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Grant Details

Grant Number: 5R01CA131148-05 Interpret this number
Primary Investigator: Keefe, Francis
Organization: Duke University
Project Title: Pain, Distress and Mammography Use in Breast Cancer Patients
Fiscal Year: 2013


Abstract

ABSTRACT Breast cancer is the leading cancer affecting women in the United States, and the second leading cause of cancer-related death among women. Evidence-based guidelines recommend annual mammography and data suggest that early detection by annual mammography increases survival rates for new and recurrent breast cancer. Yet, studies indicate that 20% to 55% of breast cancer survivors and half of all women without a cancer history do not adhere to mammography screening guidelines. A better understanding of the factors that predict sustained mammography use is needed to develop strategies for improving adherence and reducing breast cancer mortality rates. This application includes two studies. Study 1 builds on our previous studies of mammography pain by focusing on women who received breast conserving surgical treatment (lumpectomy). The proposed research addresses a critical public health issue - does heightened mammography pain in these women impact their adherence to potentially life saving screening. Study 2 extends our research efforts to women age 50 and over with no cancer history to explore the impact of pain and distress on adherence to screening mammograms. These studies will be the first longitudinal studies to assess pain, pain appraisal, and mammography specific distress at the time of mammography and examine their impact on sustained mammography adherence. In addition to addressing a novel research question with important public health implications, the proposed studies will include a number of innovative design elements, including real time assessment of women at the time of their mammogram and state-of-the-art measures of pain, pain appraisal, mammography specific distress, and health behavior theory variables. These data will allow us to examine the impact of pain and distress on mammography adherence after accounting for other potentially important factors. Study 1 will recruit 552 post-lumpectomy breast cancer patients from two complementary sites (N=276 at Duke University Medical Center (DUMC) and N=276 at University of Pittsburgh Medical Center (UPMC) and Study 2 will recruit 530 women age 50 and over with no cancer history (N=265 at DUMC and N=265 at UPMC). Assessments will be conducted in the mammography clinic at the time of mammogram. Prior to the procedure, women will complete measures of ongoing breast pain, mammography specific distress, past mammography experience, health behavior theory variables, and psychological symptoms. Following the procedure, women will complete measures of mammography pain and pain appraisal. Adherence to annual mammography will be determined 30 months later (excluding women with cancer diagnosis/recurrence or recommendation for further testing or mammograms at < 12 month intervals). The proposed studies have the potential to provide valuable, new information that can aid in: 1) identifying women who are less likely to adhere to annual mammography, 2) identifying women at high risk for pain and distress during mammography, and 3) developing strategies to improve adherence to mammography and reduce breast cancer mortality.



