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1.
Cancer Treat Rev ; 79: 101888, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31491663

RESUMO

Metaplastic breast carcinomas (MPBC) are rare, aggressive and relatively chemorefractory tumors with a high unmet need. While most are "triple negative" and lack expression of estrogen, progesterone and HER2 receptors, MPBC are associated with worse outcomes compared to conventional triple negative invasive tumors. MPBCs are genetically heterogeneous and harbor somatic mutations, most frequently in TP53, PIK3CA and PTEN, with emerging studies suggesting a role for novel targeted therapies. These tumors have also been associated with overexpression of PD-L1 and tumor-infiltrating lymphocytes suggesting an endogenous immune response and therefore a rationale for treatment with immunotherapies. Here, we focus on therapeutic options for this difficult to treat breast cancer subtype and encourage physicians to consider targeted therapies/immunotherapies as part of ongoing clinical trials.


Assuntos
Neoplasias da Mama/patologia , Neoplasias da Mama/terapia , Animais , Biomarcadores Tumorais , Neoplasias da Mama/etiologia , Neoplasias da Mama/mortalidade , Ensaios Clínicos como Assunto , Terapia Combinada/métodos , Gerenciamento Clínico , Transição Epitelial-Mesenquimal , Feminino , Variação Genética , Humanos , Estadiamento de Neoplasias , Células-Tronco Neoplásicas/metabolismo , Resultado do Tratamento
2.
Anticancer Res ; 39(9): 4971-4975, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31519603

RESUMO

BACKGROUND/AIM: We evaluated the incidence of uterine and breast cancer among women diagnosed with granulosa cell tumors (GCTs) of the ovary. PATIENTS AND METHODS: The US Surveillance, Epidemiology, and End Results (SEER) database was accessed and patients diagnosed with a GCT and had a known follow-up between 1973-2014 were identified. Personal tumor history was extracted and patients with a previous or subsequent malignant breast or uterine tumor were identified. The expected incidence of breast and uterine cancer was calculated based on the U.S age-specific rate of breast and uterine cancer per 100,000 women. Standardized incidence ratio (SIR) with 95% confidence intervals (95% CI) were calculated for each tumor. RESULTS: A total of 1908 cases of GCT were identified. Seventy- nine (4.14%) and 53 (2.78%) patients were diagnosed with a malignant breast and uterine malignancy. The cumulative expected number of malignant breast and uterine tumors was 27 (1.41%) and 6 (0.31%), respectively. The calculated SIR for breast and uterine malignancies was 2.96 (95%CI=2.34, 3.68) and 8.83 (95%CI=6.61, 11.56), respectively. CONCLUSION: An increased incidence of breast and uterine malignancies among patients diagnosed with GCTs was observed.


Assuntos
Neoplasias da Mama/epidemiologia , Neoplasias da Mama/etiologia , Tumor de Células da Granulosa/epidemiologia , Segunda Neoplasia Primária/epidemiologia , Segunda Neoplasia Primária/etiologia , Neoplasias Uterinas/epidemiologia , Neoplasias Uterinas/etiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Incidência , Pessoa de Meia-Idade , Medição de Risco , Fatores de Risco , Programa de SEER , Estados Unidos/epidemiologia , Adulto Jovem
3.
J Cancer Res Clin Oncol ; 145(10): 2583-2593, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31401675

