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1.
J. Health Biol. Sci. (Online) ; 10(1): 1-4, 01/jan./2022. tab
Artigo em Inglês | LILACS | ID: biblio-1379702

RESUMO

Objectives: to describe and examine oral hygiene habits and self-reported gingival bleeding in women with breast cancer undergoing chemotherapy. Methods: in an observational and prospective study, 140 women were evaluated during chemotherapy between 2017 and 2019. Results and Conclusion: more than 40% of participants reported gingival bleeding at some point during chemotherapy. Flossing was unsatisfactory at baseline and in the intermediate cycle as well as did not affect self-reported gingival bleeding. The amount of tooth brushing per day was a predictor of self-reported gingival bleeding at the end of chemotherapy.


Objetivos: descrever e examinar os hábitos de higiene bucal e o autorrelato de sangramento gengival em mulheres com câncer de mama em quimioterapia. Métodos: em um estudo observacional prospectivo, foram avaliadas 140 mulheres ao longo da quimioterapia, entre 2017 e 2019. Resultados e Conclusão: mais de 40% das participantes relataram sangramento gengival em algum momento da quimioterapia. O uso de fio dental foi insatisfatório no baseline e ciclo intermediário, bem como não afetou o autorrelato de sangramento gengival. A quantidade de escovação dentária por dia foi um preditor para o autorrelato de sangramento gengival ao fim da quimioterapia.


Assuntos
Neoplasias da Mama , Tratamento Farmacológico , Higiene Bucal , Dispositivos para o Cuidado Bucal Domiciliar , Autorrelato
2.
Artigo em Inglês | MEDLINE | ID: mdl-35988844

RESUMO

INTRODUCTION AND OBJECTIVE: Prediction of the pathologic response to neoadjuvant chemotherapy (NAC) in patients with locally advanced breast cancer is essential for optimal treatment strategy. The current approach of adjuvant or neoadjuvant treatment is based on the molecular subtype. Obesity may have affected chemotherapy response. This study aims to evaluate the relationship between metabolic activity of adipose tissue (AT) and pathological responses to NAC. And to define the association with body mass index (BMI) and metabolic parameters of standardized uptake value (SUV) of adipose tissue measured by positron emission computed tomography (PET/CT). MATERIAL AND METHODS: One-hundred and sixteen consecutive patients with stage II and III breast cancer who underwent PET/CT before receiving NAC, were evaluated in the study. Metabolic parameters of visceral adipose tissue (VAT-SUV), subcutaneous adipose tissue (SAT-SUV), and calculated SUV of visceral-to-subcutaneous ratio (V/S-ratio) were regarded. The relationship between SUV of AT and pathologic response was evaluated from medical records retrospectively. RESULTS: Univariate-analysis revealed that good pathological response was significantly associated with clinical stage (P<.001), HER-2 positivity (P<.001), VAT-SUV (P=.037), VAT-density (P=.043) and V/S-ratio (P=.003). In multivariate-analysis clinical stage, HER-2 positivity and V/S-ratio were found to have statistically effect on pathological response. VAT-volume (P<.001), VAT-SUV (P=.016), SAT-volume (P<.001) and SAT-SUV (P<.001) has positive correlation with BMI value. On the other hand, V/S-ratio (P=.039) and SAT-density (P=.003) has negative correlation with BMI. CONCLUSION: Metabolic activity of AT is associated with BMI and effected chemotherapy responses. LowV/S ratio was associated with high BMI and poor pathological response to NAC. V/S ratio may be a useful marker for the prediction of NAC responses.

3.
Rev. APS ; 25(Supl. 2): 21-39, 16/08/2022.
Artigo em Português | LILACS | ID: biblio-1393131

RESUMO

Em relação à última diretriz brasileira do Instituto Nacional do Câncer/Ministério da Saúde sobre a detecção precoce do câncer de mama, destacamos as incertezas sobre a tomada de decisão compartilhada relativas a benefícios e riscos do rastreamento mamográfico. Este artigo expressa as percepções de usuárias de serviços de Atenção Primária à Saúde sobre a decisão compartilhada nesse cenário, sendo resultado de uma pesquisa qualitativa que utilizou grupos focais, como instrumentos de produção de dados, e análise de conteúdo temática, para a sistematização de resultados. As participantes revelaram não participarem dedecisão compartilhada no rastreamento mamográfico, o que nos leva a ressaltar a importância de nortear os cuidados em saúde com base em tecnologias leves, ou seja, tecnologias relacionais, e a valorizar, também, a necessidade de implementação de certos aspectos conceituais e de princípios fundamentais, que precisam ser discutidos e realçados para que a decisão compartilhada seja implementada.


According to the latest Brazilian guidelines from the National Cancer Institute/Ministry of Health on early detection of breast cancer, we highlight the uncertainties about shared decision-making concerning the benefits and risks of mammographic screening. This article expresses the perceptions of users of Primary Health Care services concerning shared decision-making in this scenario. As a result of qualitative research, it used focus groups as an instrument for data production and thematic content analysis to systematize the results. The participants revealed that there is no shared decision-making concerning mammographic screening, which leads us to emphasize that health care guidelines should be based on light technologies,that is, relational technologies. They should also discuss and highlight related conceptual aspects and fundamental principles so that shared decision-making can be implemented.