Publications

Persistent breast pain in post-surgery breast cancer survivors and women with no history of breast surgery or cancer: associations with pain catastrophizing, perceived breast cancer risk, breast cancer worry, and emotional distress.
Authors: Bovbjerg D.H. , Keefe F.J. , Soo M.S. , Manculich J. , Van Denburg A. , Zuley M.L. , Ahrendt G.M. , Skinner C.S. , Edmond S.N. , Shelby R.A. .
Source: Acta oncologica (Stockholm, Sweden), 2019 May; 58(5), p. 763-768.
EPub date: 2019-02-12.
PMID: 30747014
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Persistent Breast Pain Among Women With Histories of Breast-conserving Surgery for Breast Cancer Compared With Women Without Histories of Breast Surgery or Cancer.
Authors: Edmond S.N. , Shelby R.A. , Keefe F.J. , Fisher H.M. , Schmidt J.E. , Soo M.S. , Skinner C.S. , Ahrendt G.M. , Manculich J. , Sumkin J.H. , et al. .
Source: The Clinical journal of pain, 2017 Jan; 33(1), p. 51-56.
PMID: 27922843
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Validating pain communication: current state of the science.
Authors: Edmond S.N. , Keefe F.J. .
Source: Pain, 2015 Feb; 156(2), p. 215-219.
PMID: 25599441
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Depressive symptoms and cytokine levels in Serum and Tumor Tissue in patients with an Astrocytoma: a pilot study.
Authors: Starkweather A.R. , Sherwood P. , Lyon D.E. , Bovbjerg D.H. , Broaddus W.C. , Elswick R.K. , Sturgill J. .
Source: BMC research notes, 2014-07-04; 7, p. 423.
EPub date: 2014-07-04.
PMID: 24997057
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Psychological and behavioral approaches to cancer pain management.
Authors: Syrjala K.L. , Jensen M.P. , Mendoza M.E. , Yi J.C. , Fisher H.M. , Keefe F.J. .
Source: Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2014-06-01; 32(16), p. 1703-11.
EPub date: 2014-05-05.
PMID: 24799497
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Psychosocial interventions for managing pain in older adults: outcomes and clinical implications.
Authors: Keefe F.J. , Porter L. , Somers T. , Shelby R. , Wren A.V. .
Source: British journal of anaesthesia, 2013 Jul; 111(1), p. 89-94.
PMID: 23794650
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Creating widely accessible spatial interfaces: mobile VR for managing persistent pain.
Authors: Schroeder D. , Korsakov F. , Jolton J. , Keefe F.J. , Haley A. , Keefe D.F. .
Source: IEEE computer graphics and applications, 2013 May-Jun; 33(3), p. 82-9.
PMID: 24807994
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Optimism and pain: a positive move forward.
Authors: Keefe F.J. , Wren A.A. .
Source: Pain, 2013 Jan; 154(1), p. 7-8.
EPub date: 2012-10-13.
PMID: 23159574
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Virtual reality for persistent pain: a new direction for behavioral pain management.
Authors: Keefe F.J. , Huling D.A. , Coggins M.J. , Keefe D.F. , Rosenthal Z.M. , Herr N.R. , Hoffman H.G. .
Source: Pain, 2012 Nov; 153(11), p. 2163-2166.
EPub date: 2012-07-04.
PMID: 22770840
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Pain and emotion: a biopsychosocial review of recent research.
Authors: Lumley M.A. , Cohen J.L. , Borszcz G.S. , Cano A. , Radcliffe A.M. , Porter L.S. , Schubiner H. , Keefe F.J. .
Source: Journal of clinical psychology, 2011 Sep; 67(9), p. 942-68.
EPub date: 2011-06-06.
PMID: 21647882
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Behavioral medicine: a voyage to the future.
Authors: Keefe F.J. .
Source: Annals of behavioral medicine : a publication of the Society of Behavioral Medicine, 2011 Apr; 41(2), p. 141-51.
PMID: 21264691
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Supporting implementation of evidence-based behavioral interventions: the role of data liquidity in facilitating translational behavioral medicine.
Authors: Abernethy A.P. , Wheeler J.L. , Courtney P.K. , Keefe F.J. .
Source: Translational behavioral medicine, 2011 Mar; 1(1), p. 45-52.
PMID: 24073032
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Yoga for persistent pain: new findings and directions for an ancient practice.
Authors: Wren A.A. , Wright M.A. , Carson J.W. , Keefe F.J. .
Source: Pain, 2011 Mar; 152(3), p. 477-480.
EPub date: 2011-01-17.
PMID: 21247696
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Integrative and behavioral approaches to the treatment of cancer-related neuropathic pain.
Authors: Cassileth B.R. , Keefe F.J. .
Source: The oncologist, 2010; 15 Suppl 2, p. 19-23.
PMID: 20489193
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Antigen receptor proximal signaling in splenic B-2 cell subsets.
Authors: Li X. , Martin F. , Oliver A.M. , Kearney J.F. , Carter R.H. .
Source: Journal of immunology (Baltimore, Md. : 1950), 2001-03-01; 166(5), p. 3122-9.
PMID: 11207264
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