Breast Cancer Resources

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Breast Cancer Treatment Research and Sources of Information & Support

Kenneth S. Pope, Ph.D., ABPP

I gathered the resources on this page to help people with breast cancer and their loved ones to find information, support, and other resources. These resources are meant to complement and not replace any advice or information from a health care professional.

I created this site to be fully accessible for people with disabilities; please follow this link to change text size, color, or contrast; please follow this link for other accessibility functions for those with visual, mobility, and other disabilities.

There are 3 sections of resources:

1) 20 Books for learning about breast cancer, exploring treatment options, and coping effectively

2) 22 Recent (published in 2021-22) articles on psychological aspects of breast cancer: citations + excerpts

3) Links to 21 web sites providing information and support

PLEASE NOTE: This web site includes other pages of related sets of resources you may find helpful:

20 BOOKS:

22 RECENT ARTICLES (I.E., PUBLISHEd in 2021-2022) ON PSYCHOLOGICAL ASPECTS OF BREAST CANCER (E.G., COGNITIVE CHANGES, ANXIETY, DEPRESSION, POST-TRAUMATIC GROWTH, STRESS MANAGEMENT, QUALITY OF LIFE, PSYCHOSOCIAL & CLINICAL INTERVENTIONS):

Buki, L. P., et al. (2022). "“¿Qué viene después?”: Latina women diagnosed with breast cancer twice." Journal of Latinx Psychology, doi:10.1037/lat0000198.

EXCERPT: "We identified three themes representing major aspects of their experiences: (a) Experiencing the First and Second Diagnoses, (b) Coping with Breast Cancer, and (c) Living With Uncertainty. Although participants transferred coping skills from their first diagnosis to the second, their experience with the second diagnosis was more challenging. Additionally, living with the uncertainty of a third diagnosis represented a chronic challenge. Overall, participants reported many unmet support needs. Findings raise several implications for research as well as clinical practice and advocacy. In future studies, researchers should consider examining separately the experiences of women diagnosed once from those diagnosed twice. Moreover, research is needed to understand whether the current practice of referring women diagnosed twice to a support group with a majority of women diagnosed once adequately addresses their unique needs. Advocacy is needed to ameliorate financial and language barriers as well as to enhance access to health care for this growing population."

 

Cox-Martin, E., et al. (2022). "Psychosocial interventions for pain management in breast cancer survivors: A re-aim evaluation." Journal of Clinical Psychology in Medical Settings: published online in advance of print.

EXCERPT: "Psychosocial interventions for breast-cancer-related pain are effective, yet over 45% of survivors continue to struggle with this often-chronic side effect....  The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework was applied to evaluate reporting of individual and setting/staff-level intervention indicators. A systematic search and multi-step screening process identified 31 randomized controlled trials for psychosocial interventions for breast cancer-related pain. Average reporting of indicators for individual-level dimensions (Reach and Effectiveness) were 65.2% and 62.3%, respectively. Comparatively, indicators for setting/staff-level dimensions were reported at a lower average frequency (Implementation, 46.8%; Adoption, 15.2%; Maintenance, 7.7%). Low reporting of setting/staff-level dimensions suggests gaps in the sustained implementation of psychosocial interventions."

 

Dijkshoorn, A. B. C., et al. (2021). "Prevalence of cognitive impairment and change in patients with breast cancer: A systematic review of longitudinal studies." Psycho-Oncology: Published online in advance of print publication.

EXCERPT: "In general, patients undergoing CT have a higher chance of cognitive impairment and decline than no-CT patients and healthy controls.... This study shows that one out of four breast cancer patients shows cognitive impairment prior to treatment administration CT and a significant number of patients decline during the course of disease, suggesting that cognitive impairment is not exclusively related to CT and/or no-CT therapies. This study shows that assessment of cognitive functioning, ideally over time, is crucial and may help the implementation of personalized rehabilitation pathways."


Dobretsova, A. and N. Derakshan (2021). "Cognitive function and emotional vulnerability in metastatic breast cancer: Moderating effects of age and social support." Psycho-Oncology: Psycho-Oncology: Published online in advance of print publication.

EXCERPT: "This study established a relationship between cognitive function and emotional vulnerability in MBC patients. It emphasised how vulnerable younger MBC women are to post-traumatic stress, and the importance of the combined effects of cognitive function and social support in buffering against depression. Our results have important implications for developing new interventions and treatment plans that consider the roles of these factors in ensuring a better quality of life in MBC."