Assuntos
Atenção Primária à Saúde , Neoplasias da Mama , Mamografia , Programas de Rastreamento
4.
Rev. esp. med. nucl. imagen mol. (Ed. impr.) ; 41(4): 223-230, jul. - ago. 2022. ilus, graf, tab
Artigo em Espanhol | IBECS | ID: ibc-205184

RESUMO

Objetivo: Conocer el estado actual de la técnica de localización radioguiada de lesiones no palpables de mama con o sin indicación de biopsia selectiva de ganglio centinela —ROLL, SNOLL y semillas de 125I— mediante la realización de una encuesta nacional elaborada por el Grupo de Trabajo de Cirugía Radioguiada (GTCRG) de la Sociedad Española de Medicina Nuclear e Imagen Molecular (SEMNIM). Material y métodos: En octubre del 2020 se envió la encuesta, en formato digital, a los distintos servicios de Medicina Nuclear de nuestra geografía. Se dio un tiempo de respuesta de 2meses con prórroga de 15 días. Se ha obtenido el número de procedimientos ROLL/SNOLL de cada centro y la metodología utilizada, recogiendo importantes detalles técnicos. Además, se ha incluido un apartado específico sobre las semillas de 125I. Los resultados se volcaron de forma automática en una hoja de cálculo Excel 2007 para su posterior análisis con el mismo programa. Resultados: La encuesta fue contestada por 55 centros; 21 utilizan arpón mientras que los 34 restantes emplean distintas técnicas de cirugía radioguiada (CRG) para la localización de lesiones no palpables de mama, desglosando los resultados en 13apartados. La dosis de trazador habitualmente utilizada es de 111 MBq para la técnica ROLL y de 222 MBq para la técnica SNOLL, con un volumen de 0,2ml. El protocolo más habitual es el de 2días. El 26% de los centros que realiza CRG utiliza semillas de 125I tanto para la detección de lesiones mamarias como de ganglios sospechosos/patológicos, siendo el tiempo entre la implantación y la extirpación es de unos 3 días, con posterior control radiológico en la mayoría de los casos. Conclusión: La encuesta pone de manifiesto la relevancia de la cirugía radioguiada en el manejo de los pacientes con cáncer de mama en las diferentes etapas de la enfermedad, con disparidad en la implementación de las nuevas técnicas y herramientas (AU)


Objective: To know the current status of the technique of radioguided localisation of non-palpable breast lesions with or without indication for selective sentinel node biopsy -ROLL, SNOLL and 125I seeds- by conducting a national survey developed by the Working Group on Radioguided Surgery (GTCRG) of the Spanish Society of Nuclear Medicine and Molecular Imaging (SEMNIM). Material and methods: In October 2020, the form was sent in digital format to the different nuclear medicine services in Spain. A response time of 2months with an overtime of 15 days was given. The number of ROLL/SNOLL procedures in each centre and the methodology used were obtained, including important technical details. In addition, a specific section on 125I seeds was included. The results were automatically downloaded into an Excel 2007 spreadsheet for subsequent analysis with the same program. Results: The survey was answered by 55 centres; 21 use wire-guided localisation while the remaining 34 use different radioguided surgery techniques (RGS) for the localisation of non-palpable breast lesions, with the results itemized into thirteen sections. The commonly used tracer dose is 111 MBq for the ROLL technique and 222 MBq for the SNOLL technique, with a volume of 0.2ml. The most common protocol is the two-day protocol. 26% of centres performing CRG use 125I seeds for both breast lesion and suspicious/pathological node detection, with the time between implantation and removal being about 3 days, with subsequent radiological control in most cases. Conclusion: The survey shows the relevance of radioguided surgery in the management of breast cancer patients at different stages of the disease, with disparity in the implementation of new techniques and tools, which responds to the multiple healthcare realities of Nuclear Medicine services (AU)


Assuntos
Humanos , Feminino , Neoplasias da Mama/cirurgia , Neoplasias da Mama/diagnóstico , Medicina Nuclear , Biópsia de Linfonodo Sentinela , Cirurgia Assistida por Computador , Pesquisas sobre Atenção à Saúde , Radioisótopos do Iodo , Imagem Molecular , Sociedades Médicas , Espanha
5.
Cir Cir ; 90(4): 473-480, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35944438

RESUMO

INTRODUCTION: To determine whether clinicopathological characteristics can improve the prediction of metastasis to nonsentinel lymph nodes (NSLNs) over the use of only mRNA copy number in sentinel lymph node (SLN) biopsies. METHODS: This was a retrospective, observational study that included a total of 824 patients with T1-3 breast cancer who had clinically negative, ultrasound-negative axilla without evidence of metastasis and who underwent one-step nucleic acid amplification in SLN biopsies. RESULTS: 118 required a complete axillary lymph node dissection (ALNhD). About 35.6% (42/118) had metastases to a NSLN, and 64.4% (76/118) had no metastasis to a NSLN. The ROC curve of the total tumor load (TTL) presented an area under the curve (AUC) of 0.651 (95%; CI: 0.552-0.751). The 7294 copies of CK19 mRNA were established as the optimal cutoff point, with sensitivity: 93%, specificity: 63%, positive predictive value: 44%, and negative predictive value: 91%. By associating the clinicopathological parameters (multicentricity, pooled immunohistochemistry [IHC], and progesterone receptors), the AUC went up to 0.752 (95% CI: 0.663-0.841). CONCLUSIONS: Clinicopathological factors should be considered together with the total CK19 mRNA copy number (the TTL) of the SLNs to improve the predictive capacity of metastatic involvement of the NSLNs.


INTRODUCCIÓN: Nuestro objetivo era determinar si la influencia de las características clínicopatológicas pueden mejorar la predicción de metástasis en los ganglios linfáticos no centinelas (GLNC) a partir de un punto de corte de copias de ARNm determinado en la biopsia del ganglio linfático centinela (GLC). MÉTODOS: Se realizó un estudio observacional retrospectivo incluyendo a un total de 824 pacientes con cáncer de mama T1-3, con axila clínica y ecográficamente negativa para metástasis en los ganglios axilares. Se les practicó una biopsia selectiva del GLC y estudio posterior mediante el método one step nucleic acid amplification (OSNA). RESULTADOS: 118 precisaron una disección completa de los ganglios linfáticos axilares. 35,6% (42/118) tuvieron metástasis en GLNC y 64.4% (76/118) no presentaron metástasis en GLNC. La curva ROC del log de la carga tumoral total (CTT) presentó un área bajo la curva de 0.651 (95%; IC: 0.552-0.751). Se estableció las 7294 copias de ARNm de CK19 como punto de corte óptimo, con sensibilidad: 93%, especificidad: 63%, valor predictivo positivo: 44% y valor predictivo negativo: 91%. Al asociar los parámetros clinicopatológicos (multicentricidad, inmunohistoquímica (IHQ) agrupado y receptores de progesterona) obtenemos un área bajo la curva mejorada de 0.752 (95% intervalo de confianza [IC] 0.663-0.841). CONCLUSIONES: Los factores clinicopatológicos deberían valorarse asociados al corte de copias de ARNm de la CTT de CK19 de los GLCs para mejorar la capacidad predictiva de afectación metastásica en los GLNCs.


