RESUMO
Background: Tamoxifen is a widely prescribed selective estrogen receptor modulator (SERM) used for the treatment and prevention of hormone receptor-positive breast cancer. While tamoxifen has proven effective in lowering the chance of cancer recurrence, current data point to a possible link between tamoxifen treatment and unfavorable psychological consequences. Objective: In this study, the World Health Organization (WHO) pharmacovigilance database will be analyzed to determine the frequency and kind of psychiatric disorders linked to the use of the tamoxifen as well as Kosovo pharmacists awareness of these reported adverse effects. Methods: The WHO pharmacovigilance database, VigiBase, was queried for adverse drug reaction reports related to tamoxifen use between 1978 and 2022. A cross-sectional survey of 70 community pharmacies operating in Kosovo was conducted as part of the data collection between January 1 and March 1, 2023, with the goal of comparison. Results: The search of VigiBase yielded a total of 1746 reported cases of psychiatric disorders. The data were further classified based on the type of psychiatric adverse effect, including depressive disorders, anxiety disorders, cognitive impairment, and other psychiatric symptoms. Depressive disorders were the most frequently reported adverse event, accounting for 30% of the cases. Anxiety disorders and sleeps disorders were also prevalent, comprising 11% and 7% of the reported cases, respectively. Other psychiatric symptoms such as mood swings, insomnia, and confusion were observed in 32% of the cases. In Kosovo, 30% of pharmacists linked tamoxifen with depression, 25% with anxiety, 56% with sleep disorders, 53% insomnia, and 18% confusion. Conclusions: Based on the WHO pharmacovigilance database and knowledge of Kosovo pharmacists for these documented adverse effects, this study analyzes tamoxifen-induced psychiatric disorders... (AU)
Assuntos
Humanos , Tamoxifeno , Receptores de Estrogênio , Terapêutica , Prevenção de Doenças , Neoplasias da Mama , Impactos da Poluição na Saúde , Estresse Psicológico , Farmacovigilância , Kosovo , Estudos TransversaisRESUMO
Objective: To explore the effect of acupuncture at Fuguan point combined with tamoxifen citrate tablet on sperm motility parameters. Methods: A total of 115 individuals with asthenospermia were categorized based on different treatment regimens: 53 patients in the control group (receiving tamoxifen citrate tablets) and 62 patients in the observation group (undergoing acupoint acupuncture in conjunction with tamoxifen citrate tablets). Both groups underwent a 3-month treatment period. The computer-assisted sperm analysis system was employed to measure various motility parameters of human sperm, including sperm motility rate, average path velocity (VAP), lateral swing amplitude (ALH), percentage of class a sperm, and percentage of class a + b sperm. Results: Prior to treatment, no statistically significant differences were observed between the two groups in terms of sperm motility rate, VAP, ALH, percentage of class a sperm, and percentage of class a + b sperm (p > 0.05). Following treatment, both groups exhibited significant enhancements in sperm motility rate, VAP, ALH, percentage of class a sperm, and percentage of class a + b sperm compared to pretreatment levels (p < 0.05). Furthermore, all measured indicators in the observation group demonstrated significantly superior improvements than those of the control group, with the differences proving statistically significant (p < 0.05). Conclusions: The combination of acupuncture at Fusiguan point and tamoxifen citrate tablets exerts a notably positive effect on sperm motility in individuals diagnosed with asthenospermia. (AU)
Assuntos
Humanos , Astenozoospermia/tratamento farmacológico , Astenozoospermia/terapia , Terapia por Acupuntura , Tamoxifeno , Estudos RetrospectivosRESUMO
Los pólipos endometriales representan un trastorno común en la práctica habitual en ginecología. Si bien se han identificado factores de riesgo asociados a su proliferación, se desconoce la causa exacta de su aparición. En ocasiones su manejo es controvertido, siendo difícil para el clínico optar en muchos casos por una actitud expectante con seguimientos periódicos dado que el riesgo de malignidad de esta entidad no es despreciable. El objetivo del presente artículo es la realización de una revisión exhaustiva de la literatura, a partir de las principales bases de datos, sobre el diagnóstico y manejo de pólipos endometriales, así como de la fisiopatología y epidemiología, con el fin de conocer la última evidencia científica sobre esta entidad.(AU)