RESUMO

OBJECTIVE: Exercise training is recently considered as a trend in adjuvant therapies for cancer patients, but its mechanisms need to be scrutinized further. This study is aimed to test the hypothesis that the patients who perform the high-intensity interval exercise training (HIIT) during hormone therapy would show improvements in low-grade inflammation and HSP70 compared to the controls receiving standard care. METHODS: Fifty two non-metastatic and hormone-responsive breast cancer patients were randomly assigned to high-intensity interval exercise (HIIT) (n = 26) and usual care (n = 26) groups. The HIIT groups participated in a high-intensity interval training protocol on a treadmill 3 days/week for 12 weeks. The training intensity was determined according to the predicted maximal heart rate. Demographic characteristics and medical history were collected via an interviewer-administered questionnaire at the baseline visit. Body fat was estimated based on skinfold thickness measured with calipers on the participant's nonsurgery side at the triceps, suprailiac crest. [Formula: see text] was estimated by 1-Mile Rockport Walk Test. Blood samples were collected 48 h before starting the exercise protocol and 48 h after the last exercise session. TNF-α, IL-6, IL-1ß, IL-10, and HSP70 levels in serum were measured using the enzyme-linked immunosorbent assay (ELISA) method according to the manufacture's instruction. Supernatant cytokine concentrations were determined by ELISA for IL-4 and IFN-γ. The data were analyzed by ANCOVA test that the pretest values were considered as covariate at P ≤ 0.05. RESULTS: HIIT improved [Formula: see text] in the HIIT group compared to the usual care group (P = 0.002). The serum levels of TNF-α (P = 0.001), IL-6 (P = 0.007), and IL-10 (P = 0.001) were lower in the HIIT group. The level of IL-4 (P = 0.050) in the stimulated peripheral blood mononuclear cells significantly increased in the HIIT group compared to the usual care group. Furthermore, the serum level of the HSP70 was significantly higher in the HIIT group in comparison to the usual care group (P = 0.050). The TNF-α/IL-10 (P = 0.050) and IL-6/IL-10 (P = 0.042) ratios were lower in the HIIT group. CONCLUSION: The results of this study indicated that HIIT has positive impacts on the cardiorespiratory fitness and inflammatory cytokines in the breast cancer patients undergoing hormone therapy.


Assuntos
Neoplasias da Mama/etiologia , Neoplasias da Mama/metabolismo , Proteínas de Choque Térmico HSP70/metabolismo , Treinamento Intervalado de Alta Intensidade , Inflamação/complicações , Inflamação/metabolismo , Biomarcadores , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/terapia , Citocinas/metabolismo , Feminino , Proteínas de Choque Térmico HSP70/genética , Treinamento Intervalado de Alta Intensidade/métodos , Humanos , Inflamação/patologia , Mediadores da Inflamação/metabolismo , Leucócitos Mononucleares/imunologia , Leucócitos Mononucleares/metabolismo
4.
J Surg Oncol ; 120(4): 573-577, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31373010

RESUMO

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a T-cell neoplasm that arises in the capsule around breast implants. While an association with implants has been proposed, no causal link has been identified and the pathophysiology and natural history of BIA-ALCL remain unknown. A literature review of 391 articles was performed to assess the current understanding of BIA-ALCL and to provide a balanced and unbiased view of the current controversy surrounding the disease.


Assuntos
Implantes de Mama/efeitos adversos , Neoplasias da Mama/cirurgia , Linfoma Anaplásico de Células Grandes/etiologia , Neoplasias da Mama/etiologia , Estudos de Avaliação como Assunto , Feminino , Humanos
5.
BMJ ; 365: l2327, 2019 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-31243001

RESUMO

OBJECTIVE: To examine whether sleep traits have a causal effect on risk of breast cancer. DESIGN: Mendelian randomisation study. SETTING: UK Biobank prospective cohort study and Breast Cancer Association Consortium (BCAC) case-control genome-wide association study. PARTICIPANTS: 156 848 women in the multivariable regression and one sample mendelian randomisation (MR) analysis in UK Biobank (7784 with a breast cancer diagnosis) and 122 977 breast cancer cases and 105 974 controls from BCAC in the two sample MR analysis. EXPOSURES: Self reported chronotype (morning or evening preference), insomnia symptoms, and sleep duration in multivariable regression, and genetic variants robustly associated with these sleep traits. MAIN OUTCOME MEASURE: Breast cancer diagnosis. RESULTS: In multivariable regression analysis using UK Biobank data on breast cancer incidence, morning preference was inversely associated with breast cancer (hazard ratio 0.95, 95% confidence interval 0.93 to 0.98 per category increase), whereas there was little evidence for an association between sleep duration and insomnia symptoms. Using 341 single nucleotide polymorphisms (SNPs) associated with chronotype, 91 SNPs associated with sleep duration, and 57 SNPs associated with insomnia symptoms, one sample MR analysis in UK Biobank provided some supportive evidence for a protective effect of morning preference on breast cancer risk (0.85, 0.70, 1.03 per category increase) but imprecise estimates for sleep duration and insomnia symptoms. Two sample MR using data from BCAC supported findings for a protective effect of morning preference (inverse variance weighted odds ratio 0.88, 95% confidence interval 0.82 to 0.93 per category increase) and adverse effect of increased sleep duration (1.19, 1.02 to 1.39 per hour increase) on breast cancer risk (both oestrogen receptor positive and oestrogen receptor negative), whereas evidence for insomnia symptoms was inconsistent. Results were largely robust to sensitivity analyses accounting for horizontal pleiotropy. CONCLUSIONS: Findings showed consistent evidence for a protective effect of morning preference and suggestive evidence for an adverse effect of increased sleep duration on breast cancer risk.


