• Title/Summary/Keyword: Premenopause

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Breast Cancer at Extreme Ages - a Comparative Analysis in Chile

  • Acevedo, Francisco;Camus, Mauricio;Sanchez, Cesar
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.4
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    • pp.1455-1461
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    • 2015
  • Background: Young onset breast cancer (BC) has a worse outcome as compared to in the elderly. However, some studies have shown that BC in the elderly, despite indolent features, does also cause increase in mortality. In an attempt to compare clinic-pathological characteristics, BC subtypes and survival in patients with BC presenting at extremes of age, we performed a retrospective study. Materials and Methods: Patients were either ${\leq}40$ or ${\geq}70$ years old. Subtypes were defined using immunohistochemistry and histological grade. Chi-Square test was used for evaluation of categorical variables, and Kaplan-meier and log-rank for disease-specific survival (DSS) and disease free survival (DFS). Results: We analyzed 256 patients ${\leq}40$ and 366 patients ${\geq}70$. Younger patients presented with more aggressive disease, with less luminal A but more luminal B and triple negative (TN) subtype. With a median follow-up of 57.5 months, DFS at 5 years in younger patients was 72.3% vs 84.6% in the elderly (p=0.007). Luminal A and B disease presented with worse DFS in younger patients. The opposite was seen in the TN subgroup. Although we found no significant differences in DSS, older patients with TN tumors died of BC more frequently. This group also received less chemotherapy. Conclusions: Young patients present with more aggressive disease, this translating into worse DFS. However, elderly patients with TN disease represent a particular subpopulation with worse DFS and DSS, suggesting that chemotherapy should not be withheld only because of age.

Attitude and Belief About Menopause and Menopausal Symptoms in Depressive or Anxiety Disorder Patients (우울, 불안장애 환자에서 폐경에 대한 태도 및 인식과 폐경기 증상)

  • Choi, In Kwang;Lee, Moon-Soo;Ham, Byung-Joo;Lee, Hwa-Young;Ko, Young-Hoon;Joe, Sook-Haeng
    • Korean Journal of Psychosomatic Medicine
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    • v.18 no.2
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    • pp.82-93
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    • 2010
  • Objectives : The purpose of this study was to explore attitude and belief about menopause and severity of menopausal symptoms according to menopausal status. This study conducted a cross-sectional assessment of the effects of depressive symptoms and the severity of trait anxiety on the severity of menopausal symptoms. Methods : Participants were all outpatients at the psychiatric outpatient clinic of Korea University Guro Hospital. All participants, aged 40 to 64, had depressive or anxiety disorders and were divided into the premenopause, perimenopause, premenopause, and postmenopause groups. Menopause Rating Scale(MRS) was used to measure the severity of menopausal symptoms. The attitude toward menopause was examined by a self-report questionnaire regarding menopause. Beck Depression Inventory(BDI) and State-Trait Anxiety Inventory(STAI) were used to assess depressive symptoms and anxiety. Results : The severity of menopausal symptoms was not different among the groups according to menopausal status. There was a significant correlation between a negative attitude toward menopause and the severity of menopausal symptoms. Patients with moderate to severe depressive symptoms and trait anxiety had more severe menopausal symptoms. Conclusion : Negative attitude toward menopause, depressive symptoms, and anxiety had a significantly negative impact on the severity of menopausal symptoms. The results of this study suggest that treatment to relieve depressive symptoms and anxiety and intervention to reduce negative attitude toward menopause are required. Further studies with larger sample size are needed to evaluate potentially effects of depressive symptoms and anxiety on severity of menopausal symptoms in middle-aged female psychiatric patients.

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Pre-post changes of sexual satisfaction and spouse support of women who have had a hysterectomy (자궁적출술을 받은 부인의 수술전후 성만족 및 배우자 지지의 변화)

