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1.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-47916

RESUMO

Este ano, a principal ação do INCA no Outubro Rosa é a palestra virtual "Câncer de mama: o que toda mulher precisa saber". Ministrada pela sanitarista Mônica de Assis, da Divisão de Detecção Precoce e Apoio à Organização de Rede, a palestra vai esclarecer quais medidas devem ser tomadas por mulheres de todas as idades para prevenir o câncer de mama, quando elas devem procurar uma unidade de saúde para investigar alterações suspeitas na mama e a faixa etária indicada para se submeter a mamografia de rastreamento (indicada para mulheres sem sinais e sintomas da doença)


Assuntos
Neoplasias da Mama/prevenção & controle , Aula
2.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-47913

RESUMO

Levantamento feito pela Fundação do Câncer, com base em dados do Sistema Único de Saúde (SUS), revela queda de 84% no número de mamografias feitas no Brasil durante a pandemia do novo coronavírus, em comparação ao mesmo período do ano passado. A instituição constatou também em estudo do Observatório de Oncologia, que aumentou de 28 dias para 45 dias o tempo médio entre a primeira consulta com um especialista e o diagnóstico do câncer de mama entre 2014 e 2018. Na média do período, o tempo médio ficou em 36 dias


Assuntos
Neoplasias da Mama/prevenção & controle , Pandemias
3.
Medicine (Baltimore) ; 99(38): e21917, 2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32957311

RESUMO

BACKGROUND: Many epidemiologic studies were performed to clarify the protective effect of regular aspirin use on breast cancer risks, but the results remain inconsistent. Here, we conducted an updated meta-analysis of 38 studies to quantitatively assess the association of regular aspirin use with risk of breast cancer. METHOD: We performed a bibliographic database search in PubMed, Embase, Web of Science, Cochrane library, Scopus, and Google Scholar from January 1939 to December 2019. Relative risk (RR) estimates were extracted from eligible case-control and cohort studies and pooled using a random effects model. Subgroup analysis was conducted based on study design, aspirin exposure assessment, hormone receptor status, menopausal status, cancer stage as well as aspirin use duration or frequency. Furthermore, sensitivity and publication bias analyses were performed. RESULTS: Thirty eight studies of 1,926,742 participants involving 97,099 breast cancer cases contributed to this meta-analysis. Compared with nonusers, the aspirin users had a reduced risk of breast cancer (RR = 0.91, 95% confidence interval [CI]: 0.87-0.95, P value of significance [Psig] < .001) with heterogeneity (P value of heterogeneity [Phet] < .001, I = 82.6%). Subgroup analysis revealed a reduced risk in case-control studies (RR = 0.83, 95% CI: 0.78-0.89, Psig < .001), in hormone receptor positive tumors (RR = 0.91, 95% CI: 0.88-0.94, Psig < .001), in situ breast tumors (RR = 0.79, 95% CI: 0.71-0.88, Psig < .001), and in postmenopausal women (RR = 0.89, 95% CI: 0.83-0.96, Psig = .002). Furthermore, participants who use aspirin for >4 times/wk (RR = 0.88, 95% CI: 0.82-0.96, Psig = .003) or for >10 years (RR = 0.94, 95% CI: 0.89-0.99, Psig = .025) appeared to benefit more from the reduction in breast cancer caused by aspirin. CONCLUSIONS: Our study suggested that aspirin use might be associated with a reduced risk of breast cancer, particularly for reducing the risk of hormone receptor positive tumors or in situ breast tumors, and the risk of breast cancer in postmenopausal women.


Assuntos
Anti-Inflamatórios não Esteroides/administração & dosagem , Aspirina/administração & dosagem , Neoplasias da Mama/patologia , Neoplasias da Mama/prevenção & controle , Humanos , Incidência , Estadiamento de Neoplasias , Estudos Observacionais como Assunto , Pós-Menopausa , Medição de Risco
4.
Adv Exp Med Biol ; 1252: 195-197, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32816282

RESUMO

Pregnancy and lactation represent the most effective protective elements against breast cancer; counter-intuitively breast cancer incidence shows a small but noticeable increase up to 5 years after delivery. The cumulative effect is however favourable and women show a reduction in breast cancer risk which is proportional to the total duration of lactation and to the number of full-term pregnancies.


Assuntos
Neoplasias da Mama/etiologia , Neoplasias da Mama/prevenção & controle , Lactação , Gravidez , Fatores de Proteção , Aleitamento Materno , Feminino , Humanos , Fatores de Risco
5.
JAMA ; 324(4): 369-380, 2020 07 28.
Artigo em Inglês | MEDLINE | ID: mdl-32721007

RESUMO

Importance: The influence of menopausal hormone therapy on breast cancer remains unsettled with discordant findings from observational studies and randomized clinical trials. Objective: To assess the association of prior randomized use of estrogen plus progestin or prior randomized use of estrogen alone with breast cancer incidence and mortality in the Women's Health Initiative clinical trials. Design, Setting, and Participants: Long-term follow-up of 2 placebo-controlled randomized clinical trials that involved 27 347 postmenopausal women aged 50 through 79 years with no prior breast cancer and negative baseline screening mammogram. Women were enrolled at 40 US centers from 1993 to 1998 with follow-up through December 31, 2017. Interventions: In the trial involving 16 608 women with a uterus, 8506 were randomized to receive 0.625 mg/d of conjugated equine estrogen (CEE) plus 2.5 mg/d of medroxyprogesterone acetate (MPA) and 8102, placebo. In the trial involving 10 739 women with prior hysterectomy, 5310 were randomized to receive 0.625 mg/d of CEE alone and 5429, placebo. The CEE-plus-MPA trial was stopped in 2002 after 5.6 years' median intervention duration, and the CEE-only trial was stopped in 2004 after 7.2 years' median intervention duration. Main Outcomes and Measures: The primary outcome was breast cancer incidence (protocol prespecified primary monitoring outcome for harm) and secondary outcomes were deaths from breast cancer and deaths after breast cancer. Results: Among 27 347 postmenopausal women who were randomized in both trials (baseline mean [SD] age, 63.4 years [7.2 years]), after more than 20 years of median cumulative follow-up, mortality information was available for more than 98%. CEE alone compared with placebo among 10 739 women with a prior hysterectomy was associated with statistically significantly lower breast cancer incidence with 238 cases (annualized rate, 0.30%) vs 296 cases (annualized rate, 0.37%; hazard ratio [HR], 0.78; 95% CI, 0.65-0.93; P = .005) and was associated with statistically significantly lower breast cancer mortality with 30 deaths (annualized mortality rate, 0.031%) vs 46 deaths (annualized mortality rate, 0.046%; HR, 0.60; 95% CI, 0.37-0.97; P = .04). In contrast, CEE plus MPA compared with placebo among 16 608 women with a uterus was associated with statistically significantly higher breast cancer incidence with 584 cases (annualized rate, 0.45%) vs 447 cases (annualized rate, 0.36%; HR, 1.28; 95% CI, 1.13-1.45; P < .001) and no significant difference in breast cancer mortality with 71 deaths (annualized mortality rate, 0.045%) vs 53 deaths (annualized mortality rate, 0.035%; HR, 1.35; 95% CI, 0.94-1.95; P= .11). Conclusions and Relevance: In this long-term follow-up study of 2 randomized trials, prior randomized use of CEE alone, compared with placebo, among women who had a previous hysterectomy, was significantly associated with lower breast cancer incidence and lower breast cancer mortality, whereas prior randomized use of CEE plus MPA, compared with placebo, among women who had an intact uterus, was significantly associated with a higher breast cancer incidence but no significant difference in breast cancer mortality.


Assuntos
Neoplasias da Mama/epidemiologia , Estrogênios Conjugados (USP)/efeitos adversos , Terapia de Reposição Hormonal/efeitos adversos , Histerectomia , Acetato de Medroxiprogesterona/efeitos adversos , Idoso , Neoplasias da Mama/induzido quimicamente , Neoplasias da Mama/mortalidade , Neoplasias da Mama/prevenção & controle , Estrogênios Conjugados (USP)/uso terapêutico , Feminino , Seguimentos , Humanos , Histerectomia/efeitos adversos , Incidência , Acetato de Medroxiprogesterona/uso terapêutico , Pessoa de Meia-Idade , Pós-Menopausa , Risco
8.
Mayo Clin Proc ; 95(6): 1268-1275, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32498779

RESUMO

Breast cancer-screening guidelines increasingly recommend that clinicians perform a risk assessment for breast cancer to inform shared decision making for screening. Precision medicine is quickly becoming the preferred approach to cancer screening, with the aim of increased surveillance in high-risk women, while sparing lower-risk women the burden of unnecessary imaging. Risk assessment also informs clinical care by refining screening recommendations for younger women, identifying women who should be referred to genetic counseling, and identifying candidates for risk-reducing medications. Several breast cancer risk-assessment models are currently available to help clinicians categorize a woman's risk for breast cancer. However, choosing the appropriate model for a given patient requires a working knowledge of the strengths, weaknesses, and performance characteristics of each. The aim of this article is to provide a stepwise approach for clinicians to assess an individual woman's risk for breast cancer and describe the features, appropriate use, and performance characteristics of commonly encountered risk-prediction models. This approach will help primary care providers engage in shared decision making by efficiently generating an accurate risk assessment and make clear, evidence-based screening and prevention recommendations that are appropriately matched to a woman's risk for breast cancer.


Assuntos
Neoplasias da Mama/diagnóstico , Programas de Rastreamento/normas , Medição de Risco/métodos , Neoplasias da Mama/prevenção & controle , Tomada de Decisão Compartilhada , Feminino , Humanos , Anamnese , Guias de Prática Clínica como Assunto , Atenção Primária à Saúde/métodos
9.
N Z Med J ; 133(1514): 10-15, 2020 05 08.
Artigo em Inglês | MEDLINE | ID: mdl-32379735

RESUMO

AIM: To evaluate the impact of public health campaigns for glaucoma and age-related macular degeneration compared to breast cancer and prostate cancer using Google Trends data. METHODS: Relative search volumes for the terms 'glaucoma', 'macular degeneration', 'breast cancer' and 'prostate cancer' for New Zealand from October 2008-September 2018 were obtained via Google Trends. Intervention time-series analyses were used to compare observations before and after each awareness campaign. RESULTS: Of the campaigns occurring in the 10-year study period, statistically significant increases in search behaviour were observed for breast cancer (45%, p<0.01), prostate cancer (32%, p<0.01) and glaucoma (16%, p<0.01). Macular degeneration search behaviour increased on average 14% but this was not statistically significant (p>0.1), although increased activity (294%) was observed in December 2016, corresponding with the release of a report, public meeting and media release on the socioeconomic impact of macular degeneration. CONCLUSIONS: Glaucoma and macular degeneration search behaviour in New Zealand has a low impact following health awareness campaigns in comparison to breast and prostate cancer. This implies there is scope for improvement with these campaigns and a large increase in macular degeneration activity following a public meeting, and report release suggests that increased funding may increase impact. This study also highlights the utility of internet data for cost-effective monitoring of public interest in health issues.


Assuntos
Neoplasias da Mama/prevenção & controle , Glaucoma/prevenção & controle , Promoção da Saúde , Degeneração Macular/prevenção & controle , Neoplasias da Próstata/prevenção & controle , Ferramenta de Busca/estatística & dados numéricos , Feminino , Humanos , Comportamento de Busca de Informação , Masculino , Nova Zelândia , Saúde Pública
10.
Chem Biol Interact ; 325: 109129, 2020 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-32418914

RESUMO

Alcohol has been classified as carcinogenic to humans by the International Agency for Research on Cancer (IARC). Studies have demonstrated that alcohol intake increases the risk of breast cancer, and alcohol also stimulates breast cancer cell growth. Deregulation of Pol III genes is tightly associated with tumour development. Transcription factor II-B (TFIIB)-related factor 1 (Brf1) is a transcription factor that specifically regulates Pol III gene transcription. Our in vivo and in vitro studies have indicated that alcohol enhances the transcription of Pol III genes to cause an alteration of cellular phenotypes, which is closely related with human breast cancer. Betaine is a vegetable alkaloid and has antitumor functions. Most reports about betaine show that the consumption level of betaine is inversely associated with a risk of breast cancer. Although different mechanisms of betaine against tumour have been investigated, nothing has been reported on the effect of betaine on the deregulation of Brf1 and Pol III genes. In this study, we determine the role of betaine in breast cancer cell growth and colony formation and explore its mechanism. Our results indicate that alcohol increases the rates of growth and colony formation of breast cancer cells, whereas betaine is able to significantly inhibit the effects of alcohol on these cell phenotypes. Betaine decreases the induction of Brf1 expression and Pol III gene transcription caused by ethanol to reduce the rates of cell growth and colony formation. Together, these studies provide novel insights into the role of betaine in alcohol-caused breast cancer cell growth and deregulation of Brf1 and Pol III genes. These results suggest that betaine consumption is able to prevent alcohol-associated human cancer development.


Assuntos
Betaína/farmacologia , Etanol/antagonistas & inibidores , Etanol/farmacologia , RNA Polimerase II/genética , Ativação Transcricional/efeitos dos fármacos , Neoplasias da Mama/induzido quimicamente , Neoplasias da Mama/patologia , Neoplasias da Mama/prevenção & controle , Proliferação de Células/efeitos dos fármacos , Humanos , Cinética , Células MCF-7 , Risco
11.
PLoS One ; 15(4): e0231653, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32294107

RESUMO

Terminal duct lobular unit (TDLU) involution is the regression of milk-producing structures in the breast. Women with less TDLU involution are more likely to develop breast cancer. A major bottleneck in studying TDLU involution in large cohort studies is the need for labor-intensive manual assessment of TDLUs. We developed a computational pathology solution to automatically capture TDLU involution measures. Whole slide images (WSIs) of benign breast biopsies were obtained from the Nurses' Health Study. A set of 92 WSIs was annotated for acini, TDLUs and adipose tissue to train deep convolutional neural network (CNN) models for detection of acini, and segmentation of TDLUs and adipose tissue. These networks were integrated into a single computational method to capture TDLU involution measures including number of TDLUs per tissue area, median TDLU span and median number of acini per TDLU. We validated our method on 40 additional WSIs by comparing with manually acquired measures. Our CNN models detected acini with an F1 score of 0.73±0.07, and segmented TDLUs and adipose tissue with Dice scores of 0.84±0.13 and 0.87±0.04, respectively. The inter-observer ICC scores for manual assessments on 40 WSIs of number of TDLUs per tissue area, median TDLU span, and median acini count per TDLU were 0.71, 0.81 and 0.73, respectively. Intra-observer reliability was evaluated on 10/40 WSIs with ICC scores of >0.8. Inter-observer ICC scores between automated results and the mean of the two observers were: 0.80 for number of TDLUs per tissue area, 0.57 for median TDLU span, and 0.80 for median acini count per TDLU. TDLU involution measures evaluated by manual and automated assessment were inversely associated with age and menopausal status. We developed a computational pathology method to measure TDLU involution. This technology eliminates the labor-intensiveness and subjectivity of manual TDLU assessment, and can be applied to future breast cancer risk studies.


Assuntos
Neoplasias da Mama/diagnóstico , Mama/patologia , Aprendizado Profundo , Processamento de Imagem Assistida por Computador , Adulto , Fatores Etários , Biópsia , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/prevenção & controle , Estudos de Coortes , Feminino , Humanos , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Medição de Risco , Fatores de Risco
12.
Maturitas ; 135: 27-33, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32252961

RESUMO

OBJECTIVES: To analyze the uptake of breast and cervical cancer screening according to the 2017 Spanish National Health Survey (SNHS), to compare uptake rates with those obtained in the previous SNHS 2011 and to identify predictors for the uptake for these two screening tests. STUDY DESIGN: Cross-sectional study. MAIN OUTCOME MEASURES: Uptake rates of breast cancer and cervical cancer screening were analyzed for women aged 40-69 and aged 25-65 years, respectively. Independent variables included sociodemographic characteristics and factors related to health status and lifestyle. RESULTS: We found that 66.8 % of women aged 40-69 years had undergone mammography in the previous two years. Positive predictors for mammography uptake were age (50-69 years); marital status (married); Spanish nationality; university education; one or more chronic diseases; no alcohol consumption; physical activity; body mass index <30 kg/m2; and not smoking. We observed that 73.0 % of women aged 25-65 years had undergone cervical cytology screening in the previous three years. Positive predictors for uptake were age (25-52 years); marital status (married); Spanish nationality; middle-high educational level; no chronic diseases; no alcohol consumption; physical activity; body mass index <30 kg/m2; and not smoking. There was a significant decrease in the uptake rate for breast cancer screening from the previous SNHS 2011 (OR 0.89; 95 % CI 0.83-0.94). CONCLUSIONS: The adherence rate for mammography in Spain in 2017 was below the recommended 70 % and was significantly lower than in 2011. The figures for cervical cancer screening were over 70 % and stable over time.


Assuntos
Neoplasias da Mama/prevenção & controle , Detecção Precoce de Câncer/estatística & dados numéricos , Programas de Rastreamento/estatística & dados numéricos , Neoplasias do Colo do Útero/prevenção & controle , Adulto , Idoso , Feminino , Humanos , Mamografia , Pessoa de Meia-Idade , Espanha
13.
Breast Cancer Res ; 22(1): 34, 2020 04 09.
Artigo em Inglês | MEDLINE | ID: mdl-32272947

RESUMO

BACKGROUND: Osteoclast activation is a hallmark of breast cancer-induced bone disease while little is known about the role of osteoblasts in this process. Recently, we identified the homeodomain protein TG-interacting factor-1 (Tgif1) as a crucial regulator of osteoblast function. In this study, we demonstrate that lack of Tgif1 also restricts the progression of breast cancer bone metastases. METHODS: Transwell migration assays were used to investigate the osteoblast-breast cancer cell interaction in vitro. Molecular analyses included RNA sequencing, immunoblotting, and qRT-PCR. To determine the role of Tgif1 in metastatic bone disease, 4T1 breast cancer cells were injected intracardially into mice with a germ line deletion of Tgif1 (Tgif1-/-) or control littermates (Tgif1+/+). Progression of bone metastases and alterations in the bone microenvironment were assessed using bioluminescence imaging, immunofluorescence staining, confocal microscopy, and histomorphometry. RESULTS: Medium conditioned by osteoblasts stimulated breast cancer cell migration, indicating a potential role of osteoblasts during bone metastasis progression. Tgif1 expression was strongly increased in osteoblasts upon stimulation by breast cancer cells, demonstrating the implication of Tgif1 in the osteoblast-breast cancer cell interaction. Indeed, conditioned medium from osteoblasts of Tgif1-/- mice failed to induce breast cancer cell migration compared to control, suggesting that Tgif1 in osteoblasts augments cancer cell motility. Semaphorin 3E (Sema3E), which is abundantly secreted by Tgif1-/- osteoblasts, dose-dependently reduced breast cancer cell migration while silencing of Sema3E expression in Tgif1-/- osteoblasts partially restored the impaired migration. In vivo, we observed a decreased number of breast cancer bone metastases in Tgif1-/- mice compared to control littermates. Consistently, the presence of single breast cancer cells or micro-metastases in the tibiae was reduced in Tgif1-/- mice. Breast cancer cells localized in close proximity to Endomucin-positive vascular cells as well as to osteoblasts. Although Tgif1 deficiency did not affect the bone marrow vasculature, the number and activity of osteoblasts were reduced compared to control. This suggests that the protective effect on bone metastases might be mediated by osteoblasts rather than by the bone marrow vasculature. CONCLUSION: We propose that the lack of Tgif1 in osteoblasts increases Sema3E expression and attenuates breast cancer cell migration as well as metastases formation.


Assuntos
Neoplasias Ósseas/prevenção & controle , Osso e Ossos/patologia , Neoplasias da Mama/prevenção & controle , Proteínas de Homeodomínio/antagonistas & inibidores , Proteínas de Homeodomínio/fisiologia , Proteínas Repressoras/antagonistas & inibidores , Proteínas Repressoras/fisiologia , Semaforinas/genética , Microambiente Tumoral , Animais , Neoplasias Ósseas/metabolismo , Neoplasias Ósseas/secundário , Osso e Ossos/metabolismo , Neoplasias da Mama/metabolismo , Neoplasias da Mama/patologia , Diferenciação Celular , Linhagem Celular Tumoral , Modelos Animais de Doenças , Feminino , Proteínas de Homeodomínio/genética , Proteínas de Homeodomínio/metabolismo , Humanos , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos C57BL , Camundongos Knockout , Osteoblastos/metabolismo , Osteoblastos/patologia , Proteínas Repressoras/genética , Proteínas Repressoras/metabolismo
14.
Cancer Res ; 80(7): 1590-1600, 2020 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-32241951

RESUMO

Mammographic features influence breast cancer risk and are used in risk prediction models. Understanding how genetics influence mammographic features is important because the mechanisms through which they are associated with breast cancer are not well known. Here, using mammographic screening history and detailed questionnaire data from 56,820 women from the KARMA prospective cohort study, we investigated the association between a genetic predisposition to breast cancer and mammographic features among women with a family history of breast cancer (N = 49,674) and a polygenic risk score (PRS, N = 9,365). The heritability of mammographic features such as dense area (MD), microcalcifications, masses, and density change (MDC, cm2/year) was estimated using 1,940 sister pairs. Heritability was estimated at 58% [95% confidence interval (CI), 48%-67%) for MD, 23% (2%-45%) for microcalcifications, and 13% (1%-25%)] for masses. The estimated heritability for MDC was essentially null (2%; 95% CI, -8% to 12%). The association between a genetic predisposition to breast cancer (using PRS) and MD and microcalcifications was positive, while for masses this was borderline significant. In addition, for MDC, having a family history of breast cancer was associated with slightly greater MD reduction. In summary, we have confirmed previous findings of heritability in MD, and also established heritability of the number of microcalcifications and masses at baseline. Because these features are associated with breast cancer risk and can improve detecting women at short-term risk of breast cancer, further investigation of common loci associated with mammographic features is warranted to better understand the etiology of breast cancer. SIGNIFICANCE: These findings provide novel data on the heritability of microcalcifications, masses, and density change, which are all associated with breast cancer risk and can indicate women at short-term risk.


Assuntos
Densidade da Mama/genética , Neoplasias da Mama/genética , Calcinose/genética , Detecção Precoce de Câncer/estatística & dados numéricos , Anamnese/estatística & dados numéricos , Adulto , Idoso , Mama/diagnóstico por imagem , Mama/patologia , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/prevenção & controle , Calcinose/diagnóstico por imagem , Estudos de Casos e Controles , Feminino , Predisposição Genética para Doença , Humanos , Mamografia/estatística & dados numéricos , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Estudos Prospectivos , Fatores de Risco , Inquéritos e Questionários/estatística & dados numéricos , Suécia/epidemiologia
15.
Front Biosci (Schol Ed) ; 12: 137-160, 2020 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-32114452

RESUMO

Breast cancer (BrCa) is the most commonly diagnosed cancer and the second leading cause of cancer-related death in women. Alarming increases in the cases quests for more effective treatment of BrCa. As most chemotherapeutic drugs are associated with drug resistance, cancer relapse, and side effects, scientists are turning to agents with more efficacy, such as natural compounds for treatment and prevention of BrCa. Selected natural compounds, substances derived from living organisms, promote apoptosis and inhibit metastasis, preventing cancer growth. As a result, these compounds have the potential to suppress BrCa progression, thus increasing patient survival rates and decreasing the number of BrCa-related deaths. In this review, we summarize natural compounds that have displayed, anti-cancer effects on BrCa cells in various studies. These natural compounds inhibit the development of BrCa, suppress the growth of cancer cells, and promote cell death. We conclude that natural compounds are efficient, effective and promising agents for treating BrCa other than therapeutic methods.


Assuntos
Produtos Biológicos/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/prevenção & controle , Animais , Apoptose/efeitos dos fármacos , Produtos Biológicos/farmacologia , Neoplasias da Mama/patologia , Feminino , Humanos , Extratos Vegetais/farmacologia , Extratos Vegetais/uso terapêutico
16.
BMC Med Inform Decis Mak ; 20(1): 45, 2020 03 02.
Artigo em Inglês | MEDLINE | ID: mdl-32122371

RESUMO

BACKGROUND: Mammographic breast density is an important predictor of breast cancer, but its measurement has limitations related to subjectivity of visual evaluation or to difficult access for automatic volumetric measurement methods. Herein, we describe the design and clinical validation of Aguida, a software program for automated quantification of breast density from flat mammography images. MATERIALS AND METHODS: The software program was developed in MatLab. After image segmentation separating the background from the breast image, the operator positions a cursor defining a region of interest on the pectoralis major muscle from the mediolateral oblique view. Then, in the craniocaudal view, the threshold for separation of the dense tissue is based on the optical density of the pectoral muscle, and the proportion of dense tissue is calculated by the program. Mammograms obtained from 2 different occasions in 291 women were used for clinical evaluation. RESULTS: The intraclass correlation coefficient (ICC) between breast density measurements by the software and by a radiologist was 0.96, with a bias of only 0.67 percentage points and a 95% limit of agreement of 13.5 percentage points; the ICC was 0.94 in the interobserver reliability assessment by two radiologists with different experience; and the ICC was 0.98 in the intraobserver reliability assessment. The distribution among the density classes was close to the values obtained with the volumetric software. CONCLUSIONS: Measurement of breast density with the Aguida program from flat mammography images showed high agreement with the visual determination by radiologists, and high inter- and intra-observer reliability.


Assuntos
Densidade da Mama , Neoplasias da Mama/prevenção & controle , Mamografia , Interpretação de Imagem Radiográfica Assistida por Computador/métodos , Validação de Programas de Computador , Adulto , Idoso , Idoso de 80 Anos ou mais , Algoritmos , Feminino , Humanos , Pessoa de Meia-Idade , Reprodutibilidade dos Testes
17.
Life Sci ; 250: 117550, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-32179071

RESUMO

Breast cancer is the frequently diagnosed cancer among women and it is the most lethal malignancy in women globally. With one million cases every year, breast cancer is the fast-growing cancer type that has a high prevalence rate in young women. The limitations and undesirable side effects of conventional therapies like chemotherapy and radiotherapy on malignant tumors necessitate the development of alternative therapeutic approaches. Gene therapy has emerged as a promising approach to cure a variety of malignant cancer types which involves the delivery of functional gene directly into the target tumor tissue. Efficient gene therapy approach relies on the effective delivery of therapeutic genes to the desired cell type. In this regard, biological and non-biological gene delivery vectors are used to protect the naked foreign DNA to mediate effective tissue entry of the desired gene of interest. In this review, the use of bacterial and viral vectors for breast cancer gene therapy was summarized.


Assuntos
Bactérias , Neoplasias da Mama/prevenção & controle , Neoplasias da Mama/terapia , Vacinas Anticâncer/administração & dosagem , Vetores Genéticos , Vírus , Animais , Feminino , Técnicas de Transferência de Genes , Terapia Genética/métodos , Humanos , Neoplasias Mamárias Experimentais/terapia , Transplante de Neoplasias , Vírus Oncolíticos , Prognóstico
18.
Cochrane Database Syst Rev ; 3: CD005004, 2020 03 02.
Artigo em Inglês | MEDLINE | ID: mdl-32118296

RESUMO

BACKGROUND: This review is an update of a previously published review in the Cochrane Database of Systematic Reviews (2009, Issue 3).Tea is one of the most commonly consumed beverages worldwide. Teas from the plant Camellia sinensis can be grouped into green, black and oolong tea, and drinking habits vary cross-culturally. C sinensis contains polyphenols, one subgroup being catechins. Catechins are powerful antioxidants, and laboratory studies have suggested that these compounds may inhibit cancer cell proliferation. Some experimental and nonexperimental epidemiological studies have suggested that green tea may have cancer-preventative effects. OBJECTIVES: To assess possible associations between green tea consumption and the risk of cancer incidence and mortality as primary outcomes, and safety data and quality of life as secondary outcomes. SEARCH METHODS: We searched eligible studies up to January 2019 in CENTRAL, MEDLINE, Embase, ClinicalTrials.gov, and reference lists of previous reviews and included studies. SELECTION CRITERIA: We included all epidemiological studies, experimental (i.e. randomised controlled trials (RCTs)) and nonexperimental (non-randomised studies, i.e. observational studies with both cohort and case-control design) that investigated the association of green tea consumption with cancer risk or quality of life, or both. DATA COLLECTION AND ANALYSIS: Two or more review authors independently applied the study criteria, extracted data and assessed methodological quality of studies. We summarised the results according to diagnosis of cancer type. MAIN RESULTS: In this review update, we included in total 142 completed studies (11 experimental and 131 nonexperimental) and two ongoing studies. This is an additional 10 experimental and 85 nonexperimental studies from those included in the previous version of the review. Eleven experimental studies allocated a total of 1795 participants to either green tea extract or placebo, all demonstrating an overall high methodological quality based on 'Risk of bias' assessment. For incident prostate cancer, the summary risk ratio (RR) in the green tea-supplemented participants was 0.50 (95% confidence interval (CI) 0.18 to 1.36), based on three studies and involving 201 participants (low-certainty evidence). The summary RR for gynaecological cancer was 1.50 (95% CI 0.41 to 5.48; 2 studies, 1157 participants; low-certainty evidence). No evidence of effect of non-melanoma skin cancer emerged (summary RR 1.00, 95% CI 0.06 to 15.92; 1 study, 1075 participants; low-certainty evidence). In addition, adverse effects of green tea extract intake were reported, including gastrointestinal disorders, elevation of liver enzymes, and, more rarely, insomnia, raised blood pressure and skin/subcutaneous reactions. Consumption of green tea extracts induced a slight improvement in quality of life, compared with placebo, based on three experimental studies. In nonexperimental studies, we included over 1,100,000 participants from 46 cohort studies and 85 case-control studies, which were on average of intermediate to high methodological quality based on Newcastle-Ottawa Scale 'Risk of bias' assessment. When comparing the highest intake of green tea with the lowest, we found a lower overall cancer incidence (summary RR 0.83, 95% CI 0.65 to 1.07), based on three studies, involving 52,479 participants (low-certainty evidence). Conversely, we found no association between green tea consumption and cancer-related mortality (summary RR 0.99, 95% CI 0.91 to 1.07), based on eight studies and 504,366 participants (low-certainty evidence). For most of the site-specific cancers we observed a decreased RR in the highest category of green tea consumption compared with the lowest one. After stratifying the analysis according to study design, we found strongly conflicting results for some cancer sites: oesophageal, prostate and urinary tract cancer, and leukaemia showed an increased RR in cohort studies and a decreased RR or no difference in case-control studies. AUTHORS' CONCLUSIONS: Overall, findings from experimental and nonexperimental epidemiological studies yielded inconsistent results, thus providing limited evidence for the beneficial effect of green tea consumption on the overall risk of cancer or on specific cancer sites. Some evidence of a beneficial effect of green tea at some cancer sites emerged from the RCTs and from case-control studies, but their methodological limitations, such as the low number and size of the studies, and the inconsistencies with the results of cohort studies, limit the interpretability of the RR estimates. The studies also indicated the occurrence of several side effects associated with high intakes of green tea. In addition, the majority of included studies were carried out in Asian populations characterised by a high intake of green tea, thus limiting the generalisability of the findings to other populations. Well conducted and adequately powered RCTs would be needed to draw conclusions on the possible beneficial effects of green tea consumption on cancer risk.


Assuntos
Camellia sinensis , Neoplasias/prevenção & controle , Fitoterapia/métodos , Extratos Vegetais/uso terapêutico , Chá , Neoplasias da Mama/prevenção & controle , Camellia sinensis/química , Estudos de Casos e Controles , Feminino , Flavonoides/farmacologia , Neoplasias Gastrointestinais/epidemiologia , Neoplasias Gastrointestinais/prevenção & controle , Humanos , Incidência , Neoplasias Hepáticas/epidemiologia , Neoplasias Hepáticas/prevenção & controle , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/prevenção & controle , Masculino , Neoplasias Bucais/epidemiologia , Neoplasias Bucais/prevenção & controle , Neoplasias/epidemiologia , Neoplasias/mortalidade , Fenóis/farmacologia , Extratos Vegetais/efeitos adversos , Polifenóis , Ensaios Clínicos Controlados Aleatórios como Assunto , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/prevenção & controle , Chá/efeitos adversos , Neoplasias Urogenitais/epidemiologia , Neoplasias Urogenitais/prevenção & controle
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