Shahpar Haghighat - Academia.edu (original) (raw)

Papers by Shahpar Haghighat

Introduction: This study aimed to evaluate the effects of yoga on lymphedema volume, range of mot... more Introduction: This study aimed to evaluate the effects of yoga on lymphedema volume, range of motion and quality of life (QOL) in women with Breast Cancer Related

Iranian Journal of Breast Disease, 2017

Introduction: The status of the axillary lymph node is the most important factor in determining t... more Introduction: The status of the axillary lymph node is the most important factor in determining the prognosis of breast cancer. The aim of this study was to evaluate the sensitivity and specificity of Axillary Ultrasound (AUS) in the diagnosis of lymph node involvement in breast cancer patients referred to the Breast Cancer Research Center (BCRC) between March 2015 and Aug 2016. Methods: Through a cross sectional study, all patients with a diagnosis of non-metastatic breast cancer with Stage I, II, IIIA and no chemotherapy before surgery were evaluated. The results of AUS and pathology after surgery were collected and analyzed using SPSS based on sensitivity and specificity formula. Results: Of a total of 140 patients, the average age was 48.87 and the mean size of masses was 2.31 cm (0.4 -10 cm). Physical examination was positive in %14.6 of patients, positive AUS in %28.6 and pathologic axillary involvement in %39.2 of the patients. Sensitivity, specificity, PPV and NPV of AUS in ...

Iranian Quarterly Journal of Breast Diseases, 2020

Iranian Journal of Breast Disease, 2017

Introduction: In spite of high prevalence of lymphedema in Iranian breast cancer patients, there ... more Introduction: In spite of high prevalence of lymphedema in Iranian breast cancer patients, there is no valid instrument for measuring Quality of Life and its subscles in them. The aim of this study was Psychometrics of Persian Version of the Lymphedema Life Impact Scale (LLIS) Questionnaire in breast cancer induced lymphedema to provide an applicable instrument. Methods: LLIS is an 18-item measure of physical, psychosocial, and functional impairments caused by lymphedema. The Persian version was validated by forward-backward method. It was fulfilled by 200 breast cancer patients with lymphedema and 200 patients without lymphedema. Accuracy of all questions and subscales of translated questionnaire in estimating outcome was evaluated by Confirmatory and Exploratory factor analysis. Results: Confirmatory Factor Analysis approeved the hypothesis of similarity of two questionnaire in predictiong the outcome. CFI and RSMA indices showed good fitness of correlation between 18 Items. Explo...

Iranian Quarterly Journal of Breast Diseases, 2020

Introduction: Therapies for many of diseases, especially cancer, have been improved significantly... more Introduction: Therapies for many of diseases, especially cancer, have been improved significantly in the recent years, resulting in an increase in the number of patients who do not experience mortality. Therefore, the application of cure models is more suitable for survival analysis in this population than the usual survival models are. The aim of this study was to estimate the recurrence-free cure rate of breast cancer using the Poisson Beta Weibull (PBW) cure model and to determine the correlating factors. Methods: The data for this study came from a cohort of 271 breast cancer patients who had visited Motamed Cancer Institute, Tehran, between 1997 and 2006 and were followed up from 2013 to 2017. In this study, the time interval between diagnosis and recurrence of the disease was calculated, and the effect of factors was estimated using a Cox survival model as the most common method of survival analysis. Then, by calculating the cure rate from recurrence, the effect of factors on patients' survival and cure was analyzed using Weibull and PBWcure models. Data were analyzed using R, v 3.4.1, at a significance level of 5%. Results: The results showed that 17 (6.3%) of patients experienced relapse after treatment. One-, 3-, and 5-year survival rates for the patients were 0.97, 0.96, and 0.93, respectively. The results of this study showed that PBW Model has a better fit to data with the smallest AIC. Based on this model, estrogen receptor positivity was a significant factor affecting patients' cure (HR = 0.27) and the cure fraction was estimated to be 92%. Conclusion: Estrogen receptor positivity is the most important factor affecting patients' cure. The Poisson Beta Weibull cure model has a better fit to data. Since the model analyzes factors affecting both survival and cure, using this model is recommended in the analysis of the events with low incidence.