Assuntos
Neoplasias da Mama , Axila , Neoplasias da Mama/genética , Neoplasias da Mama/patologia , Feminino , Humanos , Excisão de Linfonodo , Linfonodos/patologia , Linfonodos/cirurgia , Metástase Linfática/patologia , RNA Mensageiro , Biópsia de Linfonodo Sentinela
7.
Cir Esp (Engl Ed) ; 2022 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-35850474

RESUMO

OBJECTIVE: Assessment of the reoperation rate in patients with positive resection margins after initial breast-conserving surgery for breast cancer and estimation of the cost to the hospital. METHOD: 146 patients with diagnosis of invasive breast cancer were included, who were initially intervened with conservative surgery by the Gynecology and Obstetrics Service of Hospital Universitario de Tarragona Juan XXIII (HUTJ23) during the years 2018 and 2019. We calculated the rate of involvement of the surgical margins of the resection piece after initial conservative surgery, establishing in which cases it was necessary to carry out a second resection, estimating the added direct costs of the second surgical procedure, and comparing them with the costs established by the Catalan Health Service according to the level of the hospital and the Diagnosis-Related Groups (DRG) established by the National Health System. RESULTS: The rate of positive margins after initial conservative surgery was 20.55% and 19.17% patients underwent reoperation, generating a total expense of € 129,696.89, € 82,654.34 in conservative surgeries (€ 3757.01 on average per patient) and € 47,042.55 in mastectomies (€ 6720.36 on average per patient). CONCLUSIONS: Margin involvement after breast-conserving surgery is synonymous for reoperation, this involves a series of direct costs. It is advisable to control the factors related to affected margins to minimize their impact.

8.
J Healthc Qual Res ; 2022 Jul 02.
Artigo em Espanhol | MEDLINE | ID: mdl-35792048

RESUMO

INTRODUCTION: The number of survivors with cancer is growing worldwide, but the adverse effects of the radiotherapy are still frequent, affecting effort capacity, respiratory function and quality of life. The objective is to know how the physical exercise influences the respiratory function and tolerance to effort, in pacients with breast cancer after the radiotherapy treatment. MATERIALS AND METHODS: The searches were carried out in the databases of Pubmed, PEDro, Web Of Science, Cochrane, EMBASE, UptoDate and Tripdatabase. Were included studies with patients with breast cancer treated with radiotherapy and included in an exercise program. The main results were: maximum oxygen consumption, 6 minutes walking test, forced vital capacity, vital capacity, forced expiratory volume in 1 second, total lounge capacity, inspiratory capacity, and the diffusion capacity of the lungs for carbon monoxide. RESULTS: The results show an increase of the effort capacity with 15% improvements in the maximum oxygen consumption and 6.675% in the 6 minutes walking test, while they are limited for the respiratory function. CONCLUSIONS: The physical exercise is effective for improve the effort capacity in pacients with breast cancer treated with radiotherapy, without changes in the respiratory function. Nevertheless, new studies are necessary to investigate deeply how the physical exercise influences in those pacients, and the ideal design of the programs.

9.
Rev. senol. patol. mamar. (Ed. impr.) ; 35(3): 146-152, Julio - Septiembre 2022. tab, ilus, graf
Artigo em Espanhol | IBECS | ID: ibc-207593

RESUMO

Objetivos: Evaluar las mastectomías reductoras de riesgo realizadas y analizar las indicaciones y resultados según las características individuales, oncológicas y quirúrgicas de nuestras pacientes.MétodosEstudio observacional retrospectivo de todas las mastectomías con reconstrucción inmediata en mamas sanas realizadas desde 2013 a 2019. Se dividieron las pacientes en tres grupos: I) riesgo genético de cáncer de mama, II) cáncer de mama diagnosticado y III) antecedente de cáncer de mama.ResultadosSe realizaron 56 mastectomías reductoras de riesgo a 46 pacientes, 15% grupo I, 50% grupo II y 35% grupo III, pero tras estudios diferidos, 20 pacientes (43%) presentaban mutación genética. La media de edad en este subgrupo fue de 40 años y con predominio de tumores HER2+ (40% frente al 12%, p=0,164). En el grupo III observamos más complicaciones inmediatas (31%, p=0,014) y tardías (69%, p=0,027) relacionadas con la reconstrucción protésica, y más evidente en mamas que tuvieron enfermedad (73% frente al 39% sanas, p=0,002). Se encontró relación entre contractura capsular y la radioterapia postoperatoria (p=0,008) y entre necrosis y radioterapia preoperatoria (p=0,001). Se reintervino al 7% por complicaciones en mastectomías profilácticas. No hemos tenido recidivas locales.ConclusionesConsideramos justificada la mastectomía reductora de riesgo realizada a mujeres jóvenes con mutación genética y a pacientes con cáncer precoz, HER2+ y riesgo familiar. En pacientes ya tratadas por cáncer, el riesgo de complicaciones supera el valor profiláctico de la técnica. La reconstrucción mamaria es la principal responsable de complicaciones postoperatorias y las pacientes deben ser plenamente conscientes de ello. (AU)