Assuntos
Neoplasias da Mama/epidemiologia , Neoplasias da Mama/etiologia , Sono , Adulto , Idoso , Estudos de Casos e Controles , Ritmo Circadiano , Comorbidade , Fatores de Confusão (Epidemiologia) , Feminino , Estudo de Associação Genômica Ampla , Humanos , Incidência , Análise da Randomização Mendeliana , Pessoa de Meia-Idade , Análise Multivariada , Estudos Prospectivos , Fatores de Risco , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Fatores de Tempo , Reino Unido/epidemiologia
6.
Rev Assoc Med Bras (1992) ; 65(5): 699-705, 2019 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-31166448

RESUMO

Breast Cancer is common in women, but its etiology is not yet fully understood. Several factors may contribute to its genesis, such as genetics, lifestyle, and the environment. Melatonin may be involved in the process of breast cancer. Therefore, the aim of this study is to evaluate the influence of the levels of melatonin on breast cancer through a systematic review and meta-analysis. We performed a systematic review according to PRISMA recommendations. The primary databases MEDLINE, Embase, and Cochrane were consulted. There was no restriction on the year of publication and language. Data of systematic reviews from April 2017 to September to 2017 were analyzed. The meta-analysis was conducted using RevMan 5.3 software provided by the Cochrane Collaboration. From a total of 570 articles, 9 manuscripts were included in this review. They analy onzed women with breast cancer and control patients, of which 10% and 90% were in the reproductive period and after menopause, respectively. The lowest level of melatonin was found in approximately 55% of studies with breast cancer in post-menopause. The metanalyses of the studies demonstrated low levels of melatonin in breast cancer patients (n=963) compared with control patients (n= 1332), with a mean difference between the studies of -3.54 (CI -6.01, -1.06). Another difference found was in the comparison between smoking patients, with an average difference between 1.80 [0.97-2.63]. Our data suggest that low levels of melatonin might be a risk factor for breast cancer.


Assuntos
Neoplasias da Mama/sangue , Neoplasias da Mama/urina , Melatonina/sangue , Melatonina/urina , Biomarcadores Tumorais/sangue , Biomarcadores Tumorais/urina , Neoplasias da Mama/etiologia , Feminino , Humanos , Valores de Referência , Fatores de Risco
7.
Eur J Epidemiol ; 34(8): 753-763, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31152367

RESUMO

Current experimental and epidemiological studies provide inconsistent evidence toward the association between tea consumption and cancer incidence. We investigated whether tea consumption was associated with the incidence of all cancers and six leading types of cancer (lung cancer, stomach cancer, colorectal cancer, liver cancer, female breast cancer and cervix uteri cancer) among 455,981 participants aged 30-79 years in the prospective cohort China Kadoorie Biobank. Tea consumption was assessed at baseline (2004-2008) with an interviewer-administered questionnaire. Cancer cases were identified by linkage to the national health insurance system. Cox proportional hazard regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). In the present population, daily tea consumers were more likely to be current smokers and daily alcohol consumers. 22,652 incident cancers occurred during 10.1 years follow-up (5.04 cases/1000 person-years). When we restricted analyses to non-smokers and non-excessive alcohol consumers to minimize confounding, tea consumption was not associated with all cancers (daily consumers who added tea leaves > 4.0 g/day vs. less-than-weekly consumers: HR, 1.03; 95%CI, 0.93-1.13), lung cancer (HR, 1.08; CI, 0.84-1.40), colorectal cancer (HR, 1.08; CI, 0.81-1.45) and liver cancer (HR, 1.08; CI, 0.75-1.55), yet might be associated with increased risk of stomach cancer (HR, 1.46; CI, 1.07-1.99). In both less-than-daily and daily tea consumers, all cancer risk increased with the amount of tobacco smoked or alcohol consumed. Our findings suggest tea consumption may not provide preventive effect against cancer incidence.


