RESUMO
OBJECTIVE: The aim of this study was to assess the synergistic effect of non-adherence to the Mediterranean Diet (MD) and lifestyle habits on the occurrence of breast cancer (BC). PATIENTS AND METHODS: A case-control study was carried out from September 2018 to February 2019 at the Teaching Hospital "Umberto I" in Rome. A Food Frequency Questionnaire was used for assessing the level of adherence to MD, the IPAQ Questionnaire to measure physical activity, and AUDIT-C to estimate alcohol consumption. The possible interaction between risk factors was tested using the synergism index. RESULTS: A total of 94 cases and 88 controls were enrolled (median age 55.8 for cases and 57.9 for controls). The MD Score over 6 was associated with low odds of having breast cancer (OR = 0.29; 95% CI: 0.12-0.69). There is a clear indication for the additivity and synergism between non-adherence to MD and many risk factors on the occurrence of BC: current smoker (S = 2.02; 95% CI 0.62-8.07), physical inactivity (S = 2.14; 95% CI 0.71 2-8.28) and alcohol consumption (S = 3.02; 95% CI 0.91-12.95). CONCLUSIONS: Primary prevention of BC can benefit from intervention targeting nutritional and lifestyle factors that act synergistically.
Assuntos
Neoplasias da Mama/epidemiologia , Dieta Mediterrânea/estatística & dados numéricos , Hábitos , Estilo de Vida , Cooperação do Paciente/estatística & dados numéricos , Idoso , Neoplasias da Mama/prevenção & controle , Estudos de Casos e Controles , Feminino , Humanos , Itália/epidemiologia , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Basal cell cancer is a malignant tumor of the skin most common in Caucasians and more common in the areas of the head and neck. At the moment there are many suggested treatment methods, however the surgical approach remains the technique most often applied. It includes excision of the oncological safety margins and the subsequent reconstructive phase can utilize local flaps or cutaneous grafts. This study aims to select the best technique for the reconstructive phase after removal of basal cell cancer from the region of the nasal pyramid, evaluation was made in terms of functional performance and aesthetics. We have evaluated 30 patients, of whom 15 treated with cutaneous grafting and 15 with flaps.
Assuntos
Carcinoma Basocelular/cirurgia , Neoplasias Nasais/cirurgia , Neoplasias Cutâneas/cirurgia , Transplante de Pele/métodos , Retalhos Cirúrgicos/transplante , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do TratamentoRESUMO
Metastatic growth in breast cancer (BC) has been proposed as an exclusive property of cancer stem cells (CSCs). However, formal proof of their identity as cells of origin of recurrences at distant sites and the molecular events that may contribute to tumor cell dissemination and metastasis development are yet to be elucidated. In this study, we analyzed a set of patient-derived breast cancer stem cell (BCSC) lines. We found that in vitro BCSCs exhibit a higher chemoresistance and migratory potential when compared with differentiated, nontumorigenic, breast cancer cells (dBCCs). By developing an in vivo metastatic model simulating the disease of patients with early BC, we observed that BCSCs is the only cell population endowed with metastatic potential. Gene-expression profile studies comparing metastagenic and non-metastagenic cells identified TAZ, a transducer of the Hippo pathway and biomechanical cues, as a central mediator of BCSCs metastatic ability involved in their chemoresistance and tumorigenic potential. Overexpression of TAZ in low-expressing dBCCs induced cell transformation and conferred tumorigenicity and migratory activity. Conversely, loss of TAZ in BCSCs severely impaired metastatic colonization and chemoresistance. In clinical data from 99 BC patients, high expression levels of TAZ were associated with shorter disease-free survival in multivariate analysis, thus indicating that TAZ may represent a novel independent negative prognostic factor. Overall, this study designates TAZ as a novel biomarker and a possible therapeutic target for BC.