Endometrial polyps are a common disorder in routine gynaecological practice. Although risk factors associated with their proliferation have been identified, the exact cause of their onset is unknown. Sometimes their management is controversial, in many cases it being difficult for the clinician to opt for a wait-and-see approach with periodic follow-ups, given that the risk of malignancy with this entity is not negligible. The objective of this article was to carry out an exhaustive review of the literature, based on the main databases, on the diagnosis and management of endometrial polyps, and their pathophysiology and epidemiology, to determine the latest evidence and scientific information regarding this entity.(AU)
Assuntos
Pré-Menopausa , Neoplasias do Endométrio , Endométrio/lesões , Endometriose/diagnóstico , Tamoxifeno , Hemorragia Uterina , Ginecologia , ObstetríciaRESUMO
Purpose Endocrine therapy is a mainstay for the treatment of hormone receptor-positive breast cancer (BC); however, only a fraction of patients experience a pronounced response to antagonists of estrogen signaling. There is a need to identify predictors for efficacy of this treatment. Methods This study included 138 patients with newly diagnosed metastatic BC, who received upfront endocrine therapy. Archival biopsy specimens were tested for CCND1 and FGFR1 gene amplification and mRNA expression by PCR-based methods. Results CCND1 and FGFR1 amplification was detected in 24 (17.9%) and 28 (20.9%) of 134 evaluable cases, respectively; 9 carcinomas had concurrent alterations of these two genes. Presence of amplification in at least one locus was more common in tumors of higher grade (p = 0.018) and was associated with higher Ki-67 proliferation index (p = 0.036). CCND1 gene amplification was associated with shorter progression-free survival (PFS) in patients receiving aromatase inhibitors (AI) [16.0 months vs. 32.4 months, HR = 3.16 (95% CI 1.267.93), p = 0.014]. FGFR1 status did not significantly affect PFS of AI-treated women; however, objective response to AI was observed less frequently in FGFR1-amplified BC as compared to cases with normal FGFR1 copy number [2/15 (13.3%) vs. 22/46 (47.8%), p = 0.031]. Meanwhile, CCND1/FGFR1 gene status did not influence the outcome of tamoxifen-treated patients. Conclusion Presence of CCND1 and/or FGFR1 amplification is associated with worse outcomes of AI therapy in patients with metastatic BC (AU)
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Inibidores da Aromatase/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/genética , Ciclina D1/genética , Amplificação de Genes , Fator 1 de Crescimento de Fibroblastos/metabolismo , Neoplasias da Mama/patologia , Resistencia a Medicamentos Antineoplásicos , Tamoxifeno/uso terapêuticoRESUMO
El cáncer de mama puede alterar ciertos componentes de la función sexual debidos a la enfermedad y los tratamientos empleados en su abordaje. OBJETIVO: Analizar si las pacientes con cáncer de mama en tratamiento con Tamoxifeno presentan disfunción sexual. MÉTODO: Estudio transversal, observacional para detectar disfunción sexual en pacientes con cáncer de mama en tratamiento con Tamoxifeno y comparar los resultados con población general. Se han analizado los casos de cáncer de mama diagnosticados en el Hospital Virgen de la Luz de abril de 2015 a abril 2016, seleccionando mujeres en tratamiento con Tamoxifeno, menores de 50 años y sexualmente activas, aplicándoseles un cuestionario de salud sexual, posteriormente se compararon los resultados obtenidos con un estudio realizado en población general. RESULTADOS: Se diagnosticaron 130 cánceres de mama en dicho periodo, siendo 34 susceptibles de estudio (26,15 %). Participaron 7 pacientes (20.6%), con edad media de 42,7 años (35-50) y pareja estable en el 85,7%. Se han objetivado trastornos moderados del deseo sexual en un 28,6% y de excitación en 14,28%, así como ausencia de iniciativa sexual en un 42,86%, trastorno de la lubricación vaginal en un 28,6% y problemas para la penetración vaginal en un 14,3 %, pero globalmente están satisfechas con su actividad sexual. Comparando con población general, llama la atención que un 14,2 % de éstas últimas muestra algún grado de insatisfacción sexual. CONCLUSIONES: No hay diferencias significativas en cuanto a disfunción sexual, aunque puede haber mayor ansiedad anticipatoria y disfunción del deseo sexual y lubricación vaginal en el grupo de Tamoxifeno, que probablemente no alcanzan la significación estadística por el tamaño muestral