Assuntos
Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Cafeína/efeitos adversos , Neoplasias/epidemiologia , Neoplasias/etiologia , Medição de Risco/métodos , Chá/efeitos adversos , Adulto , Idoso , Consumo de Bebidas Alcoólicas/epidemiologia , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/etiologia , China/epidemiologia , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/etiologia , Feminino , Humanos , Incidência , Neoplasias Hepáticas/epidemiologia , Neoplasias Hepáticas/etiologia , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco , População Rural , Neoplasias Gástricas/epidemiologia , Neoplasias Gástricas/etiologia , Fumar Tabaco/epidemiologia , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/etiologia
8.
Int J Mol Sci ; 20(8)2019 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-31013830

RESUMO

Breast cancer is the most common malignancy in women worldwide and can be categorized into several subtypes according to histopathological parameters or genomic signatures. Such heterogeneity of breast cancer can arise from the reactivation of mammary stem cells in situ during tumorigenesis. Moreover, different breast cancer subtypes exhibit varieties of cancer incidence, therapeutic response, and patient prognosis, suggesting that a specific therapeutic protocol is required for each breast cancer subtype. Recent studies using molecular and cellular assays identified a link between specific genetic/epigenetic alterations and distinct cells of origin of breast cancer subtypes. These alterations include oncogenes, tumor suppressor genes, and cell-lineage determinants, which can induce cell reprogramming (dedifferentiation and transdifferentiation) among two lineage-committed mammary epithelial cells, namely basal and luminal cells. The interconversion of cell states through cell reprogramming into the intermediates of mammary stem cells can give rise to heterogeneous breast cancers that complicate effective therapies of breast cancer. A better understanding of mechanisms underlying cell reprogramming in breast cancer can help in not only elucidating tumorigenesis but also developing therapeutics for breast cancer. This review introduces recent findings on cancer gene-mediated cell reprogramming in breast cancer and discusses the therapeutic potential of targeting cell reprogramming.


Assuntos
Neoplasias da Mama/etiologia , Transformação Celular Neoplásica , Reprogramação Celular , Animais , Antineoplásicos/farmacologia , Antineoplásicos/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/metabolismo , Linhagem da Célula/genética , Transformação Celular Neoplásica/efeitos dos fármacos , Transformação Celular Neoplásica/genética , Transformação Celular Neoplásica/metabolismo , Reprogramação Celular/efeitos dos fármacos , Reprogramação Celular/genética , Epigênese Genética/efeitos dos fármacos , Células Epiteliais/metabolismo , Células Epiteliais/patologia , Feminino , Humanos , Terapia de Alvo Molecular , Células-Tronco/metabolismo , Células-Tronco/patologia
9.
J BUON ; 24(1): 5-10, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30941945

RESUMO

This article investigates the possibility and the extent of breast cancer rates being higher in European and Asian countries that have been damaged by warfare or nuclear accidents and the use of chemical weapons in relation to the rest of the countries in those two continents. After a literature review, although there are gaps in the local reports of the responsible bodies as well as many economic, geopolitical, cultural and time constraints, the rates of breast cancer incidence and mortality of the citizens of those areas are significant and have been increasing over time, especially in people of older ages, who were exposed to various disease factors at each specific period of time.


Assuntos
Neoplasias da Mama/epidemiologia , Acidente Nuclear de Chernobyl , Poluentes Ambientais/efeitos adversos , Centrais Nucleares , Cinza Radioativa/efeitos adversos , Guerra/estatística & dados numéricos , Adolescente , Adulto , Idoso , Ásia/epidemiologia , Neoplasias da Mama/etiologia , Europa (Continente)/epidemiologia , Feminino , Seguimentos , Humanos , Incidência , Pessoa de Meia-Idade , Prognóstico , Adulto Jovem
10.
BMC Public Health ; 19(1): 360, 2019 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-30935404

