Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 531
Filtrar
1.
Gan To Kagaku Ryoho ; 47(12): 1703-1705, 2020 Dec.
Artigo em Japonês | MEDLINE | ID: mdl-33342987

RESUMO

We experienced a case of right sided accessory breast cancer complicated by contralateral breast cancer. A 50-year-old woman came to us for an examination because a tumor in her left breast was pointed out at breast cancer screening. A breast MRI confirmed a tumor in her left breast and a tumor continuing from the skin to the subcutis of the right axilla. A skin biopsy for the tumor in the right axilla and a core needle biopsy(CNB)for the tumor in the left breast were performed. The pathological result of the CNB for the left breast indicated an invasive ductal carcinoma of the tubular formative scirrhous type. Although the tumor of the right axilla was poorly differentiated adenocarcinoma demonstrating cord-like arrays, it was examined by skin biopsy and therefore no deep part of the tissue was included. We conducted immunostaining, in consideration of the possibility of metastasis from the left sided breast cancer. ER, PgR, mammaglobin, GATA 3 were positive, strongly suggesting that the tumor in the right axilla was also derived from a mammary gland. We also performed a wide local excision of the right axilla plus axillary dissection(level Ⅰ)in addition to conducting a left mastectomy plus sentinel lymph node biopsy, in consideration of the possibility of primary right sided accessory breast cancer. The pathological result following surgery confirmed a difference in the histologic features between both sides, residual normal accessory mammary glands around the tumor on the right side, and the presence of rich DCIS and a lobular replacement image, leading to a definitive diagnosis of primary invasive ductal carcinoma of the accessory breast on the right side.


Assuntos
Doenças Mamárias , Neoplasias da Mama , Carcinoma Ductal de Mama , Axila , Neoplasias da Mama/cirurgia , Carcinoma Ductal de Mama/complicações , Carcinoma Ductal de Mama/cirurgia , Feminino , Humanos , Excisão de Linfonodo , Linfonodos , Metástase Linfática , Mastectomia , Pessoa de Meia-Idade , Biópsia de Linfonodo Sentinela
2.
Rev Mal Respir ; 37(9): 752-755, 2020 Nov.
Artigo em Francês | MEDLINE | ID: mdl-32888731

RESUMO

INTRODUCTION: Hypersensitivity pneumonitis (HP) is an interstitial lung disease due to an immunological reaction to exposure, by inhalation, to a large variety of antigens. The patho-physiological mechanism remains poorly understood. The diagnosis can be challenging and requires a detailed medical history taking especially when the clinical presentation is atypical or when the causal agent remains unknown. CASE REPORT: We report the case of a 75-year-old woman with a history of mammary carcinoma who presented with recently identified intramammary adenopathy. Biopsy of the adenopathy revealed non-necrotising, giant cell epithelioid granuloma. A diagnosis of hot tub lung with extra-pulmonary granulomatous lymph node involvement was made based on the clinical, functional, radiological and microbiological investigations. The evolution was favorable following antigen avoidance. CONCLUSION: Extrapulmonary lymph node involvement is rare in HP, suggesting a systemic inflammatory involvement.


Assuntos
Alveolite Alérgica Extrínseca/complicações , Alveolite Alérgica Extrínseca/diagnóstico , Neoplasias da Mama/complicações , Carcinoma Ductal de Mama/complicações , Linfadenopatia/diagnóstico , Idoso , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/diagnóstico , Carcinoma Ductal de Mama/patologia , Diagnóstico Diferencial , Feminino , Humanos , Linfadenopatia/complicações , Complexo Mycobacterium avium/imunologia , Infecção por Mycobacterium avium-intracellulare/complicações , Infecção por Mycobacterium avium-intracellulare/diagnóstico
3.
Bull Cancer ; 107(10): 1019-1023, 2020 Oct.
Artigo em Francês | MEDLINE | ID: mdl-32972763

RESUMO

In this review, we report a case of a bone's metastatic breast cancer in Malian patient treated by chemotherapy in whom SRAS-COV-2's diagnosis was made 9days after the onset gastrointestinal symptoms. Patient quickly died before any COVID-19's treatment. According to the poor outcomes of cancer patients with COVID-19, authors emphasize to an intensive attention to such patients in order to find the best therapeutic balance between the two pathologies during this pandemic.


