Breast cancer has the highest incidence rate among malignant tumors in China, with a trend of affecting younger women. The survival rate of young patients with breast cancer has improved significantly, but the treatment to which they are subjected has short- and long-term adverse effects such as damage to the ovaries, which may result in infertility. Such consequences, in turn, increase patients’ concerns over future reproduction and childrearing. At present, patients lack easy access to the informative consultations and accurate patient education. Nor do medical staff continuously assess their overall wellbeing, engage in mental health interventions, or ensure that they have the knowledge necessary to manage their reproductive concerns. This study sought to investigate the reproductive concerns of young female patients with breast cancer, identify the factors that influence those concerns, and provide a theoretical and practical scientific basis for the future fertility management of this specific population. Our study is based on a cross-sectional survey of 112 young patients with breast cancer recruited by a convenience sampling method in the Shanghai Cancer Center, Fudan University, from October 2020 to January 2021. A self-designed questionnaire and the Chinese version of the Reproductive Concerns After Cancer were used for data collection. Multivariable linear regression was performed to analyze the data. The total score for reproductive concerns was 59.96 ​± ​9.91, indicating that young women with breast cancer have relatively high levels of concern about reproduction. Multivariable linear regression analyses suggested that age, education level, and the desire for parenthood were the factors that influenced these concerns. The younger the patient, the higher the level of concern. Patients with a higher level of education and a greater desire for parenthood indicated greater levels of concern about reproductive issues. The levels of concern about reproduction expressed by these young patients with breast cancer were high. The factors that influenced their concern were their age, education level, and desire to have children. We suggest that medical staff focus on young patients during treatment and develop effective intervention measures based on their desire for parenthood, disease condition, and psychological status to promote the patients’ physical and mental health.

Background: Breast cancer has the highest incidence rate among malignant tumors in China, with a trend of affecting younger women. The treatment has short- and long-term adverse effects such as damage to the ovaries, which may result in infertility. Such consequences then increase patients’ concerns over future reproduction. At present, nor do medical staffs continuously assess their overall well-being, or ensure that they have the knowledge necessary to manage their reproductive concerns. This qualitative study aimed to explore psychological and reproductive decision-making experiences of young women who had experienced childbirth after their diagnosis. Methods: The phenomenological research, as a kind of qualitative study, was conducted on 12 young women who experienced childbirth after breast cancer diagnosis. Data collection was from September 2021 to January 2022 and content analysis method was used to analyze the data. Results: Five main themes were identified: (1) desire for childbearing from individual, familial, and social aspects after the diagnosis of breast cancer; (2) emotional experiences through pregnancy till raising children; (3) support needs from professionals, family, and peer; (4) self and doctors’ influencing factors on reproductive decision-making; and (5) satisfaction with the outcome of reproductive decision-making. Conclusions: The desire for childbearing of young women should be considered during the reproductive decision-making process. A multidisciplinary team is suggested to be set up to provide professional support. During the reproductive process, professional and peer support should be strengthened to improve decision-making abilities, alleviate negative emotional experience, and smoothen the process of reproductive experience for young patients.

Background: Breast loss causes negative influence on women physically, psychologically, and socially. Breast prosthesis can improve patient's figure externally, increase self-confidence, thus improving quality of life (QOL). Prospective study of different breast prostheses has not yet been performed in China. Our objective was to evaluate the QOL of patients wearing different types of breast prostheses and to compare the physical and psychological effects of different temperature-controlled breast prostheses on patients. Methods: Thirty patients with breast cancer were recruited through the Yankang E-follow-up Platform at the Department of Breast Surgery of Fudan University, Shanghai Cancer Center and were randomized into either intervention or control group. Random number tables were used in this study for randomization. In the first 6 weeks of the study, self-adhesive breast prostheses and conventional breast prostheses had been used in the intervention and control group, respectively. In the later 6 weeks, the breast prostheses used were switched into another kind. Several dimensional parameters including skin conditions, breast prosthesis knowledge, breast prosthesis knowledge, QOL, and body image were examined by different questionnaires in the end of both 6th and 12th week. Results: There were no significant difference in QOL and body image between the 2 groups during 6th and 12th week. At the 6th week of the study, patients of the intervention group preferred to the self-adhesive breast prosthesis, indicating that the self-adhesive breast prosthesis seemed more likely to feel like part of their body, while prosthesis cleaning remaining their biggest concern. At the end of 12th week, in comparison with the number at 6th week, more patients in both groups were willing to choose self-adhesive breast prosthesis. Conclusions: We conclude that women are satisfied with the temperature-controlled breast prosthesis and are more willing to choose self-adhesive breast prostheses although cleaning remains a problem. In China, patients still lack information about breast prostheses. Therefore, specialist breast nurses should provide comprehensive information about breast prostheses, assist patients in selecting suitable breast prostheses, collect feedback about the prostheses, and reduce each patient's physical and mental discomfort.