 

Esmkhani, M., et al. (2021). "Comparison of the effects of the plissit model versus the sexual health model on quality of life among women with breast cancer." Sexuality and Disability: Psycho-Oncology: Published online in advance of print publication.

EXCERPT: "At the baseline, there were no significant differences in dimensions of quality of life between the three groups. Also, at 6 and 12 weeks follow-ups, almost all dimensions of the quality of life in all groups improved significantly (all Ps < 0.001). However, there were no significant differences between the three groups at these phases.... The study revealed that both the PLISSIT Model and grouped SHM have similar effects on improving the quality of life of women."

 

Favez, N. and S. Cairo Notari (2021). "Body image, sexual activity, and side effects of treatments across the first year after surgery in women facing breast cancer: The influence of attachment insecurity." Journal of Psychosocial Oncology: Psycho-Oncology: Published online in advance of print publication.

EXCERPT: "Generalized linear modeling showed that (1) having more avoidant and anxious attachment tendencies predicted a more negative body image, as did being younger and having undergone a mastectomy; (2) having more avoidant attachment tendencies predicted being sexually inactive, as did having undergone neoadjuvant chemotherapy or adjuvant hormonal therapy, whereas being younger and in a committed relationship predicted being sexually active; and (3) attachment tendencies did not predict the intensity of side effects, whereas a higher cancer stage and being at the beginning of treatment predicted more side effects.... Women with avoidant and anxious attachment tendencies may be especially vulnerable to the consequences of oncological treatment, in particular regarding body image and sexual activity.


Garduño-Ortega, O., et al. (2021). "Spiritual well-being, depression, and quality of life among latina breast cancer survivors." Journal of Religion and Health: Psycho-Oncology: Published online in advance of print publication.

EXCERPT: "Cancer survivors often use their spirituality as a way of coping. Among a sample of 97 Latina breast cancer survivors (LBCS), SWB was assessed with the Functional Assessment of Chronic Illness Therapy—Spiritual Well-being Scale, QOL was measured using the Functional Assessment of Cancer Therapy—General (FACT-G), and depression was measured with the Patient Health Questionnaire. Study findings revealed that SWB, specifically the meaning/peace factor, is the main predictor of an increase in QOL and a reduction in depression among LBCS."

 

Gutiérrez-Hermoso, L., et al. (2021). "The effect of treatment and coping on the quality of life in breast cancer patients: A moderated mediation model." Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care & Rehabilitation: Psycho-Oncology: Published online in advance of print publication.

EXCERPT: "Treatment had a significant negative effect on physical domain in both patients receiving chemotherapy and hormone therapy. Moderated mediation analysis show that this relationship was significant when it was mediated by helplessness. Furthermore, this model is only significant when there are high levels of alexithymia. No significant effect direct was found on emotional and social functioning of quality of life.... Results confirmed that coping based on helplessness and stable emotional variables such as alexithymia can have an effect, mediator or moderator, respectively, in the decrease of the physical functionality of women with breast cancer. Our findings highlight the need to include psychological therapy to help patients alleviate their psychological state because it can affect their physical condition."

 

Janelsins, M. C., et al. (2022). "Relationships between cytokines and cognitive function from pre- to post-chemotherapy in patients with breast cancer." Journal of Neuroimmunology 362.

EXCERPT: "We found that concentrations of IL-6, MCP-1, sTNFRI, and sTNFRII significantly increased in patients, while IL-1β significantly decreased (p p < 0.05). Higher baseline IL-6 was associated with better performance on executive function and verbal fluency post chemotherapy (p < 0.05). Overall, these results suggest that chemotherapy-associated increases in cytokines/receptors is associated with worse cognitive function."

 

Jebahi, F., et al. (2021). "Effects of tamoxifen on cognition and language in women with breast cancer: A systematic search and a scoping review." Psycho-Oncology: Psycho-Oncology: Published online in advance of print publication.

EXCERPT: "Tamoxifen affects specific cognitive and language domains. Language domains beyond semantics have not been studied and thus conclusions related to these domains, and language in general, could not be made."

 

Karademas, E. C., et al. (2021). "Cognitive, emotional, and behavioral mediators of the impact of coping self-efficacy on adaptation to breast cancer: An international prospective study." Psycho-Oncology: Published online in advance of print publication.

EXCERPT:"Coping self-efficacy was related to all mediators and outcomes. Illness representations of treatment control, positive and negative affect, and certain coping behaviors (mostly, anxiety preoccupation) mediated the effects of coping self-efficacy. Coping self-efficacy was related to each outcome through a different combination of mediators.... Coping self-efficacy is a major self-regulation factor which is linked to well-being through multiple cognitive, emotional, and behavioral pathways. Enhancement of coping self-efficacy should be a central intervention goal for patients with breast cancer, towards promotion of their well-being."

