tbuckley/cabot-search huggingface dataset:
Difficulties and countermeasures of community intervention in Chronic obstructive pulmonary disease remission
Authors: 徐剑文
Journal: BMJ (2010)

慢性阻塞性肺疾病(COPD)是呼吸系统常见病,以持久性气道阻塞为特征,位居全球致死疾病的第4位,预计到2020年,将成为世界疾病经济负担的第5位[1].利用便捷的社区卫生服务资源对COPD缓解期的患者进行有效、系统的干预,能让更多的COPD患者获益,提高患者的生存质量,减轻家庭和社会的负担。
Association between proprotein convertase subtilisin/kexin type 9 and late saphenous vein graft disease after coronary artery bypass grafting: a cross-sectional study
Authors: 高静, 汪海波, 肖健勇, 任珉, Reilly Kathleen Heather, 李玉明, 刘寅
Journal: BMJ (2019)

目的
探讨冠状动脉旁路移植术(CABG)后血清前蛋白转化酶枯草溶菌素9(PCSK9)与隐静脉移植血管疾病(SVGD)的关系。


研究设计
一项横断面研究。


研究地点
中国天津市1所二级医院。


研究对象
总计231名患者参与该研究。入选标准如下：年龄≥18岁；CABG术后12个月以上；至少含有1支SVG，非侵入性检查结果异常或复发稳定型心绞痛有冠脉造影指征；愿意参与研究并签署知情同意书。存在以下任何一种情况的患者予以排除：先天性心脏瓣膜病、失代偿性心力衰竭、贫血(定义为女性血红蛋白水平<12 g/dl或男性血红蛋白水平<13 g/dl)、恶性肿瘤、肾功能衰竭、严重肝脏疾病、甲状腺疾病、急性或慢性炎症性疾病和慢性阻塞性肺部疾病。


主要结果测量
SVGD被定义为至少1支SVG狭窄≥50%。应用ELISA试剂盒并根据制造商提供的说明书测定循环PCSK9浓度。


结果
SVGD组平均PCSK9水平显著高于非SVGD组(275.2±38.6比249.3±37.7，P<0.01)。多因素回归模型显示血清PCSK9每增加1个标准差，SVGD发生风险显著增加(比值比2.08，95%可信区间1.46~2.95)。


结论
本研究在调整了确定的心血管危险因素后，首次确定PCSK9与晚期SVGD之间独立相关。未来需多中心大样本的前瞻性队列研究来进一步探究它们之间的关系。
Evolving risk of therapy-related myelodysplastic syndromes and acute myeloid leukemia (tMDS/AML) following modern cancer therapies.
Authors: Abhay Singh, Chebli Mrad, Mark G Faber, Theresa Hahn, Eunice S. Wang, Megan Herr, Swapna Thota
Journal: Journal of Clinical Oncology (2020)

7516 Background: Data describing risks of tMDS/AML after targeted and immunotherapy (IO) agents are lacking. Melanoma (Mel) and renal cell carcinoma (RCC) are considered chemotherapy insensitive and have been treated with IO (interferon and interleukin) since the 1990s. In 2004, use of tyrosine kinase inhibitors (TKIs) began in non-small cell lung cancer (NSCLC) and expanded to RCC in 2005 and Mel trials in 2011. Checkpoint inhibitor (CPI) use began in 2011 for Mel, 2012 for NSCLC in trials and later for RCC. For multiple myeloma (MM), use of lenalidomide has been increasing since 2007. All these modern therapies have well described immunomodulatory functions. Methods: Using 17 population-based SEER cancer registries, we studied 565,149 patients diagnosed from 2000-2015 with Mel, RCC, NSCLC, or MM who survived ≥1 year and assessed risk of tMDS/AML across periods P1 (2000-2005), P2 (2006-2010) and P3 (2011-2015). Censoring occurred at 5 years of follow up to limit bias and assess risk alteration across approval and utilization periods of these modern therapies. Results: tMDS/AML risk was significantly elevated after RCC in P1 [standardized incidence ratio (SIR): 1.61, possibly from chemo exposure that was still prevalent to some extent in P1 period] and a downtrend noted in P2 (SIR: 1.11) and P3 (SIR: 0.60). tMDS/AML risk after Mel showed similar downtrend, not statistically significant. In contrast, risk for tMDS/AML after MM increased across all periods ( SIRs 4.51 &gt; 5.05 &gt; 5.23), and risk after NSCLC increased from P1 to P2 but decreased thereafter, pattern most pronounced in stage I-III NSCLC ( 1.64 &gt; 3.15 &gt; 1.92). Conclusions: Periods when TKI and CPI use became standard in Mel and RCC, we observed a decrease in tMDS/AML risk. Similar decrease in the most recent period for stage I-III NSCLC was observed, possibly due to progression of these earlier staged cancers resulting in receipt of TKIs and CPI for stage IV disease. tMDS/AML risk after MM increased contradicting the decline in risk previously reported in the literature. Discordance may be due to survival bias as MM patients are now living longer (SEER 5-yr survival in ‘00 was 35% and 53% in ‘15) with more time to develop tMDS/AML. Overall, aside from better efficacy and/or tolerability of modern therapies, another observed benefit was lower tMDS/AML risk. This risk was lower than general population in Mel/RCC, suggesting a possible protective effect of these therapies. SIR tables/graphs with updated SEER data (available 04/2020) with follow up through 2018 will be presented.
Predictors of first line systemic therapy for metastatic renal cell carcinoma in IMDC favorable risk patients.
Authors: Ryuichi Mizuno, Kimiharu Takamatsu, Nobuyuki Tanaka, Nozomi Hayakawa, Takeo Kosaka, Eiji Kikuchi, Mototsugu Oya
Journal: Journal of Clinical Oncology (2020)