Assuntos
Betacoronavirus , Neoplasias da Mama/complicações , Carcinoma Ductal de Mama/secundário , Infecções por Coronavirus/complicações , Diarreia/etiologia , Pandemias , Pneumonia Viral/complicações , Neoplasias da Coluna Vertebral/secundário , Vômito/etiologia , Adulto , Antineoplásicos Fitogênicos/uso terapêutico , Conservadores da Densidade Óssea/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Carcinoma Ductal de Mama/complicações , Carcinoma Ductal de Mama/tratamento farmacológico , Docetaxel/uso terapêutico , Evolução Fatal , Feminino , Infecções por HIV/complicações , Humanos , Neoplasias Hepáticas/complicações , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/secundário , Neoplasias da Coluna Vertebral/complicações , Neoplasias da Coluna Vertebral/diagnóstico por imagem , Neoplasias da Coluna Vertebral/tratamento farmacológico , Tomografia Computadorizada por Raios X , Ácido Zoledrônico/uso terapêutico
4.
Asian J Surg ; 43(1): 240-243, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31130499

RESUMO

BACKGROUND: Atypical ductal hyperplasia (ADH) is known to be associated with underlying malignant breast conditions. Previous studies have shown that up to 40% of ADH found in core needle biopsy of the breasts had undiagnosed malignant lesions after excision. METHODS: This is a retrospective study on a prospectively maintained database. From 1st January 2005 to 31st December 2014, a total of 262 excision or mastectomy specimens were identified to contain ADH. Clinical, radiological and pathological data were retrieved and analyzed. Correlating factors for the presence of co-existing pre-malignant or malignant conditions were analyzed. Overall survival in patients with or without co-existing malignant breast lesions were evaluated. RESULTS: 95 (36.3%) had co-existing malignant breast lesions within the same specimen. The median age at diagnosis was 49 (Range 17-85). Suspicious breast imaging features (BIRADS 4 or above) and lesions larger than 10 mm on breast imaging were independent risk factor for co-existing malignant pathology (p < 0.001 and 0.005 respectively). After median follow-up interval of 60 months (6-120 months), the overall survival was comparable between the groups of patients having ADH with or without co-existing malignant pathologies (98.2% and 97.9% respectively). CONCLUSION: Co-existing malignant lesions were present in up to 36.3% of the pathology specimens containing ADH, in which its presence could be predicted by pre-operative breast imaging.


Assuntos
Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Mama/patologia , Carcinoma Ductal de Mama/patologia , Carcinoma Ductal de Mama/cirurgia , Carcinoma Intraductal não Infiltrante/complicações , Carcinoma Intraductal não Infiltrante/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia com Agulha de Grande Calibre , Neoplasias da Mama/complicações , Neoplasias da Mama/mortalidade , Carcinoma Ductal de Mama/complicações , Carcinoma Ductal de Mama/mortalidade , Feminino , Humanos , Masculino , Mastectomia , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida , Adulto Jovem
5.
J Womens Health (Larchmt) ; 29(4): 524-533, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31460829

RESUMO

Background: Weight gain after breast cancer has been associated with recurrence and mortality. We therefore examined factors associated with ≥5% weight gain over 2-year follow-up of a cohort of newly diagnosed early-stage invasive breast cancer (EIBC) and ductal carcinoma in situ (DCIS) patients and age-matched controls without a breast cancer history. Materials and Methods: We interviewed participants 4-6 weeks after definitive surgical treatment (patients) or a negative/benign screening mammogram (controls). Multivariable logistic regression models were used to identify socioeconomic, psychosocial, and treatment factors associated with ≥5% weight gain over 2-year follow-up. Results: Overall, 88 (24%) of 362 EIBC patients, 31 (17%) of 178 DCIS patients, and 82 (15%) of 541 controls had ≥5% weight gain during follow-up. EIBC patients were more likely to experience ≥5% weight gain than DCIS patients (Odds ratio [OR] = 2.16; 95% confidence interval [95% CI] = 1.19-3.95) and controls (OR = 1.76; 95% CI = 1.23-2.51). Among EIBC patients, older patients (OR = 0.96; 95% CI = 0.93-0.99), patients who underwent endocrine therapy (OR = 0.43; 95% CI = 0.19-0.95), smokers (OR = 0.35; 95% CI = 0.14-0.86), and African Americans (OR = 0.23; 95% CI = 0.09-0.58) were less likely to have ≥5% weight gain than their respective counterparts. Among DCIS patients, older patients (OR = 0.94; 95% CI = 0.89-0.99) were less likely to have ≥5% weight gain. Among controls, smokers were more likely to have ≥5% weight gain (OR = 3.03; 95% CI = 1.49-6.17). Conclusions: EIBC patients were more likely than DCIS patients and controls to experience ≥5% weight gain over follow-up. Studies are necessary to elucidate mechanisms of weight gain in early-stage breast cancer survivors.