  • 장순복;정승은
    • Journal of Korean Academy of Nursing
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    • v.25 no.1
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    • pp.173-183
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    • 1995
  • The research questions of this study were : Will the level of sexual satisfaction of women who have had a hysterectomy 4 months before be decreased compare to the level of sexsual satisfaction before the hysterectomy\ulcorner, Will the level of perceived spouse support of women who have had a hysterectomy 4 months before be decreased compare to the level before the hysterectomy\ulcorner, and What is the relationship between sexual satisfaction and spouse support\ulcorner This is a perspective descriptive correlational study. The number of subjects was 44. The subjects were limited to Korean women who had an abdominal or vaginal hysterectomy for non - malignant diseases, were married(living with their husbands), mentally healthy, and premenopause at the time of operation. The instrument was consisted of 4 items of demo-graphic characteristics, 13 items of spouse support, and 10 items of sexual satisfaction. The instrument of sexual satisfaction was a component of the Derogatis Sexual Function Inventory. Data analysis was done by paired t-test to see the differences between the pre-post scores of sexual satisfaction and spouse support. The Pearson Correlation Coefficiency was calculated to see the relationship between the scores of sexual satis-faction and spouse spport of pre-post hysterectomy. Results were summerized as follow : The mean age of the subjects was 43.5 years : 72.7% of the subjects were above middle school graduates : their mean income level was 1, 453, 000 Korean won and 86.4% of the subjects have had bi-lateral oophrectomy. 1. The scores of sexual satisfaction of women at 4 months after hysterectomy was decreased significantly compare to the score before hysterectomy(paired t=.274, p=.009). 2. The scores of spouse support of the women at 4 months after hysterectomy was not decreased significantly compare to the score before hysterectomy(paired t=.19, p=.847). 3. The scores of sexual satisfaction and spouse support before hysterectomy was significantly related(r=.5186, p=.000). 4. The scores of sexual satisfaction and spouse support at 4 months after hysterectnmy was significantly related(r=.4110, p=.005). It carl be conlcluded that the sexual satisfaction level could be decreased 4 months after the hyster ectomy, but the spouse support level may not be decreased at 4 months after hysterectomy. Further studies have to be done to identify the factors related to the decrease of sexual satisfaction and spouse support after hysterectomy.

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A Study on Health Promoting Behavior In Post-Mastectomy Patients (유방절제술을 받은 여성의 건강증진행위에 관한 연구)

  • Kim, Hyun Ju;So, Hyang Sook
    • Korean Journal of Adult Nursing
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    • v.13 no.1
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    • pp.82-95
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    • 2001
  • The purpose of this study was to examine the relationship among perceived health status, self-esteem, self-efficacy and health promoting behavior, and to determine the predictors of health promoting behavior in post-mastectomy patients. The study, a descriptive correlational study, was done with structural questionnaires. A total of 51 post-mastectomy subjects from C university hospital in Kwang-ju, South Korea completed mail-in self-reporting questionnaires during a three month period from March to June, 1999. The data were collected using Lawstone's(1982) perceived health status scale, Rosenberg's(1965) self-esteem scale, the modified self-efficacy scale(Shere et al, 1982), and the modified health promoting lifestyle profile (Walker et al, 1987). The data obtained were analyzed according to percentage, mean and standard deviation, principal component analysis, varimax rotation, t-test, ANOVA, Pearson's correlation, and stepwise multiple regression. The results were as follows: 1. The health promoting behavior measurement resulted in six factors. Each factor was labelled as follows: self-actualization, nutrition, stress management, exercise, health responsibility and interpersonal support. The total percent of variance explained by the six factors was 58.4%. 2. The mean score of health promoting behavior was 85.92(range 58~117). The scores of six factor were nutrition 3.20, self-actualization 2.59, stress management 2.58, interpersonal support 2.58, health responsibility 2.49, and exercise 2.34 on a four point scale. 3. When the score of health promoting behavior factors were compared by general characteristics. Factor I: self-actualization, differed significantly by the frequency of pregnancy (F=3.06, p=.037). Factor II: nutrition differed significantly by drinking experience(t=-2.26, p=.028) and the pre- or post stage of menopause(F=2.69, p=078). FactorIII: stress management differed significantly depending on regularity of mensturation(t=-2.12, p= .042). FactorIV: exercise differed significantly by type of religion (F=2.49, p=.072), marital status(F=5.03, p=.010), and feeding type (F=2.64, p=.036). Factor V: health responsibility differed significantly by regularity of mensturation(t=2.18, p=.037). 4. The total health promoting behavior score was significantly related to self-esteem and perceived health status(r=.610, p.006; r= .378, p=.006). The score of selfactualization also corresponded with selfesteem and perceived health status(r=.556, p=.001; r=.343, p=.013). 5. The predictor to explain the score of health promoting behavior was self-esteem, which accounted for 37.1% of the total variance. The predictor to explain the score of self-actualization was self-esteem, which accounted for 30.9% of the total variance. The score of nutrition was primarily affected by both premenopause and drinking experience, which accounted for 13.1% and 9.5% respectively. Finally, the score of exercise was dictated by marriage, Buddhism, no experience of breast feeding, which accounted for 17%, 9.8%, & 5.2% respectively. In conclusion, self-esteem is the main predictor for health promoting behavior in post-mastectomy women. These findings suggest a need for nursing strategies which promote self-esteem in such patients.