Objectives: To evaluate the risk-reducing mastectomies performed and to analyse the indications and results according to the individual, oncological and surgical characteristics of our patients.MethodsRetrospective observational study of all mastectomies with immediate reconstruction in healthy breasts performed from 2013 to 2019. The patients were divided into three groups: I) genetic risk of breast cancer, II) diagnosed breast cancer and III) history of cancer breast.ResultsA total of 56 risk-reducing mastectomies were performed in 46 patients, 15% in group I, 50% in group II and 35% in group III. After deferred studies, 20 (43%) patients had a genetic mutation. This subgroup had an average age of 40 years and a predominance of HER2+ tumours (40% versus 12%, p=0.164). In group III, we observed more immediate (31%, p=0.014) and late (69%, p=0.027) complications related to prosthetic reconstruction, which were more evident in breasts with disease (73% versus 39% healthy, p=0.002). A relationship was found between capsular contracture and postoperative radiotherapy (p=0.008) and between necrosis and preoperative radiotherapy (p=0.001). Reoperation was required in 7% for complications of prophylactic mastectomies. There were no local relapses.ConclusionsWe consider risk-reducing mastectomy to be justified in young women with a genetic mutation and in patients with early cancer, HER2+ and family risk. In patients already treated for cancer, the risk of complications exceeds the prophylactic value of the technique. Breast reconstruction is primarily responsible for postoperative complications and patients should be fully aware of this. (AU)


Assuntos
Humanos , Feminino , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/prevenção & controle , Neoplasias da Mama/terapia , Mastectomia Profilática/tendências
10.
Rev. senol. patol. mamar. (Ed. impr.) ; 35(3): 153-159, Julio - Septiembre 2022. tab, ilus
Artigo em Inglês | IBECS | ID: ibc-207594

RESUMO

Introduction: Metastasis from Triple-negative breast cancer (TNBC) is a significant cause of morbidity and death and also presents a diagnostic challenge. There are significant therapeutic implications for making a correct and timely diagnosis of metastatic TNBC because the tumors may respond to chemotherapy. PELP1 expression has been reported recently in BC but is poorly studied in the diagnosis of primary and metastasis of TNBC.ObjectivesThe aim of the present study is to assess the diagnostic utility of PELP1and compare it with GATA3, the most commonly used in our practice for breast cancer.MethodsPELP1 and GATA3 were assessed by immunohistochemistry in formalin fixed paraffin embedded tissue blocks of 30 cases of primary TNBC and 15 cases of metastatic TNBC at the Pathology department, Zagazig University, Egypt.ResultsThe immunohistochemical expression of PELP1 revealed a higher frequency of expression than GATA3 in both primary and metastatic TNBC. PELP1 revealed a (96.67%) positive expression rate in primary TNBC and a (86.67%) positive in metastatic TNBC. In comparison to GATA3, revealed (53.33%) positive expression rate in primary TNBC and (60%) positive in metastatic TNBC. Furthermore, the majority of the PELP1 positive cases showed diffuse strong staining, making observation of the staining easy and suggested that PELP1 may be a molecular target for TNBC therapy. We predict that this analysis will shed light on PELP1's significance in TNBC.ConclusionIn comparison to GATA3, PELP1 protein expression is substantially higher in diagnosis of primary and metastatic TNBC. (AU)


Introducción: La metástasis del cáncer de mama triple negativo (TNBC) es una causa importante de morbilidad y muerte y también presenta un desafío diagnóstico. Existen importantes implicaciones terapéuticas para hacer un diagnóstico correcto y oportuno de TNBC metastásico porque los tumores pueden responder a la quimioterapia. La expresión de PELP1 se ha informado recientemente en BC, pero está poco estudiada en el diagnóstico de metástasis primaria y de TNBC.ObjetivosEl objetivo del presente estudio es evaluar la utilidad diagnóstica de PELP1 y compararlo con GATA3, el más utilizado en nuestra práctica para el cáncer de mama.MétodosPELP1 y GATA3 se evaluaron mediante inmunohistoquímica en bloques de tejido embebidos en parafina fijados con formalina de 30 casos de TNBC primario y 15 casos de TNBC metastásico en el departamento de Patología de la Universidad de Zagazig, Egipto.ResultadosLa expresión inmunohistoquímica de PELP1 reveló una mayor frecuencia de expresión que GATA3 en TNBC tanto primaria como metastásica. PELP1 reveló una tasa de expresión positiva (96,67%) en TNBC primario y un (86,67%) positivo en TNBC metastásico. En comparación con GATA3, reveló (53,33%) tasa de expresión positiva en TNBC primaria y (60%) positiva en TNBC metastásica. Además, la mayoría de los casos positivos de PELP1 mostraron una tinción fuerte difusa, lo que facilitó la observación de la tinción y sugirió que PELP1 puede ser un objetivo molecular para la terapia de TNBC. Predecimos que este análisis arrojará luz sobre la importancia de PELP1 en TNBC.ConclusiónEn comparación con GATA3, la expresión de la proteína PELP1 es sustancialmente mayor en TNBC primaria y metastásica. (AU)


Assuntos
Humanos , Feminino , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/diagnóstico , Metástase Neoplásica/diagnóstico
11.
Rev. senol. patol. mamar. (Ed. impr.) ; 35(3): 160-166, Julio - Septiembre 2022. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-207595

RESUMO

Objective: Quantitative analysis of tumor-infiltrating lymphocytes (TILs) is currently considered as a prognostic factor in several malignant tumors. The aim of our study was to assess the prognostic value of TILs in breast cancers and its association with other clinicopathological prognostic factors in non-specific type (NST) breast carcinoma in Tunisian population.MethodsRetrospective study included 53 women with NST breast carcinoma. The data were collected over a period of 13 months with a follow-up of 40 months for all the patients. The TILs were evaluated according to the 2014 recommendations of the international working group on TILs.ResultsTILs level was between 3% and 60% with mean of 21%. Ten patients had lymphocyte predominant breast cancer (LPBC). Statistical analysis had shown that the TILs level ≤50% was associated with the presence of vascular emboli and the absence of HER2 amplification. Inflammatory-type carcinoma and HER2 amplification significantly worsened OS. Presence of vascular emboli, lymph node metastases, inflammatory type of carcinoma, TILs ≤50%, and absence of estrogen receptors (ER) were associated with reduced RFS. In multivariate analysis, the presence of vascular emboli was an independent factor for OS. TILs ≤50%, inflammatory type of carcinoma and presence of vascular emboli were independent risk factors for RFS.ConclusionThis Tunisian pilot study showed higher level of TILs in NST breast carcinomas is associated with improved RFS. The therapeutic implications will benefit from multiple research studies including ours on the predictive value of TILs for neoadjuvant or adjuvant treatment. (AU)