Assuntos
Neoplasias da Mama/complicações , Carcinoma Ductal de Mama/complicações , Carcinoma Intraductal não Infiltrante/complicações , Ganho de Peso , Adulto , Afro-Americanos/estatística & dados numéricos , Fatores Etários , Idoso , Estudos de Casos e Controles , Estudos de Coortes , Feminino , Humanos , Modelos Logísticos , Mamografia , Pessoa de Meia-Idade , Razão de Chances , Estudos Prospectivos , Fatores de Risco , Fatores Socioeconômicos
8.
Medicine (Baltimore) ; 98(19): e15266, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31083157

RESUMO

RATIONALE: Wilson disease (WD) is an autosomal recessive hereditary disease in which the patient usually has a reduced risk of developing cancer. In particular, with the exception of hepatocellular carcinoma and cholangiocarcinoma, the incidence of cancer is significantly lower in WD patients compared with the general population. This case study presents a rare case of WD complicated with primary breast cancer. PATIENT CONCERNS: A 40-year-old woman who was diagnosed with WD at 25 years of age found a lump in her left breast. She has a family history of cancer. DIAGNOSES: Ultrasound and mammography results were highly suggestive of a malignant lesion. After core needle biopsy, it was confirmed that she had invasive breast cancer. INTERVENTIONS: A modified radical mastectomy was performed for the left breast. As the tumor was defined as a stage IIa triple negative breast cancer, the patient would have been recommended epirubicin/cyclophosphamide + docetaxel for 8 cycles if WD was not a comorbidity. As the patient had cirrhosis and abnormal liver function, she was given paclitaxel weekly for 6 cycles instead. OUTCOMES: The patient showed good tolerance, and has not had a recurrence in 2 years. LESSONS: We reviewed the literature for studies of patients with WD complicated with cancers, and to our knowledge, this is the first report on WD complicated with breast cancer. The patient received chemotherapy even with liver dysfunction, which suggests that patients with WD can be safely treated with paclitaxel chemotherapy under close surveillance.


Assuntos
Neoplasias da Mama/complicações , Carcinoma Ductal de Mama/complicações , Degeneração Hepatolenticular/complicações , Adulto , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Neoplasias da Mama/terapia , Carcinoma Ductal de Mama/diagnóstico por imagem , Carcinoma Ductal de Mama/patologia , Carcinoma Ductal de Mama/terapia , Diagnóstico Diferencial , Feminino , Humanos
9.
Neurol Sci ; 40(7): 1461-1463, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30843116

RESUMO

INTRODUCTION: Motor neuron disease (MND) can occur in patients with cancer, but there is minimal evidence that this is more than by chance. We contrast two cases of motor neuronopathies occurring in the context of systemic malignancy and argue that in one case the cause was most likely paraneoplastic, while in the other it was not. CASE 1: A 61-year-old woman developed progressive walking difficulties over 9 months with weakness and stiffness in her legs. EMG showed fibrillations and positive sharp waves in multiple lower limb muscles bilaterally, with neurogenic units and a reduced recruitment pattern. An invasive ductal carcinoma of the breast was identified and she continued to deteriorate neurologically with worsening mobility, upper limb spasticity and fasciculations. She died approximately 26 months after symptom onset. CASE 2: A 57-year-old woman developed weight loss and weakness of her right arm without any sensory symptoms. At presentation, she had wasting and fasciculations in her right upper limb muscles, with normal reflexes, normal left upper limb and lower limb examination. Over the following week, she developed left upper limb weakness and fasciculations, brisk knee reflexes, and flexor plantar responses. Her EMG showed upper and lower limb denervation. She was found to have anti-Hu and anti-CV2 antibodies present in serum. A PET-CT showed active uptake in lymph nodes in the right hilum. Biopsy confirmed a small cell lung cancer. She had chemoradiation therapy and the tumour went into remission. She has remained well on follow-up 24 months later, regaining weight and strength after her chemotherapy. She continues to be monitored for cancer recurrence, but thus far appears to be in remission. CONCLUSION: In cases with rapidly progressive MND, particularly of upper limb onset, consideration should be given to testing anti-neuronal antibodies and searching for an occult tumour.


Assuntos
Neoplasias da Mama/complicações , Carcinoma Ductal de Mama/complicações , Neoplasias Pulmonares/complicações , Doença dos Neurônios Motores/complicações , Síndromes Paraneoplásicas do Sistema Nervoso , Carcinoma de Pequenas Células do Pulmão/complicações , Neoplasias da Mama/imunologia , Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/imunologia , Carcinoma Ductal de Mama/patologia , Evolução Fatal , Feminino , Humanos , Neoplasias Pulmonares/imunologia , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/terapia , Pessoa de Meia-Idade , Doença dos Neurônios Motores/etiologia , Doença dos Neurônios Motores/imunologia , Síndromes Paraneoplásicas do Sistema Nervoso/imunologia , Carcinoma de Pequenas Células do Pulmão/imunologia , Carcinoma de Pequenas Células do Pulmão/patologia , Carcinoma de Pequenas Células do Pulmão/terapia
10.
Curr Probl Cancer ; 43(6): 100461, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-30686567

