CLINICAL, MAMMOGRAPHIC AND HISTOPATHOLOGICAL CORRELATION OF BREAST CANCER IN WOMEN AGED BETWEEN 50 AND 70 YEARS / Correlação clínica, mamográfica e histopatológica do câncer mamário em mulheres com idade entre 50 e 70 anos

Objective: To correlate the clinical, mammographic and histopathological findings of women aged between 50 and 70 years old who were diagnosed with breast cancer and were assisted between 1998 and 2013 at the Mastology Outpatient Clinic of the Center for Full Attention to Women's Health in Universidade Estadual de Campinas (CAISM-Unicamp). Methods: This was a cross-sectional and retrospective study, in which the medical records and mammograms of 160 women were analyzed, a sufficient sample size for the statistical analysis. The variables used for comparison were the clinical, mammographic and histopathological findings, analyzed through descriptive and associative statistics. Results: Of the 160 cases analyzed, 76.9% were symptomatic, and the main clinical findings included palpable nodule (68.1%) and skin alterations (30%). The prevalent mammographic presentations in asymptomatic women were microcalcifications (48.7%), nodules (43.2%) and architectural distortion (8.1%). Regarding the histological type, 81.3% presented invasive ductal carcinoma (IDC) and 10.7%, ductal carcinoma in situ (DCIS). Conclusion: The present study showed that there was a predominance of symptomatic women with mammographic presentation of spiculated nodules and histological type of IDC. In the other patients with lesions detected in the screening test, pleomorphic microcalcifications were prevalent as the main finding of DCIS. Diagnostic mammography was the main form of detection of breast cancer, which may represent the lack of access of these women to screening or early detection of malignant lesions. This reveals the need to improve control actions and care protocols of these patients.

Objetivo: Correlacionar os achados clínicos, mamográficos e histopatológicos de mulheres na faixa etária entre 50 e 70 anos que tiveram diagnóstico de câncer mamário e foram atendidas, entre 1998 e 2013, no Ambulatório de Mastologia do Centro de Atenção Integral à Saúde da Mulher da Universidade Estadual de Campinas (CAISM-Unicamp). Métodos: Trata-se de um estudo de corte transversal e retrospectivo, no qual foram analisados os prontuários e as mamografias de 160 mulheres, tamanho amostral suficiente para a análise estatística. As variáveis usadas para comparação foram os achados clínicos, mamográficos e histopatológicos, analisados por meio da estatística descritiva e associativa. Resultados: Entre os 160 casos analisados, 76,9% eram sintomáticos e os principais achados clínicos incluíram nódulo palpável (68,1%) e alterações de pele (30%). As apresentações mamográficas prevalentes nas mulheres assintomáticas foram microcalcificações (48,7%), nódulos (43,2%) e distorção arquitetural (8,1%). Com relação ao tipo histológico, 81,3% apresentaram carcinoma ductal invasivo (CDI) e 10,7%, carcinoma ductal in situ (CDIS). Conclusão: O presente trabalho evidenciou que houve uma predominância de mulheres sintomáticas, com apresentação mamográfica de nódulos espiculados e tipo histológico de CDI. Já nas demais pacientes com lesões detectadas no exame de rastreamento predominaram as microcalcificações pleomórficas como o principal achado do CDIS. A mamografia diagnóstica foi a principal forma de detecção do câncer mamário, podendo representar a falta de acesso dessas mulheres aos exames de rastreamento ou à não detecção precoce das lesões malignas, o que revela a necessidade de melhorar as ações de controle e os protocolos de atendimento dessas pacientes.

[Association between breast arterial calcifications and cardiovascular risk factors in menopausal women]. / Associação entre calcificações arteriais mamárias e fatores de risco para doença cardiovascular em mulheres menopausadas.