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A Study on Relationship to Risk Factors according to Menopausal Status in Breast Cancer (유방암 환자에 있어서 폐경상태에 따른 위험인자의 상관성 연구)

  • Yoon, Han-Sik
    • Journal of radiological science and technology
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    • v.23 no.1
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    • pp.49-54
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    • 2000
  • It is important to identify modifiable risk factors for breast cancer, because the breast cancer is one of the major causs of mortality among women. Some reported that obesity is a risk factor for breast cancer, but the results are not constant. Many risk factors are related to the duration of estrogenic stimulation of the breast. In general, early menarche and late menopause are positive risk factors. Human breast cancer has different characteristics according to the status of menopause(premenopause and postmenopause). In premenopausal women, about 60% of circulating estrogen is from the ovaries in the form of estradiol, and the remaining 40% is estrogen formed primarily in the adipose(fat) tissue via aromatization of androstenedion from the adrenal glands. After menopause this adipose cell production of estrone is the main source of estrogens and the level of estrone is maintained approximately at premenopausal levels. This study was undertaken to determine the role of body size and body mass index by status of menopause in development of breast cancer using retrospective case/control study. From March 1991 to February 1997 at the Wonkwang University Hospital, the breast cancer cases(n=72) and controls(n=86) were selected. By statistical analysis method, regression analysis, paired T-test and multiple logistic regression were done to estimate the influenced factors same as height, weight, BMI, age at menarche and age at menopause. The following results were obtained : 1. In premenopausal women, age at menarche was showed comparatively high correlation coefficients and BMI was described prominently highly in postmenopause. 2. At the results of multiple regression analysis, age at monarch, BMI and weight were showed as significant variables. In this method, critical factor ($R^2$) was 0.054. 3. Paired samples T-test was undertaken to test mean difference between two groups of cases and controls. The result of test performance showed a significant difference. 4. In comparison with women whose weight less than 50 kg, the ORs for the upper 5th group was 1.82(95% confidence interval). The heaviest women had a higher risk(OR=1.14, 95% confidence interval $1.12{\sim}1.31$, p=0.005). Higher body mass index was significantly associated with increased risk of premenopausal breast cancer (OR=1.01, 95% confidence interval $1.08{\sim}l.18$, p=0.05).

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The Association between Regular Physical Activity Types And Metabolic Syndrome in Fertile Women (가임기 여성의 규칙적 운동 및 운동종류에 따른 대사증후군 간의 관련성)

  • Lee, Guna
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.22 no.1
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    • pp.94-103
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    • 2021
  • The purpose of this study was to identify the association between regular physical activity (PA) types and metabolic syndrome (MetS) in fertile women. Data were obtained from the seventh Korea National Health and Nutrition Examination Survey (KNHANES VII-3, 2018). The sample consisted of 4,172 fertile women over 19 years of age. The data were analyzed using an independent t-test, χ2 test, and multiple logistic regression analysis for examining the association of regular PA and MetS. The prevalence of MetS in fertile women was 3.1% (n =128), and 1,972 fertile women (47.2%) practiced regular PA. Compared to the non-regular PA group, regular PA resulted in a significantly lower systolic blood pressure (p =.002), lower waist circumference (p <.001), lower fasting blood sugar (p =.007), and higher high-density lipoprotein cholesterol (p <.001). After controlling the confounding variables, multiple logistic regression showed that the regular PA group (odds ratio 0.59, 95% confidence interval 0.35-0.98, p =.040) and the regular muscle-strengthen PA group (odds ratio 0.34, 95% confidence interval 0.14-0.80, p =.013) were associated with a decreased risk of MetS. Therefore, regular PA, including muscle-strengthen PA should be considered to develop effective MetS intervention in fertile women.