Tratamiento a medida en paciente con recurrencia tardía locorregional Hospital Alemán Unidad de Mastología / Tailored treatment in patient with Locoregional late recurrence

Introducción: Entendemos por recurrencia tardía del cáncer de mama (CM) a la enfermedad que aparece nuevamente después de más de 5,10 o incluso más de 20 años. En mujeres con tumores con receptor de estrógeno (RE) positivo y HER2 negativo, al menos la mitad de las recurrencias ocurren luego de 5 años después del diagnóstico primar Las recurrencias posteriores a mastectomía pueden comprometer la pared torácica, la piel o los ganglios linfáticos regionales. Las recurrencias invasivas pueden ser localizadas o difusas e involucrar la piel, los tejidos subcutáneos, la musculatura torácica o el tejido blando extraganglionar. Las recurrencias en los ganglios mamarios interno e infraclavicular son poco frecuentes, alrededor del 1,5%, mas allá de que estos ganglios son el segundo sitio de drenaje linfático en el CM Los tratamientos extendidos y más efectivos contra el CM han aumentado la prevalencia de sobrevivientes a largo plazo y con ello un retraso en el tiempo de recaída, mucho más marcado en los tumores de tipo luminal. En este reporte de caso nos abocamos a este tipo de pacientes, cómo es su diagnóstico y cuáles fueron sus tratamientos. Objetivo: Reportar mediante un caso clínico el manejo individualizado de una paciente con antecedente de CM y recurrencia tardía locorregional(AU)

Access of patients with breast and lung cancer to chemotherapy treatment in public and private hospitals in the city of Buenos Aires.

OBJECTIVES: Describe the time elapsed from the diagnosis to treatment with chemotherapy for patients with breast and lung cancer at public and private hospitals in Buenos Aires. DESIGN: Retrospective cohort study. SETTING: Three public and three private academic hospitals in Buenos Aires. PARTICIPANTS: Patients with breast (n = 168) or lung cancer (n = 100) diagnosis treated with chemotherapy. MAIN OUTCOMES MEASURES: Clinical and sociodemographic data were collected in a stratified sample. We used the Kaplan-Meier estimator to analyse the time elapsed and the log rank test to compare both groups. RESULTS: For breast cancer patients, median time elapsed between diagnosis and treatment with chemotherapy was 76 days (95% CI: 64-86) in public and 60 days (95% CI: 52-65) in private hospitals (P = 0.0001). For adjuvant and neoadjuvant treatments, median time was 130 (95% CI: 109-159) versus 64 (95% CI: 56-73) days (P < 0.0001) and 57 days (95% CI: 49-75) versus 26 (95% CI: 16-41) days, respectively (P = 0.0002). There were no significant differences in the time from first consultation to diagnosis. In patients with lung cancer, median time from diagnosis to treatment was 71 days (95% CI: 60-83) in public hospitals and 31 days (95% CI: 24-39) in private hospitals (P = 0.0002). In the metastatic setting, median time to treatment was 63 days (95% CI: 45-83) in public and 33 (95% CI: 26-44) days in private hospitals (P = 0.005). CONCLUSIONS: There are significant disparity in the access to treatment with chemotherapy for patients in Buenos Aires, Argentina.

Nuclear localization of MUC1 extracellular domain in breast, head and neck, and colon cancer.

BACKGROUND: The glycoprotein MUC1 is overexpressed and underglycosylated in cancer cells. MUC1 is translated as a single polypeptide that undergoes autocleavage into 2 subunits (the extracellular domain and the cytoplasmic tail), and forms a stable heterodimer at the apical membrane of normal epithelial cells. The MUC1 cytoplasmic tail localizes to the cytoplasm of transformed cells and is targeted to the nucleus. AIMS: To study the expression of the MUC1 extracellular subunit in cell nuclei of neoplastic breast, head and neck, and colon samples. MATERIALS AND METHODS: 330 primary tumor samples were analyzed: 166 invasive breast carcinomas, 127 head and neck tumors, and 47 colon tumors; 10 benign breast disease (BBD) and 40 normal specimens were also included. A standard immunohistochemical method with antigen retrieval was performed. Nuclear fractions from tissue homogenates and breast cancer cell lines (ZR-75, MDA-MB-231, MCF7, and T47D) were obtained and analyzed by Western blotting (WB). The anti-MUC1 extracellular subunit monoclonal antibody HMFG1 was used for immunohistochemistry. RESULTS: 37/166 breast cancer specimens, 5/127 head and neck cancer specimens, 2/47 colon cancer samples, and 3/10 BBD samples showed immunohistochemical staining at the nuclear level. No nuclear reaction was detected in normal samples. By WB, breast and colon cancer purified nuclear fractions showed reactivity at 200 kDa in 3/30 breast and 3/20 colon cancer samples as well as purified nuclear fractions obtained from breast cancer cell lines. CONCLUSIONS: This study shows that the MUC1 extracellular domain might be translocated to the cell nucleus in breast, head and neck, and colon cancer as well as BBD.

Features related to breast cancer in an entire Argentine rural population.

AIM: A descriptive study was developed in an entire Argentine rural community considering breast cancer risk factors, preventive strategies and breast cancer incidence. PATIENTS AND METHODS: the study comprised of 83 women. A questionnaire of 34 items was employed; a mammogram and a breast ultrasound were performed. ANOVA and Pearson correlation were employed. RESULTS: Mean age was 54.5 years; 69% of women were postmenopausal; 96% had children; breastfeeding was X=10 months/child; Body Mass Index (BMI) was X=27.8 kg/m(2); 13% had first-degree relatives with breast cancer; 90% of women considered mammographic screening a necessary study. One woman had presented breast cancer. Argentine screening guidelines were not followed and an inverse relationship between education level and age of first mammogram was found (p<0.05). Mammographic and ultrasound studies did not reveal potential abnormalities. CONCLUSION: Peculiar social and cultural characteristics may be relevant to evaluate breast cancer risk factors in Argentina.

Invasive breast cancer in Argentine women: association between risk and prognostic factors with antigens of a peptidic and carbohydrate nature.

OBJECTIVE: In breast cancer, several tumor markers have been identified. The marker most extensively associated with breast cancer is MUC1. The objective of the study was to analyze prognostic and risk factors in relation to tumor markers in order to clarify breast cancer biology. A total of 349 primary tumor samples and lymph nodes from breast cancer patients were studied. Risk and prognostic factors were considered. An immunohistochemical approach was applied and an extensive statistical analysis was performed, including frequency analysis and analysis of variance. Correlation among variables was performed with principal component analysis. RESULTS: All the antigens showed an increased expression according to tumor size increment; moreover, sialyl Lewis x expression showed a significant increase in relation to disease stage, whereas Tn and TF presented a positive tendency. Vascular invasion was related to sialyl Lewis x expression and number of metastatic lymph nodes. Taking into account risk factors, when a patient had at least one child, Lewis antigens diminished their expression. In relation to breastfeeding, sialyl Lewis x expression diminished, although its apical expression increased. CONCLUSION: Associations between MUC1 and carbohydrate antigens and risk and prognostic factors show the complexity of the cellular biological behavior that these antigens modulate in breast cancer.