Objetivo: El análisis cuantitativo de los linfocitos infiltrantes de tumor (TIL) se considera actualmente como un factor pronóstico en varios tumores malignos. El objetivo de nuestro estudio fue evaluar el valor pronóstico de los TIL en los cánceres de mama y su asociación con otros factores pronósticos clinicopatológicos en el carcinoma de mama de tipo no específico (NST) en la población tunecina.MétodosEn un estudio retrospectivo se incluyó a 53 mujeres con carcinoma de mama NST. Los datos se recogieron durante un período de 13 meses, con un seguimiento de 40 meses para todas las pacientes. Los TIL se evaluaron según las recomendaciones de 2014 del grupo de trabajo internacional sobre TIL.ResultadosEl nivel de TIL estuvo entre el 3% y el 60% con una media del 21%. Tenían cáncer de mama con predominio de linfocitos (LPBC) 10 pacientes. El análisis estadístico mostró que el nivel de TIL ≤ 50% se asociaba a la presencia de émbolos vasculares y a la ausencia de amplificación de HER2. El carcinoma de tipo inflamatorio y la amplificación de HER2 empeoraron significativamente la SG. La presencia de émbolos vasculares, las metástasis en los ganglios linfáticos, el carcinoma de tipo inflamatorio, los TIL ≤ 50% y la ausencia de receptores de estrógeno se asociaron a una menor SSR. En el análisis multivariante, la presencia de émbolos vasculares fue un factor independiente para la SG. Los TIL ≤ 50%, el tipo de carcinoma inflamatorio y la presencia de émbolos vasculares fueron factores de riesgo independientes para la RFS.ConclusiónEste estudio piloto tunecino mostró que un mayor nivel de TIL en los carcinomas de mama NST se asocia a una mejor RFS. Las implicaciones terapéuticas se beneficiarán de múltiples estudios de investigación, incluido el nuestro, sobre el valor predictivo de los TIL para el tratamiento neoadyuvante o adyuvante. (AU)


Assuntos
Humanos , Feminino , Neoplasias da Mama/prevenção & controle , Prognóstico , Linfócitos do Interstício Tumoral , Previsões
12.
Rev. senol. patol. mamar. (Ed. impr.) ; 35(3): 167-174, Julio - Septiembre 2022. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-207596

RESUMO

Introducción: el cáncer de mama es la neoplasia más frecuente en mujeres españolas. Los continuos avances en su tratamiento han contribuido a mejorar de forma progresiva la supervivencia en estadios precoces. Entre los avances durante los últimos años, hay que destacar el tratamiento neoadyuvante.Material y métodoshemos valorado la evolución temporal de las indicaciones y los resultados del tratamiento neoadyuvante del cáncer de mama durante un periodo de 10 años. Para ello, se han analizado las características clínicas, la respuesta completa patológica (RCp), la supervivencia global (SG) y libre de progresión (SLP) de todos los pacientes con cáncer de mama tratados con neoadyuvancia entre el 1 de enero de 2007 y el 31 de diciembre de 2016.Resultadosse han tratado 212 pacientes con cáncer de mama. A lo largo de los 10 años hemos observado un progresivo aumento en el número de pacientes tratadas con neoadyuvancia, en la edad de los pacientes incluidos (p < 0,001), en los casos de menopausia (p = 0,029), de casos triple negativo y HER2 positivo. También, hemos observado un aumento en el número de casos en los que se ha realizado cirugía conservadora y biopsia selectiva del ganglio centinela.Conclusionesel tratamiento neoadyuvante se utiliza cada vez más en las pacientes con cáncer de mama, sobre todo en los subtipos de mal pronóstico (triple negativo y HER2). La incorporación de nuevos fármacos y el tratamiento de estadios más precoces está contribuyendo a la mejora de las tasas de RCp y las cirugías conservadoras. (AU)


Introduction: Breast cancer is the most frequent tumor in Spanish women. Continuous advances in the treatment of this neoplasm, have contributed to progressively improve survival in early stages. In the last years, neoadjuvant treatment has evolved and changes have occurred in the treatment indication and in the results.Material and methodsWe have assessed the temporal evolution of indications and results of neoadjuvant therapy in breast cancer over a 10-year period. We have analyzed the clinical characteristics, the complete pathological response (CRp), overall survival (OS) and progression-free survival (PFS) of all patients with breast cancer treated with neoadjuvant therapy between January 1st 2007 and December 31st 2016.ResultsDuring the study period, 212 patients were treated.  Throughout the 10-year period, we observed that increasingly older patients had been treated (p < 0.001), a greater number of menopausal patients (p = 0.029), a greater number of triple negative and HER2 positive cases. In addition, a larger number of conservative surgeries and sentinel lymph node biopsies had been performed.ConclusionsNeoadjuvant therapy is increasing in patients with breast cancer, especially in subtypes with poor prognosis (triple negative and HER2). The emerging new drugs and treatment in earlier stages has increased the rate of pCR and breast conserving surgery. (AU)


Assuntos
Humanos , Feminino , Neoplasias da Mama/terapia , Terapia Neoadjuvante/métodos , Terapia Neoadjuvante/tendências , Estudos de Séries Temporais
13.
Rev. senol. patol. mamar. (Ed. impr.) ; 35(3): 175-183, Julio - Septiembre 2022. graf, tab
Artigo em Inglês | IBECS | ID: ibc-207597