RESUMO

BACKGROUND: The incidence of cancer is rising but data available regarding prevalence of cancer and patient perception of the disease in Pakistan is limited. It is difficult to deal with Cancer if the main causes are negligence towards risk factors and bizarre myths. This study was aimed to investigate common cancer presentations at a government sector hospital and to gain insight into patient knowledge of the disease. METHODS: This was a cross-sectional study conducted on cancer patients from Jinnah Postgraduate Medical Centre. A self-made questionnaire was used to assess the norms related to cancer prevalence in our society, associated myths, and the most common risk factors per them. RESULTS: A total of 402 participants consented to participate in the study (mean age 42.3 ± 15.07 years), 204(50.7%) were females and 190(47.3%) were illiterate. Biomass exposure was found in 147(37%), drug abuse in 132(33%) and smoking in 63(16%). We found 103(25.6%) had positive family histories of cancer. The most common primary tumor site was breast for females 98(48%) and Head and neck 66(33.3%) for males. Patients considered fate 328(82%), gutka 284(71%) and injuries 282(70%) as the most common causes for cancer; while 222(55.5%) considered black magic and 236(58.75%) considered evil eye as a risk factor for cancer. Cancer treatment caused significant financial stress in 376(93.5%) patients. CONCLUSION: Breast and head and neck cancers were found to be prevalent among patients. It was noted that patients are negligent in daily life regarding the consumption of substances that commonly cause cancer. Individuals had diminished knowledge and majority linked cancer to unrelated causes and myths like black magic and fate. Almost all the patients complained of severe financial stress imposed by the disease.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Neoplasias , Adulto , Idoso , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/etiologia , Estudos Transversais , Feminino , Neoplasias de Cabeça e Pescoço/epidemiologia , Neoplasias de Cabeça e Pescoço/etiologia , Gastos em Saúde , Humanos , Incidência , Magia , Masculino , Pessoa de Meia-Idade , Neoplasias/epidemiologia , Neoplasias/etiologia , Paquistão/epidemiologia , Percepção , Prevalência , Fatores de Risco , Inquéritos e Questionários , Centros de Atenção Terciária , Tabaco sem Fumaça
11.
Nat Commun ; 10(1): 1941, 2019 04 26.
Artigo em Inglês | MEDLINE | ID: mdl-31028273

RESUMO

Mendelian randomization (MR) has emerged as a major tool for the investigation of causal relationship among traits, utilizing results from large-scale genome-wide association studies. Bias due to horizontal pleiotropy, however, remains a major concern. We propose a novel approach for robust and efficient MR analysis using large number of genetic instruments, based on a novel spike-detection algorithm under a normal-mixture model for underlying effect-size distributions. Simulations show that the new method, MRMix, provides nearly unbiased or/and less biased estimates of causal effects compared to alternative methods and can achieve higher efficiency than comparably robust estimators. Application of MRMix to publicly available datasets leads to notable observations, including identification of causal effects of BMI and age-at-menarche on the risk of breast cancer; no causal effect of HDL and triglycerides on the risk of coronary artery disease; a strong detrimental effect of BMI on the risk of major depressive disorder.


Assuntos
Algoritmos , Neoplasias da Mama/genética , Doença da Artéria Coronariana/genética , Transtorno Depressivo Maior/genética , Genoma Humano , Análise da Randomização Mendeliana/estatística & dados numéricos , Fatores Etários , Índice de Massa Corporal , Neoplasias da Mama/sangue , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/etiologia , HDL-Colesterol/sangue , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/etiologia , Conjuntos de Dados como Assunto , Transtorno Depressivo Maior/sangue , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/etiologia , Feminino , Estudo de Associação Genômica Ampla , Humanos , Menarca/sangue , Menarca/genética , Característica Quantitativa Herdável , Fatores de Risco , Triglicerídeos/sangue
12.
Phys Med ; 60: 44-49, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31000085

RESUMO

PURPOSE: To assess the risk of contralateral breast and ipsilateral lung cancer induction from forward-planned IMRT for breast carcinoma. METHODS: The study group included 13 females irradiated for breast cancer with 6 MV photons. The plans were initially generated by using standard fractionated (SF) forward-planned IMRT (50 Gy at 2 Gy/fraction). Hypofractionated (HF) IMRT (42.56 Gy at 2.66 Gy/fraction) was also employed for plan creation. Differential DVHs derived from the treatment plans were used to estimate the patient-specific organ equivalent dose (OED) to the contralateral breast and ipsilateral lung and the relevant lifetime attributable risks of cancer development. These estimates were made with a non-linear mechanistic model. The radiotherapy-induced cancer risks were combined with the lifetime intrinsic risk (LIR) values for unexposed people to determine the patient- and organ-specific relative risk (RR) for second cancer induction. RESULTS: The OED of the contralateral breast from SF and HF forward-planned IMRT was up to 0.99 and 0.86 Gy, respectively. The corresponding values for the ipislateral lung were 4.15 and 3.66 Gy. The patient-specific RR range for the contralateral breast and ipislateral lung cancer induction following SF forward-planned IMRT was 1.04-1.10 and 1.60-1.81, respectively. The corresponding RRs from hypofractionated treatment were 1.03-1.09 and 1.53-1.73. CONCLUSIONS: The treatment of primary breast carcinoma with the use of SF or HF forward-planned IMRT results in increased probabilities for developing secondary malignancies in the healthy contralateral breast or ipsilateral lung compared to the respective LIRs for an unexposed population.