Assuntos
Neoplasias da Mama/genética , Peptídeos e Proteínas de Sinalização Intracelular/genética , Metástase Neoplásica/genética , Recidiva Local de Neoplasia/genética , Animais , Biomarcadores Tumorais/genética , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/patologia , Linhagem Celular Tumoral , Intervalo Livre de Doença , Feminino , Regulação Neoplásica da Expressão Gênica , Humanos , Peptídeos e Proteínas de Sinalização Intracelular/biossíntese , Camundongos , Metástase Neoplásica/patologia , Recidiva Local de Neoplasia/patologia , Células-Tronco Neoplásicas , Transativadores , Fatores de Transcrição , Proteínas com Motivo de Ligação a PDZ com Coativador Transcricional , Ensaios Antitumorais Modelo de XenoenxertoRESUMO
Tumor cell infiltration causes the remodelling of peritumoral tissues, determined by an increased lytic activity of extracellular matrix exerted by the neoplastic invasive phenotype. Among the principal lytic enzymes produced by tumor cells and mainly involved in invasion process there are the matrix metalloproteases (MMPs). The Authors compared the plasmatic values of MMPs 2, 3, 9 from patients with breast carcinomas and fibroadenomas in order to evaluate whether there was a significant difference between the two groups of patients. MMPs 2, 3, 9 values were quantified by ELISA test from plasma collected 24 hours before surgery in 50 breast carcinomas and 30 fibroadenomas. MMP2 mean value from the patients with carcinomas resulted significantly higher as compared to that from the patients with fibroadenomas; while for MMP 3 and 9 mean values was not possible to find a significant difference between the two groups of malignant and benign breast tumors. These data confirm the main role played by MMPs during the tumor invasion process. Therefore, it is possible to propose the future inclusion of MMP2 test, together to other biological and clinical data, for prognostic evaluation of neoplastic breast lesions.
Assuntos
Biomarcadores Tumorais/sangue , Neoplasias da Mama/enzimologia , Carcinoma/enzimologia , Fibroadenoma/enzimologia , Metaloproteinase 2 da Matriz/sangue , Metaloproteinase 3 da Matriz/sangue , Metaloproteinase 9 da Matriz/sangue , Adulto , Neoplasias da Mama/patologia , Carcinoma/patologia , Feminino , Fibroadenoma/patologia , Humanos , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Sensibilidade e EspecificidadeRESUMO
The authors describe their surgical technique for pilonidal sinus outpatient total excision with local anaesthesia and primary repair of surgical wound. The results for recurrences and off work short time are good. Fewer complications and recurrences are observed in comparison to patients treated with general anaesthesia. For decreasing recurrence rate, the Authors stress the importance of body weight control and correct local hygiene. Local anaesthesia is safe e cost-effectiveness for outpatient treatment of the pilonidal sinus.
Assuntos
Procedimentos Cirúrgicos Ambulatórios , Seio Pilonidal/cirurgia , Adolescente , Adulto , Anestesia Local , Análise Custo-Benefício , Feminino , Seguimentos , Humanos , Masculino , Recidiva , Resultado do TratamentoRESUMO
The Authors report the results of the tumescent anesthesia in 187 patients submitted to various outpatient surgical procedures comparing with those in patients submitted to local anesthesia by direct infiltration.
Assuntos
Procedimentos Cirúrgicos Ambulatórios , Anestesia Local/métodos , Anestésicos Locais/administração & dosagem , Lidocaína/administração & dosagem , Adulto , Anestesia Local/efeitos adversos , Bicarbonatos/administração & dosagem , Epinefrina/administração & dosagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Reprodutibilidade dos Testes , Estudos RetrospectivosRESUMO
Cancer of supernumerary breast or ectopic breast tissue has haigher incidence than the cancer on ortotopic breast. This finding puts some problems about the diagnosis and therapy of ectopic breast cancer. The Authors describe their personal experience in three patients surgically treated and discuss about problems and solutions of this pathology.
Assuntos
Axila/patologia , Mama , Carcinoma Ductal de Mama/diagnóstico , Carcinoma Ductal de Mama/cirurgia , Coristoma/patologia , Neoplasias de Tecidos Moles/diagnóstico , Neoplasias de Tecidos Moles/cirurgia , Parede Torácica/patologia , Adulto , Idoso , Axila/cirurgia , Biomarcadores Tumorais/análise , Calcinose/diagnóstico por imagem , Calcinose/patologia , Carcinoma Ductal de Mama/química , Coristoma/cirurgia , Feminino , Humanos , Mamografia , Pessoa de Meia-Idade , Palpação , Neoplasias de Tecidos Moles/química , Neoplasias de Tecidos Moles/patologia , Parede Torácica/cirurgiaRESUMO
The Authors present a rare association of gastric adenocarcinoma and somatostatin-producing duodenal carcinoid. The pre-operative abdominal CT scan revealed the gastric lesions and a duodenal polypoid lesion, giving an important indication to perform a subtotal gastrectomy and a duodenal resection. The definitive diagnosis was possible with histological examination.
