ABSTRACT
Abstract The present paper reports on the local treatment of breast cancer from a historical perspective. A search for articles written in English was made in the Medline and EMBASE databases, and 40 papers were selected. Over the past 10 years, various randomized, controlled clinical trials on the local treatment of breast cancer indicated that patients with the samemolecular subtypemay receive different individualized surgical treatments aimed atoptimizing systemic adjuvant therapy. With a view to retaining the gainsmade in diseasefree and overall survival, surgical techniques have advanced from radical surgery to conservative mastectomies, thus reducing sequelae, while adjuvant and neoadjuvant therapies have contributed toward controlling the disease, both distant metastases and local recurrence. Current studies evaluate whether future breast cancer therapy may even succeed in eliminating surgery to the breast and axilla altogether.
Resumo Este artigo discute o tratamento local do câncer de mama a partir de uma perspectiva histórica. Uma busca de artigos publicados em inglês foi realizada nas bases de dados Medline e EMBASE, sendo selecionados 40 artigos. Nos últimos 10 anos, vários ensaios clínicos controlados e randomizados sobre o tratamento local do câncer de mama indicaram que pacientes com o mesmo subtipo molecular podem receber diferentes tratamentos cirúrgicos individualizados como objetivo de otimizar a terapia adjuvante sistêmica. Pretendendo reter os ganhos obtidos na sobrevida livre de doença e na sobrevida global, as técnicas cirúrgicas avançaram progressivamente da cirurgia radical para mastectomias conservadoras, reduzindo sequelas, enquanto as terapias adjuvantes e neoadjuvantes contribuíram para o controle da doença, tanto em relação às metástases distantes quanto à recorrência local. Estudos atuais avaliam se a terapia futura contra o câncer de mama poderá até mesmo eliminar a cirurgia da mama e da axila por completo.
Subject(s)
Humans , Female , Breast Neoplasms/therapy , Mastectomy, Segmental , Chemotherapy, Adjuvant , Neoadjuvant Therapy , Randomized Controlled Trials as TopicABSTRACT
RESUMO OBJETIVO: Investigar alterações no consumo dietético, bem como a influência das características gerais, dos fatores sociodemográficos, clínicos e nutricionais, e do tratamento antineoplásico sobre as mudanças do consumo energético, em mulheres do sul do Brasil, antes e após a realização de terapia adjuvante para o câncer de mama. MÉTODOS: Ensaio clínico não randomizado, conduzido em hospital da rede pública de saúde, com 53 pacientes. Informações dietéticas foram coletadas com questionário de frequência alimentar. Para avaliar os fatores que influenciaram alterações longitudinais da ingestão energética, usou-se modelo de regressão linear de efeitos mistos. RESULTADOS: Houve aumento significativo no consumo diário de energia, de gorduras, cálcio, ferro, cobre, ácidos graxos poli-insaturados, ômega 6 e ômega 3, e uma diminuição significativa da vitamina B2. O modelo final de regressão mostrou aumento médio de 19,2 kcal/mês. As maiores associações com ingestão energética foram frutas e leguminosas, sendo que cada 100 g de consumo destas, resultou um acréscimo médio de 68,4 e 370,5 kcal, respectivamente. Mulheres com idade compreendida entre 51 e 60 anos consumiram 403,5 kcal menos do que aquelas com idade de 31 a 50 anos. CONCLUSÃO: Observou-se que houve aumento na ingestão energética durante o tratamento e que o aumento na ingestão de frutas e leguminosas foi associado com aumentos significativos na ingestão de energia.
PURPOSE: To investigate changes in the dietary consumption as well as the influence of the general characteristics, of the sociodemographic, clinical and nutritional factors, and of the antineoplastic therapy on the changes in the energy intake of women from southern Brazil, before and after adjuvant therapy for breast cancer. METHODS: A non-randomized clinical study was conducted on 53 patients at a hospital of the public health network. Dietary information was collected with a food frequency questionnaire. A mixed-effects linear regression model was used to evaluate the factors that influenced longitudinal alterations of energy intake. RESULTS: A significant increase was observed in daily energy intake of fats, calcium, iron, copper, polyunsaturated fatty acids, omega 6 and omega 3, and a significant decrease in vitamin B2 intake. The final regression model for the change in energy intake showed an average increase of 19.2 kcal/month. Fruit and legume consumption showed the highest association with energy intake, with each 100 g consumed resulting in an average increase of 68.4 and 370.5 kcal, respectively. Women in the 51 to 60 year age range consumed 403.5 kcal less than those in the 31 to 50 year age range. CONCLUSION: There was an increase in energy intake during treatment and the increase in the ingestion of fruits and legumes was associated with significant increases in energy intake.
Subject(s)
Adult , Female , Humans , Middle Aged , Breast Neoplasms/therapy , Energy Intake , Retrospective StudiesABSTRACT
Objective To explore the suppressive effect of survivin antisense oligonucleotide on transplanted human breast cancer in nude mice. Methods 30 nude mice were transplanted with human breast cancer MCF-7 cells to construct tumor models, which were divided into three groups (10 mice per group): (Lipofectin), ASODN/Lip, and NODN/Lip were injected in to the tumor or around the tumor, respectively. A total of 3 injections were given, once every five days. Observations were made on tumor suppression rate, tumor volume and changes in weight of the animals. TUNEL method and transmission electron microscopy were used to investigate cell apoptosis of the tumor; western blot was used to detemine the expression of survivin protein in the 3 groups. Results The subcutaneous tumor model in nude mice was successfully established. The tumor volume in the group of ASODN/Lip decreased during treatment, the rate of tumor suppression reached 70.10%; while the tumor volume of the other two groups increased. There was no statistical (difference) among the groups in weight changes of the 3 groups mice, the apoptosis rate in ASOND/Lip group was 38.6% detected by TUNEL and the rate was markedly higher than the other two groups(P