 

Lengacher, C. A., et al. (2021). "Mindfulness-based stress reduction for breast cancer survivors (mbsr(bc)): Evaluating mediators of psychological and physical outcomes in a large randomized controlled trial." Journal of Behavioral Medicine: Published online in advance of print publication.

EXCERPT: "MBSR(BC) is known to have a positive impact on psychological and physical symptoms among breast cancer survivors (BCS).... Among 322 BCS (167 MBSR(BC) and 155 UC), fear of recurrence and perceived stress, but not mindfulness, mediated reductions in anxiety and fatigue at weeks 6 and 12, partially supporting our hypothesis of cognitive mechanisms of MBSR(BC)."

 

Li, Y., et al. (2021). "Hope and symptom burden of women with breast cancer undergoing chemotherapy: A cross-sectional study." Journal of Clinical Nursing: Published online in advance of print publication.

EXCERPT: "Patients [aged 45 or less], religious beliefs and lighter symptom burden have a higher level of hope. These variables explained a total of 22.9% of the variation in hope.... The level of hope for women undergoing breast cancer chemotherapy still needs to be further improved. Symptom burden can negatively predict hope."

 

Ma, Y., et al. (2021). "Efficacy of cognitive behavioral therapy for insomnia in breast cancer: A meta-analysis." Sleep Medicine Reviews 55.

EXCERPT: "Insomnia is highly prevalent among patients with breast cancer (BC). Although cognitive behavioral therapy for insomnia (CBT-I) is available in integrative oncology settings, it poses unique challenges for BC survivors. Our review aimed to assess the evidence for the therapeutic effects of CBT-I on insomnia in BC. Randomized controlled trials (RCTs) that included patients/survivors with BC and insomnia, and at least one validated self-report measure of sleep quality were included in the review. Of the 14 included RCTs (total N = 1363), the most common components incorporated in CBT-I interventions were sleep hygiene, stimulus control and sleep restriction. Pooled effect sizes favored CBT-I at post-intervention (Hedges' g = −0.779, 95% CI = −0.949, −0.609), short-term follow-up (within six months, Hedges' g = −0.653, 95% CI = −0.808, −0.498), and long-term follow-up (12 mo, Hedges’ g = −0.335, 95% CI = −0.532, −0.139). In sub-analyses, CBT-I had similar effect sizes regardless of potential modifiers (comparison design, delivery formats, etc.). As an integrative oncology intervention, CBT-I is efficacious for reducing insomnia and improving sleep quality in women treated for BC, with medium-to-large effect sizes that persist after intervention delivery ends."

 

Manigault, A. W., et al. (2021). "Vulnerability to inflammation-related depressive symptoms: Moderation by stress in women with breast cancer." Brain, Behavior, and Immunity 94: 71-78.

EXCERPT: "Stress was found to heighten sensitivity to inflammation-associated depressive symptoms over a 2-year period, with notably stronger effects for subjective stress responses to a concurrent life event. Individuals who are most distressed following a major life event may exhibit the greatest risk for inflammation-induced depression."

 

Quincey, K., et al. (2021). "Men with breast cancer and their encounters with masculinity: An interpretative phenomenological analysis using photography." Psychology of Men & Masculinities: Published online in advance of print publication.

EXCERPT: "Thus, the analysis presented identifies and illustrates three experiential and interconnected encounters with masculinity: “Threatened–exposed,” “Protected–asserted,” and “Reconsidered–reconfigured” which are presented both thematically and through a novel schematic representation. We demonstrate how men’s relationship with masculinity shapes their accounts of both the embodied lived experience of breast cancer and how the cancer experience, with its many changes, challenges, and consequences, is communicated to others. How and why men encounter/perform these different masculinities at different points in time across the breast cancer trajectory, and how this aids their adjustment to illness and life postdiagnosis is considered. We conclude with recommendations for improved future breast cancer care and support and suggest future research directions with this community of hitherto underresearched and underrepresented men."

 

Rashidi, E., et al. (2021). "“I will not be defined by this. I’m not going to live like a victim; it is not going to define my life”: Exploring breast cancer survivors’ experiences and sense of self." Qualitative Health Research 31(2): 349-360.

EXCERPT: "We identified three master themes: Diseased Self, focused on emotional distress and the presentation of a façade; Coping Self, explored resilience and post-traumatic growth; and Transformed Self, engaged in presentations of self-image, meaning-making, and psychological ownership addressing survivorship and empowerment."