e17086 Background: With the induction of molecular targeted agents, which interfere with proteins that play critical roles in tumor growth and progression, and immune checkpoint inhibitors (ICI), the scenario of systemic treatment of metastatic renal cell carcinoma (mRCC) have dramatically been changed with improved survival. Prognostic risk assessment is essential for choosing the most appropriate first line treatment option, with selection based on International Metastatic RCC Database Consortium (IMDC) Risk Category. This study was designed to evaluate the actual efficacy of systemic therapy in the IMDC favorable risk group patients with mRCC. Methods: A total of 218 patients with mRCC who received systemic therapy were retrospectively reviewed (Institutional review board approval No 2013-0425). Among them, 55 (25%) patients were classified as favorable risk group based on the IMDC Risk Category. These mRCC patients in the favorable risk were divided into 2 groups by following factors; gender (male or female), age (≥70, or not), baseline serum CRP levels (≥0.6, and &lt; 0.6 mg/dl), metastatic sites (exclusive lung, or lung and others), BMI (≥22, or &lt; 22), respectively. The overall survival (OS) of patients in the favorable risk group were compared between the two cohorts. Results: The median PFS for first line treatment and OS of patients in favorable risk group were 31.6 (95% CI 19.9–33.7)) and 85.8 (56.8-NE) months, respectively. The median OS in patients with BMI≥22 and &lt; 22 was 65.6 (95% CI 56.8–NE) and 56.8 (95% CI 30.8–NE) months, respectively (p = 0.0497). The median OS in patients with exclusive lung metastasis, and lung and other metastases were 115.1 (95% CI NE) and 65.6 (95% CI 43.9–NE) months, respectively (p = 0.0073). No significant difference was found in OS between male and female, age≥70 and &lt; 70, and baseline serum CRP levels ≥0.6 mg/dl and &lt; 0.6, respectively. Conclusions: The first line systemic treatment for mRCC patients in IMDC favorable risk group was feasible and effective in patients with BMI≥22 or exclusive lung metastasis.
Influence of long-term home noninvasive positive pressure ventilation on respiratory muscle strength in patients with stable severe chronic obstructive pulmonary disease
Authors: Jing-tang He, Hai-tao Liu, Jing Zhang, Tao Tian, Jian-guo Li, Bao-cai Yang, Jun-min Wang
Journal: BMJ (2008)