Assuntos
Neoplasias da Mama/radioterapia , Carcinoma/radioterapia , Neoplasias Pulmonares/epidemiologia , Neoplasias Induzidas por Radiação/epidemiologia , Segunda Neoplasia Primária/epidemiologia , Radioterapia de Intensidade Modulada/efeitos adversos , Adulto , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/etiologia , Carcinoma/epidemiologia , Fracionamento da Dose de Radiação , Feminino , Humanos , Neoplasias Pulmonares/etiologia , Pessoa de Meia-Idade , Segunda Neoplasia Primária/etiologia , Dinâmica não Linear , Órgãos em Risco , Modelagem Computacional Específica para o Paciente , Fótons/uso terapêutico , Planejamento da Radioterapia Assistida por Computador , Radioterapia de Intensidade Modulada/métodos , Risco
13.
Actas dermo-sifiliogr. (Ed. impr.) ; 110(3): 206-211, abr. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-181710

RESUMO

Introducción y objetivos: El cáncer de mama es la causa más frecuente de metástasis cutáneas. En la literatura revisada no hallamos estudios que estimen la prevalencia de las mismas en Latinoamérica ni que comparen la sobrevida con relación a la localización de las metástasis cutáneas y al diagnóstico de metástasis viscerales. Los objetivos de este trabajo fueron: describir prevalencia, clínica y sobrevida de las metástasis cutáneas de acuerdo con la localización y con relación al diagnóstico de metástasis viscerales. Materiales y métodos: Cohorte retrospectiva. Se evaluó a pacientes con cáncer de mama con metástasis cutáneas confirmadas por histopatología. Resultados: Se analizó a 914 pacientes con cáncer de mama en el período 2007-2014. Presentaron metástasis cutáneas 31 pacientes (prevalencia 3,4%, IC del 95%: 2,3%-4,7%), todas mujeres. La forma nodular, metacrónica y asintomática fue la más frecuente. En 5/21 pacientes hubo discordancia en la inmunohistoquímica entre el tumor primario y la metástasis cutánea. En 23 pacientes las metástasis cutáneas fueron locorregionales y en 8, a distancia. Entre estos 2 grupos, no hubo diferencias en la sobrevida desde el diagnóstico del tumor primario (mediana 4,7 y 4,8 años respectivamente; p = 0,85) ni desde el diagnóstico de las metástasis cutáneas (mediana 2,9 años y 1,1 años; p = 0,06). La menor sobrevida la presentaron las pacientes con diagnóstico simultáneo de metástasis cutánea y visceral. Conclusiones: Este es el primer estudio en Latinoamérica que estima la prevalencia de metástasis cutáneas de cáncer de mama, siendo inferior a la comunicada por autores de otras regiones del mundo


Background and objectives: Breast cancer is the most common cause of cutaneous metastases. In our review of the literature, we found no studies that have investigated the prevalence of cutaneous metastases from breast cancer in Latin America or compared survival in relation to the site of cutaneous involvement or the presence of visceral metastases. The aims of this study were to characterize the prevalence and clinical features of cutaneous metastases from breast cancer and analyze survival in relation to site of involvement and the concomitant presence of visceral metastases. Materials and methods: Retrospective cohort study. We evaluated patients with breast cancer and histologically confirmed cutaneous metastases. Results: Data from 914 patients with breast cancer seen between 2007 and 2014 were analyzed. Thirty-one of the patients, all women, had cutaneous metastases (prevalence, 3.4%; 95% CI, 2.3%-4.7%). The most common form of metástasis was nodular, metachronous, and asymptomatic. There were discrepancies between the immunohistochemical findings for the primary tumor and the metastases in 5 of 21 women. The metastases were locorregional in 23 patients and distant in 8. No differences were observed between patients with locorregional and distant metastases for survival after diagnosis of the primary tumor (median of 4.7 vs. 4.8 years; P=.085) or the cutaneous metastases (median of 2.9 vs. 1.1 years, P=.06). Women with a simultaneous diagnosis of cutaneous and visceral metastases had the shortest survival. Conclusions: This is the first study in Latin America to estimate the prevalence of cutaneous metastases from breast cancer and we found it to be lower than rates reported for other parts of the world