RESUMO

AIM: The positive energy balance and insulin resistance caused by weight gain, physical inactivity, poor dietary quality are linked to a decreased breast cancer (BC)-specific survival. The aim of the present study was to assess whether or not hepatosteatosis, which reflect underlying insulin resistance, has a predictive value on recurrence in patients with nonmetastatic BC. MATERIAL METHOD: All diagnosed nonmetastatic BC patients between 2005 and 2016 were included in this retrospective analysis. Patients' medical characteristics included for analysis were age, menopausal status, presence of obesity, diabetes, dyslipidemia, and tumor features. Liver parenchyma was evaluated by ultrasonography, and then patients divided into 2 groups according to final follow-up findings; group 1: without hepatosteatosis or presence of grade 1 steatosis; group 2: presence of grades 2 and 3 hepatosteatosis. Survival distributions were estimated with the Kaplan-Meier method and compared between groups with the log-rank statistic. RESULTS: Four hundred twenty-four patients included in this study. The median follow-up period of all patients was 6.7 years (range, 0.6-13 years). The mean age was 48.2 ± 0.5 years. Of total, 154 (36.3%) patients experienced recurrence. In total, 171 (40.6%) patients had grades 2 and 3 hepatosteatosis, and the remaining had no, or grade 1 hepatosteatosis during last follow-up or at recurrence. The clinicopathologic characteristics of the participants were well balanced between the 2 groups. Younger age (odds ratio [OR]: 2.19; 95% confidence interval [CI]: 1.3-3.8, P = 0.005), and higher tumor stage (OR: 7.52; 95% CI: 1.2-48.5, P = 0.035 for stage Ia vs stage IIIC) were associated with recurrence of BC during the entire follow-up in multivariate analysis. Hepatosteatosis predicted late recurrence after 5 years in nonmetastatic BC after adjusted for age, diabetes, tumor stage, grade, and luminal type (OR: 2.45; 95% CI: 1.1-5.6, P = 0.034) and the hazard ratio was 0.40 (95% CI: 0.18-0.88, P = 0.023 adjusted value) for relapse-free survival after 5 years. CONCLUSION: Higher degree of hepatosteatosis may predict recurrence after 5 years in BC survivors.


Assuntos
Neoplasias da Mama/complicações , Carcinoma Ductal de Mama/complicações , Carcinoma Lobular/complicações , Fígado Gorduroso/etiologia , Recidiva Local de Neoplasia/diagnóstico , Adulto , Biomarcadores Tumorais/metabolismo , Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/patologia , Carcinoma Lobular/patologia , Fígado Gorduroso/patologia , Feminino , Seguimentos , Humanos , Incidência , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/epidemiologia , Prognóstico , Receptor ErbB-2/metabolismo , Receptores Estrogênicos/metabolismo , Receptores de Progesterona/metabolismo , Estudos Retrospectivos , Taxa de Sobrevida , Turquia/epidemiologia
11.
Curr Probl Cancer ; 43(3): 213-221, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30195804

RESUMO

BACKGROUND: We aimed to investigate the risk and survival of chronic myeloid leukemia (CML) after breast cancer (BC) diagnosis. METHODS: We used the Surveillance, Epidemiology, and End Results 'SEER' database. Females, diagnosed with BC between 1992 and 2014, were selected and followed for the development of CML after a 6-month latency period from BC diagnosis. We used the Multiple Primary Standardized Incidence Ratios session of the SEER*Stat software (version 8.3.4) to calculate the Observed/Expected (O/E) ratios with 95% confidence intervals (CI). To calculate the overall survival, we performed an unadjusted Kaplan-Meier analysis using the SPSS software. RESULTS: We included 474,866 females with BC, of which 178 were later diagnosed with CML. We found the risk of CML to increase significantly after BC diagnosis (O/E = 1.26, 95% CI: 1.08-1.45) and the risk was specifically higher within the first 5 years of diagnosis (O/E = 1.45, 95% CI: 1.16-1.8). When the risk was stratified by cancer stage, localized BC was associated with a significant increase in CML risk within 5 years of diagnosis (O/E = 1.4, 95% CI: 1.06-1.82), while regional BC was associated with a significant increase in CML risk after more than 5 years of diagnosis (O/E = 1.59, 95% CI: 1.09-2.25). Moreover, radiotherapy, chemotherapy, and presence of hormonal receptors were associated with a significant increase in CML risk in BC patients. The median overall survival of CML after BC was 28 months. CONCLUSION: Breast cancer patients have an increased risk of developing CML and further investigation is required to establish the causes of this finding.


Assuntos
Neoplasias da Mama/mortalidade , Carcinoma Ductal de Mama/mortalidade , Carcinoma Lobular/mortalidade , Leucemia Mielogênica Crônica BCR-ABL Positiva/mortalidade , Segunda Neoplasia Primária/mortalidade , Adulto , Neoplasias da Mama/complicações , Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/complicações , Carcinoma Ductal de Mama/patologia , Carcinoma Lobular/complicações , Carcinoma Lobular/patologia , Feminino , Seguimentos , Humanos , Incidência , Leucemia Mielogênica Crônica BCR-ABL Positiva/epidemiologia , Leucemia Mielogênica Crônica BCR-ABL Positiva/etiologia , Leucemia Mielogênica Crônica BCR-ABL Positiva/patologia , Pessoa de Meia-Idade , Segunda Neoplasia Primária/epidemiologia , Segunda Neoplasia Primária/etiologia , Segunda Neoplasia Primária/patologia , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Programa de SEER , Taxa de Sobrevida , Estados Unidos/epidemiologia
12.
Lymphat Res Biol ; 17(1): 78-86, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30358471