Breast cancer can alter certain components of sexual function due to the disease and the treatments used. OBJECTIVE: To analyze if patients with breast cancer treated with Tamoxifen have sexual dysfuntion. METHOD: Cross-sectional, observational study to detect sexual dysfunction in patients with breast cancer with Tamoxifen treatment and compare it with general population. The cases of breast cancer at Virgen de La Luz Hospital from April 2015 to April 2016 have been analyzed, selecting women in treatment with tamoxifen, under 50 years and sexually active, applying a sexual health questionnarie and comparing them with general population. RESULTS: 130 breast cancers were diagnosed, 34 were susceptible to study (26,15%). Seven patients (20,6%) participated, with a mean age of 42,7 years (35-50) and stable partner in 85,7%. Moderate disorders of sexual desire have been observed in 28,6% and in arousal in 14,28%, as well as lack of sexual initiative in 42,86%, disorder of vaginal lubrication in 28,6% and problems with vaginal penetration in 14,3%, but overall they are satisfied with their sexual activity. Comparing with general population, it's striking that 14,2% of the last show some degree of sexual insatisfaction. CONCLUSIONS: There are no significant differences regarding sexual dysfunction, although there may be greater anticipatory anxiety, sexual desire dysfunction and vaginal lubrication in the Tamoxifen group, which probably do not reach statistical significance due to sample size
Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Tamoxifeno/uso terapêutico , Tamoxifeno/efeitos adversos , Antineoplásicos Hormonais/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Saúde Sexual , Disfunções Sexuais Fisiológicas/etiologia , Disfunções Sexuais Psicogênicas/etiologia , Inquéritos e Questionários , Estudos TransversaisRESUMO
INTRODUCCIÓN: El tamoxifeno es un antiestrógeno no esteroideo que actúa como antagonista en el tejido mamario, la retina neurosensorial y el epitelio pigmentario de la retina (EPR). La incidencia de sus efectos oculares varía entre el 0,9 y el 11%. MÉTODOS: Serie de casos. Se evaluaron tres pacientes de sexo femenino mediante estudio por imagen multimodal que recibieron tamoxifeno por cáncer de mama con el propósito de realizar el seguimiento y determinar si hay cambios luego de la suspensión del tratamiento. RESULTADOS: Las tres pacientes presentaron signos de retinopatía cristalina durante el seguimiento con tomografía de coherencia óptica de dominio espectral (SD-OCT). CONCLUSIÓN: El seguimiento mediante estudios de imagen multimodal permitió evaluar la progresión de los cambios aportando una valoración pronóstica. Los hallazgos encontrados (agudeza visual e imagen multimodal) confirmaron los resultados de estudios previos que indicaban que, a un determinado nivel de toxicidad, el daño era irreversible
INTRODUCTION: Tamoxifen is a non-steroidal anti-oestrogen that acts as an antagonist in breast tissue, neurosensory retina, and retinal pigment epithelium (RPE). The reported incidence of its ocular effects varies between 0.9% and 11%. METHODS: Case series. Multimodal image studies were used to evaluate three female patients who were receiving tamoxifen for breast cancer for the purpose of monitoring and determining whether there are changes after discontinuation of treatment. RESULTS: All three patients showed signs of crystalline retinopathy using spectral domain optical coherence tomography (SD-OCT) during follow-up. CONCLUSION: The follow-up using multimodal imaging studies allowed evaluating the progression of the changes, providing a prognostic assessment. The findings reported (visual acuity and multimodal imaging) confirmed the results of previous studies, indicating that, at a certain level of toxicity, the damage was irreversible
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Idoso , Tamoxifeno/toxicidade , Doenças Retinianas/induzido quimicamente , Imagem Multimodal/métodos , Progressão da Doença , Doenças da Coroide/induzido quimicamente , Doenças Retinianas/patologia , Tomografia de Coerência Óptica/métodos , Acuidade Visual , Doenças da Coroide/diagnósticoRESUMO