Assuntos
Adenocarcinoma , Neoplasias Duodenais , Neoplasias Primárias Múltiplas , Somatostatinoma , Neoplasias Gástricas , Adenocarcinoma/diagnóstico , Adenocarcinoma/cirurgia , Idoso , Neoplasias Duodenais/diagnóstico , Neoplasias Duodenais/cirurgia , Humanos , Masculino , Neoplasias Primárias Múltiplas/diagnóstico , Neoplasias Primárias Múltiplas/cirurgia , Somatostatinoma/diagnóstico , Somatostatinoma/cirurgia , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/cirurgiaRESUMO
The Authors present a singular case of seroma which developed in residual fibrous capsule after explantation of breast prostheses without replacement. Mammographic and sonographic findings of the seroma make difficult the diagnosis: mammograms revealed a radiopaque, well-circumscribed mass anterior to the pectoralis major muscle in the region of the prior sub-glandular implant, that was initially misinterpreted as breast implant radiographic feature. It is particularly important review and carefully correlate mammographic and sonographic findings with patient's surgical history for a correct diagnosis.
Assuntos
Doenças Mamárias/diagnóstico , Doenças Mamárias/etiologia , Implantes de Mama/efeitos adversos , Remoção de Dispositivo/efeitos adversos , Seroma/diagnóstico , Seroma/etiologia , Doenças Mamárias/diagnóstico por imagem , Feminino , Humanos , Mamoplastia/métodos , Mamografia , Pessoa de Meia-Idade , Reoperação , Seroma/diagnóstico por imagem , Géis de Silicone/efeitos adversos , Resultado do Tratamento , Ultrassonografia MamáriaRESUMO
Authors review their outpatient lymph node biopsies in order to verify safety and diagnostic accuracy. They didn't observe any complication and in every case, the procedure provided the correct diagnosis. Lymph node biopsy is the procedure of choice to study the pharmacologic therapy non responsive lymph node pathology that is not surely defined by fine needle aspiration, as almost always in lymphomas.
Assuntos
Assistência Ambulatorial , Biópsia por Agulha Fina/métodos , Linfonodos/patologia , Linfoma/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Linfoma/diagnóstico , Linfoma não Hodgkin/patologia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Sensibilidade e EspecificidadeRESUMO
Multiple and ripetitive mammary fibroadenomas represent a rare disease. The etiology is uncertain. The diagnostic radiology is able to allow a correct diagnosis. The authors report a case of a woman 22 years old undergone a surgical treatment many times to remove multiple and ripetitive mammary fibroadenomas. The proposed management provides for periodic radiological exams; the surgical treatment is proposed only for the lesions with a rapid growth.
Assuntos
Neoplasias da Mama/cirurgia , Fibroadenoma/cirurgia , Neoplasias Primárias Múltiplas/cirurgia , Adulto , Feminino , HumanosRESUMO
Examination of more than 700 cutaneous melanoma cases, the authors have identified 19 so-called thin melanomas, which have evolved in the long time in metastases. Two tumor distinctive features, vascularization and regression, correlated between them, seem to be particularly important in outlining the future tumor behavior, and so these two parameters must be analysed and included in the histological report. In these cases it is undoubted the need to make a strict surveillance protocol, also more than 10 years. According to our opinion, surgical treatment can immediately provides, in selected cases, the use of sentinel lymph node technique or the integration with other therapies (immuno-treatment).
Assuntos
Melanoma/cirurgia , Neoplasias Cutâneas/cirurgia , Feminino , Humanos , Masculino , Melanoma/patologia , Pessoa de Meia-Idade , Neoplasias Cutâneas/patologiaRESUMO
Of unknown etiology, mainly located on the upper limbs, the nodular fasciitis nowadays is considered as a reactive inflammatory lesion more than a neoplastic one. With very few symptoms, it can be diagnosed through histology and the extent of the excision is related to the report of the pathological examination.
Assuntos
Fasciite/patologia , Adulto , Feminino , Humanos , Masculino , Sarcoma/patologiaRESUMO
By clinical observation and surgical treatment of a patient with a primitive lymphoma of the breast, the authors describe the nosological approach, the correct diagnosis and the relative surgical treatment in that disease.