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1.
Psychooncology ; 26(6): 836-842, 2017 06.
Artículo en Inglés | MEDLINE | ID: mdl-27478976

RESUMEN

OBJECTIVE: To examine the protective role of relationship satisfaction on body image in women with breast cancer throughout the first year post-surgery. METHODS: Seventy-four Swiss patients engaged in a relationship filled out a questionnaire assessing body image disturbance 2 weeks, 3 months, and 1 year after surgery. A univariate latent change score model was used to analyze the evolution of body image disturbance and the contribution of relationship satisfaction to body image disturbance. RESULTS: Women who were satisfied with their relationship reported less body image disturbance than did dissatisfied women at 2 weeks post-surgery. Being married was also associated with less body image disturbance at that time. The protective effect of these relational variables was still observable 1 year later. Changes in body image disturbance over time were explained by the negative impacts of mastectomy and chemotherapy. CONCLUSIONS: How women perceive the impact of breast cancer treatment on their body may be partly determined by the quality of the relational context in which they live.


Asunto(s)
Imagen Corporal/psicología , Neoplasias de la Mama/cirugía , Relaciones Interpersonales , Satisfacción Personal , Adulto , Anciano , Femenino , Humanos , Estudios Longitudinales , Persona de Mediana Edad , Factores Protectores , Encuestas y Cuestionarios , Suiza
2.
Nature ; 481(7379): 85-9, 2011 Dec 07.
Artículo en Inglés | MEDLINE | ID: mdl-22158103

RESUMEN

Metastatic growth in distant organs is the major cause of cancer mortality. The development of metastasis is a multistage process with several rate-limiting steps. Although dissemination of tumour cells seems to be an early and frequent event, the successful initiation of metastatic growth, a process termed 'metastatic colonization', is inefficient for many cancer types and is accomplished only by a minority of cancer cells that reach distant sites. Prevalent target sites are characteristic of many tumour entities, suggesting that inadequate support by distant tissues contributes to the inefficiency of the metastatic process. Here we show that a small population of cancer stem cells is critical for metastatic colonization, that is, the initial expansion of cancer cells at the secondary site, and that stromal niche signals are crucial to this expansion process. We find that periostin (POSTN), a component of the extracellular matrix, is expressed by fibroblasts in the normal tissue and in the stroma of the primary tumour. Infiltrating tumour cells need to induce stromal POSTN expression in the secondary target organ (in this case lung) to initiate colonization. POSTN is required to allow cancer stem cell maintenance, and blocking its function prevents metastasis. POSTN recruits Wnt ligands and thereby increases Wnt signalling in cancer stem cells. We suggest that the education of stromal cells by infiltrating tumour cells is an important step in metastatic colonization and that preventing de novo niche formation may be a novel strategy for the treatment of metastatic disease.


Asunto(s)
Metástasis de la Neoplasia/patología , Células Madre Neoplásicas/patología , Nicho de Células Madre/fisiología , Animales , Neoplasias de la Mama/patología , Moléculas de Adhesión Celular/genética , Moléculas de Adhesión Celular/metabolismo , Femenino , Neoplasias Pulmonares/secundario , Ratones , Ratones Endogámicos C57BL , Células Madre Neoplásicas/metabolismo , Células del Estroma/metabolismo , Vía de Señalización Wnt
3.
Breast Cancer Res Treat ; 159(2): 203-13, 2016 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-27522516

RESUMEN

The purpose of this study is to obtain a consensus for the therapy of B3 lesions. The first International Consensus Conference on lesions of uncertain malignant potential in the breast (B3 lesions) including atypical ductal hyperplasia (ADH), flat epithelial atypia (FEA), classical lobular neoplasia (LN), papillary lesions (PL), benign phyllodes tumors (PT), and radial scars (RS) took place in January 2016 in Zurich, Switzerland organized by the International Breast Ultrasound School and the Swiss Minimally Invasive Breast Biopsy group-a subgroup of the Swiss Society of Senology. Consensus recommendations for the management and follow-up surveillance of these B3 lesions were developed and areas of research priorities were identified. The consensus recommendation for FEA, LN, PL, and RS diagnosed on core needle biopsy or vacuum-assisted biopsy (VAB) is to therapeutically excise the lesion seen on imaging by VAB and no longer by open surgery, with follow-up surveillance imaging for 5 years. The consensus recommendation for ADH and PT is, with some exceptions, therapeutic first-line open surgical excision. Minimally invasive management of selected B3 lesions with therapeutic VAB is acceptable as an alternative to first-line surgical excision.