OBJETIVO: Los inhibidores de la aromatasa (IA) se han asociado con una pérdida de masa ósea acelerada y un mayor riesgo de fracturas osteoporóticas. Con este trabajo se pretendió evaluar los factores de riesgo de fractura incidente en pacientes con cáncer de mama que reciben IA. MATERIAL Y MÉTODOS: Estudio prospectivo-observacional de cohorte de mujeres con cáncer de mama que inician tratamiento con IA (cohorte B-ABLE). Las pacientes realizaron tratamiento durante 5 años o bien 2 ó 3 años si habían recibido previamente tamoxifeno. Se les evaluó la salud ósea desde el inicio del tratamiento hasta un año después de finalizar dicho tratamiento mediante densitometría ósea, marcadores de remodelado óseo, niveles de vitamina D y una radiografía antero-posterior y otra lateral de columna. Se realizó el cálculo de riesgo de fractura mediante la herramienta FRAX® antes de iniciar IA. Se utilizaron modelos de Cox para calcular los ratios de riesgo (HR [IC 95%]) de fractura. RESULTADOS: Un total de 943 pacientes fueron incluidas en el estudio. El 5,4% sufrieron una fractura incidente, la mayoría durante el tratamiento con IA, aunque un 21,5% ocurrieron durante el primer año después de finalizar la terapia. La mayoría de las fracturas incidentes fueron vertebrales clínicas (29,4%) y de Colles (31,4%). El 86,3% de las pacientes tenían un diagnóstico de osteopenia u osteoporosis en el momento de la fractura y el 33% tenían los niveles de β-CTX (isómero β del telopéptido carboxiterminal del colágeno tipo I) por encima de la normalidad. Las pacientes diagnosticadas de osteoporosis o con riesgo de fractura al inicio del estudio fueron tratadas con antirresortivos óseos. No se encontraron diferencias significativas en el riesgo de fractura entre pacientes con y sin tratamiento antirresortivo: HR=1,75 [IC 95%: 0,88 a 3,46]. Tampoco se encontraron diferencias entre las pacientes que habían hecho tratamiento previo con tamoxifeno respecto a las que no (HR=1,00 [IC 95%: 0,39 a 2,56]). La herramienta FRAX® dio valores de media dentro del rango de riesgo intermedio, con 13 pacientes con valores de alto riesgo de fractura principal. CONCLUSIONES: El principal factor de riesgo detectado para fractura incidente en pacientes tratadas con IA es el diagnóstico de osteopenia u osteoporosis. El cálculo de la herramienta FRAX® y la determinación de los niveles de β-CTX son herramientas útiles para identificar a pacientes de alto riesgo
OBJETIVO:Aromatase inhibitors (AI) have been associated with an accelerated loss of bone mass and an increased risk ofosteoporosis fractures. This study assesses the risk factors for incident fracture in breast cancer patients receiving AI. MATERIAL AND METHODS:Prospective‐observational cohort study of women with breast cancer who begin treatment withAI (B‐ABLE cohort). Patients were treated for 5 years or 2 or 3 years if they had previously received tamoxifen. Bone healthwas assessed from the beginning of the treatment until one year post treatment by bone densitometry, bone remodelingmarkers, vitamin D levels and an anteroposterior and lateral spine radiography. The fracture risk calculation was performedusing the FRAX® tool before starting AI. Cox models were used to calculate the risk ratios (HR [95% CI]) of fracture. RESULTS: A total of 943 patients were included in the study.5.4% suffered an incident fracture, most during AI treatment,although 21.5% occurred during the first year after the end of therapy. Most of the incident fractures were clinical vertebral (29.4%) and Colles (31.4%).86.3% of the patients had a diagnosis of osteopenia or osteoporosis at the time of the fractureand 33% had the levels of β‐CTX (β isomer of the carboxyterminal telopeptide of type I collagen) above normal. Patients diagnosed with osteoporosis or at risk of fracture at the start of the study were treated with bone antiresorptives. No significant differences in fracture risk were found between patients with and without antiresorptive therapy: HR=1.75[95% CI: 0.88 to 3.46]. Nor were differences found among patients who had previously treated with tamoxifen comparedto those who did not (HR=1.00 [95% CI 0.39 to 2.56]). The FRAX®tool gave average values within the intermediate riskrange, with 13 patients with high risk of major fracture values. CONCLUSIONS:The main risk factor detected for incident fracture in patients treated with AI is the diagnosis of osteopeniaor osteoporosis. The calculation of the FRAX® tool and the determination of β‐CTX levels are useful tools to identifyhigh‐risk patients
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Idoso , Neoplasias da Mama/tratamento farmacológico , Inibidores da Aromatase/efeitos adversos , Inibidores da Aromatase/uso terapêutico , Índice de Massa Corporal , Fraturas por Osteoporose/induzido quimicamente , Tamoxifeno/efeitos adversos , Tamoxifeno/uso terapêutico , Fatores de Risco , Estudos Prospectivos , Estudos de Coortes , IncidênciaRESUMO