Research in Medicine, 2018

Background: : Therapies for many diseases especially cancers have been improved significantly in ... more Background: : Therapies for many diseases especially cancers have been improved significantly in the recent year, so there have been an increased number of patients who do not experience mortality. In the analysis of these diseases, cure models are used instead of usual survival models. Weibull model and its generalized version, beta Weibull Poisson (BWP), are flexible models in cure models and are used in the present study to analyze breast cancer patients data. Materials and Methods: The data of the present descriptive study are from patients with breast cancer, who referred to Motamed Cancer Institute in Tehran during 1997-2006 and were followed from 2013 to 2017. A total of 270 patients were randomly selected and their individual characteristics were registered. The data were analyzed using Stata 12 and R3.4.1 softwares with the the significance level set at 0.05. Results: The results showed that 43 (15.9%) of patients deaths occurred after treatment. The rate of cure after one, three, and five years were found to be 0.99, 0.87, and 0.83 respectively. The results of the current study showed that PBW Non-Mixture Cure Model (AIC=427) has better fit compared with weibull (AIC=593). Based on this model, variables of tumor size greater than 5 (P<0.001) and tumor grade 3 (P<0.001) are factors affecting patients cured. Also, the cure rate was estimated to be 80%. Conclusion: By studying the effects of factors affecting the occurrence of death, considering the unknown number of causes and using BWP models, the cancer trend can better be analyzed and more accurate information can be available for researchers.

Health and Quality of Life …, 2003

The Functional Assessment of Chronic Illness Therapy (FACIT) Measurement System is a collection o... more The Functional Assessment of Chronic Illness Therapy (FACIT) Measurement System is a collection of health-related quality of life (HRQOL) questionnaires targeted to the management of chronic illness. The measurement system, under development since 1987, began with the creation of a generic CORE questionnaire called the Functional Assessment of Cancer Therapy-General (FACT-G). The FACT-G (now in Version 4) is a 27-item compilation of general questions divided into four primary QOL domains: Physical Well-Being, Social/Family Well-Being, Emotional Well-Being, and Functional Well-Being. It is appropriate for use with patients with any form of cancer, and extensions of it have been used and validated in other chronic illness condition (e.g., HIV/AIDS; multiple sclerosis; Parkinson's disease; rheumatoid arthritis), and in the general population. The FACIT Measurement System now includes over 400 questions, some of which have been translated into more than 45 languages. Assessment of any one patient is tailored so that the most-relevant questions are asked and administration time for any one assessment is usually less than 15 minutes. This is accomplished both by the use of specific subscales for relevant domains of HRQOL, or computerized adaptive testing (CAT) of selected symptoms and functional areas. FACIT questionnaires can be administered by self-report (paper or computer) or interview (face-to-face or telephone). Available scoring, normative data and information on meaningful change now allow one to interpret results in the context of a growing literature base. Review What is the FACIT Measurement System? The FACIT Measurement System is a collection of healthrelated quality of life (HRQOL) questionnaires targeted to the management of chronic illness. "FACIT" (Functional Assessment of Chronic Illness Therapy) was adopted as the formal name of the measurement system in 1997 to portray the expansion of the familiar "FACT" (Functional Assessment of Cancer Therapy) questionnaires into other chronic illnesses and conditions.

Patient education and …, 2007

OBJECTIVE: This study compares telephone consultations with the results of clinical examinations ... more OBJECTIVE: This study compares telephone consultations with the results of clinical examinations to assess the value and accuracy of telephone consultations for the future planning in a breast cancer clinic in Tehran, Iran. METHODS: In 2500 telephone calls, 800 Symptomatic ...