RESUMO

BACKGROUND: Multilayer bandaging used in complex decongestive therapy (CDT) may increase tissue pressure resulting in nerve entrapments. The aim of this study was to discover if median nerve damage is a consequence of CDT in patients with breast cancer-related lymphedema (BCRL). METHODS AND RESULTS: Eighty-two arms of 41 patients with BCRL were included. Mean age was 56.05 (8.16) years and all stages of lymphedema were equally included. Fifteen sessions of CDT was applied to all patients. The calculated volume of extremities, the quality of life (cancer adaptation of Ferrans-Powell), neuropathic pain (NP; Douleur Neuropathique 4), and disability (quick disabilities of arm, shoulder, and hand [Q-DASH]) tests were recorded before and after therapy. Skin and subcutaneous tissue thicknesses of volar and dorsal sides and median nerve cross-sectional area (CSA) at the level of carpal tunnel were measured using ultrasonography (US), before and after therapy. Carpal tunnel syndrome (CTS; 41.37%) and polyneuropathy (10.34%) were common findings confirmed by electromyography. Neuropathic pain profile was also found in 34.14% of patients. The arm volume of affected side, quality of life, and skin and subcutaneous tissue thicknesses were improved after therapy (p < 0.05). However, median nerve CSA, the NP, and Q-DASH scores were not changed after therapy. CONCLUSIONS: Although lymphedema is a painless condition, NP and CTS should not be ignored in patients with BCRL. US is an alternative, precise, and high technological method for evaluating treatment response. CDT is an effective and safe treatment according to volumetric calculations, US measurements of tissue thicknesses, and median nerve size.


Assuntos
Linfedema Relacionado a Câncer de Mama/terapia , Neoplasias da Mama/complicações , Carcinoma Ductal de Mama/complicações , Síndrome do Túnel Carpal/terapia , Bandagens Compressivas , Drenagem Linfática Manual/métodos , Neuralgia/prevenção & controle , Adulto , Idoso , Braço/diagnóstico por imagem , Braço/inervação , Braço/fisiopatologia , Braço/cirurgia , Linfedema Relacionado a Câncer de Mama/diagnóstico por imagem , Linfedema Relacionado a Câncer de Mama/etiologia , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/radioterapia , Neoplasias da Mama/cirurgia , Carcinoma Ductal de Mama/diagnóstico por imagem , Carcinoma Ductal de Mama/radioterapia , Carcinoma Ductal de Mama/cirurgia , Síndrome do Túnel Carpal/diagnóstico por imagem , Síndrome do Túnel Carpal/etiologia , Eletromiografia , Exercício Físico , Feminino , Humanos , Nervo Mediano/diagnóstico por imagem , Nervo Mediano/fisiopatologia , Pessoa de Meia-Idade , Neuralgia/etiologia , Neuralgia/fisiopatologia , Estudos Prospectivos , Qualidade de Vida/psicologia , Higiene da Pele/métodos , Resultado do Tratamento , Ultrassonografia
13.
Lymphat Res Biol ; 17(1): 45-50, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30281384

RESUMO

BACKGROUND: The aim of this prospective clinical study was to compare the long-term efficacy of complex decongestive therapy (CDT) in obese and nonobese patients with breast cancer-related lymphedema (BCRL). MATERIALS AND METHODS: A total of 59 patients (29 obese patients group 1, 30 normoweight overweight patients group 2) with unilateral BCRL were enrolled. All patients underwent CDT that included manual lymphatic drainage, intermittent pneumatic compression pump, multilayer compression bandaging, lymphedema exercises, and skin care. The CDT was performed for 1 hour a day, 5 days a week for 3 weeks. Patients were assessed according to limb volume difference before CDT, after CDT, and after 1 year. RESULTS: The initial lymphedema volume of group 1 was 866.34 ± 389.34 mL and that of group 2 was 661.84 ± 470.6 mL (p = 0.031). The lymphedema severity percentage of excess volume (PEV) of group 1 was 33.37 ± 15.71 and that of group 2 was 31.86 ± 19.63, which was moderate lymphedema. After 15 sessions of CDT program, in group 1, lymphedema volume decreased to 771.46 ± 389.14 mL (post-CDT p = 0.013) and in group 2, lymphedema volume decreased to 468.38 ± 417.36 mL (post-CDT p < 0.0001), and in group 1, PEV decreased to 28.54 ± 16.84 (post-CDT p = 0.002) and that in group 2 decreased to 22.1 ± 16.87 (post-CDT p < 0.0001). After 1 year, group 1 reached the baseline values of the extremity volumes, but in group 2, the volumes of extremities could maintain their post-CDT values. CONCLUSION: Obesity is a factor that deteriorates the CDT efficacy. Early treatment, before developing fat accumulation and fibrosis, must be primary goal in the treatment of BCRL.