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/etiologia , Neoplasias Cutâneas/complicações , Neoplasias Cutâneas/secundário , Metástase Neoplásica , Neoplasias da Mama/patologia , Neoplasias Cutâneas/epidemiologia , Imuno-Histoquímica , Estudos Retrospectivos , Argentina/epidemiologia , Registros Eletrônicos de Saúde/estatística & dados numéricos
15.
Breast Cancer Res ; 21(1): 35, 2019 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-30823902

RESUMO

BACKGROUND: Breast cancer is the second most common cause of cancer-related death among women. Advances in our understanding of the disease have translated into better diagnostics and more effective therapeutics, leading to earlier detection and improved outcomes. Several studies have pointed at lifestyle and environmental factors as contributory for the onset and progression of the disease. Obesity and cholesterol stand out for their potential causal relationship with breast cancer and ease of modification. MAIN TEXT: Obesity and cholesterol represent risk factors for breast cancer, but their impact is largely affected by cofounding variables including menopausal status, disease subtype, and inflammation. Establishing a causal relationship between lifestyle factors and clinical outcomes may be challenging. Epidemiological studies and meta-analyses have rendered conflicting or sometimes contradictory results, possibly owing to the multifactorial nature of the disease. We discuss the supporting evidence and limitations in our understanding of obesity and cholesterol as risk factors for breast cancer. CONCLUSIONS: There is sufficient evidence that obesity and cholesterol impact clinical outcomes. Physicians are advised to take steps to help patients with their weight, such as recommending dietary and lifestyle interventions.


Assuntos
Neoplasias da Mama/etiologia , Colesterol/sangue , Estilo de Vida , Obesidade/complicações , Peso Corporal/fisiologia , Neoplasias da Mama/sangue , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/prevenção & controle , Feminino , Humanos , Obesidade/sangue , Fatores de Risco , Perda de Peso/fisiologia
16.
BMC Res Notes ; 12(1): 171, 2019 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-30909983

RESUMO

OBJECTIVE: The most common cancer amongst women is breast cancer. Reports on the role of EBV, BKV, and JCV in the development of breast cancer are controversial. Hence, the aim of this study was to determine the frequency of EBV, BKV, and JCV in malignant breast tumors in comparison with benign ones. RESULTS: A total of 300 breast biopsy tissues were included, of which 150 were malignant and 150 benign. After deparaffinization, tissues were subjected to DNA extraction. ß-globin gene was amplified by PCR to evaluate the quality of extracted DNA. In house PCRs assay was performed to detect EBV, JCV, and BKV genome fragment. The mean age of malignant and benign groups was 45.0 ± 9.4 and 35.2 ± 12.1 years old. Out of 150 malignant samples, 146 were ductal, two lobular and two samples both invasive ductal and lobular carcinoma. In the benign group, 96, 52 and two samples were fibroadenoma, fibrocystic, and adenosis types, respectively. Genomic DNA fragment of EBV, BKV, and JCV was not found in any of the malignant and benign breast tissues. CONCLUSION: According to our finding, there is the possibility that EBV, BKV, and JCV are not involved in breast cancer pathogenesis.


Assuntos
Vírus BK/isolamento & purificação , Neoplasias da Mama/etiologia , Neoplasias da Mama/virologia , DNA Viral/isolamento & purificação , Herpesvirus Humano 4/isolamento & purificação , Vírus JC/isolamento & purificação , Adulto , Neoplasias da Mama/patologia , Feminino , Humanos , Irã (Geográfico) , Pessoa de Meia-Idade
17.
Nutrients ; 11(2)2019 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-30813337

