John Neuhaus

Publications (5)14.86 Total impact

• Article: Lymphatic and Angiogenic Candidate Genes Predict the Development of Secondary Lymphedema following Breast Cancer Surgery.

  Christine Miaskowski, Marylin Dodd, Steven M Paul, Claudia West, Deborah Hamolsky, Gary Abrams, Bruce A Cooper, Charles Elboim, John Neuhaus, Brian L Schmidt, Betty Smoot, Bradley E Aouizerat
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  ABSTRACT: The purposes of this study were to evaluate for differences in phenotypic and genotypic characteristics in women who did and did not develop lymphedema (LE) following breast cancer treatment. Breast cancer patients completed a number of self-report questionnaires. LE was evaluated using bioimpedance spectroscopy. Genotyping was done using a custom genotyping array. No differences were found between patients with (n = 155) and without LE (n = 387) for the majority of the demographic and clinical characteristics. Patients with LE had a significantly higher body mass index, more advanced disease and a higher number of lymph nodes removed. Genetic associations were identified for four genes (i.e., lymphocyte cytosolic protein 2 (rs315721), neuropilin-2 (rs849530), protein tyrosine kinase (rs158689), vascular cell adhesion molecule 1 (rs3176861)) and three haplotypes (i.e., Forkhead box protein C2 (haplotype A03), neuropilin-2 (haplotype F03), vascular endothelial growth factor-C (haplotype B03)) involved in lymphangiogensis and angiogenesis. These genetic associations suggest a role for a number of lymphatic and angiogenic genes in the development of LE following breast cancer treatment.
  PLoS ONE 01/2013; 8(4):e60164. · 4.09 Impact Factor
• Article: Identification of patient subgroups and risk factors for persistent breast pain following breast cancer surgery.

  Christine Miaskowski, Bruce Cooper, Steven M Paul, Claudia West, Dale Langford, Jon D Levine, Gary Abrams, Deborah Hamolsky, Laura Dunn, Marylin Dodd, John Neuhaus, Christina Baggott, Anand Dhruva, Brian Schmidt, Janine Cataldo, John Merriman, Bradley E Aouizerat
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  ABSTRACT: Study purposes were to determine the prevalence of persistent pain in the breast; characterize distinct persistent pain classes using growth mixture modeling; and evaluate for differences among these pain classes in demographic, preoperative, intraoperative, and postoperative characteristics. In addition, differences in the severity of common symptoms and quality of life outcomes measured prior to surgery, among the pain classes, were evaluated. Patients (n = 398) were recruited prior to surgery and followed for 6 months. Using growth mixture modeling, patients were classified into no (31.7%), mild (43.4%), moderate (13.3%), and severe (11.6%) pain groups based on ratings of worst breast pain. Differences in a number of demographic, preoperative, intraoperative, and postoperative characteristics differentiated among the pain classes. In addition, patients in the moderate and severe pain classes reported higher preoperative levels of depression, anxiety, and sleep disturbance than the no pain class. Findings suggest that approximately 25% of women experience significant and persistent levels of breast pain in the first 6 months following breast cancer surgery. PERSPECTIVE: Persistent pain is a significant problem for 25% of women following surgery for breast cancer. Severe breast pain is associated with clinically meaningful decrements in functional status and quality of life.
  The journal of pain: official journal of the American Pain Society 12/2012; 13(12):1172-87. · 3.78 Impact Factor
• Article: Differences in depression, anxiety, and quality of life between women with and without breast pain prior to breast cancer surgery.