Assuntos
Linfedema Relacionado a Câncer de Mama/terapia , Neoplasias da Mama/complicações , Carcinoma Ductal de Mama/complicações , Bandagens Compressivas , Drenagem Linfática Manual/métodos , Obesidade/complicações , Adulto , Linfedema Relacionado a Câncer de Mama/etiologia , Linfedema Relacionado a Câncer de Mama/patologia , Neoplasias da Mama/patologia , Neoplasias da Mama/radioterapia , Neoplasias da Mama/cirurgia , Carcinoma Ductal de Mama/patologia , Carcinoma Ductal de Mama/radioterapia , Carcinoma Ductal de Mama/cirurgia , Exercício Físico , Feminino , Humanos , Pessoa de Meia-Idade , Obesidade/patologia , Obesidade/radioterapia , Obesidade/cirurgia , Estudos Prospectivos , Higiene da Pele/métodos , Resultado do Tratamento
14.
Breast Cancer Res Treat ; 173(3): 709-717, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30406869

RESUMO

PURPOSE: To examine whether pre-diagnosis patient-reported health-related quality of life (HRQOL) and depressive symptoms are associated with local treatment for older women with ductal carcinoma in situ (DCIS) and stage I breast cancer (BC). METHODS: Using the SEER-MHOS dataset, we identified women ≥ 65 years old with DCIS or stage I BC diagnosed 1998-2011 who completed surveys ≤ 24 months before diagnosis. Depressive symptoms were measured by major depressive disorder (MDD) risk and HRQOL was measured by Physical and Mental Component Summary scores (PCS and MCS, respectively) of the SF-36/VR-12. Associations with treatment choice (breast-conserving surgery [BCS] and radiation therapy [RT], BCS alone, mastectomy) were assessed with multivariable multinomial logistic regression, controlling for patient characteristics. RESULTS: We identified 425 women with DCIS and 982 with stage I BC. Overall, 20.4% endorsed depressive symptoms placing them at risk for MDD pre-diagnosis; mean MCS and PCS scores were 52.3 (SD = 10.1) and 40.5 (SD = 11.5), respectively. Among women with DCIS, those at risk for MDD were more likely to receive BCS (adjusted odds ratio [AOR] 2.04, 95% CI 1.04-4.00, p = 0.04) or mastectomy (AOR 1.88, 95% CI 0.91-3.86, p = 0.09) compared to BCS + RT. For DCIS, MCS score was not associated with treatment; higher PCS score was associated with decreased likelihood of receiving mastectomy versus BCS + RT (AOR 0.71 per 10-point increase, 95% CI 0.54-0.95, p = 0.02). For BC, none of the measures were significantly associated with treatment. CONCLUSION: Older women at risk for MDD before DCIS diagnosis were less likely to receive RT after BCS, compared to BCS alone or mastectomy.


Assuntos
Neoplasias da Mama/complicações , Neoplasias da Mama/epidemiologia , Carcinoma Ductal de Mama/complicações , Carcinoma Ductal de Mama/epidemiologia , Depressão/epidemiologia , Depressão/etiologia , Qualidade de Vida , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/terapia , Carcinoma Ductal de Mama/diagnóstico , Carcinoma Ductal de Mama/terapia , Terapia Combinada , Depressão/diagnóstico , Feminino , Humanos , Mastectomia , Estadiamento de Neoplasias , Programa de SEER , Avaliação de Sintomas , Resultado do Tratamento
15.
Clin J Gastroenterol ; 12(1): 52-56, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30109570

RESUMO

Gallbladder metastasis from breast cancer, especially from ductal carcinoma, is rare. Herein, we report a rare case of gallbladder metastasis from ductal carcinoma of the breast that was diagnosed after laparoscopic cholecystectomy (LC) for acute cholecystitis. A 78-year-old woman presented with right upper abdominal tenderness and positive Murphy's sign during chemotherapy for advanced multiple metastases of the breast cancer. Abdominal ultrasonography and computed tomography showed a slightly thickened gallbladder wall and two calculi. After a diagnosis of acute calculous cholecystitis was established, LC was performed. Pathological examination revealed poorly differentiated adenocarcinoma infiltrating the submucosal and subserosal layer over the entire gallbladder, and a lymph node metastasis in the gallbladder neck. Immunohistochemical examination revealed that the tumor cells tested positive for estrogen receptor and negative for progesterone receptor, which was consistent with primary breast cancer. The patient was uneventfully discharged without abdominal pain 7 days later. Although she subsequently underwent several chemotherapies, she died 16 months later. In conclusion, gallbladder metastasis should be considered in patients with multiple metastatic breast cancer who present with signs or symptoms of cholecystitis. Moreover, LC should be considered to relieve the symptoms of cholecystitis for improved prognosis, even in a patient with multiple metastases.