RESUMO

Whole grain rye (WGR) and whole grain wheat (WGW) have been suggested to protect against the development of breast cancer. In this study, we estimated long-term intake of WGR and WGW, using both a food frequency questionnaire (FFQ) and alkylresorcinol concentrations in adipose tissue biopsies, in relation to the risk of developing invasive breast cancer in a case-cohort study (n = 414 in the case group, n = 933 in the subcohort group) on the Danish "Diet, Cancer and Health" cohort. The median follow-up time of the subcohort was 5.3 years. Total WGR and WGW intake estimated with FFQ or reflected by total alkylresorcinol concentration in adipose tissue was not significantly associated with risk of breast cancer. However, after adjustment for total WGR and WGW intake, women in the highest quartile of relative WGR intake, reflected by the alkylresorcinol C17:0/C21:0 ratio, had a higher risk of overall breast cancer and estrogen-receptor-positive (ER+) breast cancer than women in the lowest quartile of relative WGR intake, while the risk of estrogen-receptor-negative (ER-) breast cancer incidence was unaffected. Similar results were obtained with the FFQ data. Based on these data, further investigation of the role of specific grain types in reducing or increasing breast cancer risk, and their overall impact on health, is warranted.


Assuntos
Neoplasias da Mama/etiologia , Resorcinóis/química , Resorcinóis/metabolismo , Secale , Triticum , Grãos Integrais , Tecido Adiposo , Idoso , Estudos de Coortes , Dieta , Fibras na Dieta , Feminino , Humanos , Pessoa de Meia-Idade , Fatores de Risco
19.
Plast Reconstr Surg ; 143(3S A Review of Breast Implant-Associated Anaplastic Large Cell Lymphoma): 7S-14S, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30817551

RESUMO

The first case of breast implant-associated anaplastic large cell lymphoma (breast implant ALCL) was described by John Keech and the late Brevator Creech in 1997. In the following 2 decades, much research has led to acceptance of breast implant ALCL as a specific clinicopathologic entity, a process that we bring up to life through the memories of 6 persons who were involved in this progress, although we acknowledge that many others also have contributed to the current state of the art of this disease. Dr. Keech recalls the events that led him and Creech to first report the disease. Ahmet Dogan and colleagues at the Mayo Clinic described a series of 4 patients with breast implant ALCL, and led to increased awareness of breast implant ALCL in the pathology community. Daphne de Jong and colleagues in the Netherlands were the first to provide epidemiologic evidence to support the association between breast implants and ALCL. Garry Brody was one of the first investigators to collect a large number of patients with the disease, present the spectrum of clinical findings, and alert the community of plastic surgeons. Roberto Miranda and L. Jeffrey Medeiros and colleagues studied the pathologic findings of a large number of cases of breast implant ALCL, and published the findings in 2 impactful studies in the medical oncology literature. The recognition and acceptance of this disease by surgeons, epidemiologists, and medical oncologists, working together, has led to subsequent studies on the pathogenesis and optimal therapy of this disease.


Assuntos
Implantes de Mama/efeitos adversos , Implantes de Mama/história , Neoplasias da Mama/etiologia , Linfoma Anaplásico de Células Grandes/etiologia , Linfoma Anaplásico de Células Grandes/história , Adulto , Implante Mamário/efeitos adversos , Implante Mamário/história , Implante Mamário/métodos , Neoplasias da Mama/história , Feminino , Saúde Global , História do Século XX , História do Século XXI , Humanos , Papel do Médico
20.
Plast Reconstr Surg ; 143(3S A Review of Breast Implant-Associated Anaplastic Large Cell Lymphoma): 15S-22S, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30817552

RESUMO

Late onset of fluid collection surrounding breast implants may represent a serious issue when considering the possibility of breast implant-associated anaplastic large cell lymphoma, a newly recognized type of T-cell malignancy. However, many other factors, including trauma and infections, may be implicated in the formation of non-neoplastic periprosthetic delayed effusions. An appropriate management of late seromas, consisting of ultrasound-guided fluid drainage, cultures, cytology, and immunocytochemical and T-cell clonality studies, should be performed to achieve a correct and prompt diagnosis of breast implant-associated anaplastic large cell lymphoma. Criticisms in the diagnosis of late peri-implant effusions are here discussed in detail.


Assuntos
Implante Mamário/efeitos adversos , Implantes de Mama/efeitos adversos , Linfoma Anaplásico de Células Grandes/diagnóstico , Linfoma Anaplásico de Células Grandes/etiologia , Seroma/diagnóstico , Adulto , Biópsia por Agulha , Implante Mamário/métodos , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/etiologia , Diagnóstico Diferencial , Drenagem/métodos , Feminino , Humanos , Imuno-Histoquímica , Antígeno Ki-1/metabolismo , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/fisiopatologia , Medição de Risco , Seroma/etiologia , Seroma/terapia , Ultrassonografia Doppler/métodos
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