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Objective: To evaluate the psychosocial situation of breast cancer (BC) patients with dependent children, with regard to who used family‐centered psychosocial support (PS) services, reasons against using it, as well as existing, unmet needs, and current PS need. Methods: Data were collected via survey and patient files during an inpatient rehabilitation program for mothers with BC, who were accompanied by a child <12 years. Descriptive statistics and tests for statistical significance were used. Results: Out of the total of 561 patients, 23.0% had used family‐centered PS services before. Common reasons against it were enough support, no anticipated need and organizational issues. Patients stated a high number of unmet needs. The most urgent ones related to their children. About 59.3% of mothers stated a current PS need (PSN) and 33.3% a need for their children. Little social support and a worse maternal HRQOL, but not time since diagnosis, were related to a higher PSN in mothers and children (bivariate association). Conclusion: Among BC patients with dependent children, clinicians need to take the whole family and their support needs into account. They should know about the existing organizational barriers, which need to be overcome with the help of tailored offers. Patients with low HRQOL, little social support and single‐mothers (with regard to children's PSN) need special attention as these can be indicators of high PSN. [ABSTRACT FROM AUTHOR]

Background: Breast cancer in young women is associated with unfavourable tumour biology and is the main cause of death in this group. Conditional survival analysis estimates survival rates under the pre-condition of already having survived a certain time. Objectives: To describe conditional disease-free and overall survival of female breast cancer patients according to clinical subtypes and age. Methods: This study analyses information from 1,858 breast cancer patients aged between 21 and 54 years, who were taking part in a post-therapeutic rehab programme (time between diagnosis and rehab start: maximum 24, median 11 months). Mean follow-up time was 3.6 years. We describe biological, clinical and pathological features in regard to different age groups (<40 and ≥40 years) and report conditional 5-year survival rates for overall and disease-free survival, and Cox proportional hazard models. Results: Very young and young patients differed in regard to hormone receptor negativity, tumour grade, lymphovascular invasion, and molecular subtypes. Young women bore triple-negative and HER2-like disease more frequently. Conditional 5-year overall survival did not differ substantially between women <40 and 40–54 years of age (95 vs. 96%). It was highest for women with cancer of the luminal A subtype (98%) and lowest for the triple-negative subtype (91%). Lymphangiosis was a significant predictor of death. Results for disease-free survival were comparable. Conclusions: Conditional 5-year overall survival after non-metastatic breast cancer was as high as 95.5%, and disease-free survival was 85.2%. When controlling for time between diagnosis and rehab start, molecular subtypes influenced overall and disease-free survival prospects. When additionally controlling for clinical characteristics, this effect only remained stable for disease-free survival. [ABSTRACT FROM AUTHOR]

Background: Complementary and alternative medicine (CAM) has received increasing attention in Western countries and is especially common among breast cancer (BC) patients. So far, its effectiveness has not been well studied, which is in part due to the contextuality of CAM along with a lack of information of why patients use it. Objectives: Young BC patients constitute a special patient group regarding clinical characteristics, QOL, and their role in society. Since little is known about their CAM use, this study aimed at exploring it as well as their reasons for CAM use. Methods: Data on CAM and sociodemographics were collected via questionnaire in the context of a rehabilitation program for young mothers with BC. Initial BC diagnoses were between 2009 and 2014 (recruitment period 2012–2015). Clinical characteristics were derived from the patient files. Descriptive statistics were used to describe frequencies and statistically significant differences were tested. Results: Among the 827 patients, with an average age of 39.6 years, 62.5% had used CAM with regard to their cancer. CAM use was significantly higher in women with higher educational level, higher employment status, and statutory health insurance, respectively. The average monthly expenses on CAM were EUR 50. Every 5th woman used CAM without her physician's knowledge. The types most often used were dietary supplements with vitamins or minerals. The most frequent reasons for CAM use were to strengthen the immune system, support conventional medicine, and combat side effects. Conclusions: CAM plays an important role for young BC patients with regard to prevalence and monthly expenses, and was used for a wide range of reasons. Certain subgroups with more frequent CAM use could be identified. Physicians should therefore proactively talk about CAM with their young BC patients, so that patients do not need to rely on information sources on CAM outside the medical system. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to analyze the effect of breast cancer therapy on fertility concerns and sexuality of young mothers with breast cancer in Germany. Methods: During a mother-child rehabilitation program, 1,191 young mothers with locoregional primary breast cancer, treated between 2006 and 2014, were recruited. Data included sociodemographic data, TNM stage, tumor biology, therapies, and patient-reported outcomes such as sexuality and fertility concerns. Results: The mean age at diagnosis was 40 years. Approximately a quarter of the patients stated that family planning had not been completed at the time of diagnosis. Nearly half of all patients had been informed as to how treatment could affect fertility, but counseling at a specialized fertility center was offered to only 13%. Of all patients, 4% took a consultation and 2% underwent fertility preservation procedures. Conclusion: Our study indicates that only a minority of patients is referred to fertility centers although family planning is incomplete at the time of diagnosis in about 25% of young women with breast cancer. Thus, these patients should not only be informed about the effects of treatment on fertility and sexuality, but should be referred to a fertility center. [ABSTRACT FROM AUTHOR]

Background: Infection with human papillomavirus (HPV) is one of the more common sexually transmitted diseases in Germany. Vaccination against HPV was introduced in Germany in 2007. In this study, we sought to detect a population-based decline in the incidence of cervical cancer in women under age 30 who were eligible for vaccination in the first 11 years after its introduction., Methods: Data on new diagnoses of HPV-associated cervical cancer from 2004 to 2018 were obtained from the cancer registries of the German federal states (Bundesländer) through the German Center for Cancer Registry Data (ZfKD). Trends in the incidence of invasive and in situ cervical cancer were determined with log-linear joinpoint regression and age-period-cohort models., Results: The incidence of cervical cancer, which had been rising in the previous decades, has been falling since 2010, with a marked decline among women in all age groups eligible for vaccination (e.g., from 70.0 to 41.8 cases per 100 000 persons per year from 2010 to 2018 in women aged 24 to 26). Women born in 1992 were the first to become eligible for vaccination and have a 24% lower incidence than the reference cohort of women born in 1989 (relative risk 0.76, 95% confidence interval [0.68; 0.86]). Larger effects were found in later birth cohorts, in which vaccination was more widespread., Conclusion: Eleven years after the introduction of HPV vaccination, a drop in the incidence of cervical cancer was observable at the population level in the birth cohorts eligible for vaccination.

Objective: The extent to which cancer patients are well-informed can have manifold effects. The aim of this study was to explore both the sources of information that young breast cancer patients with children use and how they evaluate the information obtained., Methods: Participants were recruited within a rehabilitation program for young mothers with non-metastatic breast cancer (the Groemitz project "gemeinsam gesund werden"). Data on information seeking, the level of information, socio-demographic data and clinical characteristics were collected using a questionnaire., Results: The patients (n=827) used several additional sources of information - most frequently the internet (69.5%; n=767). The majority felt well informed about their disease and found the information provided easy to understand. A social gradient was observed in relation to media use, information evaluation and obtaining a second opinion., Conclusion: To young breast cancer patients, the internet is crucial for obtaining further information. The indication of a social gradient underlines the importance of addressing the information needs of patients with a lower socioeconomic status., (Copyright © 2018. Published by Elsevier GmbH.)