Objetivos: Evaluar la proporción de afiliados al Seguro de Salud del Hospital Italiano de Buenos Aires con adherencia primaria a: 1) bifosfonatos para la prevención secundaria de fractura osteoporótica; 2) insulina y metformina para el tratamiento de diabetes tipo 2, y 3) tamoxifeno en el contexto del tratamiento del cáncer mamario. Diseño: Cohorte retrospectiva para determinar la proporción de la adherencia primaria durante los años 2012 y 2013. Emplazamiento: Hospital Italiano de Buenos Aires, Argentina. Participantes: Afiliados al Seguro de Salud del Hospital Italiano de Buenos Aires, a quienes en el periodo descrito anteriormente se les hubiera realizado una prescripción electrónica nueva de los fármacos descritos previamente. Fueron evaluadas 1.403 nuevas prescripciones electrónicas de los fármacos analizados, de las cuales se excluyeron 673 por no cumplir con los criterios de inclusión. Mediciones principales: Adherencia primaria: constatación de que se dispensó la nueva medicación durante los primeros 30 días de haber sido realizada la prescripción electrónica índice. El análisis primario evaluó la proporción de adherencia primaria de los diferentes medicamentos. Se realizó un análisis bivariado para comparar las características y los posibles predictores. Resultados: La proporción de adherencia primaria para los fármacos y las familias de los fármacos analizados fue: bifosfonatos, 93%; metformina, 88%; insulina, 96%; y tamoxifeno, 92%. Conclusiones: Este es el primer estudio que evaluó la adherencia primaria en Argentina y, según los resultados de nuestra búsqueda, el primero en el mundo para tamoxifeno. La adherencia primaria documentada en nuestra investigación fue algo mayor que la informada en la bibliografía (AU)
Objectives: To assess the proportion of members of a private health insurance at the Hospital Italiano de Buenos Aires with primary adherence to, 1) bisphosphonates for secondary prevention of osteoporotic fractures, 2) insulin and metformin in type 2 diabetes, and 3) tamoxifen in the context of treatment of breast cancer. Design: Retrospective cohort study to determine the proportion of primary treatment adherence during 2012 and 2013. Site: Hospital Italiano de Buenos Aires, Argentina. Participants: Members of the Hospital Italiano de Buenos Aires private health insurance, who had received a new electronic prescription (alendronate or ibandronate for secondary prevention of fractures following an osteoporotic fracture; insulin and/or metformin for type 2 diabetes; or tamoxifen as a treatment for breast cancer) during the years 2012 and 2013. An analysis was performed on 1,403 new electronic prescriptions, of which 673 were excluded for not meeting the inclusion criteria. Main measurements: Primary adherence has been defined as the execution of a first-time treatment after it was agreed with the health care provider. The primary analysis assessed the proportion of primary adherence for the three medications. A bivariate analysis was performed to compare the characteristics and potential predictors of primary adherence. Results: Primary adherence for each drug group was, 93% Bisphosphonates, 88% Metformin, 96% Insulin, and 92% Tamoxifen. Conclusions: To the best of our knowledge, this is the first study that has evaluated primary adherence in Argentina, and the first for Tamoxifen world wide. The primary adherence documented in our study was somewhat higher than that reported in the literature (AU)
Assuntos
Humanos , Adesão à Medicação/estatística & dados numéricos , Doença Crônica/tratamento farmacológico , Doença Crônica/epidemiologia , Seguro Saúde/organização & administração , Difosfonatos/uso terapêutico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Osteoporose/tratamento farmacológico , Argentina/epidemiologia , Insulina/uso terapêutico , Metformina/uso terapêutico , Tamoxifeno/uso terapêutico , Estudos RetrospectivosRESUMO
No disponible
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Ascite Quilosa/complicações , Ascite Quilosa , Carcinoma/etiologia , Carcinoma , Achados Incidentais , Neoplasias da Mama , Paracentese/métodos , Mastectomia Radical/métodos , Excisão de Linfonodo/métodos , Carcinoma Ductal de Mama/complicações , Antraciclinas/uso terapêutico , Tamoxifeno/uso terapêutico , Nutrição Enteral/métodosRESUMO
No disponible
Assuntos