Objective To study the influence of long-term home noninvasive positive pressure ventilation (HNPPV) on respiratory muscle strength in patients with stable severe chronic obstructive pulmonary disease (COPD).Methods Sixty-four patients with stable severe COPD discharged from Huabei Oil-field Hospital,Renqiu,Hebei were divided into two groups,one (n=24) with HNPPV plus conventional therapy,and the other (n=40) with conventional therapy plus long-term oxygen therapy as controls.All parameters were followed-up for one-year and compared for the two groups,including maximal iuspiratory pressure (MIP),transdiaphragmatic pressure (Pdi),maximal transdiaphragmatic pressure (Pdimax),ratio of Pdi/Pdimax,arterial partial pressure of carbon dioxide (PaCO2),forced expiratory volume in one second (FEV1),6-min walking distance (6MWD),mortality and re-hospitalization rate.Results Age,gender,course of the disease,body mass index (BMI),arterial PaCO2,PaO2,MIP,Pdi,Pdiraax,ratio of Pdi/ Pdimax,FEV1,ratio of FEV1/FVC%,6MWD and re-hospitalization rate of the patients between the two groups were all comparable (P>0.05).In one-year follow-up,PaCO2averaged (52±8)mm Hg,MIP (64±7) cm H2O,Pdi (33±5) cm H2O,Pdimax (101±9) cm H2O,Pdi/Pdimax (0.31±0.04),FEV1 (35±4) %,FEV1/FVC% (44±4) %,6MWD (272±26) m and (2.6 ± 0.8) admissions per year in the HNPPV group,significantly different from those in the control group [ (57 ± 6) mm Hg,(59 ± 6) cm H2O,(31±4) cm H2O,(84±7) cm H2O,(0.35±0.05),(33±3)%,(41±4)%,(212±28) m,and (3.7±0.8) admissions per year] (P 0.05).Conclusions Long-term use of HNPPV for patients with stable severe COPD could efficiently improve their respiratory muscle strength and endurance,thus improving their pulmonary ventilation and treatment efficcacy.

Key words: 
Continuous positive airway pressure ventilation; Pulmonary disease,chronic obstructive; Respiratory muscule
Ultrasonography in diagnosis of breast granulomatous lobular mastitis
Authors: Guangju Liang
Journal: BMJ (2018)

The findings of preoperative ultrasonography in patients with granulomatous lobular mastitis treated in Xintai People′s Hospital from December 2013 to December 2016 were retrospectively analyzed. Among 15 cases of granulomatous lobular mastitis confirmed by pathology, there were 6 cases of mass type, 5 cases of tubular type and 4 cases of mixed type diagnosed by ultrasound before operation, which were consistent to pathological diagnosis in 3, 4, 3, respectively. On the ultrasound images, the blood flow signals are more rich, the tubular and mixed type have certain specificity, and color Doppler flow imaging (CDFI) usualy can make correct diagnosis. For the atypical mass lesions, the final diagnosis can be made by ultrasound-guided needle aspiration biopsy.


Key words: 
Granulomatous mastitis; Ultrasonography
Accuracy of prostate imaging reporting and data system (PI-RADS v2) in the detection of prostate cancer (PCa).
Authors: David Michael Gill, Jay Bishoff, Steven C. Lynch, Bridget Foy, Jaden D. Evans, Derrick S. Haslem, Timothy Joseph Yeatman, Logan McLean
Journal: Journal of Clinical Oncology (2020)

e17604 Background: MRI-targeted biopsy is increasingly utilized over standard 12-core transrectal ultrasound (TRUS) biopsy for men with MRI-visible prostate lesions. Some clinicians defer biopsy for PI-RADS v2 category 1 and 2 lesions per the PRECISION Study (Kasivisvanathan et. Al, NEJM, 2018). The aim of this study was to independently validate the accuracy of PI-RADS v2 in detecting prostate cancer (PCa) when applied to MRI/US fusion-guided biopsies in an independent cohort of 156 patients from a large integrated community health system. Methods: Men undergoing MRI/US fusion-guided biopsy from 2016-2020 in the Intermountain Healthcare system were consecutively analyzed in this retrospective study. MRI were interpreted from four abdominal fellowship trained radiologists all with at least 5 years of experience. Fusion biopsies were performed by two urologists. Men were stratified into groups based on their PI-RADS v2 category 1-5. Biopsies were considered positive when Gleason ≥3+3. Results: A total of 156 men had 258 lesions for which they underwent MRI/US fusion-guided biopsies in the Intermountain Healthcare system from 2016 to 2020. The PCa detection rate for PIRADSv2 category 1-2 was 29.8%, category 3 32.6%, and category 4-5 37.6%. PIRADS v2 category 1, 2, 3, 4, and 5 yielded any PCa in 25, 15.9, 23.8, 53.1, and 66.7%, respectively (Table). PIRADS v2 category 1-2, 3, and 4-5 yielded any PCa in 16.8%, 23.8%, and 57.7%, respectively. Conclusions: PI-RADS v2 categories generally correlate with PCa detection rates, however, to avoid biopsy, the test must be both sensitive and specific, with low false negative rates. In our institution, we show that PI-RADS 1, 2, and 3 do not rule out the presence of PCa, and therefore should not be used as the sole factor in determining the need for prostate lesion biopsy. [Table: see text]
Alternative anti-CD20 antibody versus desensitization for lymphoma patients with drug hypersensitivity reactions requiring discontinuation of rituximab, obinutuzumab, or ofatumumab.
Authors: Paola Ghione, Erel Joffe, Nadia De Paola, Timothy Mainardi, Sarah J. Noor, Sabela Bobillo, Patricia L. Myskowski, M. Lia Palomba, Alison J. Moskowitz, Anthony R. Mato, Fushen Sha, Gottfried Von Keudell, David J. Straus, Ariela Noy, Anas Younes, Paul A. Hamlin, Renier J. Brentjens, Miguel Angel Tejedor-Alonso, Steven M. Horwitz, Andrew David Zelenetz
Journal: Journal of Clinical Oncology (2020)

