The use of telemedicine to maintain breast cancer follow-up and surveillance during the COVID-19 pandemic.

As a result from restricted economic activities and social distancing due to the coronavirus disease-2019 (COVID-19) pandemic, we observed a 49.4% decrease in outpatient appointments at our Institution. to minimize this impact on screening and oncological follow-up of breast cancer patients, telemedicine appointments were established. The authors demonstrate how a cancer center in the largest city in Brazil has managed outpatient appointments during the COVID-19 pandemic. This is a retrospective study of patients who had their appointments through telemedicine at the AC Camargo Cancer Center between June 2020 and October 2020, during the COVID-19 pandemic. Of the 77 patients who had telemedicine appointments, 36 (46.8%) accounted for breast cancer follow-up, 20 (26%) for breast cancer screening, 10 (13%) for benign breast disease evaluation, 7 (9%) for a second opinion, and 4 (5.2%) for general orientations. Routine surveillance/follow-up exams were requested for 45 (58.4%) patients and breast image exams and a request to return for a personal appointment for 30 (39%) patients. Two (2.6%) patients were requested to schedule a personal appointment immediately for a physical exam. In conclusion, telemedicine may be a feasible alternative to reduce personal outpatient appointments for cancer follow-up and breast cancer screening during the COVID-19 pandemic.

Carcinoma ductal in situ de mama: avaliação de potenciais fatores prognósticos / Ductal carcinoma in situ of the breast: assessment of potential prognostic factors

Introdução: O carcinoma ductal in situ de mama, apesar de consistir em doença inicial e de bom prognóstico, tem na terapêutica a mesma agressividade utilizada em tumores invasivos. O tratamento geralmente é multimodal, trazendo impacto às pacientes. O presente estudo tem por objetivo avaliar características morfológicas e marcadores imuno-histoquímicos do carcinoma ductal in situ de mama, correlacionando-os com evolução e prognóstico dos pacientes. Método: Foram revisados 565 prontuários de pacientes com CDIS tratados no A.C.Camargo Cancer Center, no período de 2000 a 2008. Destes, selecionamos 12 casos de CDIS recidivados ou novos carcinomas ductais de mama, pareados com 24 controles. Realizamos avaliação de variáveis epidemiológicas e morfológicas tradicionais, além da análise imuno-histoquímica para marcadores de metaloproteinases (MMP 1, MMP 2 e MMP9) e marcadores de células mioepiteliais (CD 10, AML, P63, Calponina, CK 5/6), com objetivo de correlacioná-los com recorrência da doença. Resultados: Observamos a seguinte distribuição de variáveis imuno-histoquímicas nos 12 casos estudados: P63 2 negativos, 9 positivos focais, 0 positivos contínuos e 1 indeterminado; CK 5/6 3 negativos, 9 positivos focais, 0 positivos contínuos, CD10 2 negativos, 8 positivos focais e 2 positivos contínuos, AML 3 negativos, 3 positivos fracos, 3 positivos intermediários, 2 positivos fortes e 1 indeterminado, MMP1 0 negativos, 4 positivos fracos, 7 positivos intermediários e 1 positivo forte, MMP2 4 negativos, 7 positivos fracos, 1 positivo intermediário e 0 positivos fortes, MMP9 0 negativos, 7 positivos fracos, 4 positivos intermediários e 1 positivo forte. Não houve correlação estatisticamente significativa entre as variáveis estudadas com recorrência local ou novos eventos de câncer de mama. Conclusão: Os índices de recidiva nas pacientes com diagnóstico de CDIS no A.C.Camargo Cancer Center são baixos (5,98%), observando-se seguimento mínimo de 60 meses. Não foram identificados fatores clinico-patológicos associados com as recidivas locais de CDIS ou outros eventos de câncer de mama. A expressão de metaloproteinases e marcadores de CME no microambiente tumoral dos CDIS de mama não apresentou correlação estatisticamente significativa com índices de recorrência local e novos eventos de câncer de mama.

Introduction: Ductal carcinoma (DCIS) of the breast has historically been treated as aggressively as invasive breast cancer, despite its good prognosis. Treatment is multimodal, which impacts the physical, psychological and social aspects of the patient. To date, there is no prognostic factor able to advocate for less morbid treatment in DCIS. The present study aims to assess the prognostic value of different markers for DCIS. Methods: We revised 565 medical records of DCIS patients treated at A.C.Ca margo Cancer Center, from 2000 to 2008. We located 12 patients with local recurrence or other cancer events and paired them with 24 controls, according to age, nuclear grade, follow up duration, treatment type and prophylactic hormone therapy. The immunohistochemical staining targeted metalloproteinases (MMP 1, MMP 2 and MMP) and myoepithelial cell markers (CD 10, AML, P63, Calponin, CK 5/6). Results: We observed the following immunohistochemical distribution in our cases: P63 2 negative, 9 focal positive, 0 continuous positive and 1 indefinite; CK 5/6 3 negative, 9 focal positive and 0 continuous positive, CD10 2 negative, 8 focal positive and 2 continuous positive, AML 3 negative, 3 weak positive, 3 intermediate positive, 2 strong positive and 01 indefinite, MMP1 0 negative, 4 weak positive, 7 intermediate positive and 1 strong positive, MMP2 4 negative, 7 weak positive, 1 intermediate positive and 0 strong positive, MMP9 0 negative, 7 weak positive, 4 1 intermediate positive and 1 strong positive There was no statistically significant correlation between the immunohistochemical staining and local recurrence or new breast cancer events. Conclusion: The recurrence rates at A.C.Camargo Cancer Center are lower than literature results (5,98%, follow up 60 months). There were no identifiable clinicopathological factors related to local recurrence. The metalloproteinases and myoepithelial cell markers expression was not correlated with local recurrence or new breast cancer events.