Humanos , Feminino , Adulto , Neurofibromatose 1/complicações , Neurofibromatose 1 , Neoplasias da Mama/complicações , Tronco Encefálico/patologia , Tronco Encefálico , Biópsia , Carcinoma Ductal , Glioma , Glioma do Nervo Óptico , Neurofibromatose 1/tratamento farmacológico , Neurofibromatose 1/radioterapia , Terapia Neoadjuvante , Tamoxifeno/uso terapêuticoRESUMO
No disponible
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias da Mama Masculina/complicações , Neoplasias da Mama Masculina/cirurgia , Neoplasias da Mama Masculina , Carcinoma Papilar/cirurgia , Carcinoma Papilar , Expectativa de Vida/tendências , Mamografia/métodos , Biópsia com Agulha de Grande Calibre/métodos , Biópsia com Agulha de Grande Calibre , Mastectomia , Biópsia de Linfonodo Sentinela/métodos , Tamoxifeno/uso terapêutico , Imuno-Histoquímica/métodosRESUMO
Metastatic breast cancer is a heterogeneous disease that presents in varying forms, and a growing number of therapeutic options makes it difficult to determine the best choice in each particular situation. When selecting a systemic treatment, it is important to consider the medication administered in the previous stages, such as acquired resistance, type of progression, time to relapse, tumor aggressiveness, age, comorbidities, pre- and post-menopausal status, and patient preferences. Moreover, tumor genomic signatures can identify different subtypes, which can be used to create patient profiles and design specific therapies. However, there is no consensus regarding the best treatment sequence for each subgroup of patients. During the SABCC Congress of 2014, specialized breast cancer oncologists from referral hospitals in Europe met to define patient profiles and to determine specific treatment sequences for each one. Conclusions were then debated in a final meeting in which a relative degree of consensus for each treatment sequence was established. Four patient profiles were defined according to established breast cancer phenotypes: pre-menopausal patients with luminal subtype, post-menopausal patients with luminal subtype, patients with triple-negative subtype, and patients with HER2-positive subtype. A treatment sequence was then defined, consisting of hormonal therapy with tamoxifen, aromatase inhibitors, fulvestrant, and mTOR inhibitors for pre- and post-menopausal patien ts; a chemotherapy sequence for the first, second, and further lines for luminal and triple-negative patients; and an optimal sequence for treatment with new antiHER2 therapies. Finally, a document detailing all treatment sequences, that had the agreement of all the oncologists, was drawn up as a guideline and advocacy tool for professionals treating patients with this disease (AU)
No disponible
Assuntos
Humanos , Feminino , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/terapia , Congressos como Assunto/normas , Metástase Neoplásica/terapia , Hormônios/uso terapêutico , Tamoxifeno/uso terapêutico , Inibidores da Aromatase/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama , Pós-Menopausa , Pré-Menopausa , Receptor ErbB-2/análise , Bevacizumab/uso terapêutico , Capecitabina/uso terapêuticoRESUMO
No disponible
Assuntos
Humanos , Masculino , Adulto , Hepatectomia/métodos , Hemangioma/complicações , Hemangioma/cirurgia , Tamoxifeno/uso terapêutico , Abdome/patologia , Abdome , Neoplasias Abdominais/patologia , Neoplasias Abdominais/cirurgia , Neoplasias AbdominaisRESUMO
No disponible
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Neoplasias da Mama/complicações , Hipopituitarismo/complicações , Metástase Neoplásica/diagnóstico , Metástase Neoplásica/fisiopatologia , Neoplasias Hipofisárias/complicações , Carcinoma Ductal de Mama/complicações , Carcinoma Ductal de Mama/diagnóstico , Neoplasias da Mama/tratamento farmacológico , Hiponatremia/diagnóstico , Hipoglicemia/complicações , Hipoglicemia/diagnóstico , Cetose/complicações , Cetose/diagnóstico , Tamoxifeno/uso terapêutico , Hidrocortisona/uso terapêutico , Tiroxina/uso terapêuticoRESUMO