8062 Background: Immunotherapy with anti CD20 is often associated with mild easily manageable infusion reactions. In rare cases, patients experience severe drug hypersensitivity reactions (DHR) serum sickness or anaphylaxis. These in turn may lead to discontinuation of the drug. In our experience, switching to a different anti-CD20 agent is a feasible alternative to discontinuation or desensitization protocols. Methods: From our pharmacology database we identified all the patients that received rituximab and/or obinutuzumab, and/or ofatumumab, and/or all the patients who received a flat dose of less than 50 mL of the same drugs and were followed at our institution. From the medical record, we identified all the cases where the anti-CD20 antibody was changed due to allergy, serum sickness or other types of DHR, and all those who received minimal doses of anti-CD20 in the context of a desensitization protocol. DHRs were evaluated either by an allergist, or by retrospective review following the World Allergy Organization guidelines. Our primary comparison, was to assess the proportion of pts able to completed planned infusion of abs using either approach (Fisher’s exact Test). Results: Among 343 patients receiving at least two different anti-CD20 antibodies or a flat dose of &lt; 50 mL, we identified 44 patients experiencing severe DHRs needing intervention. At the time of the reaction, 16 (36%) received the anti-CD20 as single agent, 24 (54%) in combination with chemotherapy, 4 (9%) in combination with ibrutinib or lenalidomide. In 9 (20%) patients the reaction was defined as anaphylactoid (8 rituximab; 1 obinutuzumab) and in 8 (18%) patients, all receiving rituximab, as serum sickness. Episodes of DHR were addressed with either desensitization (n = 29) or change of anti-CD20 agent (n = 25), 9 patients received both of these approaches, one patient switched anti-CD20 antibodies twice. Overall, 21 desensitizations were successful (72.4%), 8 failed; 23 changes of anti-CD20 were successful (92%) and 2 failed (p = 0.09). Conclusions: In patients with DHR use of an alternative anti-CD20 antibody is safe and is an alternative or complementary approach to anti-CD20 desensitization.
The intention of quitting smoking and its influencing factors:a survey of 734 smokers in Guangzhou City
Authors: Yuan-yun Xiao
Journal: BMJ (2008)

The intention of quitting smoking and its influencing factors were surveyed with questionnaire developed by Chinese Center for Disease Control in 734 smokers in Guangzhou City.The results showed that 57.6%of the interviewed smokers intended to quit smoking.Logistic regression analysis demonstrated that 5 factors were significantly associated with the quitting intention:the attitude against smoking of family,educational background,the cost of cigarettes,addiction to smoking,awareness of the harm of smoking to health.

Key words: 
Smoking cessation; Factor analysis,statistical
异位嗜铬细胞瘤二例
Authors: 常桂娟, 洪静, 沙依热, 王新玲, 李南方
Journal: BMJ (2002)

例1 男,35岁,汉族,以反复头晕、多汗4年,加重1周于2004年5月4日入院.4年前患者无诱因出现头晕,无头痛,测血压160/100 mm Hg(1 mm Hg=0.133 kPa),未予重视及治疗。
Clinical characteristics of 277 cases with dengue fever in Guangzhou during an epidemic of 2006
Authors: 王建, 洪文昕, 陈燕清, 贾卫东, 唐小平
Journal: BMJ (2007)