  Maria Kyranou, Steven M Paul, Laura B Dunn, Kathleen Puntillo, Bradley E Aouizerat, Gary Abrams, Deborah Hamolsky, Claudia West, John Neuhaus, Bruce Cooper, Christine Miaskowski
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  ABSTRACT: PURPOSE OF THE RESEARCH: Little is known about the relationships between pain, anxiety, and depression in women prior to breast cancer surgery. The purpose of this study was to evaluate for differences in anxiety, depression, and quality of life (QOL) in women who did and did not report the occurrence of breast pain prior to breast cancer surgery. We hypothesized that women with pain would report higher levels of anxiety and depression as well as poorer QOL than women without pain. METHODS AND SAMPLE: A total of 390 women completed self-report measures of pain, anxiety depression, and QOL prior to surgery. KEY RESULTS: Women with preoperative breast pain (28%) were significantly younger, had a lower functional status score, were more likely to be Non-white and to have gone through menopause. Over 37% of the sample reported clinically meaningful levels of depressive symptoms. Almost 70% of the sample reported clinically meaningful levels of anxiety. Patients with preoperative breast pain reported significantly higher depression scores and significantly lower physical well-being scores. No between group differences were found for patients' ratings of state and trait anxiety or total QOL scores. CONCLUSIONS: Our a priori hypotheses were only partially supported. Findings from this study suggest that, regardless of pain status, anxiety and depression are common problems in women prior to breast cancer surgery.
  European journal of oncology nursing: the official journal of European Oncology Nursing Society 08/2012; · 1.13 Impact Factor
• Article: Differences in sleep disturbance, fatigue and energy levels between women with and without breast pain prior to breast cancer surgery.

  Christina Van Onselen, Bradley E Aouizerat, Laura B Dunn, Steven M Paul, Claudia West, Deborah Hamolsky, Kathryn Lee, Michelle Melisko, John Neuhaus, Christine Miaskowski
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  ABSTRACT: The purpose of this study was to evaluate for differences in occurrence and severity ratings of sleep disturbance, fatigue, and decreased energy in women who reported breast pain prior to surgery for breast cancer. Of the 390 women who completed self-report measures for each symptom, 28.2% reported pain in their breast prior to surgery. A higher percentage of women in the pain group (i.e., 66.7% versus 53.5%) reported clinically meaningful levels of sleep disturbance. However, no between group differences were found in the severity of sleep disturbance, fatigue, or decreased energy. Findings from this study suggest that sleep disturbance, fatigue, and decreased levels of energy are significant problems for women prior to breast cancer surgery. Future studies need to evaluate for specific characteristics that place women at greater risk for these symptoms as well as the mechanisms that underlie these symptoms.
  Breast (Edinburgh, Scotland) 07/2012; · 2.09 Impact Factor
• Article: Associations between pro- and anti-inflammatory cytokine genes and breast pain in women prior to breast cancer surgery.

  Birha McCann, Christine Miaskowski, Theresa Koetters, Christina Baggott, Claudia West, Jon D Levine, Charles Elboim, Gary Abrams, Deborah Hamolsky, Laura Dunn, Hope Rugo, Marylin Dodd, Steven M Paul, John Neuhaus, Bruce Cooper, Brian Schmidt, Dale Langford, Janine Cataldo, Bradley E Aouizerat
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  ABSTRACT: The purposes of this study were to determine the occurrence rate for preoperative breast pain; describe the characteristics of this pain; evaluate for differences in demographic and clinical characteristics; and evaluate for variations in pro- and anti-inflammatory cytokine genes between women who did and did not report pain. Patients (n = 398) were recruited prior to surgery and completed self-report questionnaires on a number of pain characteristics. Genotyping was done using a custom genotyping array. Women (28.2%) who reported breast pain were significantly younger (P < .001); more likely to be nonwhite (P = .032); reported significantly lower Karnofsky Performance Status scores (P = .008); were less likely to be postmenopausal (P = .012); and had undergone significantly more biopsies (P = .006). Carriers of the minor allele for a single nucleotide polymorphism in interleukin (IL)1-receptor 1 (IL1R1) (rs2110726) were less likely to report breast pain prior to surgery (P = .007). Carriers of the minor allele for a single nucleotide polymorphism in IL13 (rs1295686) were more likely to report breast pain prior to surgery (P = .019). Findings suggest that breast pain occurs in over a quarter of women who are about to undergo breast cancer surgery. Based on phenotypic and genotypic characteristics found, inflammatory mechanisms contribute to preoperative breast pain. PERSPECTIVE: In women with breast cancer, preoperative pain may be associated with increases in inflammatory responses associated with an increased number of biopsies. In addition, differences in cytokine genes may contribute to this preoperative breast pain.
  The journal of pain: official journal of the American Pain Society 04/2012; 13(5):425-37. · 3.78 Impact Factor