RESUMO

Introduction: Due to the high incidence and aggressiveness of breast cancer, understanding specific factors associated with the profile of the disease is necessary. Thus, the study aimed to analyze data from 155 patients with breast cancer, grouping them according to their clinicopathological characteristics, attended at a reference hospital for Oncology, in 2015–2020, in the southwest region of Paraná, Brazil.Material and MethodsUsing multivariate statistical analysis, sample data were divided into three clusters. The heterogeneity between clusters was obtained by Ward's method. The clinicopathological variables obtained from the patients' medical records were: the presence of intratumoral emboli and lymph nodes, menopausal status, molecular subtype, histological grade, TNM staging of the disease, tumor size, age at diagnóstico, weight, height, and body mass index.ResultsIt is observed that 70% of the patients were in menopause at diagnóstico, 31.5% had tumors containing emboli, and 41% had positive lymph nodes. The prevalence of Luminal B subtype, intermediate histological grade, and TNM staging II was verified. The prevalence of the disease was higher in women aged over 50 years, representing 66% of cases. The BMI of the patients ranged from 17.63 kg/m2 to 51.26 kg/m2, with 73.55% above 25 kg/m2. Using the spatial distribution of patients, cluster analysis identified the regions with the worst averages of clinicopathological variables and the highest number of cancer cases.ConclusionThrough the statistical analysis, it was possible to determine the heterogeneity of the data, so the patients were separated into three clusters. When analyzing the obtained clusters, each one of them had specific characteristics. (AU)


Introducción: Debido a la alta incidencia y agresividad del cáncer de mama, es necesario el conocimiento de factores específicos asociados al perfil de la enfermedad. Así, el objetivo del estudio fue analizar datos de 155 pacientes con cáncer de mama, agrupándolas según sus características clínico-patológicas, atendidas en un hospital de referencia en Oncología, en el período 2015–2020, en la región suroeste de Paraná, Brasil.Material y métodosA partir de la utilización de un análisis estadístico multivariado, los datos de la muestra se dividieron en tres grupos. La heterogeneidad entre clústeres se obtuvo mediante el método de Ward. Las variables clínico-patológicas obtenidas de la historia clínica de las pacientes fueron: presencia de émbolos y ganglios linfáticos intratumorales, estado menopáusico, subtipo molecular, grado histológico, estadificación TNM de la enfermedad, tamaño tumoral, edad al momento del diagnóstico, peso, talla, e índice de masa corporal.ResultadosSe observa que el 70% de las pacientes se encontraba en menopausia al momento del diagnóstico, el 31,5% tenía tumores con émbolos y el 41% tenía ganglios positivos. Se verificó la prevalencia de subtipo luminal B, grado histológico intermedio y estadificación TNM II. La prevalencia de la enfermedad fue mayor en mujeres mayores de 50 años, lo que representa el 66% de los casos. El IMC de los pacientes osciló entre 17,63 kg/m2 y 51,26 kg/m2, con un 73,55% encima de 25 kg/m2. El análisis de clúster, utilizando la distribución espacial de pacientes, identificó las regiones con los peores promedios de variables clínico-patológicas y el mayor número de casos de cáncer.ConclusiónA través del análisis estadístico fue posible determinar la heterogeneidad de los datos, por lo que las pacientes fueron separadas en tres grupos. Al analizar los clústeres obtenidos, pudo verificarse que cada uno de ellos presentaba características específicas. (AU)


Assuntos
Humanos , Feminino , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/terapia , Índice de Massa Corporal , Estadiamento de Neoplasias , Menopausa , Interpretação Estatística de Dados , Brasil
14.
Rev. senol. patol. mamar. (Ed. impr.) ; 35(3): 192-198, Julio - Septiembre 2022.
Artigo em Espanhol | IBECS | ID: ibc-207599

RESUMO

Consciente del problema que supone el cáncer de mama, tanto a nivel de incidencia como de mortalidad, la Dirección General para la Salud y la Seguridad Alimenticia de la Comisión Europea ha creado el programa de la Iniciativa para el Cáncer de Mama de la Comisión Europea (ECIBC) para establecer una igualdad en la oportunidad del manejo del cáncer de mama en todas las pacientes de la Unión con independencia del país en el que se traten. En este proyecto se han redactado 86 requerimientos que engloban aspectos generales de cribado, de diagnóstico, de tratamiento, de rehabilitación, de seguimiento y de cuidados paliativos del cáncer de mama, que han de cumplir aquellas Unidades de Mama (UM) que quieran obtener esta certificación. De momento se ha lanzado un programa piloto para las UM voluntarias con la finalidad de evaluar la viabilidad de la aplicación de estos requerimientos y obtener un feedback por parte de las mismas para el redactado final de estos. En esta contribución se exponen los requerimientos que integran el proyecto. (AU)


Aware of the problem of breast cancer in terms of both incidence and mortality, the European Commission's Directorate General for Health and Food Safety has created the European Commission Initiative on Breast Cancer (ECIBC) program to establish equal opportunity in the management of breast cancer in all patients in the Union, regardless of the country in which they are treated. In this project, 86 requirements have been designed, covering general aspects of: screening, diagnosis, treatment, rehabilitation, follow-up and palliative care of breast cancer, which must be met by those Breast Cancer Services (BCS) that wish to obtain this certification. A pilot program has been launched for voluntary BCS in order to evaluate the feasibility of applying these requirements and to obtain feedback from them for the final drafting of these requirements. This contribution sets out the requirements. (AU)


Assuntos
Humanos , Feminino , Indicadores de Qualidade em Assistência à Saúde/normas , Indicadores de Qualidade em Assistência à Saúde/tendências , Neoplasias da Mama/prevenção & controle , Neoplasias da Mama/terapia
15.
Rev. senol. patol. mamar. (Ed. impr.) ; 35(3): 199-204, Julio - Septiembre 2022. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-207600

