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Background: The survival of women with early‐stage breast cancer varies by racial group. Filipino women with breast cancer are an understudied group and are often combined with other Asian groups. We compared clinical presentations and survival rates for Filipino and White women with breast cancer diagnosed in the United States. Methods: We conducted a retrospective cohort study of women with breast cancer diagnosed between 2004 and 2015 in the SEER18 registries database. We compared crude survival between Filipino and White women. We then calculated adjusted hazard ratios (HR) in a propensity‐matched design using the Cox proportional hazards model. Results: There were 10,834 Filipino (2.5%) and 414,618 White women (97.5%) with Stage I–IV breast cancer in the SEER database. The mean age at diagnosis was 57.5 years for Filipino women and 60.8 years for White women (p < 0.0001). Filipino women had more high‐grade and larger tumors than White women and were more likely to have node‐positive disease. Among women with Stage I–IIIC breast cancer, the crude 10‐year breast cancer‐specific survival rate was 91.0% for Filipino and 88.9% for White women (HR 0.81, 95% CI 0.74–0.88, p < 0.01). In a propensity‐matched analysis, the HR was 0.73 (95% CI 0.66–0.81). The survival advantage for Filipino women was present in subgroups defined by age of diagnosis, nodal status, estrogen receptor status, and HER2 receptor status. Conclusion: In the United States, Filipino women often present with more advanced breast cancers than White women, but experience better breast cancer‐specific survival. [ABSTRACT FROM AUTHOR]

Background: Knowledge of pathogenic variants in cancer‐predisposing genes is important when making breast cancer treatment decisions, but genetic testing is not universal and criteria must be met to qualify for genetic testing. The objective of this study was to evaluate the pathogenic variant yield for nine cancer predisposition genes by testing criteria, singly and in combination. Methods: Women diagnosed with breast cancer between June 2013 and May 2018 were recruited from four centers in Toronto, Canada. Participants completed a demographics and family history questionnaire and clinical characteristics were collected from medical charts. Genetic testing was done for BRCA1, BRCA2, PALB2, ATM, CHEK2, BRIP1, RAD51D, RECQL, and TP53. Pathogenic variant frequencies were calculated according to five criteria (age ≤ 50, triple‐negative breast cancer, family history, bilateral breast cancer, or Jewish ethnicity). Results: Of the 1006 women studied, 100 women (9.9%) were found to have a pathogenic variant in one of the nine genes tested. The highest prevalence of pathogenic variants was found in women with triple‐negative breast cancer (23%). Of the 100 pathogenic variants detected, 78 were detected in women diagnosed at age 50 or less. A total of 96% of the mutations were identified with three criteria (age of diagnosis, family history, and triple‐negative status). Conclusions: Genetic testing criteria for women with breast cancer should include women with triple‐negative breast cancer, regardless of age. All women aged 50 years or below at time of breast cancer diagnosis should be offered genetic testing. [ABSTRACT FROM AUTHOR]

Background: The rates of contralateral prophylactic mastectomy (CPM) are increasing in women with breast cancer. Previous retrospective research has examined clinical and demographic predictors of the uptake of CPM. However, to the authors' knowledge, there has been very little prospective research to date that has examined psychosocial functioning prior to breast cancer surgery to determine whether psychosocial functioning predicts uptake of CPM. The current study was conducted to evaluate demographic, clinical, and psychosocial predictors of the uptake of CPM in women with unilateral breast cancer without a BRCA1 or BRCA2 mutation.Methods: Women with unilateral non-BRCA-associated breast cancer completed questionnaires prior to undergoing breast cancer surgery. Participants completed demographic and psychosocial questionnaires assessing anxiety, depression, cancer-related distress, optimism/pessimism, breast satisfaction, and quality of life. Pathological and surgical data were collected from medical charts.Results: A total of 506 women consented to participate, 112 of whom (22.1%) elected to undergo CPM. Age was found to be a significant predictor of CPM, with younger women found to be significantly more likely to undergo CPM compared with older women (P < .0001). The rate of CPM was significantly higher in women with noninvasive breast cancer compared with those with invasive breast cancer (P < .0001). Women who elected to undergo CPM had lower levels of presurgical breast satisfaction (P = .01) and optimism (P = .05) compared with women who did not undergo CPM.Conclusions: Psychosocial functioning at the time of breast cancer surgery decision making impacts decisions related to CPM. Women who have lower levels of breast satisfaction (body image) and optimism are more likely to elect to undergo CPM. It is important for health care providers to take psychosocial functioning into consideration when discussing surgical options. [ABSTRACT FROM AUTHOR]

Background: Management of breast disease is an integral component of general surgery. This study was performed to describe the exposure to breast disease by residents in Canadian general surgery programs. Methods: This study involved a 20-item survey and pilot semistructured interviews. Surgical trainees at 12 training programs in Canada participated in the survey. Results were used to characterize resident experience with breast surgery and clinics. Results: Residents across all post-graduate training years and from 12 Canadian medical schools responded ( n = 162, 44 %). Residents had the most breast surgery experience in PGY2 and PGY3 years. One third of trainees performed ≤1 breast procedure per month. Only 25 % had attended more than one breast clinic per month. Lumpectomies were the most common procedure (20.7/year) and 94 % of residents performed sentinel lymph node biopsy. Four pilot semistructured interviews were performed. The greatest stated barriers to breast training were 'lack of time' and the impression that these were 'lower priority cases.' Conclusions: Achieving competence in breast disease management is a key requirement for general surgery trainees. Surgical educators must ensure that the quality and quantity of residency training in breast diseases is sufficient for future surgeons to provide optimal patient care. [ABSTRACT FROM AUTHOR]

BACKGROUND: A family history of breast cancer has been shown to affect psychosocial functioning. However, the majority of research has focused on the daughters of patients with breast cancer and families with multiple relatives with the disease. The purpose of the current study was to examine cancer-related distress and breast cancer risk perception, and further examine the predictors of these outcomes, in the sisters of newly diagnosed patients with breast cancer without a previous family history of the disease. METHODS: Sisters of newly diagnosed index breast cancer patients were identified and asked to complete a study-specific questionnaire (demographics and cancer risk perception) and the Impact of Events Scale. Pathological information was abstracted from the medical chart for the index breast cancer patients. RESULTS: A total of 205 sisters completed the questionnaires. The mean time between breast cancer diagnosis and the sisters' completion of the questionnaire was 9.8 months. Approximately one-half of the women scored in the moderate or severe distress range. The most significant predictor of cancer-related distress was perceived lifetime breast cancer risk ( P = .04). Women with a lifetime risk of breast cancer > 20% were more than twice as likely to have moderate or severe distress compared with those with a lifetime risk of < 20%. CONCLUSIONS: Cancer-related distress is high in the sisters of newly diagnosed patients with breast cancer in whom there is no other family history of breast cancer. Specifically, women with a perceived lifetime risk of breast cancer of > 20% experienced the highest levels of distress. Future interventions that target this group should be considered. Cancer 2013. © 2013 American Cancer Society. [ABSTRACT FROM AUTHOR]

The article discusses a pilot study which examined the Encounter Critique Module (ECM) learning tool for familiarising students with the clinical breast examination (CBE) through critiquing or performance feedback. Topics include a review of clinical literature that led to the development of a list of best practice for CBE, student recruitment at the University of Toronto, and the potential of the tool to address the challenges of undergraduate students associated with CBE.