Asunto(s)
Neoplasias de la Mama/diagnóstico , Carcinoma Intraductal no Infiltrante/patología , Carcinoma Lobular/patología , Mamografía/métodos , Tumor Filoide/patología , Biopsia con Aguja Gruesa , Mama/patología , Manejo de la Enfermedad , Femenino , Humanos , Biopsia Guiada por Imagen , Vigilancia de la Población/métodos , Guías de Práctica Clínica como Asunto
4.
PLoS Comput Biol ; 11(3): e1004050, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-25768678

RESUMEN

Angiogenesis plays a key role in tumor growth and cancer progression. TIE-2-expressing monocytes (TEM) have been reported to critically account for tumor vascularization and growth in mouse tumor experimental models, but the molecular basis of their pro-angiogenic activity are largely unknown. Moreover, differences in the pro-angiogenic activity between blood circulating and tumor infiltrated TEM in human patients has not been established to date, hindering the identification of specific targets for therapeutic intervention. In this work, we investigated these differences and the phenotypic reversal of breast tumor pro-angiogenic TEM to a weak pro-angiogenic phenotype by combining Boolean modelling and experimental approaches. Firstly, we show that in breast cancer patients the pro-angiogenic activity of TEM increased drastically from blood to tumor, suggesting that the tumor microenvironment shapes the highly pro-angiogenic phenotype of TEM. Secondly, we predicted in silico all minimal perturbations transitioning the highly pro-angiogenic phenotype of tumor TEM to the weak pro-angiogenic phenotype of blood TEM and vice versa. In silico predicted perturbations were validated experimentally using patient TEM. In addition, gene expression profiling of TEM transitioned to a weak pro-angiogenic phenotype confirmed that TEM are plastic cells and can be reverted to immunological potent monocytes. Finally, the relapse-free survival analysis showed a statistically significant difference between patients with tumors with high and low expression values for genes encoding transitioning proteins detected in silico and validated on patient TEM. In conclusion, the inferred TEM regulatory network accurately captured experimental TEM behavior and highlighted crosstalk between specific angiogenic and inflammatory signaling pathways of outstanding importance to control their pro-angiogenic activity. Results showed the successful in vitro reversion of such an activity by perturbation of in silico predicted target genes in tumor derived TEM, and indicated that targeting tumor TEM plasticity may constitute a novel valid therapeutic strategy in breast cancer.


Asunto(s)
Neoplasias de la Mama/fisiopatología , Modelos Biológicos , Monocitos/fisiología , Neovascularización Patológica/fisiopatología , Animales , Neoplasias de la Mama/metabolismo , Neoplasias de la Mama/mortalidad , Línea Celular , Biología Computacional , Citocinas/metabolismo , Citocinas/fisiología , Femenino , Humanos , Estimación de Kaplan-Meier , Ratones , Ratones Transgénicos , Persona de Mediana Edad , Monocitos/química , Monocitos/clasificación , Neoplasias Experimentales , Fenotipo , Transducción de Señal/fisiología
5.
Mod Pathol ; 26(3): 336-42, 2013 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-23041831

RESUMEN

Several authors have demonstrated an increased number of mitotic figures in breast cancer resection specimen when compared with biopsy material. This has been ascribed to a sampling artifact where biopsies are (i) either too small to allow formal mitotic figure counting or (ii) not necessarily taken form the proliferating tumor periphery. Herein, we propose a different explanation for this phenomenon. Biopsy and resection material of 52 invasive ductal carcinomas was studied. We counted mitotic figures in 10 representative high power fields and quantified MIB-1 immunohistochemistry by visual estimation, counting and image analysis. We found that mitotic figures were elevated by more than three-fold on average in resection specimen over biopsy material from the same tumors (20±6 vs 6±2 mitoses per 10 high power fields, P=0.008), and that this resulted in a relative diminution of post-metaphase figures (anaphase/telophase), which made up 7% of all mitotic figures in biopsies but only 3% in resection specimen (P<0.005). At the same time, the percentages of MIB-1 immunostained tumor cells among total tumor cells were comparable in biopsy and resection material, irrespective of the mode of MIB-1 quantification. Finally, we found no association between the size of the biopsy material and the relative increase of mitotic figures in resection specimen. We propose that the increase in mitotic figures in resection specimen and the significant shift towards metaphase figures is not due to a sampling artifact, but reflects ongoing cell cycle activity in the resected tumor tissue due to fixation delay. The dwindling energy supply will eventually arrest tumor cells in metaphase, where they are readily identified by the diagnostic pathologist. Taken together, we suggest that the rapidly fixed biopsy material better represents true tumor biology and should be privileged as predictive marker of putative response to cytotoxic chemotherapy.