Iranian Quarterly Journal of Breast Diseases

Introduction: Breast cancer-related lymphedema is a chronic swelling accompanied by physical disc... more Introduction: Breast cancer-related lymphedema is a chronic swelling accompanied by physical discomfort and prolonged treatment negatively affecting patients' quality of life (QoL). Self-management is a vital phase in managing the results of treatment. So, the study aims to compare the effect of in-person and virtual self-management education on women's quality of life. Methods: This was a randomized clinical trial conducted on 70 women with breast cancer-related lymphedema in the last one year, attending to Seyed_Khandan rehabilitation center in Tehran. Sampling was done by random allocation method in blocks of 2 with 35 subjects in each group. All subjects received routine lymphedema treatment. The in-person and virtual groups received the education at the clinic and the Telegram messenger, respectively. QoL was assessed using the Persian version of EORTC QLQ-C30 and QLQ-BR23 questionnaires on before, immediately, and three months after the intervention. Results: The mean age of the individuals was 51.42±9.71. Most subjects were married, had a diploma or higher, and the mean duration of lymphedema was 6.88 months. At the end of the study compared to the beginning of the study, physical, role, emotional and social functions decreased significantly in the virtual group compared with the in-person group. In this way, the status of the mentioned variables in the in-person group was better than the virtual one (P=0.006, P=0.026, P=0.014, P=0.023, respectively). Three months after the intervention, median scores on global health (P=0.21), physical functioning (P=0.004), role functioning (P=0.009), emotional functioning (P<0.001), social functioning (P=0.048) were still significantly greater for the in-person group. Also, the in-person group had a greater reduction in the median scores of systemic therapy side effects (P=0.002) and arm symptoms (P=0.45) compare with the virtual group. Conclusion: Self-management education led to improved quality of life, and in the comparison between the two methods, in-person method was more effective than virtual method. However, further studies are needed to investigate the efficacy and cost-effectiveness of both methods in educating patients with lymphedema.

Background: The present study aimed to review the existing cellular and molecular research system... more Background: The present study aimed to review the existing cellular and molecular research systematically carried out in the field of breast cancer in Iran. This study was part of a big project, which evaluated a variety of studies conducted on breast cancer in Iran.Methods: All molecular articles about breast cancer in Iran which were published from January 2005 to October 21, 2015 were included. English and Persian databases consisted of Web of Science, PubMed, Scopus, Scientific Information Database (SID) and IranMedex. Finally of 3331 abstracts, a total of 379 articles, including 219 English and 160 Persian papers related to molecular studies were included in this study.Results: After initial evaluations, 240 studies were included. Molecular studies conducted in Iran were divided into four main groups based on their focus. They evaluated breast cancer susceptibility genes, Prognosis and clinicopathologic features of the patients, compounds with therapeutic properties, and diagno...

Background: The objective of this study was to compare the efficacy and side effects of to evalua... more Background: The objective of this study was to compare the efficacy and side effects of to evaluate the efficacy and safety of a single dose (Peg-Filgrastim or PDL) or repeated six daily injections (Filgrastim or PDG) during chemotherapy courses in breast cancer patients in a non-inferiority clinical trial.Methods: In this randomized clinical trial, 80 patients recruited and allocated randomly in two equal arms. In one group, a single subcutaneous dose of 6 mg of PDL was injected the day after receiving a chemotherapy regimen in each cycle. The second arm received a subcutaneous injection of 300 micrograms per day for six consecutive days in each course of treatment. Side effects of GCF treatment and its effect on blood parameters were compared in each cycle and during eight courses of chemotherapy.Results: hematologic parameters showed no significant difference in each course of treatment between two groups of study. The comparison of the WBC (p=0.527), Hgb (p=0.075), Platelet (p=0...

Background: Sexual and reproductive health problems significantly decrease quality of life in sur... more Background: Sexual and reproductive health problems significantly decrease quality of life in survivors of breast cancer. The best approach is to provide services according to evidence based guidelines developed based on their practical context. Here, we aim to develop and validate a guideline on the sexual and reproductive health of breast cancer survivors in Iran.Methods: The guideline will be developed and validated using an exploratory sequential mixed methods approach in four phases: 1) describing sexual and reproductive health needs of survivors of breast cancer in Iran and the health services they receive in this regard 2) performing a systematic review of existing guidelines, resources, and documents on the sexual and reproductive health of breast cancer survivors worldwide 3) developing a guideline on the sexual and reproductive health of women who survived breast cancer in Iran based on the results of phase one and two 4) validating the guideline developed in phase three w...