PURPOSE: To analyze associations between mammographic arterial mammary calcifications in menopausal women and risk factors for cardiovascular disease. METHODS: This was a cross-sectional retrospective study, in which we analyzed the mammograms and medical records of 197 patients treated between 2004 and 2005. Study variables were: breast arterial calcifications, stroke, acute coronary syndrome, age, obesity, diabetes mellitus, smoking, and hypertension. For statistical analysis, we used the Mann-Whitney, χ2 and Cochran-Armitage tests, and also evaluated the prevalence ratios between these variables and mammary artery calcifications. Data were analyzed with the SAS version 9.1 software. RESULTS: In the group of 197 women, there was a prevalence of 36.6% of arterial calcifications on mammograms. Among the risk factors analyzed, the most frequent were hypertension (56.4%), obesity (31.9%), smoking (15.2%), and diabetes (14.7%). Acute coronary syndrome and stroke presented 5.6 and 2.0% of prevalence, respectively. Among the mammograms of women with diabetes, the odds ratio of mammary artery calcifications was 2.1 (95%CI 1.0-4.1), with p-value of 0.02. On the other hand, the mammograms of smokers showed the low occurrence of breast arterial calcification, with an odds ratio of 0.3 (95%CI 0.1-0.8). Hypertension, obesity, diabetes mellitus, stroke and acute coronary syndrome were not significantly associated with breast arterial calcification. CONCLUSION: The occurrence of breast arterial calcification was associated with diabetes mellitus and was negatively associated with smoking. The presence of calcification was independent of the other risk factors for cardiovascular disease analyzed.

Associação entre calcificações arteriais mamárias e fatores de risco para doença cardiovascular em mulheres menopausadas / Association between breast arterial calcifications and cardiovascular risk factors in menopausal women

OBJETIVO: Avaliar a presença de calcificações arteriais em mamografias de mulheres menopausadas e a sua associação com fatores de risco para doenças cardiovasculares. MÉTODOS: Trata-se de um estudo de corte transversal e retrospectivo, em que foram analisados as mamografias e os prontuários médicos de 197 pacientes atendidas no período entre 2004 e 2005. As variáveis do estudo foram: calcificação arterial mamária, acidente vascular cerebral, síndrome coronariana aguda, idade, obesidade, diabetes mellitus, tabagismo e hipertensão arterial sistêmica. Para a análise estatística dos dados, utilizaram-se os testes de Mann-Whitney, χ2 e Cochran-Armitage, sendo também avaliadas as razões de prevalência entre as variáveis descritas e calcificação arterial mamária. Os dados foram analisados com o software SAS, versão 9.1. RESULTADOS: Dos 197 exames e prontuários analisados, observou-se a prevalência de 36,6% para calcificações arteriais nas mamografias. Entre os fatores de risco para doença cardiovascular avaliados, os mais frequentes foram: hipertensão (56,4%), obesidade (31,9%), tabagismo (15,2%) e diabetes (14,7%). A síndrome coronariana aguda e o acidente vascular cerebral tiveram prevalências de 5,6 e 2,0% respectivamente. Entre as mamografias de mulheres diabéticas, a maior ocorrência foi de calcificação arterial mamária com razão de prevalência de 2,1 (IC95%1,0-4,1) e valor p de 0,02. Por outro lado, nas mamografias de pacientes fumantes, foi menor a ocorrência de calcificação arterial mamária com razão de prevalência de 0,3 (IC95% 0,1-0,8). Hipertensão arterial sistêmica, obesidade, diabetes mellitus, acidente vascular cerebral e síndrome coronariana aguda não apresentaram ...

PURPOSE: To analyze associations between mammographic arterial mammary calcifications in menopausal women and risk factors for cardiovascular disease. METHODS: This was a cross-sectional retrospective study, in which we analyzed the mammograms and medical records of 197 patients treated between 2004 and 2005. Study variables were: breast arterial calcifications, stroke, acute coronary syndrome, age, obesity, diabetes mellitus, smoking, and hypertension. For statistical analysis, we used the Mann-Whitney, χ2 and Cochran-Armitage tests, and also evaluated the prevalence ratios between these variables and mammary artery calcifications. Data were analyzed with the SAS version 9.1 software. RESULTS: In the group of 197 women, there was a prevalence of 36.6% of arterial calcifications on mammograms. Among the risk factors analyzed, the most frequent were hypertension (56.4%), obesity (31.9%), smoking (15.2%), and diabetes (14.7%). Acute coronary syndrome and stroke presented 5.6 and 2.0% of prevalence, respectively. Among the mammograms of women with diabetes, the odds ratio of mammary artery calcifications was 2.1 (95%CI 1.0-4.1), with p-value of 0.02. On the other hand, the mammograms of smokers showed the low occurrence of breast arterial calcification, with an odds ratio of 0.3 (95%CI 0.1-0.8). Hypertension, obesity, diabetes mellitus, stroke and acute coronary syndrome were not significantly associated with breast arterial calcification. CONCLUSION: The occurrence of breast arterial calcification was associated with diabetes mellitus and was negatively associated with smoking. The presence of calcification was independent of the other risk factors for cardiovascular disease analyzed. .