Asunto(s)
Neoplasias de la Mama/patología , Neoplasias de la Mama/cirugía , Carcinoma Ductal de Mama/patología , Carcinoma Ductal de Mama/cirugía , Proliferación Celular , Mastectomía , Mitosis , Índice Mitótico , Biopsia , Neoplasias de la Mama/química , Carcinoma Ductal de Mama/química , Femenino , Humanos , Inmunohistoquímica , Antígeno Ki-67/análisis , Modelos Lineales , Clasificación del Tumor , Invasividad Neoplásica , Valor Predictivo de las Pruebas , Reproducibilidad de los Resultados , Factores de Tiempo , Fijación del Tejido
6.
Rev Med Suisse ; 14(624): 1875, 2018 Oct 24.
Artículo en Francés | MEDLINE | ID: mdl-30375786
7.
Rev Med Suisse ; 9(403): 1943-4, 1946-9, 2013 Oct 23.
Artículo en Francés | MEDLINE | ID: mdl-24245016

RESUMEN

Although the incidence of ovarian cancer is low, mortality from this cancer is high due to discovery at a late stage in the majority of cases. So it seems worthwhile to detect ovarian cancer at an early stage. The clinical presentation is nonspecific, thus screening tools have been evaluated. The most efficient screening technique includes two steps: evaluation of CA-125 and then sonography in case of abnormal results of CA-125. Two main studies have been performed in large populations. The PLCO-study has led to negative results: no reduction in ovarian cancer mortality in the screening group with an important increase in surgical morbidity. The final results of the UKCTOCS-study will be known in two years. Currently these data can't allow the realization of ovarian cancer screening in the general population, mainly due to their natural history.


Asunto(s)
Tamizaje Masivo/métodos , Neoplasias Ováricas/diagnóstico , Antígeno Ca-125/sangre , Femenino , Humanos , Proteínas de la Membrana/sangre
8.
Rev Med Suisse ; 8(359): 2003-4, 2006, 2012 Oct 24.
Artículo en Francés | MEDLINE | ID: mdl-23167073

RESUMEN

Reconstructive surgery takes an important place in breast cancer treatment. Immediate breast reconstruction is performed during the same operation as mastectomy. It is contraindicated following radiotherapy. Reconstruction performed after mastectomy is called differed breast reconstruction. It is completed 6 months after chemotherapy and 1 year after radiotherapy. Prosthetic breast reconstruction is indicated when tissues are of good qualities and breast are small. Autologous reconstruction is performed in case of radiotherapy or large breast. After breast reconstruction, imperfections can be corrected with autologous fat injection.


Asunto(s)
Mamoplastia/métodos , Tejido Adiposo/trasplante , Implantes de Mama , Femenino , Humanos , Mastectomía , Colgajo Perforante
10.
Health Psychol Open ; 8(1): 2055102920987463, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33598303

RESUMEN

Little is known about the variables explaining individual variability in the long-term adaptation of breast cancer survivors. Attachment tendencies have, however, been shown to explain negative psychological outcomes in the postsurgical period. The present study aimed to assess the continuing influence of attachment tendencies in the survivorship period. A sample of 28 women were surveyed 2 weeks, 3 months, 12 months, and 5 to 7 years after surgery. Attachment tendencies and psychological outcomes (distress, body image, sexuality) were assessed through questionnaires, and medical and sociodemographic data collected. Results show that insecure attachment tendencies predict negative body image and elevated distress.

11.
J Cancer Educ ; 25(1): 101-5, 2010 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-20082176

RESUMEN

Breast cancer is a public health issue in numerous countries. Multidisciplinary collaboration is required for patient care, research, and also education of future physicians. This paper uses Kern's framework for curriculum design to demonstrate how a breast diseases module for undergraduate medical students created in 1993 evolved over 15 years. The main outcomes of program refinements were better integrated course content, the development of electronic course documents, and implementation of computer-aided small group learning. A main future challenge is to further develop efficient instructional strategies in line with well-defined learning needs for undergraduate students.