Multidisciplinary Cancer Investigation

Introduction: Breast cancer is a tragic experience that accompanies stressful situations for pati... more Introduction: Breast cancer is a tragic experience that accompanies stressful situations for patients. Adjustment with breast cancer has a significant effect on decreasing stress and increasing the patients› quality of life. Methods: In a prospective cross-sectional study, breast cancer patients› experiences were evaluated at Breast Cancer Research Center (BCRC), Motamed Cancer Institut (MCI), Tehran, Iran. To evaluate coping strategies in breast cancer patients, a modified Ways of Coping-cancer Version (WOC-CA) questionnaire was used. A written informed consent was obtained from the patients. Results: From a total of 187 breast cancer patients participated in this study, 177 cases followed up for 6 months later. The mean age of the patients was 47.3 ± 9.6 years. Eighty-seven percent of the patients were married, 91% of the subjects had middle and high education and most of them (83%) were housewife. Seven coping strategies were used by the patients after diagnosis and 6 months later. The most commonly used coping strategies after diagnosis included «seeking for social support», «spirituality», and «positive cognitive restructuring» and the least used coping strategy was «detachment». The most frequently used strategies 6 months after the diagnosis were «seeking for social support», «spirituality», «positive cognitive restructuring», and «making changes» and the least commonly used ones included «wishful thinking», and «keeping feelings to self-coping strategies». Conclusions: It seems that clinicians should provide enough information about the treatment and survival before the surgery. The patients› concerns about the way of adjustment with the disease, especially religious thinking and advices about the way of coping with breast cancer should be considered.

International Surgery Journal

Background: Breast cancer is a common malignant tumor and treatment predominantly consists of sur... more Background: Breast cancer is a common malignant tumor and treatment predominantly consists of surgery. Modern society has increased the demands of women to have higher requirements for breast appearance and quality of life. Therefore, exploring effective measures to control or reduce the rate of loco-regional recurrence (LRR) after breast conserving surgery (BCS) is the main focus of this study.Methods: This cohort included 743 consecutive patients with invasive breast cancer, treated with BCS in 2 centers in Tehran, Iran between 2005 and 2010. The primary endpoint was the rate of loco-regional recurrence in a 5-year follow- up period. Authors also investigated the factors that could predict LRR after BCS.Results: The prevalence of LRR after BCS was 7.6% in a median follow-up of 56.9 months. The Median time to local recurrence was 20.45 months. A correlation between follow-up outcome and age; histologic sub-type; surgical margin; number of positive nodes; complete pathologic respo...

International Journal of Cancer Management

Quality of Life Research

Background Breast cancer-related lymphedema (BCRL) and its associated symptoms harm the quality o... more Background Breast cancer-related lymphedema (BCRL) and its associated symptoms harm the quality of life (QoL) of cancer survivors and can stimulate fear of cancer recurrence (FCR). Self-management education for lymphedema has been introduced as an effective method in controlling FCR. This study investigates the effect of lymphedema group-based education compared to the social network-based and control group on QoL and FCR in breast cancer patients. Methods This three-arm clinical trial studied 105 patients with breast cancer-related lymphedema referred to Seyed_Khandan rehabilitation center. Sampling was done by random allocation method in blocks of 3 with 35 subjects in each group. All subjects received routine lymphedema treatments. The group-based education (GE) and social network-based education (SNE) groups received self-management education in the clinic and Telegram™ messenger channel, respectively. Impairment in QoL and mean score of FCR were assessed before, immediately aft...

Breast Cancer: Basic and Clinical Research

Background: Using data from different health centers can provide more accurate knowledge of the s... more Background: Using data from different health centers can provide more accurate knowledge of the survival prognostic factors and their effect on the patient’s survival. In this multicenter study, we aimed to investigate the role of prognostic factors on breast cancer survival with large data set. Methods: This historical cohort study was carried out using data from 1785 participants with breast cancer. Data were gathered from medical records of patients referring to 4 breast cancer research centers in Tehran, Iran, between 1997 and 2013. Age at diagnosis (year), size of the tumor, involve lymph nodes, tumor grade, type of surgery, auxiliary treatment of chemotherapy, radiotherapy, recurrence, and metastasis were the prognosis factors considered in this study. A shared frailty model with a gamma distribution for frailty term was used. Results: The median follow-up period was 29.71 months with the interquartile range of 19 to 61 months. During the follow-up period, 337 (18.9%) patients...