RESUMO

Objetivo: Revisar la concordancia entre patólogos en el diagnóstico de atipia epitelial plana de mama.MétodosRevisión sistemática de artículos registrados en la base de datos de Pubmed, Scopus y Embase con los términos «pathologists» y «flat epithelial atypia», «flat epithelial atypia» e «interobserver variability», «interobserver agreement in flat epithelial atypia» (Scopus y Embase) y en la base de datos Lilacs con los términos en español «patólogos» y «atipia epitelial plana», buscando artículos con valoración de concordancia entre observadores en el diagnóstico de atipia epitelial plana mediante el coeficiente kappa. Se excluyeron artículos de revisión, resúmenes de congresos y comentarios.ResultadosCon los términos de búsqueda se encontraron 140 publicaciones. De estas, se excluyeron 121 en el cribado por título y resumen. De la revisión restante de artículos completos, fueron seleccionados 5 para análisis cualitativo. Los valores kappa variaron desde un acuerdo regular, kappa=0,39 en residentes y patólogos en entrenamiento sin aplicación de tutorial hasta un acuerdo casi perfecto de 0,83 en patólogos con un interés especial en patología mamaria y tutorial previo.ConclusionesEste estudio revisa la reproducibilidad entre observadores en el diagnóstico de atipia epitelial plana en biopsias de mama. Una baja concordancia puede darse principalmente en centros que no disponen de patólogos experimentados. Un proceso de enseñanza previo reduce la posibilidad de error, pero preferentemente se deberían remitir estos casos a centros especializados para revisión y diagnóstico. (AU)


Objective: To review the agreement between pathologists in the diagnosis of flat epithelial atypia of the breast.MethodsWe performed a systematic review of articles with the terms “pathologists” and “flat epithelial atypia”, “flat epithelial atypia” and “interobserver variability” registered in the Pubmed, Scopus and Embase databases, those with the terms “interobserver agreement in flat epithelial atypia” in Scopus and Embase, and those with the terms “pathologists” and “flat epithelial atypia” in the Lilacs database. We sought articles with interobserver variability assessment in the diagnosis of flat epithelial atypia using the kappa coefficient. We excluded review articles, conference abstracts and comments.ResultsA total of 140 publications were identified with the search terms. Of these, 121 were excluded in the screening after reading the title and abstract. Of the remaining review of full-text articles, 5 were selected for qualitative analysis. The kappa values ranged from fair agreement, Kappa=0.39 in residents and pathologists in training not receiving prior training, to near perfect agreement of 0.83 in pathologists with a special interest in breast pathology and prior training.ConclusionsThis study reviews the interrater agreement in the diagnosis of flat epithelial atypia in breast biopsies. Low reproducibility occurs mainly in centres without experienced pathologists. A prior teaching process reduces the possibility of error, but these cases should preferably be referred to specialised centres for review and diagnosis. (AU)


Assuntos
Humanos , Feminino , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/prevenção & controle , Neoplasias da Mama/terapia
16.
Rev. senol. patol. mamar. (Ed. impr.) ; 35(3)Julio - Septiembre 2022. graf
Artigo em Espanhol | IBECS | ID: ibc-207602

RESUMO

A pesar de los avances en el tratamiento del cáncer de mama existen casos en los que la enfermedad se presenta en estadios avanzados y precisa tratamientos quirúrgicos agresivos que originan grandes defectos en la pared torácica. Dentro de las diferentes técnicas comprendidas en la cirugía oncoplástica, los colgajos toracoabdominales, incluidos en el grupo de colgajos de rotación, se han postulado como una técnica atractiva para cubrir los amplios defectos que resultan de estas cirugías tan extensas, con el fin de comenzar precozmente el tratamiento adyuvante y mejorar la supervivencia sin aumentar la morbilidad. Es importante establecer una correcta indicación y el exhaustivo conocimiento de la anatomía con el objetivo de conseguir un cierre simple del defecto con una buena cobertura cutánea. (AU)


Despite advances in the treatment of breast cancer, there are cases in which the disease occurs in advanced stages and requires aggressive surgical treatments that cause large defects in the chest wall. Within the different techniques included in oncoplastic surgery, the thoracoabdominal flaps, included in the group of rotation flaps, have been postulated as an attractive technique to cover the wide defects resulting from these extensive surgeries, in order to start adjuvant treatment earlier and improve survival without increasing morbidity. It is important to establish a correct indication and an exhaustive knowledge of the anatomy in order to achieve a simple closure of the defect with good skin coverage. (AU)


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Neoplasias da Mama/reabilitação , Neoplasias da Mama/cirurgia , Cirurgia Plástica
17.
Gac Med Mex ; 158(3): 141-149, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35894744

RESUMO

Complement regulatory proteins (mCRPs) CD55, CD46 and CD59 have been proposed as key elements in therapeutic resistance against cancer. mCRP-expressing tumor cells, in addition to hindering trastuzumab, pertuzumab and sacituzumab-govitecan therapeutic activity in breast cancer, can regulate biological processes that promote tumor progression. This review describes the structure of mCRPs and analyzes their expression using transcriptomic databases from breast cancer patients, in addition to collecting information on mCRPs interactions and signaling in tumor cells. Given that mCRPs are relevant targets, several strategies that have been explored for their inhibition and regulation in order to increase therapeutic efficacy and prevent cancer resistance and progression are described.


Se ha propuesto a las proteínas reguladoras de complemento (mCRP) CD55, CD46 y CD59 como piezas clave en la resistencia terapéutica contra el cáncer. Las células tumorales que expresan las mCRP, además de obstaculizar la actividad terapéutica de trastuzumab, pertuzumab y sacituzumab-govitecan en cáncer de mama, pueden regular procesos biológicos que promueven la progresión tumoral. Esta revisión describe la estructura de las mCRP y analiza su expresión a partir de bases de datos transcriptómicos de pacientes con cáncer de mama; también recopila información de interacciones y señalización de las mCRP en células tumorales. Dado que estas mCRP son dianas relevantes, se describen diversas estrategias para su inhibición y regulación para incrementar la eficacia terapéutica y evitar la resistencia y progresión del cáncer.