 

Renna, M. E., et al. (2021). "Worry and rumination in breast cancer patients: Perseveration worsens self-rated health." Journal of Behavioral Medicine 44(2): 253-259.

EXCERPT: "Worry was associated with higher cancer-related distress, which in turn predicted greater pain and breast cancer symptoms, poorer physical functioning, and lower self-rated health. Rumination also predicted greater cancer-related distress, which ultimately contributed to greater pain along with poorer physical functioning and self-rated health. Models with fatigue as an outcome were not significant. These findings suggest that perseveration can heighten cancer-related distress and subsequent perceptions of physical symptoms and health among breast cancer patients prior to adjuvant treatment. Perseveration early in the cancer trajectory can adversely increase the impact of a cancer diagnosis and treatment on functioning and quality of life."

 

Rivers, A. S. and K. Sanford (2021). "A special kind of stress: Assessing feelings of decisional distress for breast cancer treatment decisions." Patient Education and Counseling: Published online in advance of print publication.

EXCERPT: "Decisional distress demonstrated a unidimensional factor structure invariant across treatment context groups, a wide range of meaningful variation, significant correlations with all hypothesized variables (especially patient confusion), but also key distinctions from other variables.... Decisional distress is a meaningful construct that can be assessed with precision, and important for understanding medical decision-making processes and patient quality of life."

 

Shrout, M. R., et al. (2021). "Breast cancer survivors' satisfying marriages predict better psychological and physical health: A longitudinal comparison of satisfied, dissatisfied, and unmarried women." Psycho-Oncology: Published online in advance of print publication.

EXCERPT: "Married women—both those in satisfying and dissatisfying marriages—experienced improvements in their depressive symptoms, stress, and fatigue from pretreatment to 6- and 18-month posttreatment. Unmarried (i.e., single, divorced/separated, or widowed) women's depressive symptoms, stress, fatigue, and pain did not change over time, instead remaining elevated 6 and 18 months after treatment ended. Women in satisfying marriages also had fewer psychological and physical symptoms after treatment than those who were unmarried or in dissatisfying marriages.... Although marriage was associated with improved psychological and physical health, the gains were most notable when survivors' marriages were satisfying. Thus, the quality of survivors' marriages, rather than the marriage itself, provided the most benefits to their psychological and physical health."

 

Warner, N. Z., et al. (2021). "A systematic review of psycho-social interventions for individuals with a brca1/2 pathogenic variant." Journal of Genetic Counseling: Published online in advance of print publication.

EXCERPT: "Of the 1,024 results from searches, fifteen interventions were eligible. Nine of these were randomized controlled trials, six were quasi-experimental. There was heterogeneity in intervention design, with limited evidence of improvement upon psychological outcome measures. No study was rated as being low risk for bias. Five studies obtained the highest level of risk for bias, the majority of issues arising from problematic outcome measurement. No single study met all criteria on the Theory Coding Scheme, with five studies mentioning a theoretical aspect to intervention design, of which three employed a middle-range theory only. Some studies demonstrated a longitudinal impact on outcomes, however, there is insufficient evidence to draw broad conclusions from this. Further research is needed to better develop interventions to support those with a pathogenic variant in BRCA1/2 throughout their coping experience."

 

Xu, J., et al. (2022). "Psychological interventions for sexual function and satisfaction of women with breast cancer: A systematic review and meta-analysis." Journal of Clinical Nursing: published onlne in advance of print.

EXCERPT: "Fifteen studies involving 1307 participants were included. The current study showed that psychological interventions made statistically significant improvements in sexual function (SMD = 0.82; 95% CI = [0.43, 1.20]; p < .001), sexual satisfaction (SMD = 0.95; 95% CI = [0.19, 1.72]; p = .01), sexual relationships (SMD = 0.37; 95% CI = [0.15, 0.60]; p = .001) and sexual distress (MD = −5.05; 95% CI = [−7.88, −2.22]; p = .0005) of women with breast cancer. A subgroup analysis regarding the types of psychological interventions indicated that cognitive behavioural therapy and psychoeducational therapy were beneficial to sexual function and satisfaction, and psychosexual counselling could also improve sexual function....  Psychological interventions, especially psychoeducational therapy and cognitive behavioural therapy, are effective for improving the sexual health of women with breast cancer."

LINKS TO 21 WEB SITES THAT MAY BE USEFUL IN FINDING INFORMATION, GUIDANCE, AND SUPPORT:

 

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