目的 探讨2006年7月至9月广州地区登革热患者的临床特点,提高临床医师对登革热的认识水平.方法 对我院收治的277例登革热患者的临床资料进行回顾性分析,用C6/36细胞进行血液登革病毒(DEV)分离,逆转录-聚合酶链反应(RT-PCR)与基因测序进行分型和鉴定.结果 277例患者的年龄在9个月～78岁,平均36岁,男148例,女129例.主要临床表现为发热(100.0%)、皮疹(85.2%)、头痛(69.3%)、全身肌痛(51.3%)、骨痛(39.0%)、恶心呕吐(39.4%).白细胞及血小板减少分别占75.5%和62.5%,血液生化ALT升高占59.6%,AST升高占81.6%,低钾血症占53.8%.病原学检查登革病毒IgM阳性占90.6%,开始出现阳性的时间为病程的第3～10天,平均为6.2 d.20例患者的病毒培养液经RT-PCR和基因测序证实为登革病毒1型感染.临床分型均为典型登革热.结论 此次广州地区流行的登革热为登革病毒1型所致.病例符合典型登革热的临床表现,肝损害较多,部分病例出现低钾血症,未出现登革出血热及登革休克综合征.患者经及时诊断和治疗,预后良好。
医院临床科室电脑的细菌污染情况调查
Authors: 王燕, 李娟
Journal: BMJ (2005)

医院是细菌聚集的场所.电脑作为医院公共办公设备,使用频率高,而且经常多人交叉操作,可能成为细菌的传播媒介,造成医院内感染.为了解医院临床科室电脑的细菌污染情况,于2003年6月至2003年12月对我院临床科室使用的189台电脑的键盘和鼠标进行了细菌学调查.现报告如下。
Intracoronary ST-segment shift in diagnosis of early myocardial injury during percutaneous coronary intervention
Authors: Xue-zhong Wang, Yue-song Wang, Ping Zhang, Yong-hua Fang, Wu-zhi Li
Journal: BMJ (2011)

Objective To evaluate role of intracoronary electrocardiogram (IcECG) in examining early myocardial damage during elective percutaneous coronary intervention (PCI). Methods Eighty-six patients of coronary heart disease with normal serum levels of creatine kinase-myoglobin (CK-MB) and cardiac troponin T (cTnT) before the procedure and undergone elective PCI were enrolled in the study.Their IcECG were recorded by a intracoronary guidewire and serum levels of CK-MB and cTnT were measured at baseline and eight and 24 hours after the procedure, respectively. The patients were divided into two group, abnormal and control, according to whether they had significant shift at ST-segment in IcECG.Cardiac events after intervention in the patients were followed-up and recorded. Myocardial damage was defined as serum level of cTnT increased to above the upper normal value after intervention. Results Significant shift at ST-segment in IcECG during PCI in 30 (35%, abnormal group) and no shift in other 56patients (65%, control group) of 86 patients with normal serum levels of cardiac markers before the procedure was observed, and all the procedure were successful Serum levels of cTuT and CK-MB significantly increased after intervention in 30 patients of abnormal group than those in control one ( P <0. 01 ). Sensitivity of intracoronary ST-segment shift was 77 percent for predicting myocardial damage, and specificity was 94 percent, with positive and negative predictive values of 90 percent and 86 percent,respectively. More cardiac events were observed at 4-week follow-up after intervention in abnormal group than those in control one (P<0. 05) and major coronary event-free survival was significantly lower in those with post-procedural ST-segment elevation in IeECG (P < 0. 05). Conclusions ST-segment shift in IcECG may be helpful for predicting myocardial damage during PCI procedure on time.

Key words: 
Electrocardiography;  Coronary disease;  Angioplasty, transluminal, percutaneous coronary
Using longitudinal PSA values and machine learning for predicting progression of early stage prostate cancer in veterans.
Authors: Ioana Danciu, Samantha Erwin, Greeshma Agasthya, Tate Janet, Benjamin McMahon, Georgia Tourassi, Amy Justice
Journal: Journal of Clinical Oncology (2020)

