T-DXd's effectiveness in HER2-low breast cancer LMD. Second, since this is type 1D LMD with absence of unequivocal measurable radiological disease in both the central nervous system (CNS) and extra-CNS, we employed a novel microfluidic CSF assay to monitor disease response. This novel assay outperformed standard CSF cytology in our case. There is an urgent need to develop CSF tumor cell assessment tool that surpasses the capabilities of conventional CSF cytology. Article highlights T-DXd is highly efficacious in treating HER2 low, leptomeningeal breast cancer. CSF CNSide™ assay utilizes a microfluidic platform and an antibody capture method to capture tumor cells. It uses the same principles used for detecting circulating tumor cells in peripheral blood. CNSide™ assay has a sensitivity of 100% compared with standard CSF cytology which has a sensitivity of 50–60%. CNSide™ assay can be used for facilitating receptor status characterization and guiding treatment. Our case demonstrates efficacy of T-DXd in treating HER2 low leptomeningeal breast cancer and also highlights the clinical utility of CNSide™ assay. Our case aligns well with the emerging literature about the efficacy of T-DXd in treating metastatic HER2-low disease. [ABSTRACT FROM AUTHOR]

Assessing self-harm through brief multiple choice items is simple and less invasive than more detailed methods of assessment. However, there is currently little validation for brief methods of self-harm assessment. This study evaluates the extent to which adolescents' perceptions of self-harm agree with definitions in the literature, and what level of question detail produces optimal concordance rates. Two hundred and thirty-three (69% female) first year university students aged 17-21 completed a self-harm coding task; we created three levels of question detail and randomly allocated participants to three study groups: "brief", "low detail", and "high detail". The present findings suggest that that adolescents' perceptions of self-harm are generally concordant with a consensus definition of self-harm. Low level of detail in the question produced greatest accuracy in responses; adolescents who demonstrated adequate task understanding were able to correctly identify 94% of examples of self-harm behaviour and 86% of examples of behaviour that were not self-harm. We identified lower concordance rates for eating disordered behaviour and recreational petrol sniffing. This indicates that adolescents perceive these behaviours to be self-harm, in contrast to the reference definition we utilised. Overall, this study provides support for using a brief assessment of self-harm where minimal detail regarding self-harm behaviour is required.

Background: Research to date suggests that as many as 12-15% of young people engage in self-harm behaviour; however, the current understanding of the psychological basis of adolescent self-harm is limited. The objective was to determine whether adolescents who self-harm are a psychologically homogenous group. It was hypothesised that psychological subtypes would exist and these groups would report different rates of self-harm. Method: Nine hundred and forty-four school students aged 11 to 19 and 166 first-year psychology students aged 21 or younger completed a self-report questionnaire. Participants were aged 11 to 21 (mean = 15.4, SD = 2.1). Sixty-two percent of the sample were female (n = 692). Students were allocated to psychologically distinct groups. Rates of self-harm were compared for the psychological subtypes of self-harmers. Results: Two hundred and thirty-four participants reported lifetime self-harm (21.1%; 95% CI 19-23%) and 78 reported recent self-harm (7.0%; 95% CI 6.7-7.3%). The present study identified three psychologically quite distinct groups of adolescents within those who reported self-harm--a psychologically pathological group, a psychologically "normal" group, and an impulsive group. The pathological group reported the highest rate of recent self-harm (50.9%); the psychologically "normal" and impulsive groups reported similar rates of self-harm (28.7% and 24.6%, respectively). Conclusions: Adolescents who self-harm are not a psychologically homogenous group. One pathological subtype of self-harmers appears to most closely reflect a number of the psychological and social factors previously associated with self-harm. However, a large proportion of the sample was allocated the psychologically "normal" subtype. This finding highlights the importance of psychological screening of adolescents presenting for treatment for self-harm as subtypes of self-harmers may require disparate strategies for intervention. Further research is required in order to identify appropriate treatment strategies for each subtype.

Objective: There is growing awareness of the range of psychosocial, lifestyle, and sociodemographic factors related to self-harm, however this research is often limited by using cross-sectional or convenience samples. And while we generally assume that young adults who self-harm experience poorer long-term outcomes, longitudinal research is needed. This paper builds on prior research using a large, representative, longitudinal sample. Methods: 5765 Australian women completed 5 surveys (age 18–23 to 31–36). Six-month self-harm was measured by self-report. We had two aims: firstly to predict future self-harm, separately for women with and without prior self-harm. Secondly, to identify outcomes 3 and 6 years following self-harm. Results: Six-month self-harm prevalence was 2.5%. Predictors among women without recent self-harm included depression, dieting behaviours, number of male sexual partners, and abuse. Among women with recent or current self-harm, predictors were number of dieting behaviours, tiredness of life, and stress. Women who self-harmed reported poorer outcomes, namely greater difficulties in relationships at 3- and 6-year follow-up. Conclusions: Longitudinal risk factors for self-harm differed depending on prior self-harm status, and included depression, dieting behaviours, tiredness of life and stress. These factors may serve as warning signs for new or continued self-harm. This study offers new insight into long-term outcomes up to six years after self-harm, particularly with relationships. [ABSTRACT FROM AUTHOR]

Chaplains often express a sense of satisfaction in helping others. But their work renders them vulnerable to secondary traumatic stress and burnout. We investigated mindful self-care, comparing the experiences of chaplains and other workers. Measures used included mindful selfcare, social support, and professional quality of life. We found self-care practices did not predict the professional quality of life. Lack of supportive structures and mindful awareness predicted burnout. Compassion satisfaction might arise from other sources.