Objetivos: El objetivo del estudio fue analizar los cambios en la densidad mineral ósea (DMO) a lo largo del tratamiento con inhibidores de aromatasa (IA) en la práctica clínica y evaluar la asociación entre el gen CYP11A1 y la variación de DMO al final del tratamiento. Material y métodos: La cohorte B-ABLE es un estudio prospectivo de mujeres postmenopáusicas con cáncer de mama, en tratamiento con IA. Se analizó la variación de DMO durante todo el tratamiento con IA, así como las diferencias entre las pacientes tratadas y no-tratadas previamente con tamoxifeno (TMX). Tres polimorfismos (rs4077581, rs11632698 y rs900798) del gen CYP11A1, fueron genotipados para su asociación con la variación de DMO. Resultados: Las pacientes tratadas con TMX mostraron pérdidas más aceleradas de DMO que las no tratadas previamente con TMX (60% menos en columna y 46% en fémur a los 2 años y 70% menos en columna y 63% en fémur a los 3 años). No obstante, al final del tratamiento no se detectaron diferencias significativas en la pérdida de DMO entre ambos grupos de pacientes. Los 3 polimorfismos del gen CYP11A1 resultaron significativamente asociados a la variación de DMO en fémur al final del tratamiento. Conclusiones: La DMO disminuyó de forma más acelerada en las pacientes con tratamiento previo con TMX que en las que solo recibieron AI, a pesar de que no se detectaron diferencias significativas al final de tratamiento. Polimorfismos en el gen CYP11A1 están relacionados con la variación de la DMO en respuesta al tratamiento con IA (AU)
Objectives: The aim of this study was to analyze bone mineral density (BMD) changes throughout aromatase inhibitor (AI) treatment in clinical cases and also consider its association with the CYP11A1 gene and the BMD variation after treatment. Material and methods: The B-ABLE cohort is a prospective study of postmenopausal women with breast cancer, in AI treatment. BMD variation was analyzed during AI treatment, as well as the differences those patients who were treated and not treated previously with tamoxifen (TMX). Three polymorphisms (rs4077581, rs11632698 and rs900798) of the CYP11A1 gene were genotyped for their association with BMD variation. Results: TMX-treated patients presented more rapid BMD loss than those who did not undergo prior TMX treatment (60% less in spine and 46% in femur at 2 years and 70% less in the spine and 63% in the femur at 3 years). However, no significant BMD loss was detected after treatment in either group. The 3 CYP11A1 gene polymorphisms were significantly associated with BMD variation in the femur at the end of the treatment. Conclusions: BMD was reduced more rapidly in patients with prior TMX treatment than in those who only received AI, although no significant differences were detected after treatment. The 3 CYP11A1 gene polymorphisms were associated with BMD variation in response to AI treatment (AU)
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Densidade Óssea , Inibidores da Aromatase/farmacocinética , Neoplasias da Mama/complicações , Estudos Prospectivos , Tamoxifeno/uso terapêutico , Antineoplásicos/efeitos adversosRESUMO
El Consenso de Cáncer de Mama y Fertilidad de la Sociedad Española de Senología y Patología Mamaria es un documento elaborado por un amplio grupo de expertos de todas las especialidades implicadas en cáncer de mama. El presente documento se concluyó en el Primer Congreso Español de la Mama, celebrado en Madrid en octubre de 2014, y es una actualización del consenso que fue publicado en Revista de Senología y Patología Mamaria en 2009. Los avances que se están produciendo, tanto en el campo de la fertilidad como en la oncología, obligarán sin ninguna duda a una nueva revisión de las recomendaciones en un futuro cercano (AU)
The Consensus on Breast Cancer and Fertility of the Spanish Society of Senology and Breast Pathology (Sociedad Española de Senología y Patología Mamaria) is a document prepared by a wide group of experts in all the specialties involved in breast cancer. This document was finished at the 1st Spanish Congress on Breast Cancer, held in Madrid in October 2014, and is an update of the consensus document published in Revista de Senología y Patología Mamaria in 2009. Because of the advances currently taking place in the fields of both fertility and oncology, a new review of the recommendations will undoubtedly be needed in the near future (AU)
Assuntos
Feminino , Humanos , Gravidez , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/prevenção & controle , Fertilidade/fisiologia , Reprodução/fisiologia , Complicações na Gravidez/fisiopatologia , Preservação da Fertilidade/métodos , Preservação da Fertilidade , Sociedades Médicas/organização & administração , Sociedades Médicas/normas , Anticoncepção/instrumentação , Anticoncepção/métodos , Aleitamento Materno , Tamoxifeno/uso terapêutico , Indução da Ovulação/métodosRESUMO