International Journal of Cancer Management

Introduction: This study aimed to evaluate the effects of yoga on lymphedema volume, range of mot... more Introduction: This study aimed to evaluate the effects of yoga on lymphedema volume, range of motion and quality of life (QOL) in women with Breast Cancer Related

Iranian Journal of Breast Disease, 2017

Introduction: The status of the axillary lymph node is the most important factor in determining t... more Introduction: The status of the axillary lymph node is the most important factor in determining the prognosis of breast cancer. The aim of this study was to evaluate the sensitivity and specificity of Axillary Ultrasound (AUS) in the diagnosis of lymph node involvement in breast cancer patients referred to the Breast Cancer Research Center (BCRC) between March 2015 and Aug 2016. Methods: Through a cross sectional study, all patients with a diagnosis of non-metastatic breast cancer with Stage I, II, IIIA and no chemotherapy before surgery were evaluated. The results of AUS and pathology after surgery were collected and analyzed using SPSS based on sensitivity and specificity formula. Results: Of a total of 140 patients, the average age was 48.87 and the mean size of masses was 2.31 cm (0.4 -10 cm). Physical examination was positive in %14.6 of patients, positive AUS in %28.6 and pathologic axillary involvement in %39.2 of the patients. Sensitivity, specificity, PPV and NPV of AUS in ...

Iranian Quarterly Journal of Breast Diseases, 2020

Iranian Journal of Breast Disease, 2017

Introduction: In spite of high prevalence of lymphedema in Iranian breast cancer patients, there ... more Introduction: In spite of high prevalence of lymphedema in Iranian breast cancer patients, there is no valid instrument for measuring Quality of Life and its subscles in them. The aim of this study was Psychometrics of Persian Version of the Lymphedema Life Impact Scale (LLIS) Questionnaire in breast cancer induced lymphedema to provide an applicable instrument. Methods: LLIS is an 18-item measure of physical, psychosocial, and functional impairments caused by lymphedema. The Persian version was validated by forward-backward method. It was fulfilled by 200 breast cancer patients with lymphedema and 200 patients without lymphedema. Accuracy of all questions and subscales of translated questionnaire in estimating outcome was evaluated by Confirmatory and Exploratory factor analysis. Results: Confirmatory Factor Analysis approeved the hypothesis of similarity of two questionnaire in predictiong the outcome. CFI and RSMA indices showed good fitness of correlation between 18 Items. Explo...

Iranian Quarterly Journal of Breast Diseases, 2020

Introduction: Therapies for many of diseases, especially cancer, have been improved significantly... more Introduction: Therapies for many of diseases, especially cancer, have been improved significantly in the recent years, resulting in an increase in the number of patients who do not experience mortality. Therefore, the application of cure models is more suitable for survival analysis in this population than the usual survival models are. The aim of this study was to estimate the recurrence-free cure rate of breast cancer using the Poisson Beta Weibull (PBW) cure model and to determine the correlating factors. Methods: The data for this study came from a cohort of 271 breast cancer patients who had visited Motamed Cancer Institute, Tehran, between 1997 and 2006 and were followed up from 2013 to 2017. In this study, the time interval between diagnosis and recurrence of the disease was calculated, and the effect of factors was estimated using a Cox survival model as the most common method of survival analysis. Then, by calculating the cure rate from recurrence, the effect of factors on patients' survival and cure was analyzed using Weibull and PBWcure models. Data were analyzed using R, v 3.4.1, at a significance level of 5%. Results: The results showed that 17 (6.3%) of patients experienced relapse after treatment. One-, 3-, and 5-year survival rates for the patients were 0.97, 0.96, and 0.93, respectively. The results of this study showed that PBW Model has a better fit to data with the smallest AIC. Based on this model, estrogen receptor positivity was a significant factor affecting patients' cure (HR = 0.27) and the cure fraction was estimated to be 92%. Conclusion: Estrogen receptor positivity is the most important factor affecting patients' cure. The Poisson Beta Weibull cure model has a better fit to data. Since the model analyzes factors affecting both survival and cure, using this model is recommended in the analysis of the events with low incidence.