Assuntos
Neoplasias da Mama , Neoplasias da Mama/tratamento farmacológico , Antígenos CD55/metabolismo , Ativação do Complemento , Proteínas do Sistema Complemento/fisiologia , Feminino , Humanos , Proteína Cofatora de Membrana/metabolismo , Trastuzumab
18.
Radiologia (Engl Ed) ; 64(3): 256-265, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35676057

RESUMO

Breast cancer is the second most common cancer in Peruvian women. Due to limitations in national breast cancer screening programs, especially in rural areas, more than 50% of cases of breast cancer in Peru are diagnosed in advanced stages. In collaboration with a local clinic registered as a nongovernmental organization (CerviCusco), RAD-AID International aims to create a sustainable diagnostic structure to improve breast cancer screening in Cuzco. With the support of local, national, and international partners that have collaborated in analyzing radiological resources, raising awareness in the population, acquiring equipment, training clinical staff, and building referral networks, our teams of radiologists, included in the RAD-AID team, have participated in training CerviCusco staff in breast ultrasound, thus enabling additional training for radiology residents through a regulated international collaboration.


Assuntos
Neoplasias da Mama , Radiologia , Neoplasias da Mama/diagnóstico por imagem , Detecção Precoce de Câncer , Feminino , Humanos , Peru , Voluntários
19.
Artigo em Inglês | MEDLINE | ID: mdl-35668015

RESUMO

OBJECTIVE: To know the current status of the technique of radioguided localisation of non-palpable breast lesions with or without indication for selective sentinel node biopsy -ROLL, SNOLL and 125I seeds- by conducting a national survey developed by the Working Group on Radioguided Surgery (GTCRG) of the Spanish Society of Nuclear Medicine and Molecular Imaging (SEMNIM). MATERIAL AND METHODS: In October 2020, the form was sent in digital format to the different nuclear medicine services in Spain. A response time of 2 months with an overtime of 15 days was given. The number of ROLL/SNOLL procedures in each centre and the methodology used were obtained, including important technical details. In addition, a specific section on 125I seeds was included. The results were automatically downloaded into an Excel 2007 spreadsheet for subsequent analysis with the same program. RESULTS: The survey was answered by 55 centres; 21 use wire-guided localisation while the remaining 34 use different radioguided surgery techniques (RGS) for the localisation of non-palpable breast lesions, with the results itemized into thirteen sections. The commonly used tracer dose is 111 MBq for the ROLL technique and 222 MBq for the SNOLL technique, with a volume of 0.2 ml. The most common protocol is the two-day protocol. 26% of centres performing CRG use 125I seeds for both breast lesion and suspicious/pathological node detection, with the time between implantation and removal being about 3 days, with subsequent radiological control in most cases. CONCLUSION: The survey shows the relevance of radioguided surgery in the management of breast cancer patients at different stages of the disease, with disparity in the implementation of new techniques and tools, which responds to the multiple healthcare realities of Nuclear Medicine services.


Assuntos
Neoplasias da Mama , Medicina Nuclear , Biópsia de Linfonodo Sentinela , Cirurgia Assistida por Computador , Neoplasias da Mama/diagnóstico , Feminino , Humanos , Radioisótopos do Iodo , Imagem Molecular , Biópsia de Linfonodo Sentinela/métodos , Sociedades Médicas , Espanha
20.
Cogit. Enferm. (Online) ; 27: e81039, Curitiba: UFPR, 2022. tab
Artigo em Português | LILACS-Express | LILACS, BDENF - Enfermagem | ID: biblio-1394308

RESUMO

RESUMO Objetivo: descrever o perfil das mulheres acometidas pelo câncer de mama e avaliar os aspectos relacionados aos métodos de detecção e estadiamento da doença e suas associações. Método estudo transversal, com 350 mulheres diagnosticadas com câncer de mama, atendidas em centros especializados de Pernambuco - Brasil, entre junho de 2018 e janeiro de 2019. Para a análise, foram realizadas associações e comparações com o teste Qui-quadrado. Resultados 40,3% da amostra tinha <50 anos, o autoexame foi o método prevalente de detecção (74,9%) em todas as faixas etárias, com associação significativa para estádios mais avançados da doença, >70% da amostra. Conclusão: a detecção pelo autoexame foi expressiva e estava relacionada com estádios mais avançados do câncer de mama, principalmente em faixas etárias mais jovens. Diante dos resultados, os atores envolvidos com a saúde da mulher poderão desenvolver novas estratégias para intensificar o rastreamento populacional.


ABSTRACT Objective: to describe the profile of women affected by breast cancer and to evaluate the aspects related to the disease detection and staging methods and their associations. Method: a cross-sectional study conducted with 350 women diagnosed with breast cancer treated in specialized centers from Pernambuco - Brazil, between June 2018 and January 2019. For the analysis, associations and comparisons were made with the Chi-square test. Results: 40.3% of the sample was <50 years old, and self-examination was the prevalent detection method (74.9%) in all age roups, with a significant association for more advanced stages of the disease, >70% of the sample. Conclusion: detection by self-examination was significant and was related to more advanced stages of breast cancer, especially in younger age groups. Given the results, the actors involved in women's health may develop new strategies to intensify population screening.


RESUMEN Objetivo: describir el perfil de las mujeres afectadas por cáncer de mama y evaluar aspectos relacionados con los métodos de detección y estadificación de la enfermedad y sus asociaciones. Método: estudio transversal, con 350 mujeres diagnosticadas con cáncer de mama, atendidas en centros especializados de Pernambuco, Brasil, entre junio de 2018 y enero de 2019. Para el análisis, se realizaron asociaciones y comparaciones con la prueba de Chi-cuadrado. Resultados: el 40,3% de la muestra tenía <50 años, el método de detección prevalente fue el autoexamen (74,9%) en todas las franjas etarias y había una asociación significativa con los estadios más avanzados de la enfermedad, >70% de la muestra. Conclusión: la detección mediante el autoexamen fue significativa y se relacionó con estadios más avanzados de cáncer de mama, especialmente en las franjas etarias más jóvenes. Estos resultados, les permitirán a los actores involucrados en la salud de la mujer desarrollar nuevas estrategias para intensificar la detección poblacional.

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