Metástasis en colon de un carcinoma lobulillar de mama / No disponible

No disponible

Doxorubicin and cyclophosphamide followed by weekly docetaxel as neoadjuvant treatment of early breast cancer: analysis of biological markers in a GEICAM phase II study

INTRODUCTION: To evaluate the sequential administration of doxorubicin (A) and cyclophosphamide (C) followed by weekly docetaxel in women with stage II to IIIA breast cancer. PATIENTS AND METHODS: Patients received 60 mg/m(2) of A and 600 mg/m(2) of C every three weeks for four cycles followed by 12 infusions of weekly docetaxel at a dose of 36 mg/m(2) and with a 2-week resting period. RESULTS: Sixty-three women were included. On an intention-to- treat basis, clinical response rate was 90% (95% CI: 83-98), with 46% complete responses. Breast-conserving surgery could be performed in 43 patients (68%). Complete pathological responses in the breast were confirmed in 17% of patients. No correlations between levels of expression of topoisomerase II alpha, survivin or p27 and the pathological response were detected. The study treatment was generally well tolerated. CONCLUSION: Neoadjuvant AC followed by weekly docetaxel is a feasible regimen for patients with early-stage breast cancer (AU)

No disponible

Utilidad de la resonancia magnética en la evaluación local del cáncer de mama: impacto en el cambio de actitud terapéutica en una serie prospectiva de 338 pacientes / No disponible

Introducción: la estadificación del cáncer de mama implicareunir información no sólo sobre el tamaño del tumor principal,sino también sobre la presencia de multifocalidad, multicentricidad,bilateralidad, componente intraductal extenso oextensión al complejo areola-pezón. El objetivo de nuestro estudioes validar la técnica en nuestro entorno asistencial y evaluarel impacto que la RM de mama con contraste ha tenido sobre338 pacientes consecutivas con diagnóstico de cáncer demama en el proceso de la toma de decisión del modelo de tratamiento.Como objetivo secundario se plantea la correlaciónde los hallazgos de la RM con los hallazgos histopatológicos.Material y métodos: estudiamos con RM a 338 pacientesconsecutivas con diagnóstico de cáncer de mama antes de decidircuál era el abordaje terapéutico más adecuado. La intenciónterapéutica se registró antes y después de cada estudio deRM. Se calculó la sensibilidad, la especificidad, el valor predictivopositivo y el valor predictivo negativo de la RM para lesionesadicionales, así como el coeficiente de correlación linealde Pearson para el diámetro del tumor índice o principal.Resultados: en 145 pacientes (42%) se identificaron 164lesiones adicionales, de las cuales 87 (53%) fueron malignas,28 (17%) fueron benignas, 35 (21,3%) se catalogaron comoprobablemente benignas, en 6 (3,6%) no se alcanzó un diagnósticofinal y 8 (4,9%) no quedaron incluidas en la pieza quirúrgicao bien desaparecieron tras la quimioterapia neoadyuvante.Estos hallazgos implicaron un cambio en la actitudterapéutica en 82 pacientes (24,2%). Este cambio se confirmócon los resultados de la anatomía patológica como correcto en69 paciente (20,4%) y como incorrecto o innecesario en 13pacientes (3,8%). El coeficiente de correlación de Pearson resultóser fuertemente positivo (r = 0,784) cuando se compararonlos resultados de la RM y la anatomía patológica...(AU)

Background: breast cancer staging implies gathering informationnot only on the size of the main tumour, but also onmultifocality, multicentricity, bilaterality, presence of an extensiveintraductal component and extension to the nipple-areolarcomplex. The objective of our study is to demonstrate thatbreast magnetic resonance (MR) is the modality of choice inthe staging of breast cancer patients due to the fact that it addsinformation capable of modifying the therapeutic approach inthese patients. A secondary objective is to validate our resultsin our clinical environment.Material and methods: 338 consecutive patients with abreast cancer diagnosis were studied with breast MR beforedeciding the most appropiate therapeutic approach. Therapeuticintention was registered before and after each MRstudy. Sensibility, specificity, postive predictive value (PPV)and negative predictive value (NPV) of MR for additional lesionswas calculated and Pearson's linear correlation coefficientwas calculated for the index lesion diameter.Results: 164 additional lesions were found in 145 patients(42%) of which 87 (53%) were malignant, 28 (17%) were benign,35 (21,3%) were probable benign, 6 (3,6%) had no diagnosisand 8 (4,9%) were not included in the surgical specimenor else dissappeared after neoadjuvant chemotherapy. Thesefindings implied change in therapeutic approach in 82 patients(24,2%). These change was pathologically validated ascorrect in 69 patients (20,4%) and as unnecessary or incorrectin 13 patients (3,8%). Pearson's linear correlation coefficientwas strongly positive (r = 0,784) when MR and pathology resultswere compared. Sensibility, specificity, PPV and NPV ofMR for additional lesions was 90,6, 55,2, 75,7 and 79,5%respectively...(AU)