Research in Medicine, 2018

Background: : Therapies for many diseases especially cancers have been improved significantly in ... more Background: : Therapies for many diseases especially cancers have been improved significantly in the recent year, so there have been an increased number of patients who do not experience mortality. In the analysis of these diseases, cure models are used instead of usual survival models. Weibull model and its generalized version, beta Weibull Poisson (BWP), are flexible models in cure models and are used in the present study to analyze breast cancer patients data. Materials and Methods: The data of the present descriptive study are from patients with breast cancer, who referred to Motamed Cancer Institute in Tehran during 1997-2006 and were followed from 2013 to 2017. A total of 270 patients were randomly selected and their individual characteristics were registered. The data were analyzed using Stata 12 and R3.4.1 softwares with the the significance level set at 0.05. Results: The results showed that 43 (15.9%) of patients deaths occurred after treatment. The rate of cure after one, three, and five years were found to be 0.99, 0.87, and 0.83 respectively. The results of the current study showed that PBW Non-Mixture Cure Model (AIC=427) has better fit compared with weibull (AIC=593). Based on this model, variables of tumor size greater than 5 (P<0.001) and tumor grade 3 (P<0.001) are factors affecting patients cured. Also, the cure rate was estimated to be 80%. Conclusion: By studying the effects of factors affecting the occurrence of death, considering the unknown number of causes and using BWP models, the cancer trend can better be analyzed and more accurate information can be available for researchers.

Health and Quality of Life …, 2003

The Functional Assessment of Chronic Illness Therapy (FACIT) Measurement System is a collection o... more The Functional Assessment of Chronic Illness Therapy (FACIT) Measurement System is a collection of health-related quality of life (HRQOL) questionnaires targeted to the management of chronic illness. The measurement system, under development since 1987, began with the creation of a generic CORE questionnaire called the Functional Assessment of Cancer Therapy-General (FACT-G). The FACT-G (now in Version 4) is a 27-item compilation of general questions divided into four primary QOL domains: Physical Well-Being, Social/Family Well-Being, Emotional Well-Being, and Functional Well-Being. It is appropriate for use with patients with any form of cancer, and extensions of it have been used and validated in other chronic illness condition (e.g., HIV/AIDS; multiple sclerosis; Parkinson's disease; rheumatoid arthritis), and in the general population. The FACIT Measurement System now includes over 400 questions, some of which have been translated into more than 45 languages. Assessment of any one patient is tailored so that the most-relevant questions are asked and administration time for any one assessment is usually less than 15 minutes. This is accomplished both by the use of specific subscales for relevant domains of HRQOL, or computerized adaptive testing (CAT) of selected symptoms and functional areas. FACIT questionnaires can be administered by self-report (paper or computer) or interview (face-to-face or telephone). Available scoring, normative data and information on meaningful change now allow one to interpret results in the context of a growing literature base. Review What is the FACIT Measurement System? The FACIT Measurement System is a collection of healthrelated quality of life (HRQOL) questionnaires targeted to the management of chronic illness. "FACIT" (Functional Assessment of Chronic Illness Therapy) was adopted as the formal name of the measurement system in 1997 to portray the expansion of the familiar "FACT" (Functional Assessment of Cancer Therapy) questionnaires into other chronic illnesses and conditions.

Patient education and …, 2007

OBJECTIVE: This study compares telephone consultations with the results of clinical examinations ... more OBJECTIVE: This study compares telephone consultations with the results of clinical examinations to assess the value and accuracy of telephone consultations for the future planning in a breast cancer clinic in Tehran, Iran. METHODS: In 2500 telephone calls, 800 Symptomatic ...

