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Introducción: Se ha demostrado en diversos protocolos que, en gran proporción de casos con cáncer de mama en estadíos tempranos y ganglio centinela positivo, no se observa enfermedad metastásica en ganglios linfáticos no centinelas (GNC). A raíz de esto es que se han descripto diferentes factores predictores de metástasis axilar. Esto nos motivó a realizar el presente trabajo. Objetivo: Analizar diferentes factores anatomopatológicos y su influencia en el compromiso metastásico de los ganglios no centinela. Material y método: Se estudiaron casos de cáncer de mama estadíos tempranos (T1-T2) con ganglio centinela positivo y seguidas de vaciamiento axilar, operadas en IMGO entre febrero del año 2000 y diciembre de 2012. De la muestra total se identificaron dos grupos: GnC negativos y GnC positivos. Analizamos diferentes variables anatomopatológicas vinculadas a cada grupo y calculamos su grado de significancia. Finalmente, analizamos estas variables en una tabla de análisis multivariado. Resultados: De una muestra de 205 casos (20,8% del total de ganglios estudia- dos en ese período de tiempo), el 48.3% (n=99) presentaba metástasis solo en el GC. De todas las características anatomopatológicas de mal pronóstico analizadas encontramos que el tamaño tumoral 2, el subtipo lobulillar y la invasión linfovascular tuvieron correlación significativa con la cantidad de GnC comprometidos. En el análisis multivariado encontramos tres factores predictivos, la invasión linfovascular, el tamaño de la metástasis en el ganglio centinela y el número de ganglios centinelas comprometidos. Conclusiones: Los factores independientes de compromiso de ganglios no centinela (GNC) en nuestra serie fueron: la invasión linfovascular, el tamaño de la metástasis en el ganglio centinela y el número de ganglios centinelas comprometidos
Introduction: It has been shown in various protocols that pathologically negative nonsentinel lymph node (NSN) disease, is observed in the rest of the armpit in a large proportion of cases with early stage breast carcinoma and positive sentinel node. As a result of this, different pathological predictors of axillary metastasis have been described. This motivated us to carry out the present work. Objetive: To analyze different pathological factors and their influence on the metastatic involvement of nonsentinel nodes. Material and method: Early stage breast cancer cases (T1-T2) with positive sentinel node and axillary emptying, operated on in IMGO between February 2000 and December 2012, were studied. Two groups were identified from the total sample: negative GnC and positive GnC, and analyzed diffe- rent pathological variables associated with metastatic nonsentinel nodes, calculating their significance. Finally, we analyze these variables in a multivariate analysis table. Results: From a sample of 205 cases (20.8% of the total lymph nodes studied), 48.3% (n = 99) had metastasis only in the SN. Of all the anatomo-pathological characteristics analyzed, we found that tumor size two, lobular subtype, and lymphovascular invasion had a significant correlation with the amount of compromised non-sentinel node (NSN). In the multivariate analysis, we found three predictive factors: lymphovascular invasion, the size of the metastasis in the sentinel node and the number of positive sentinel nodes. Conclusions: The independent factors of nonsentinel node involvement (NSN) in our series are: lymphovascular invasion, the size of the sentinel node metastasis, and the number of sentinel nodes involved
Subject(s)
Female , Breast Neoplasms , Axilla , Sentinel Lymph Node , Lymph Nodes , Neoplasm MetastasisABSTRACT
Objetivo: Proponer una consulta de enfermería en sexualidad para mujeres con cáncer de mama en fase perioperatoria para una institución oncológica. Metodología: Revisión integrativa de literatura. Se llevó a cabo una búsqueda de literatura en las bases de datos LILACS, SpringerLink, ClinicalKey, Biblioteca Virtual en Salud (BVS), Scopus, SAGE Journals y búsquedas secundarias en revistas científicas en Taylor & Francis Online. Se encontraron 35 artículos, los cuales se organizaron y se caracterizaron por año de publicación, idioma, país, edad promedio de la muestra, tipos de tratamiento, metodología, perspectiva disciplinar, enfoque, diseño y tendencia temática. Esta estrategia permitió desarrollar los objetivos. Resultados: La tendencia de investigación identificada se agrupó en cuatro categorías de necesidades en cuanto a la sexualidad: Respuesta sexual fisiológica; Adaptación psicológica a los sentimientos; Pérdida del atractivo físico y Salud sexual y reproductiva. Se propuso una consulta de enfermería con base en el modelo PLISSIT para abordar la sexualidad, de modo que fuera factible otorgar respuestas a las necesidades reales de la mujer con cáncer de mama. Conclusiones: La sexualidad en mujeres con cáncer de mama es un factor importante en la fase perioperatoria, pues permanentemente se ve alterada por la enfermedad y los tratamientos, afectando tanto a la mujer como a su pareja. De este modo, se requiere realizar intervenciones en una consulta de enfermería especializada en sexualidad para mujeres con cáncer de mama.