Asunto(s)
Neoplasias de la Mama , Educación de Pregrado en Medicina/organización & administración , Relaciones Interprofesionales , Enfermedades de la Mama , Curriculum , Femenino , Humanos , Aprendizaje , Evaluación de Programas y Proyectos de Salud
12.
Int J Gynecol Cancer ; 19(5): 873-8, 2009 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-19574776

RESUMEN

The purpose of the study was to compare postoperative vaginal irradiation with surgery alone in low-risk International Federation of Gynecology and Obstetrics (FIGO) stage IA-IB endometrial carcinoma. The study was a prospective, randomized trial of 645 evaluable low-risk endometrial carcinoma patients from 6 European gynecologic cancer centers. All tumors were in FIGO stage IA-IB, of endometrioid histological type, and FIGO grade 1-2. High-dose-rate afterloading equipments (iridium [Ir] 192 or cobalt [co] 60) were used at 5 centers, and low-dose-rate (LDR) afterloading equipment (cesium [Cs] 137) at 1 center. Perspex vaginal applicators or ovoids were normally used, and the dose was specified at 5 mm from the surface of the applicator. Three to 6 fractions (3.0-8.0 Gy) were given, and the overall treatment time was 4 to 15 days. A total of 319 patients were treated with surgery plus vaginal irradiation (treatment group), and 326 patients with surgery alone (control group).Twenty-six recurrences (4.0%) were recorded in the complete series. The locoregional recurrence rate was 2.6%, whereas distant metastases occurred in 1.4%. The rate of vaginal recurrences was 1.2% in the treatment group versus 3.1% in the control group. The difference was not statistically significant (P = 0.114). Side effects were few and mild (grade 1-2). Dysuria, frequency, and incontinence were slightly more common after vaginal irradiation (2.8% vs 0.6%, respectively). Late intestinal problems were few and similar in the 2 groups. The conclusions were that the impact of postoperative brachytherapy on even the locoregional recurrence rate seems to be limited in patients with low-risk endometrial carcinoma. The overall recurrence rate and survival were similar in the 2 groups.


Asunto(s)
Braquiterapia/métodos , Carcinoma Endometrioide/radioterapia , Radioisótopos de Cesio/uso terapéutico , Radioisótopos de Cobalto/uso terapéutico , Neoplasias Endometriales/radioterapia , Radioisótopos de Iridio/uso terapéutico , Recurrencia Local de Neoplasia/diagnóstico , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma Endometrioide/patología , Fraccionamiento de la Dosis de Radiación , Neoplasias Endometriales/patología , Femenino , Humanos , Persona de Mediana Edad , Estadificación de Neoplasias , Pronóstico , Estudios Prospectivos , Dosificación Radioterapéutica , Factores de Riesgo , Tasa de Supervivencia , Resultado del Tratamiento
14.
Rev Med Suisse ; 5(211): 1525-9, 2009 Jul 15.
Artículo en Francés | MEDLINE | ID: mdl-19694364

RESUMEN

Her2/neu is a tyrosine kinase receptor which stimulates cell growth. The receptor is overexpressed in about 20% of breast cancers. Her2/neu expression is an indicator of poor prognosis but also the target of the treatment of breast cancer using humanised anti-Her2/ neu antibodies. Only cancers overexpressing the protein will respond to this therapy, but which has significant (cardiac) side effects and is expensive. It is therefore important to test for the overexpression of the protein on breast cancer cells. This paper discusses how this can be done and ongoing research into new therapeutic options targeting the involved signaling pathways.


Asunto(s)
Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/metabolismo , Receptor ErbB-2/antagonistas & inhibidores , Receptor ErbB-2/metabolismo , Anticuerpos Monoclonales/uso terapéutico , Anticuerpos Monoclonales Humanizados , Antineoplásicos/uso terapéutico , Femenino , Humanos , Inmunohistoquímica , Hibridación Fluorescente in Situ , Trastuzumab
16.
Rev Med Suisse ; 4(176): 2281-2, 2284-5, 2008 Oct 22.
Artículo en Francés | MEDLINE | ID: mdl-19025179

RESUMEN

Vulvar cancer is a rare disease and its screening is depending on the quality and the relevance of our clinical examination. Incidence of vulvar cancer and especially precancerous lesions, vulvar intraepithelial neoplasias (VIN), increased during these last years. The new terminology of vulvar intraepithelial neoplasia will help us to identify high risk groups which could develop a cancer: usual and differentiated VIN. An early diagnosis is essential to propose an adequate treatment. Management is a major point according to the rising incidence of these lesions in younger women. Until we can observe a benefit from the vaccination against human papillomavirus, we must increase the quality of screening by a careful examination of the vulva.