Purpose. Trastuzumab has proven to improve the prognosis of HER2-positive breast cancer, but the information available about its administration for small tumors is still limited. Therefore, we assessed the use of adjuvant regimens with trastuzumab for the treatment of small HER2-positive breast cancer in routine clinical practice. Methods. This observational study was conducted in patients with HER2-positive breast adenocarcinoma ≤1.5 cm who received trastuzumab-based adjuvant treatment in clinical practice. Clinical/histopathological data were retrieved from patients medical charts. Results. A total of 101 evaluable patients were enrolled (median age [range], 56.7 [49.064.8] years; ECOG 0, 98.0 %; ductal carcinoma, 88.1 %; lymph nodes N0, 79.2 %). Only five (5.0 %) patients received neoadjuvant treatment, while all patients underwent tumor surgery. Adjuvant trastuzumab was administered at a mean (±SD) dose of 5.9 ± 1.5 mg/kg/cycle, and mostly in a three-weekly schedule (89 [89.0 %] patients). The most frequent adjuvant therapy used with trastuzumab was chemotherapy (87 [86.1 %] patients), followed by radiotherapy (63 [62.4 %] patients) and hormone therapy (52 [51.5 %] patients). Chemotherapy regimens mainly included doxorubicin, cyclophosphamide and paclitaxel/docetaxel (n = 30), docetaxel and cyclophosphamide (n = 15), docetaxel and carboplatin (n = 13). Hormone therapy mainly included letrozole (n = 17) and tamoxifen (n = 17). Nine (8.9 %) patients reported trastuzumab-related adverse events; only one allergic reaction reached grade 3 toxicity. Conclusion. This study shows that trastuzumab-based adjuvant treatment of small HER2-positive breast cancer is mostly based on chemotherapymainly paclitaxel/docetaxel. Adjuvant administration of trastuzumab for small HER2-positive breast cancer seems to be similar to that used for larger tumors (AU)
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Assuntos
Feminino , Humanos , Neoplasias da Mama/tratamento farmacológico , Quimioterapia Adjuvante/instrumentação , Quimioterapia Adjuvante/métodos , Quimioterapia Adjuvante , Ciclofosfamida/uso terapêutico , Paclitaxel/uso terapêutico , Carboplatina/uso terapêutico , Receptor ErbB-2/análise , Receptor ErbB-2 , Anticorpos Monoclonais/uso terapêutico , Tamoxifeno/uso terapêutico , Imuno-Histoquímica/métodos , Imuno-HistoquímicaRESUMO
Objetivo. Determinar la influencia a nivel celular y molecular de varios tratamientos hormonales (estrógeno, tamoxifeno y fulvestrant) sobre las células epiteliales y las células madre de la mama sana y tumoral. Métodos. Se emplearon muestras de tejido mamario sano y tumoral, así como líneas celulares de cáncer de mama y células resistentes a tamoxifeno, para analizar los efectos de las hormonas sobre la proliferación y diferenciación celular. Resultados. Las células epiteliales y las células madre de la mama respondieron de forma diferente a los tratamientos hormonales. Las células resistentes a tamoxifeno presentaban un mayor contenido de células madre cancerosas y expresaban niveles de Sox2 más elevados, mientras que los niveles de expresión del receptor de progesterona eran muy bajos. Las células resistentes a tamoxifeno eran, además, más resistentes al tratamiento con fulvestrant. Conclusiones. El desarrollo de resistencia a tamoxifeno está asociado con un incremento en el contenido de células madre cancerosas. El tratamiento con fulvestrant no parece disminuir la población de células madre cancerosas. Sox2 podría ser un biomarcador de resistencia a tamoxifeno en el cáncer de mama (AU)
Objective. To determine the influence of various hormones (estrogen, tamoxifen and fulvestrant) on cell proliferation and differentiation in normal and cancer breast stem cells. Methods. Primary tissue samples, breast cancer cell lines and tamoxifen-resistant cells were used to analyze the effects of hormones on cell proliferation and differentiation. Results. Breast epithelial cells and stem cells responded differentially to hormone treatments. Tamoxifen-resistant cells showed increased cancer stem cell content and expressed higher Sox2 levels, while progesterone receptor levels were very low. Tamoxifen-resistant cells were resistant to fulvestrant treatment. Conclusions. The development of tamoxifen resistance is associated with an increase in cancer stem cell content. Treatment with fulvestrant does not appear to reduce the cancer stem cell population. Sox2 could represent a biomarker of tamoxifen resistance in breast cancer (AU)
Assuntos
Humanos , Feminino , Células-Tronco/patologia , Células-Tronco , Tamoxifeno , Tamoxifeno/metabolismo , Resistência a Medicamentos , Resistência a Medicamentos/fisiologia , Biomarcadores , Neoplasias da Mama/diagnóstico , Antagonistas de Estrogênios , Estrogênios , Estrogênios/uso terapêutico , 28599RESUMO
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