Objective: To propose a sexuality nursing consultation for women with breast cancer in the perioperative phase in an oncological institution. Methodology: Integrative literature review. A literature search was carried out in databases LILACS, SpringerLink, ClinicalKey, Virtual health Library (BVS), Scopus, and SAGE Journals; a secondary literature searches also was carried out in several scientific journals in Taylor & Francis Online. 35 articles were found and they were put together and characterized in accordance with publication year, language, publication country, average age of the sample, forms of treatment, methodology, field of study outlook, approach, design, and trending topic. This framework enabled to sort the objective out. Results: The trending research topic identified was clustered into four categories of requirements about sexuality: Physiological sexual response; Psychological adjustment to feelings; Loss of attractiveness; and Sexual and reproductive health. A nursing consultation was proposed based on the PLISSIT model of sex therapy in order to give responses to the real needs of women with breast cancer. Conclusions: Sexuality of women with breast cancer is a significant feature in the perioperative phase; it is permanently disrupted by disease and treatments, impacting both the woman and her partner. Therefore, it is necessary to carry out interventions in a sexuality nursing consultation for women with breast cancer
Subject(s)
Humans , Female , Breast Neoplasms , Sexuality , Perioperative Period , Review Literature as Topic , Office NursingABSTRACT
Objective To analysis the changes of serum adiponectin level in patients with breast cancer and its clinical signifi‐cance .Methods 35 cases of serum adiponectin levels in breast cancer patients using enzyme‐linked immunosorbent assay ,and 35 healthy serum adiponectin level in peripheral blood of women ,analysis of significance of changes of serum adiponectin levels in breast cancer patients .Results Average serum adiponectin level in patients with breast cancer group(6 .13 ± 1 .55)μg/mL ,health group average serum adiponectin levels (8 .72 ± 1 .86)μg/mL ,the difference was statistically significant(P<0 .05) .Postmenopausal women in breast cancer group and health group compared with premenopausal women ,the serum adiponectin levels were signifi‐cantly increased ,there was a statistically significant difference(P<0 .05) .Lymph node metastasis of breast cancer serum adiponec‐tin levels were significantly lower in patients without lymph node metastasis in patients with breast cancer ,the difference was statis‐tically significant(P<0 .05) .Serum adiponectin level in breast cancer patients with stage Ⅱ and Ⅲ were significantly lower than breast cancer patients with stage Ⅰ ,there was a statistically significant difference(P<0 .05) .Conclusion Serum adiponectin levels as an important marker in the diagnosis of breast cancer ,serum adiponectin level and grade of the tumor ,lymph node metastases . Significantly reduced serum adiponectin level in patients with breast cancer ,and not under the influence of patients with menopause .
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Objective To investigate the therapy effect and adverse reaction of the abraxane chemotherapy as a alternative plan in metastatic breast cancer.Methods Twenty-one patients with advanced metastatic breast cancer were selected as our subject.All the patients received rescue chemotherapy after relapse and metastasis.Abraxane were administrated with 260 mg/m2 3 weeks/time,and evaluated the effect in every two course of radiotherapy.Results Of 21 cases,4 cases were remission and 8 cases were with stable progress of cancer.No allergic reaction occurred.The majority adverse reaction were granulocytopenia and nerve toxicity.Conclusion Abraxane migh be considered as the altemate therapy medicine of metastatic breast cancer due to good curative effect,less toxicity reaction and no allergic reaction.
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BACKGROUND: Technetium-99m sestamibi scintimammography (SMM) has been shown to be a useful diagnostic test in the detection of breast cancer, and the receiver operating characteristic (ROC) curve analysis provides detailed information about the diagnostic test. A ROC curve analysis was performed to evaluate the feasibility of Tc-99m sestamibi quantitative scintimammography (qSMM) for differentiating malignant from benign breast lesions. METHODS: Prone anterior, lateral planar, and supine SPECT imagings were performed on 75 female patients (mean age=43.4 yr) with breast masses (size> or =0.8 cm) after intravenous injection of 30 mCi of Tc-99m sestamibi. 45 malignant and 30 benign lesions were histologically proven. Three regions of interest (ROIs) were drawn over designated areas: lesion (L), normal breast opposite to the lesion (NL), and right chest wall (CW). L/NL and the L/CW ratios on both the SPECT and the planar images were analyzed. RESULTS: ROC curve analysis revealed that planar L/NL ratio and the SPECT L/NL and L/CW ratios provide better diagnostic accuracies for detecting breast cancer than the planar L/CW ratio did (p<0.05). From the qSMM (mean), which was an arithmetic mean of the planar L/NL, ratio the SPECT L/NL ratio and the SPECT L/CW ratio, the sensitivity, the specificity, the positive predictive value, the negative predictive value, and the accuracy were 84%, 77%, 84%, 77%, and 81%, respectively. Presence of axillary lymph-node metastasis showed a higher qSMM (mean) value (4.09 {n=17} vs 3.09 {n=28}, p=0.06). CONCLUSIONS: qSMM (mean) is a useful objective method for differentiating malignant from benign breast lesions.