Asunto(s)
Carcinoma in Situ/clasificación , Neoplasias de la Vulva/clasificación , Adulto , Anciano , Anciano de 80 o más Años , Biopsia , Carcinoma in Situ/diagnóstico , Carcinoma de Células Escamosas/diagnóstico , Colposcopía , Condiloma Acuminado/diagnóstico , Diagnóstico Diferencial , Detección Precoz del Cáncer , Femenino , Humanos , Tamizaje Masivo , Lesiones Precancerosas/clasificación , Lesiones Precancerosas/diagnóstico , Enfermedades de la Vulva/diagnóstico , Liquen Escleroso Vulvar/diagnóstico , Neoplasias de la Vulva/diagnóstico
17.
Rev Med Suisse ; 3(130): 2382-4, 2386-8, 2007 Oct 24.
Artículo en Francés | MEDLINE | ID: mdl-18062501

RESUMEN

Today, breast cancer prognosis and (neo-) adjuvant treatment selection are based on clinical as well as on histological and immunohistochemical data. Will genetic expression profiles have a better predictive value? Ongoing studies will provide the answer.


Asunto(s)
Neoplasias de la Mama/patología , Neoplasias de la Mama/terapia , Neoplasias de la Mama/genética , Femenino , Humanos , Medición de Riesgo
18.
Rev Med Suisse ; 3(130): 2389-90, 2392-5, 2007 Oct 24.
Artículo en Francés | MEDLINE | ID: mdl-18062502

RESUMEN

Breast conserving surgery followed by radiation therapy is the treatment of choice for early breast cancer. For patients who choice or need a mastectomy, breast reconstruction provides an acceptable alternative. Breast cancer surgery has been evolving through minimally invasive approaches. Sentinel node biopsy has already remplaced axillary lymph node dissection in the evaluation of the axilla. Local ablation of the tumor may be a valuable alternative to surgery in the future.


Asunto(s)
Neoplasias de la Mama/cirugía , Mastectomía/métodos , Femenino , Humanos
19.
Rev Med Suisse ; 3(119): 1737-42, 2007 Jul 18.
Artículo en Francés | MEDLINE | ID: mdl-17727094

RESUMEN

Tailoring adjuvant therapy in breast cancer patients relies on prognostic and predictive factors, most of which are currently established by histopathological analysis of tumors. The quality of the assessment of the former (i.e.: tumor size, lymph node status, tumor grade, HER2 status, and lymphovascular invasion) and the latter (estrogen and progesteron receptors expression, HER2 overexpression or amplification) is an essential prerequisite for an optimal therapeutic decision. If the prognostic and predictive values of multigenes signatures are confirmed by on-going clinical studies, this approach could enter the clinical practice in the coming years and result in improved accuracy of adjuvant therapies in breast cancer patients. This approach might especially allow avoiding overtreatment in patients at low risk of recurrence.


Asunto(s)
Neoplasias de la Mama/patología , Neoplasias de la Mama/terapia , Femenino , Humanos , Persona de Mediana Edad
20.
J Health Psychol ; 22(13): 1668-1677, 2017 11.
Artículo en Inglés | MEDLINE | ID: mdl-26945011

RESUMEN

We examined the evolution of the subjective burden of romantic partners caring for women with non-metastatic breast cancer and investigated the moderating role of couple satisfaction on caring stress. Forty-seven partners filled out questionnaires 3 and 12 months after surgery. Using a stress process model, we examined caring stressors and moderating factors (couple satisfaction, coping and social support) as predictors of subjective burden. Results showed that subjective burden decreases over time and that the couple satisfaction largely explains it above and beyond other influential variables. Partners dissatisfied with their couple relationship are especially vulnerable to the stress of caregiving.


Asunto(s)
Adaptación Psicológica , Neoplasias de la Mama/psicología , Cuidadores/psicología , Satisfacción Personal , Parejas Sexuales/psicología , Apoyo Social , Estrés Psicológico , Composición Familiar , Femenino , Humanos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Factores de Tiempo
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