Iranian Quarterly Journal of Breast Diseases

Introduction: Breast cancer-related lymphedema is a chronic swelling accompanied by physical disc... more Introduction: Breast cancer-related lymphedema is a chronic swelling accompanied by physical discomfort and prolonged treatment negatively affecting patients' quality of life (QoL). Self-management is a vital phase in managing the results of treatment. So, the study aims to compare the effect of in-person and virtual self-management education on women's quality of life. Methods: This was a randomized clinical trial conducted on 70 women with breast cancer-related lymphedema in the last one year, attending to Seyed_Khandan rehabilitation center in Tehran. Sampling was done by random allocation method in blocks of 2 with 35 subjects in each group. All subjects received routine lymphedema treatment. The in-person and virtual groups received the education at the clinic and the Telegram messenger, respectively. QoL was assessed using the Persian version of EORTC QLQ-C30 and QLQ-BR23 questionnaires on before, immediately, and three months after the intervention. Results: The mean age of the individuals was 51.42±9.71. Most subjects were married, had a diploma or higher, and the mean duration of lymphedema was 6.88 months. At the end of the study compared to the beginning of the study, physical, role, emotional and social functions decreased significantly in the virtual group compared with the in-person group. In this way, the status of the mentioned variables in the in-person group was better than the virtual one (P=0.006, P=0.026, P=0.014, P=0.023, respectively). Three months after the intervention, median scores on global health (P=0.21), physical functioning (P=0.004), role functioning (P=0.009), emotional functioning (P<0.001), social functioning (P=0.048) were still significantly greater for the in-person group. Also, the in-person group had a greater reduction in the median scores of systemic therapy side effects (P=0.002) and arm symptoms (P=0.45) compare with the virtual group. Conclusion: Self-management education led to improved quality of life, and in the comparison between the two methods, in-person method was more effective than virtual method. However, further studies are needed to investigate the efficacy and cost-effectiveness of both methods in educating patients with lymphedema.

Background: The present study aimed to review the existing cellular and molecular research system... more Background: The present study aimed to review the existing cellular and molecular research systematically carried out in the field of breast cancer in Iran. This study was part of a big project, which evaluated a variety of studies conducted on breast cancer in Iran.Methods: All molecular articles about breast cancer in Iran which were published from January 2005 to October 21, 2015 were included. English and Persian databases consisted of Web of Science, PubMed, Scopus, Scientific Information Database (SID) and IranMedex. Finally of 3331 abstracts, a total of 379 articles, including 219 English and 160 Persian papers related to molecular studies were included in this study.Results: After initial evaluations, 240 studies were included. Molecular studies conducted in Iran were divided into four main groups based on their focus. They evaluated breast cancer susceptibility genes, Prognosis and clinicopathologic features of the patients, compounds with therapeutic properties, and diagno...

Background: The objective of this study was to compare the efficacy and side effects of to evalua... more Background: The objective of this study was to compare the efficacy and side effects of to evaluate the efficacy and safety of a single dose (Peg-Filgrastim or PDL) or repeated six daily injections (Filgrastim or PDG) during chemotherapy courses in breast cancer patients in a non-inferiority clinical trial.Methods: In this randomized clinical trial, 80 patients recruited and allocated randomly in two equal arms. In one group, a single subcutaneous dose of 6 mg of PDL was injected the day after receiving a chemotherapy regimen in each cycle. The second arm received a subcutaneous injection of 300 micrograms per day for six consecutive days in each course of treatment. Side effects of GCF treatment and its effect on blood parameters were compared in each cycle and during eight courses of chemotherapy.Results: hematologic parameters showed no significant difference in each course of treatment between two groups of study. The comparison of the WBC (p=0.527), Hgb (p=0.075), Platelet (p=0...

Background: Sexual and reproductive health problems significantly decrease quality of life in sur... more Background: Sexual and reproductive health problems significantly decrease quality of life in survivors of breast cancer. The best approach is to provide services according to evidence based guidelines developed based on their practical context. Here, we aim to develop and validate a guideline on the sexual and reproductive health of breast cancer survivors in Iran.Methods: The guideline will be developed and validated using an exploratory sequential mixed methods approach in four phases: 1) describing sexual and reproductive health needs of survivors of breast cancer in Iran and the health services they receive in this regard 2) performing a systematic review of existing guidelines, resources, and documents on the sexual and reproductive health of breast cancer survivors worldwide 3) developing a guideline on the sexual and reproductive health of women who survived breast cancer in Iran based on the results of phase one and two 4) validating the guideline developed in phase three w...