Carcinoma ductal in situ de mama: avaliação de potenciais fatores prognósticos / Ductal carcinoma in situ of the breast: assessment of potential prognostic factors

Introdução: O carcinoma ductal in situ de mama, apesar de consistir em doençainicial e de bom prognóstico, tem na terapêutica a mesma agressividade utilizada em tumores invasivos. O tratamento geralmente é multimodal, trazendo impacto às pacientes. O presente estudo tem por objetivo avaliar características morfológicas e marcadores imuno-histoquímicos do carcinoma ductal in situ de mama, correlacionando-os com evolução e prognóstico dos pacientes. Método: Foram revisados 565 prontuários de pacientes com CDIS tratados no A.C.Camargo Cancer Center, no período de 2000 a 2008. Destes, selecionamos 12 casos de CDIS recidivados ou novos carcinomas ductais de mama, pareados com 24 controles. Realizamos avaliação de variáveis epidemiológicas e morfológicas tradicionais, além da análise imuno-histoquímica para marcadores de metaloproteinases (MMP 1, MMP 2 e MMP9) e marcadores de células mioepiteliais (CD 10, AML, P63, Calponina, CK 5/6), com objetivo de correlacioná-los com recorrência da doença. Resultados: Observamos a seguinte distribuição de variáveis imuno-histoquímicas nos 12 casos estudados: P63 2 negativos, 9 positivos focais, 0 positivos contínuos e 1 indeterminado; CK 5/6 3 negativos, 9 positivos focais, 0 positivos contínuos, CD10 2 negativos, 8 positivos focais e 2 positivos contínuos, AML 3 negativos, 3 positivos fracos, 3 positivos intermediários, 2 positivos fortes e 1 indeterminado, MMP1 0negativos, 4 positivos fracos, 7 positivos intermediários e 1 positivo forte, MMP2 4negativos, 7 positivos fracos, 1 positivo intermediário e 0 positivos fortes, MMP9 0negativos, 7 positivos fracos, 4 positivos intermediários e 1 positivo forte. Não houve correlação estatisticamente significativa entre as variáveis estudadas com recorrência local ou novos eventos de câncer de mama. Conclusão: Os índices de recidiva nas pacientes com diagnóstico de CDIS no A.C.Camargo Cancer Center são baixos (5,98%), observando-se seguimento mínimo de 60 meses...

Introduction: Ductal carcinoma (DCIS) of the breast has historically been treatedas aggressively as invasive breast cancer, despite its good prognosis. Treatment ismultimodal, which impacts the physical, psychological and social aspects of thepatient. To date, there is no prognostic factor able to advocate for less morbidtreatment in DCIS. The present study aims to assess the prognostic value of differentmarkers for DCIS. Methods: We revised 565 medical records of DCIS patientstreated at A.C.Camargo Cancer Center, from 2000 to 2008. We located 12 patients with local recurrence or other cancer events and paired them with 24 controls, according to age, nuclear grade, follow up duration, treatment type and prophylactic hormone therapy. The immunohistochemical staining targeted metalloproteinases (MMP 1, MMP 2 and MMP) and myoepithelial cell markers (CD 10, AML, P63, Calponin, CK 5/6). Results: We observed the following immunohistochemical distribution in our cases: P63 2 negative, 9 focal positive, 0 continuous positive and 1 indefinite; CK 5/6 3 negative, 9 focal positive and 0 continuous positive, CD10 2 negative, 8 focal positive and 2 continuous positive, AML 3 negative, 3 weak positive, 3 intermediate positive, 2 strong positive and 01 indefinite, MMP1 0 negative, 4 weak positive, 7 intermediate positive and 1 strong positive, MMP2 4 negative, 7 weak positive, 1 intermediate positive and 0 strong positive, MMP9 0 negative, 7 weak positive, 4 1 intermediate positive and 1 strong positive There was no statistically significant correlation between the immunohistochemical staining and local recurrence or new breast cancer events. Conclusion: The recurrence rates at A.C.Camargo Cancer Center are lower than literature results (5,98%, follow up 60 months). There were no identifiable clinicopathological factor related to local recurrence...