e17554 Background: The ability to understand and predict at the time of diagnosis the trajectories of prostate cancer patients is critical for deciding the appropriate treatment plan. Evidence-based approaches for outcome prediction include predictive machine learning algorithms that harness health record data. Methods: All our analyses used the Veterans Affairs Clinical Data Warehouse (CDW). We included all individuals with a non-metastatic (early stage) prostate cancer diagnosis between 2002 and 2017 as documented in the CDW cancer registry (N = 111351). Our predictors were demographics (age at diagnosis, race), disease staging parameters abstracted at diagnosis ( Stage grouping AJCC, Gleason score, SEER summary stage) and prostate specific antigen (PSA) laboratory values in the last 5 years prior to diagnosis (last value, the value before last, average, minimum, maximum, rate of the change of the last 2 PSAs and density). The predicted outcome was disease progression at 2 years (N = 3469) and 5 years (N = 6325) defined as metastasis - taking either Abiraterone, Sipuleucel-T, Enzalutamide or Radium 223, registry cancer related death or PSA &gt; 50. We used 4 different machine learning classifiers to train prediction models: random forest, k-nearest neighbor, decision trees, and xgboost all with hyper parameter optimization. For testing, we used two approaches: (1) 20% sample held out at the beginning of the study, and (2) stratified test/train split on the remaining data. Results: The table below shows the performance of the best classifier, xgboost. The top five predictors of disease progression were the last PSA, Gleason Score, maximum PSA, age at diagnosis, and SEER summary stage. The last PSA had a significantly higher contribution than the other predictors. More than one PSA value is important for prediction, emphasizing the need for investigating the PSA trajectory in the period before diagnosis. The models are overall very robust going from outcome at 2 years compared to 5 years. Conclusions: A machine learning based xgboost classifier can be integrated in clinical decision support at diagnosis, to robustly predict disease progression at 2 and 5 years. [Table: see text]
Applying the Collaborative Care Model to treat depression and anxiety in breast cancer (BC) patients.
Authors: Kevin Nathaniel Johns, Steven Kalister, Noah Mwandha, Elizabeth J. Adams, Heidi Basinger, Susan Fugett, Danielle Crawford, Michelle Draime, Namrata Vilas Shinde, Mahmoud Kassem, Lindsey Radcliff, Brittany Unthank, Mathew Amprayil Cherian, Sagar D. Sardesai, Daniel G. Stover, Jeffrey Vandeusen, Robert Wesolowski, Nicole Olivia Williams, Bhuvaneswari Ramaswamy, Maryam B. Lustberg
Journal: Journal of Clinical Oncology (2020)

e14004 Background: Depression and anxiety are frequent causes of excess morbidity for cancer patients, but access to mental health care, including outpatient psychiatry, is limited across academic and community settings. The Collaborative Care Model (CoCM) is a team-based model of care that is proven to leverage limited mental health resources across a wider population in primary care (Raney L, Am J Psychiatry, 2015). Evidence suggests that CoCM can be effectively applied to cancer populations too (Walker J, Gen Hosp Psychiatry, 2009). Methods: The investigators adapted CoCM to treat depression and anxiety in an academic BC clinic. A quality protocol was approved by the institutional board. All English-speaking BC patients were screened for depression using the PHQ-2 and PHQ-9. Patients with PHQ-9 ≥15 or clinical suspicion of severe anxiety or depression were referred to CoCM. The CoCM intervention included social work care management and regular case reviews by a psychiatrist. Medical oncologists prescribed all psychiatric medications. Patients were referred to mental health services in the community as needed. Results: From November 2018 through January 2020, a total of 74 patients were enrolled in CoCM. Median age was 50 years (range: 28-74 years) with BC stages I-III (n = 49, 66.2%) and stage IV (n = 25, 33.8%). Treatments within the cohort include: endocrine therapy (n = 39, 52.7%), chemotherapy (n = 18, 24.3%), observation (n = 9, 12.1%), single agent HER2 inhibitor targeted therapy (n = 4, 5.4%), immunotherapy (n = 2, 2.7%), single agent CDK4/6 inhibitor (n = 1, 1.4%), and radiation (n = 1, 1.4%). Of the 74 patients, 28 had PHQ-9 scores ≥15 at enrollment. On average, ending PHQ-9 scores decreased 39% from the initial score (average beginning score of 19.3 and ending score of 11.3 [n = 19]). 50 patients had GAD-7 ≥10 at enrollment. On average, ending GAD-7 scores decreased 36% from the initial score (average beginning score of 15.4 and ending score of 9.9 [n = 32]). On a 5-point scale, the average patient satisfaction score was 4.3 [range: 4.1-4.5] and the average medical oncology satisfaction score was 4.6 [range: 4.5-4.7]. Financial viability is promising based on projections that 93.4% of psychiatry costs (10% salary + benefits) are covered by reimbursements for care and 2 existing social workers serving as care managers. Conclusions: The collaborative care model is an effective and financially sustainable approach to promptly address depression and anxiety symptoms in BC. Further studies are needed to assess its applicability to patients with other forms of cancers.