Multidisciplinary Cancer Investigation

Introduction: Breast cancer is a tragic experience that accompanies stressful situations for pati... more Introduction: Breast cancer is a tragic experience that accompanies stressful situations for patients. Adjustment with breast cancer has a significant effect on decreasing stress and increasing the patients› quality of life. Methods: In a prospective cross-sectional study, breast cancer patients› experiences were evaluated at Breast Cancer Research Center (BCRC), Motamed Cancer Institut (MCI), Tehran, Iran. To evaluate coping strategies in breast cancer patients, a modified Ways of Coping-cancer Version (WOC-CA) questionnaire was used. A written informed consent was obtained from the patients. Results: From a total of 187 breast cancer patients participated in this study, 177 cases followed up for 6 months later. The mean age of the patients was 47.3 ± 9.6 years. Eighty-seven percent of the patients were married, 91% of the subjects had middle and high education and most of them (83%) were housewife. Seven coping strategies were used by the patients after diagnosis and 6 months later. The most commonly used coping strategies after diagnosis included «seeking for social support», «spirituality», and «positive cognitive restructuring» and the least used coping strategy was «detachment». The most frequently used strategies 6 months after the diagnosis were «seeking for social support», «spirituality», «positive cognitive restructuring», and «making changes» and the least commonly used ones included «wishful thinking», and «keeping feelings to self-coping strategies». Conclusions: It seems that clinicians should provide enough information about the treatment and survival before the surgery. The patients› concerns about the way of adjustment with the disease, especially religious thinking and advices about the way of coping with breast cancer should be considered.

International Surgery Journal

Background: Breast cancer is a common malignant tumor and treatment predominantly consists of sur... more Background: Breast cancer is a common malignant tumor and treatment predominantly consists of surgery. Modern society has increased the demands of women to have higher requirements for breast appearance and quality of life. Therefore, exploring effective measures to control or reduce the rate of loco-regional recurrence (LRR) after breast conserving surgery (BCS) is the main focus of this study.Methods: This cohort included 743 consecutive patients with invasive breast cancer, treated with BCS in 2 centers in Tehran, Iran between 2005 and 2010. The primary endpoint was the rate of loco-regional recurrence in a 5-year follow- up period. Authors also investigated the factors that could predict LRR after BCS.Results: The prevalence of LRR after BCS was 7.6% in a median follow-up of 56.9 months. The Median time to local recurrence was 20.45 months. A correlation between follow-up outcome and age; histologic sub-type; surgical margin; number of positive nodes; complete pathologic respo...

International Journal of Cancer Management

Quality of Life Research

Background Breast cancer-related lymphedema (BCRL) and its associated symptoms harm the quality o... more Background Breast cancer-related lymphedema (BCRL) and its associated symptoms harm the quality of life (QoL) of cancer survivors and can stimulate fear of cancer recurrence (FCR). Self-management education for lymphedema has been introduced as an effective method in controlling FCR. This study investigates the effect of lymphedema group-based education compared to the social network-based and control group on QoL and FCR in breast cancer patients. Methods This three-arm clinical trial studied 105 patients with breast cancer-related lymphedema referred to Seyed_Khandan rehabilitation center. Sampling was done by random allocation method in blocks of 3 with 35 subjects in each group. All subjects received routine lymphedema treatments. The group-based education (GE) and social network-based education (SNE) groups received self-management education in the clinic and Telegram™ messenger channel, respectively. Impairment in QoL and mean score of FCR were assessed before, immediately aft...

Breast Cancer: Basic and Clinical Research

Background: Using data from different health centers can provide more accurate knowledge of the s... more Background: Using data from different health centers can provide more accurate knowledge of the survival prognostic factors and their effect on the patient’s survival. In this multicenter study, we aimed to investigate the role of prognostic factors on breast cancer survival with large data set. Methods: This historical cohort study was carried out using data from 1785 participants with breast cancer. Data were gathered from medical records of patients referring to 4 breast cancer research centers in Tehran, Iran, between 1997 and 2013. Age at diagnosis (year), size of the tumor, involve lymph nodes, tumor grade, type of surgery, auxiliary treatment of chemotherapy, radiotherapy, recurrence, and metastasis were the prognosis factors considered in this study. A shared frailty model with a gamma distribution for frailty term was used. Results: The median follow-up period was 29.71 months with the interquartile range of 19 to 61 months. During the follow-up period, 337 (18.9%) patients...

International Journal of Cancer Management