Assuntos
Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/secundário , Colecistite Aguda/etiologia , Neoplasias da Vesícula Biliar/secundário , Cálculos Biliares/etiologia , Idoso , Carcinoma Ductal de Mama/complicações , Colecistectomia Laparoscópica , Colecistite Aguda/cirurgia , Feminino , Neoplasias da Vesícula Biliar/complicações , Cálculos Biliares/cirurgia , Humanos , Metástase Linfática , Metástase Neoplásica
17.
Rev. bras. cir. plást ; 33(4): 469-477, out.-dez. 2018. ilus, tab
Artigo em Inglês, Português | LILACS | ID: biblio-979965

RESUMO

Introdução: Câncer de mama localmente avançado é caracterizado pelos estádios clínicos IIIb ou IV e representam de 20 a 25% de todos os casos. A reconstrução dos defeitos é feita com retalhos musculocutâneos e fasciocutâneos, sendo os mais utilizados o latíssimo do dorso e o reto abdominal. O objetivo é avaliar resultados das reconstruções de parede torácica em câncer de mama localmente avançados com retalhos musculocutâneos e fasciocutâneos. Métodos: Estudo retrospectivo, observacional descritivo, em único centro. Variáveis estudadas: dimensões do defeito e do retalho, tipo de retalho utilizado para a reconstrução, metástases cutâneas e viscerais, evolução pós-operatória e complicações. Resultados: 11 pacientes, com média de idade de 49 anos, com o lado esquerdo mais acometido. O tipo tumoral mais encontrado foi o carcinoma ductal invasivo. Os retalhos realizados foram: 2 latíssimos do dorso com desenho VY (LDVY), 2 latíssimos do dorso associados a retalho toracoabdominal (LDVYTA), 4 verticais do músculo reto do abdome (VRAM) e 3 toracoabdominais (TA). A área média dos defeitos foi 421,72cm2 e a área média dos retalhos utilizados foi de 451cm2. A complicação mais frequente foi deiscência parcial da ferida operatória, presente em 7 pacientes. Da amostra, 6 pacientes atingiram êxito letal. VRAM foi o retalho que apresentou mais complicações. A sobrevida média para VRAM foi de 25,5 meses, para LDVY de 17 meses, TA de 17 meses e LDVYTA de 20,5 meses. Conclusão: Os retalhos musculocutâneos e fasciocutâneos são eficazes para a reconstrução da parede torácica após a ressecção de neoplasias mamárias localmente avançadas.


Introduction: Breast cancer is the most common cancer among women worldwide. Locally advanced breast cancer is characterized by clinical stage IIIb or IV and accounts for 20­25% of all cases. Defects are reconstructed using myocutaneous and fasciocutaneous flaps, primarily from the latissimus dorsi and rectus abdominis muscles. The objective is to evaluate the results of thoracic wall reconstructions in cases of locally advanced breast cancer using fasciocutaneous and myocutaneous flaps. Methods: This was a retrospective, observational, and descriptive single-center study. Variables studied included defect size and flap dimensions, myocutaneous flap type, presence of cutaneous and visceral metastasis, postoperative evolution, and complications. Results: We selected 11 patients with a mean age of 49 years; the left side was the most commonly affected. The most common tumor type was invasive ductal carcinoma. The flaps were made of latissimus dorsi VY (LDVY) in two patients, latissimus dorsi associated with thoracoabdominal flaps (LDVYTA) in two, vertical rectus abdominus myocutaneous flap (VRAM) in four, and thoracoabdominal flaps (TA) in three. The mean defect area was 421.72 cm2, while the mean flap area was 451 cm2. The most frequent complication was partial dehiscence (seven patients). Six patients achieved lethal exit. VRAM flaps presented more complications. The mean survival for VRAM was 25.5 months, LDVY was 17 months, TA was 17 months, LDVYTA was 20.5 months. Conclusion: Myocutaneous and fasciocutaneous flaps are effective for chest wall reconstruction after locally advanced breast cancer resection.


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Complicações Pós-Operatórias/terapia , Traumatismos Torácicos/terapia , Neoplasias da Mama/cirurgia , Neoplasias da Mama/terapia , Carcinoma Ductal de Mama/cirurgia , Carcinoma Ductal de Mama/complicações , Procedimentos Cirúrgicos Reconstrutivos/métodos , Parede Torácica/cirurgia , Retalhos de Tecido Biológico/cirurgia , Retalho Miocutâneo/cirurgia , Metástase Neoplásica/terapia
18.
Rev. senol. patol. mamar. (Ed. impr.) ; 31(4): 155-156, oct.-dic. 2018. ilus
Artigo em Espanhol | IBECS | ID: ibc-176857

RESUMO

Presentamos el caso de una paciente intervenida de mastectomía radical modificada por carcinoma ductal infiltrante de tipo inflamatorio, que durante el postoperatorio inmediato presenta un empeoramiento clínico generalizado secundario a un fallo hepático fulminante desencadenado por la aparición de múltiples metástasis. La paciente fallece a las horas del comienzo del cuadro por fallo multiorgánico