Background: Breast loss has a negative effect on women physically, psychologically and socially. External breast prostheses can improve patients’ figure physically, increase their self-confidence, and thus improve quality of life. Little is known about the knowledge of medical professionals on the use of external breast prostheses in mainland China. This study sought to examine medical professionals’ knowledge of the use of external breast prostheses among breast cancer patients in China. Methods: Self-designed questionnaires were administered to 635 medical professionals specializing in breast cancer in China to examine their knowledge. Results: Medical professionals who were older in age, those who had higher levels of education and those who had senior professional titles had a broader professional knowledge of external breast prostheses. Medical professionals who were younger in age and those who had junior professional titles thought that the patients were willing to choose direct-adhesive breast prostheses. Medical professionals who were older in age, those who had higher levels of education, those who had senior professional titles and those who had been working for many (but less than 30) years were more likely to think that patients could wear external breast prostheses shortly after surgery, and at all times except when sleeping. More highly educated doctors, head nurses and medical staffs from the East were more likely to think that patients would accept the use of high-priced external breast prostheses. Conclusions: Medical professionals’ knowledge about the wearing of external breast prostheses is lacking. A number of factors, including age, education level, professional title, number of years working years and geographical region have different effects on medical professionals’ knowledge. Medical professionals with a good knowledge of external breast prostheses, especially specialist breast nurses, can provide patients with comprehensive information about breast prostheses, assist patients in selecting the appropriate prostheses, understand patients’ wearing experiences, and help to reduce patients’ physical and mental distress.

Background: Breast cancer-related lymphedema (BCRL) seriously affects patients’ quality of life. We aimed to understand the stage of postoperative lymphedema and the occurrence of related symptoms in breast cancer patients, and to analyze the relationship between the two, so as to provide reference for the implementation of targeted clinical interventions. Methods: Convenience sampling method was used to select postoperative breast cancer patients attending the lymphedema evaluation clinic of a tertiary hospital in Shanghai for questionnaire survey. A professional lymphedema therapist assessed the severity of the patients’ lymphedema according to the International Society of Lymphology (ISL) lymphedema grading criteria, and the Breast Cancer and Lymphedema Symptom Experience Index (BCLE-SEI) was used to assess the severity of the patients’ lymphedema and patients’ experience of lymphedema-related symptoms. This study aimed to understand the occurrence of lymphedema in breast cancer patients after surgery, and to explore the characteristics of related symptoms in patients with different stages of lymphedema. Results: Of the 1,021 patients, 744 (72.86%) were in stage 0, 161 (11.36%) in stage 1, 98 (9.5%) in stage 2, and 18 (1.7%) in stage 3. The higher the lymphedema stage, the number and severity of symptoms significantly increased (P<0.001), with stage 2 and 3 patients reporting more symptoms and greater severity compared to stage 0 and 1 patients. In terms of symptom distress, the higher lymphedema stage was associated with a significant increase in the total symptom distress score as well as in the functional and emotional dimensions of distress (P<0.001). Conclusions: The number of symptom presentations, symptom severity and their degree of distress increased with higher lymphedema stage. Attention should be paid to patients' symptom complaints, and early identification and timely intervention should be made in patients with stage 0 and 1 lymphedema to alleviate their symptoms and slow down the progression of edema.

This study aimed to translate the Breast Cancer Prevention Trial Eight Symptom Scale (BESS) into Chinese and subsequently examine the latent constructs and psychometric properties of the Chinese BESS (C-BESS) among patients with breast cancer. In Phase 1, the BESS was translated from English into Chinese using the FACIT translation method. An expert panel was convened to assess the content validity, and pilot testing was performed with 20 patients with breast cancer. In Phase 2, a total of 427 patients with breast cancer from four Grade-A public hospitals in China were recruited to examine psychometric properties of the C-BESS. The internal consistency was evaluated based on the Cronbach's α, and the construct validity was tested using confirmatory factor analysis, convergent validity, and discriminant validity. The C-BESS demonstrated satisfactory content validity index (item-level content validity index [I-CVI]: 0.8–1.0; scale-level content validity index [S-CVI]: 0.97). The Cronbach's α value for the entire C-BESS scale was 0.92. Confirmatory factor analysis indicated that eight-factor structure of the C-BESS was a good fit to the data (CFI = 0.959, AGFI = 0.904, RMSEA = 0.05, RMR = 0.029). The scale exhibited good convergent validity and discriminant validity. This study translated and validated the C-BESS for use in the Chinese population. The results demonstrate that the C-BESS exhibits good reliability and validity, with ideal psychometric properties for assessing the symptom burden in Chinese patients with breast cancer. This tool can be effectively integrated into the routine symptom monitoring of patients with breast cancer in China, helping Chinese clinical professionals in conducting comprehensive assessments of symptom burden.