ABSTRACT
SUMMARY OBJECTIVE: In multicentric/multifocal breast tumors, there may be immunological and histological differences between foci that may affect survival and treatment choice. We aimed to evaluate the effect of focal heterogeneity seen in multicentric/multifocal breast tumors on survival. METHODS: We retrospectively collected and analyzed the clinicopathological data of 89 female patients with multifocal/multicentric breast cancer, whose surgical and medical treatment was completed and who were followed up for 5 years. RESULTS: Of all patients, 29.2% (26/89) were heterogeneous. Heterogeneity of these foci was as follows: histologic heterogeneity of index foci (mix type): 15.7% (14/89), histologic heterogeneity of inter-foci: 7.9% (7/89), and immunohistochemical heterogeneity of inter-foci: 10.1% (9/89). When additional foci were evaluated, oncological therapy was changed for 3 (3.3%) of 89 patients. Heterogeneity does not have a significant (p>0.05) effect on recurrence and survival in multicentric/multifocal breast cancers. Pathological N stage is an independent risk factor for disease-free survival (hazard ratio=2.29, 95% confidence interval=1.39-3.76, p=0.001). CONCLUSIONS: In multifocal/multicentric breast cancers, less than 4% of patients may experience heterogeneity requiring change in the therapeutic decision. However, heterogeneity does not have a significant effect on recurrence and survival in multifocal/multicentric breast cancers. The pathological N stage is an independent risk factor for disease-free survival.
ABSTRACT
The outline of "Healthy China 2030 Program" has put forward a "double-aspect" health management policy of " all-around and all-cycle protection of peoples' health".Therefore,Chinese experts started to draw up the "comprehensive management guidelines of following-up and concomitant diseases of breast cancer patients" which begins to focus on the concomitant diseases of breast cancer caused by the untoward effects of acute therapy and chronic treatment,and aims at providing integrated health care strategy in the convalescence period for clinicians and breast cancer patients.This is the first time to standardize the principles of preventing and managing concomitant diseases of breast cancer during cancer therapy and follow-ups.Currently,three kinds of disease entities regarding bone,cardiovascular and dyslipidemia,mental and psychiatric disorders were defined as concomitant diseases of breast cancer.Besides,authors have found higher prevalence of sleep disorder,cognitive dysfunction,diabetes and prediabetes,thyroid diseases and metabolic syndrome,in which these diseases should also be considered as concomitant diseases of breast cancer.We'll discuss these diseases in this paper to increase the consciousness in prevention and management of them,and improve the life quality and prognosis of breast cancer patients.
ABSTRACT
O linfedema é um problema quantitativo entre o fluxo linfático produzido e a capacidade de transporte. O risco está associado a esvaziamento e radioterapia axilar; idade; número de linfonodos dissecados e positivos; nível de retirada dos linfonodos; obesidade; extensão da técnica cirúrgica e infecção. Medidas preventivas são adotadas rotineiramente no pós-operatório, na orientação dessas pacientes. Entretanto, não há comprovação científica, questionando-se então, a eficácia dessas medidas na sua prevenção. Objetivo: objetivou-se neste estudo analisar a associação do aparecimento do finfedema com o cumprimento das medidas preventivas. Métodos: foram utilizadas 50 mulheres, tendo realizado cirurgia por câncer de mama há pelo menos 1 ano. As pacientes responderam a um questionário a fim de conhecer se as medidas preventivas geralmente orientadas no pós-operatório, como não tirar a cutícula, raspar ou depilar a axila, expor braço ao sol; tirar sangue; tomar injeção vacina ou medir a pressão; carregar peso; usar luvas paras lavar louças, roupas ou mexer no jardim; não se ferir, queimar; não fazer atividades com peso e não ser picada por insetos, eram seguidas. Resultados/conclusão: os resultados demonstraram estatisticamente que as variáveis analisadas não se relacionam com o aparecimento do linfedema.
The lymphedema is a quantitative problem between the produced lymphatic flow and the capacity of transportation. The risk is associated with to the axillary dissection and armpit radiotherapy, age, number of dissected lymphonodes and positive ones, level of withdrawal, obesity, extension of surgical technique and infection. prophylactic measures routinely adopted on the post operation, due to the necessity of information from these patients. However theres no scientific affirmative, so its questioned the efficacy of these prevention measures. Objective: It was objectified on this study to analyse the association of the lymphedema appearance with the accomplishment of the prophylactic measures. Methods: There were used 50 women, that went through the breast cancer surgery at, at least 1 (one) year. The referred patients answered a questionnaire with the purpose of knowing if the prophylactic measures generally oriented in the post operative as not to go to the manicure, shave or wax the armpit, expose the arm to the sunlight, blood withdrawal,have shots, vaccines, or measure the blood pressure on the surgically treated arm, lift weight, use gloves to do the dishes, do the laundry and to do yard work, not to injure yourself, or not to burn yourself, not to do activities with heavy weight, and not to be bitten by bugs were followed. Results/Conclusion: The results show statistically that the analyzed variables arent related to the appearance of the lymphedema