We present the case of a woman who underwent a modified radical mastectomy due to an infiltrating inflammatory ductal carcinoma and who, during the immediate postoperative period showed clinical deterioration due to acute liver failure caused by the presence of multiple metastases. The patient died a few hours after the onset of multiorgan failure


Assuntos
Humanos , Feminino , Idoso de 80 Anos ou mais , Neoplasias da Mama/complicações , Carcinoma Ductal de Mama/complicações , Metástase Neoplásica/patologia , Falência Hepática Aguda/patologia , Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/patologia , Insuficiência de Múltiplos Órgãos/complicações
19.
J Cancer Res Ther ; 14(6): 1184-1190, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30488827

RESUMO

Introduction: The relation between Behçet's disease (BD) and breast cancer (BC) is unclear. Our purpose is to investigate whether BD has an important effect on BC or vice versa. Patients and Methods: A total of 12 female BC patients with a diagnosis of BD were identified from a cohort including 5050 BC patients. The demographic data of the selected patients including previous chemotherapy (CT), radiotherapy (RT), hormonal therapy (HT), drugs used for BD, history of thrombotic events, and overall survival were examined. Results: The rate of BD in the entire cohort was found to be 0.25% (12/4800), and all had early BC at the time of BC diagnosis, with a median age of 47 years (range: 38-51). All patients underwent curative surgery for BC. In the adjuvant setting, CT, RT, and HT were administered in 11 (91%), 10 (83.4%), and 9 (75%) patients, respectively. All patients received acetylsalicylic acid and colchicine for BD. No serious adverse event associated with BC and/or BD was observed. Clinical symptoms in 11 patients with BD were observed to be improved following the BC treatment. Only one patient developed disease progression and then expired. Conclusion: Unlike the natural behavior of BD, which is well-defined to have an increased risk of thrombosis, BC patients with BD in this study did not have any adverse event. However, due to small sample size, it is difficult to drive any definite conclusion regarding the relation between these two pathologies.


Assuntos
Síndrome de Behçet/terapia , Neoplasias da Mama/terapia , Carcinoma Ductal de Mama/terapia , Carcinoma Lobular/terapia , Carcinoma de Células em Anel de Sinete/terapia , Trombose/prevenção & controle , Adulto , Síndrome de Behçet/complicações , Síndrome de Behçet/patologia , Neoplasias da Mama/complicações , Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/complicações , Carcinoma Ductal de Mama/patologia , Carcinoma Lobular/complicações , Carcinoma Lobular/patologia , Carcinoma de Células em Anel de Sinete/complicações , Carcinoma de Células em Anel de Sinete/patologia , Terapia Combinada , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Trombose/etiologia
20.
Asian Pac J Cancer Prev ; 19(11): 3087-3092, 2018 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-30485946

RESUMO

Background: Low levels of vitamin D have been described as a risk factor for the development of breast cancer. The aim of this study was to evaluate the serum levels of vitamin D (25OHD) in patients with impalpable breast lesions comparing with a control group. Methods: Vitamin D quantification (25OHD) was assessed in the plasma of 65 patients with impalpable breast lesions and from 20 health controls using a chemiluminescent microparticle immunoassay. Pearson's chi-square test and nonparametric t-Student were used to evaluate statistical significance between the clinical variables and the means of quantification of vitamin D. The receiver operating characteristic (ROC) curve was used to evaluate the correlation between age and vitamin sufficiency for the cases and the controls. Results: The prevalence of vitamin D deficiency and/or insufficiency in women with malignant lesions was 84% and 60% for the control group. Using the chi-square or Fisher's exact test, the relationship between vitamin D levels and age presented significant association only for the control group (P=0.002). Using ROC curve, the plot area (0.778) for the control group defined a cut-off value of 45 years to age, with specificity and sensitivity of 60% and 50%, respectively. Thus, the odds ratio for vitamin D insufficiency in women over 45 years was 1.37 (P=0.011). For the case group, clinical characteristics, histological grade, and lymph node involvement did not show any significant association. Conclusion: The prevalence of vitamin D deficiency/insufficiency is high in women with impalpable breast lesions, as well as in the control group, even in a tropical city. According to the results the age advancement may be involved with the decrease in vitamin D levels in plasma, but there was no statistical association between low levels of Vitamin D and breast cancer.


Assuntos
Neoplasias da Mama/complicações , Carcinoma Ductal de Mama/complicações , Carcinoma Intraductal não Infiltrante/complicações , Carcinoma Lobular/complicações , Deficiência de Vitamina D/epidemiologia , Vitamina D/sangue , Vitaminas/sangue , Adulto , Brasil/epidemiologia , Neoplasias da Mama/sangue , Carcinoma Ductal de Mama/sangue , Carcinoma Intraductal não Infiltrante/sangue , Carcinoma Lobular/sangue , Estudos de Coortes , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Prevalência , Prognóstico , Fatores de Risco , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/etiologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA