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1.
Medwave ; 24(9): e2801, 30-10-2024.
Article in English, Spanish | LILACS-Express | LILACS | ID: biblio-1585361

ABSTRACT

Introducción La progresión del cáncer de mama involucra mecanismos fisiológicos como metástasis. Los retrasos en diagnóstico y tratamiento aumentan el riesgo de mortalidad y se asocian a barreras de acceso a la salud. En Chile, el cáncer de mama es altamente prevalente y su diagnóstico temprano ha mejorado, aunque persisten disparidades en el proceso de enfermedad. Este estudio caracterizó exámenes de diagnóstico y etapificación, tiempos de espera y perfiles sociodemográficos para identificar demoras e inequidades en la atención. Métodos Estudio de encuesta. Utilizando una muestra no probabilística, se aplicó un cuestionario en plataforma encriptada previo consentimiento informado. En el instrumento se recogieron datos de exámenes solicitados, tiempos asociados, etapificación y características sociodemográficas. Estas variables fueron analizadas utilizando estadística descriptiva, test de asociación, intervalos de confianza y test de comparación utilizando . Resultados Se logró una muestra de 263 personas. Los exámenes más solicitados fueron biopsia (99,62%) y exámenes de sangre (80,23%). La mediana de exámenes solicitados fue de 6 (Q1:4, Q3:8), con media 5,87 (desviación estándar: 2,24). No se observaron diferencias significativas en el porcentaje de personas a quienes se solicitó la totalidad de exámenes según variables estudiadas. Los intervalos día-hora-resultado oscilaron entre 1 y 365 días. La mediana día-hora-resultado de la biopsia fue de 15 días (Q1:10, Q3:30). Las personas entre 40 y 49 años, no residentes de la capital, pertenecientes al quintil I de ingreso, con educación media, del sistema público de salud, con diagnóstico en etapa tardía presentaron mayores medianas de día-hora-resultado en biopsia. No hubo diferencia significativa en la cantidad de exámenes solicitados según etapificación (I a II y III a IV). Conclusiones La biopsia en Chile es el examen de elección para la confirmación diagnóstica en cáncer de mama. Otros exámenes son solicitados independientemente de la etapa del diagnóstico, existiendo una discordancia con las recomendaciones de la guía clínica. El pronóstico del cáncer es crucial, especialmente en países con mayores inequidades.


Introduction Breast cancer progression involves physiological mechanisms such as metastasis. Delays in diagnosis and treatment increase the risk of mortality and are associated with barriers to healthcare access. In Chile, breast cancer is highly prevalent, and early diagnosis has improved, although disparities in the disease evolution persist. This study characterized diagnostic and staging tests, waiting times, and sociodemographic profiles to identify delays and inequities in care. Methods Survey study. Using a non-probabilistic sample, a questionnaire was applied in an encrypted platform with prior informed consent. The instrument collected data on requested tests, associated times, staging, and sociodemographic characteristics. These variables were analyzed using descriptive statistics, tests of association, confidence intervals, and comparison tests using bootstrapping. Results A sample of 263 persons was obtained. The most requested tests were biopsy (99.62%) and blood tests (80.23%). The median number of tests requested was six (Q1:4, Q3:8), with a mean of 5.87 (standard deviation: 2.24). No significant differences were observed in the percentage of persons from whom the total number of examinations were requested according to the studied variables. The day-hour-result intervals ranged from 1 to 365 days. The median day-hour-result of the biopsy was 15 days (Q1:10, Q3:30). People between 40 and 49 years old, non-residents of the capital city, belonging to income quintile I, with high school education, from the public health system, with late-stage diagnosis had higher median day-hour-result in biopsy. There was no significant difference in the number of requested tests according to staging (I and II, or III and IV). Conclusions Biopsy in Chile is the test of choice for diagnostic confirmation in breast cancer. Other tests are requested regardless of the diagnosis stage, contrary to the recommendations of clinical guidelines. Cancer prognosis is crucial, especially in countries with greater inequalities.

2.
J Cancer Res Ther ; 2024 Sep; 20(5): 1390-1393
Article | IMSEAR | ID: sea-238245

ABSTRACT

Aim: Carcinogenesis is associated with multiple mutations that lead to chromosomal instability (CIN). Our aim was to study the role of markers of CIN on breast cytology and correlate with histopathological diagnosis. Materials and Methods: A retrospective observational study was conducted over a year on 100 breast cytology cases. Leishman?stained smears were examined for the number of micronuclei (MN), chromatin bridge (CB), and multipolar mitosis (MPM). MNs were counted manually in 1,000 cells under oil immersion (1000×). The frequency of CB and MPM was also noted. The malignant cases were graded as low (grades 1 and 2) and high (grade 3). Results: The mean age of the patients was 43.47 ± 15.81 years. The mean MN score for fibroadenoma cases was 4.54 (±1.5) and for malignant cases was 29.32 (±8.15). The receiver?operator curve (ROC) curve analysis confirmed >9 MN score as 100% specific and 100% sensitive for malignancy (area under the curve [AUC] =1). A significant comparison was noted between the mean MN of benign and malignant cases (P < 0.000001). The mean MN score for low?grade cases was 26.64 (±5.85) and for high?grade cases was 33.68 (±5.85) with a significant difference observed on comparing the population mean MN with a grade of malignancy (P?value = 0.01886). The difference between the frequencies of CB in low and high?grade cases was also found to be significant (P?value = 0.04135). Conclusion: The presence and scoring of markers of CIN (MN, CB, and MPM) on breast cytology have potential significance in the diagnosis of breast lesions.

3.
J Cancer Res Ther ; 2024 Aug; 20(4): 1314-1322
Article | IMSEAR | ID: sea-238233

ABSTRACT

Objective: This retrospective study is to explore the risk factors and prognostic factors of brain metastases of triple?negative breast cancer (TNBC) in a single center. Methods: Clinical data of patients with stages I–III TNBC were collected. The Kaplan?Meier method, log?rank test, and stepwise COX regression were performed. Results: The 437 patients with stages I–III TNBC were followed up for five years. Among them, 89 cases (20.4%) developed brain metastases, and they were followed up for 2 years after brain metastasis. The cumulative brain metastasis rates of TNBC patients at six months, one year, two years, three years, and five years were 1.38%, 5.75%, 12.94%, 17.63%, and 21.26%, respectively. Multivariate analysis suggested that the first diagnosis age ?35 years old, advanced pathological stage, lymph node metastasis, and Ki?67 ?30% represented the risk factors for brain metastasis. In contrast, the surgical method was a protective factor for brain metastasis. The median survival time after brain metastasis was 4.87 months. The survival rates at one, three, six, 12, and 24 months were 84.27%, 60.67%, 34.83%, 15.69%, and 6.64%, respectively. The age >60 years at first diagnosis, Ki?67 ?30%, local recurrence, and distant metastasis were closely related to the poor prognosis of TNBC patients with brain metastases, while radiotherapy alone, systemic therapy, and combined chemotherapy and radiotherapy represented the prognostic protective factors. Conclusions: Patient age, Ki?67 level, metastasis, and treatment methods are the risk factors and prognostic factors for brain metastasis of TNBC. Surgical resection of the primary lesion during the first treatment is essential to reduce the incidence of brain metastases. Close postoperative follow?up (such as brain magnetic resonance imaging [MRI]) within 2–3 years after surgery is recommended to improve the prognosis.

4.
An. Fac. Med. (Perú) ; 85(3): 329-333, jul.-set. 2024. graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1581621

ABSTRACT

RESUMEN El cáncer de mama es una neoplasia poco frecuente en hombres y representa el 1% de todos los cánceres de mama. Su baja prevalencia y el limitado conocimiento de los médicos sobre esta enfermedad genera un diagnóstico en estadios avanzados. Presentamos el caso de un paciente varón de 44 años, con tumor en región esternal, de larga duración, cuya demora en el diagnóstico clínico e histopatológico favoreció la progresión de la enfermedad a nivel axilar derecho, retrasando su tratamiento. Recibió radioterapia y quimioterapia adyuvante, al igual que terapia con trastuzumab, con buena tolerabilidad.


ABSTRACT Breast cancer is a rare neoplasm in men and represents 1% of all breast cancers. Its low prevalence and the limited knowledge of physicians about this disease generates a diagnosis in advanced stages. We present the case of a 44-year-old male patient with a long-lasting tumor in the sternal region, whose delayed clinical and histopathological diagnosis favored the progression of the disease to the right axillary region, delaying his treatment. He received radiotherapy and adjuvant chemotherapy, as well as trastuzumab therapy, with good tolerability.

5.
Rev. Fac. Med. Hum ; 24(3): 113-121, jul.-set. 2024. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1583221

ABSTRACT

RESUMEN Introducción: El cáncer de mama sigue siendo uno de los cánceres más frecuentes a nivel global, específicamente, el más frecuente en el sexo femenino. El uso de inteligencia artificial promete contribuir al diagnóstico precoz, a través de la imagenología. Previamente, no se ha descrito el panorama y avance de esta producción científica. Métodos: Estudio bibliométrico de corte transversal, que usó Scopus como fuente de datos. Se utilizó el paquete bibliometrix de R para el cálculo de indicadores bibliométricos y visualización de los resultados. Resultados: Se seleccionaron 1292 documentos, publicados entre 1989 y 2024. El 75,3% (n=973) fueron artículos con datos primarios, seguido de un 16,2% (n=209) correspondiente a revisiones. Se identificó una colaboración internacional del 26,5%, y un crecimiento anual de la producción del 10,78%. Se observó que, la clasificación de riesgo por screening, tomosíntesis digital de la mama, aprendizaje por transferencia, segmentación y selección por características, son las palabras clave más comúnmente usadas. En los últimos cinco años, el aprendizaje profundo y la mamografía, han sido los temas con mayor popularidad. La colaboración internacional, ha sido liderada por Estados Unidos, China y Reino Unido. Conclusiones: Se identificó un crecimiento notable en la investigación global sobre el uso de inteligencia artificial en imagenología para la detección de cáncer de mama, marcado a partir de la década del 2010, esencialmente por medio de publicación de artículos con datos primarios. La relación entre inteligencia artificial e imagenología para diagnóstico de cáncer de mama, se ha centrado en riesgo y predicción.


ABSTRACT Introduction: Breast cancer remains one of the most prevalent cancers globally, specifically the most common in females. The use of artificial intelligence promises to contribute to early diagnosis through imaging. Previously, the landscape and evolution of this scientific production have not been described. Methods: Cross-sectional bibliometric study using Scopus as the data source. The bibliometrix package in R was employed for calculating bibliometric indicators and visualizing the results. Results: 1292 documents published between 1989 and 2024 were selected. 75.3% (n=973) were articles with primary data, followed by 16.2% (n=209) corresponding to reviews. An international collaboration rate of 26.5% was identified, with an annual production growth of 10.78%. It was observed that risk classification through screening, digital breast tomosynthesis, transfer learning, segmentation, and feature selection were the most commonly used keywords. In the last five years, deep learning and mammography have been the most popular topics. International collaboration has been led by the United States, China, and the United Kingdom. Conclusion: A notable growth in global research on the use of artificial intelligence in breast cancer imaging for detection was identified, particularly since the 2010s, primarily through the publication of articles with primary data. The relationship between artificial intelligence and imaging for breast cancer diagnosis has focused on risk and prediction.

6.
Article in English, Portuguese | LILACS-Express | LILACS | ID: biblio-1572257

ABSTRACT

Introduction: breast cancer has been the leading cause of death among women in Brazil and worldwide. During the years of social isolation due to COVID-19, health services, including breast cancer screening, were suspended in an attempt to contain the spread of the virus, interfering with the early detection and treatment of breast cancer, effective means of reducing mortality. Objective: to identify how the COVID-19 pandemic has interfered with the therapeutic itinerary for breast cancer in Brazilian regions. Method: this is an observational, ecological study, carried out through secondary analysis of data available on the website of the Department of Informatics of the Unified Health System (DATASUS). Results: information was collected from all screening bilateral mammography exams in women aged 50 to 69 years, positive cases, and therapeutic modalities from 2018 to 2022. The data showed that the pandemic impacted Brazilian regions differently, requiring different strategies and investments to ensure access to health services and minimize the impacts of the pandemic. Conclusion: although the survey did not show statistically significant results, the southeast region stood out in the registration of cases, but shows a drop-in case registered between 2021 and 2022. On the other hand, the northern region had the lowest number of cases in all years.


Introdução: o câncer de mama tem sido a principal causa de morte entre mulheres no Brasil e no mundo. Durante os anos de isolamento social devido à COVID-19, serviços de saúde, incluindo o rastreamento do câncer de mama, foram suspensos na tentativa de conter a disseminação do vírus, interferindo na detecção e tratamento precoce do câncer de mama, meios efetivos para redução de mortalidade. Objetivo: Identificar como a pandemia de COVID-19 interferiu no itinerário terapêutico do câncer de mama nas regiões brasileiras. Método: Trata-se de um estudo observacional, de caráter ecológico, realizado através de análise secundária de dados disponíveis no site do Departamento de Informática do Sistema Único de Saúde (DATASUS). Resultado: Foram coletadas informações da realização de todos os exames de mamografia bilateral de rastreamento em mulheres de 50 a 69 anos de idade, casos positivos e modalidades terapêuticas no período de 2018 a 2022. Os dados mostraram que a pandemia impactou de forma diferente as regiões brasileiras exigindo estratégias e investimentos diversos para garantir o acesso aos serviços de saúde e minimizar os impactos da pandemia. Conclusão: Apesar da pesquisa não apresentar resultados estatisticamente significantes, a região sudeste se destacou no registro de casos, mas apresenta uma queda de casos registrados entre 2021 e 2022. Em contrapartida, a região norte apresentou os menores números de casos em todos os anos.

7.
Invest. educ. enferm ; 42(2): 45-57, 20240722. tab
Article in English | LILACS, BDENF, COLNAL | ID: biblio-1567285

ABSTRACT

Objective. To analyze whether the COVID-19 pandemic had an impact on the screening, diagnosis and treatment of breast cancer in women up to 50 years of age in the state of Pará. Methods. Retrospective, cross-sectional study with a quantitative approach, using data from the Information Technology Department of the Brazilian Unified Health System. (DATASUS). The number of exams carried out in the pre-pandemic (2018-2019) and pandemic (2020-2021) period was analyzed based on the percentage variation, application of the chi-square test and G test for the time of exams and start time of treatment. Results. During the pandemic period, there was a greater number of screening mammograms (+3.68%), cytological (+23.68%), histological (+10.7%) and a lower number of diagnostic mammograms (-38.7%). The time interval for carrying out the exams was up to 30 days for screening and diagnostic exams and more than 60 days to start treatment during the pandemic period. Conclusion. Although the results indicate an increase in the number of screening and diagnostic procedures for breast cancer during the pandemic period, with the exception of diagnostic mammography, when considering probability values, the study points out that statistically the COVID-19 pandemic did not interfere with actions of breast cancer, in women over 50 years of age, in the state of Pará. Considering the autonomy of nursing and its role in public health, it is up to the professionals who are in charge of primary care programs to implement contingency plans in periods of crisis so that the population is not left unassisted.


Objetivo. Analizar si la pandemia de COVID-19 tuvo impacto en el tamizaje, diagnóstico y tratamiento del cáncer de mama en mujeres de 50 años y más del Estado do Pará-Brasil. Métodos. Estudio retrospectivo, transversal, con abordaje cuantitativo, en el que se utilizaron los datos del Departamento de Informática del Sistema Único de Salud de Brasil (DATASUS). Se comparó el número de exámenes realizados y el tiempo para el inicio de tratamiento en los períodos prepandémico (2018-2019) y pandémico (2020-2021). Resultados. Se observó un mayor número de mamografías de cribado (+3.68%), citologías (+23.68%) e histologías (+10.7%) y un menor número de mamografías diagnósticas (-38.7%) en el período pandémico. El tiempo para la realización de las pruebas fue de hasta 30 días para el cribado y diagnóstico y de más de 60 días para el inicio del tratamiento durante el período pandémico. Conclusión. Aunque los resultados indican un aumento del número de procedimientos de cribado y diagnóstico del cáncer de mama en el periodo pandémico, con la excepción de la mamografía diagnóstica, cuando consideramos los valores de p) el estudio muestra que la pandemia COVID-19 estadísticamente no interfirió en las acciones preventivas contra el cáncer de mama en mujeres de 50 años y más en el estado de Pará. Teniendo en cuenta la autonomía de la enfermería y su papel en la salud pública, corresponde a los profesionales responsables de los programas de atención primaria implementar planes de contingencia en tiempos de crisis para no dejar desatendida a la población.


Objetivo. Analisar se a pandemia da COVID-19 repercutiu no rastreamento, diagnóstico e tratamento do câncer de mama em mulheres paraenses a partir de 50 anos. Métodos. Estudo retrospectivo, transversal, de abordagem quantitativa, com utilização de dados do Departamento de Informática do Sistema Único de Saúde brasileiro. (DATASUS). Analisou-se o número de exames realizados no período pré-pandemia (2018-2019) e pandêmico (2020-2021) com base na variação percentual, aplicação do teste qui quadrado e teste G para o tempo de realização de exames e tempo de início de tratamento. Resultados. Observou-se no período pandêmico maior quantitativo de mamografias de rastreamento (+3.68%), citológicos (+23.68%), histológicos (+10.7%) e menor registro de mamografias diagnósticas (-38.7%). O intervalo de tempo para realização dos exames foi de até 30 dias para os exames de rastreamento e diagnóstico e tempo maior que 60 dias para início de tratamento no período pandêmico. Conclusão. Embora os resultados indiquem aumento no quantitativo de procedimentos de rastreamento e diagnósticos para o câncer de mama no período pandêmico, com exceção da mamografia diagnóstica, ao considerarmos os valores de probabilidade, o estudo aponta que estatisticamente a pandemia da COVID-19 não interferiu nas ações do câncer de mama, em mulheres a partir de 50 anos, no Estado do Pará. Considerando a autonomia da enfermagem e sua atuação na saúde pública, cabe aos profissionais que estão à frente dos programas da atenção básica implementar planos de contingência em períodos de crise para que a população não fique desassistida.


Subject(s)
Humans , Male , Female , Breast Neoplasms , Mammography , Breast Carcinoma In Situ , SARS-CoV-2 , COVID-19
8.
Rev. bras. cir. plást ; 39(2): 1-5, abr.jun.2024. ilus
Article in English, Portuguese | LILACS-Express | LILACS | ID: biblio-1556481

ABSTRACT

Introdução: A reconstrução mamária pós-tratamento cirúrgico do câncer de mama (um dos principais cânceres que acometem as mulheres) tem sido progressivamente mais indicada, haja vista o benefício da recuperação psicológica e da qualidade de vida, seja utilizando implantes e/ou tecidos autólogos. O presente trabalho visa demonstrar a experiência da equipe, discutir técnicas operatórias e complicações em relação aos dados da literatura mundial, além de verificar a aplicabilidade da técnica na prática clínica da equipe. Método: Estudo observacional retrospectivo desenvolvido em hospital universitário em Juiz de Fora a partir da revisão de prontuários de pacientes submetidas a mastectomia com reconstrução mamária entre 2010 e 2020. Resultados: Das 860 mamas abordadas, 84% foram imediatas à cirurgia oncológica e 16% foram tardias; o principal acesso ao tecido mamário foi a incisão de Stewart, seguido de incisões inframamárias estendidas, periareolares e T invertido; quanto às técnicas reconstrutoras, destaca-se 35% dos casos com retalho com músculo grande dorsal, 25% com prótese pré-peitoral, 20% com retalho miocutâneo transverso do músculo reto abdominal e 10% com retalho muscular local. As complicações mais incidentes foram deiscência de sítio cirúrgico, seguida de necrose cutânea, seroma, infecção de sítio cirúrgico e hematoma, além de outros menos comuns como dor crônica e ruptura de prótese após mamografia. Conclusão: A reconstrução mamária pós-mastectomia é indispensável para a recuperação física e emocional da mulher, sendo as técnicas utilizadas nos últimos dez anos consistentes, confiáveis, de baixa morbidade e com ótimos resultados estéticos quando bem indicadas.


Introduction: Breast reconstruction after surgical treatment for breast cancer (one of the main cancers that affect women) has been progressively more recommended, given the benefits of psychological recovery and quality of life, whether using implants and/or autologous tissues. The present work aims to demonstrate the team's experience, and discuss operative techniques and complications concerning data from the world literature, in addition to verifying the applicability of the technique in the team's clinical practice. Method: Retrospective observational study developed at a university hospital in Juiz de Fora based on a review of medical records of patients who underwent mastectomy with breast reconstruction between 2010 and 2020. Results: Of the 860 breasts treated, 84% underwent immediate oncological surgery and 16% were late; the main access to the breast tissue was the Stewart incision, followed by extended inframammary, periareolar, and inverted T incisions; regarding reconstructive techniques, 35% of cases used a latissimus dorsi muscle flap, 25% used a prepectoral prosthesis, 20% used a transverse rectus abdominis myocutaneous flap and 10% used a local muscle flap. The most common complications were surgical site dehiscence, followed by skin necrosis, seroma, surgical site infection, and hematoma, in addition to other less common complications such as chronic pain and prosthesis rupture after mammography. Conclusion: Postmastectomy breast reconstruction is essential for a woman's physical and emotional recovery, with the techniques used in the last ten years being consistent, reliable, with low morbidity, and with excellent aesthetic results when correctly indicated.

9.
Medicina (B.Aires) ; Medicina (B.Aires);84(2): 227-235, jun. 2024. graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1564777

ABSTRACT

Resumen Introducción : El endofenotipo de cáncer de mama triple negativo (TNBC) es uno de los menos frecuentes y sin diana terapéutica, por tanto, se plantea estudiar la correlación del punto de control inmunológico PD-L1 con el establecimiento de microambiente tumoral evaluado por la infiltración linfocitaria intratumoral estromal (TILs) y su importancia en la práctica clínica. Métodos : Se realizó un estudio retrospectivo de casos y controles, con 31 casos de carcinoma infiltrante de la mama triple negativo y 57 controles no pareados de endofenotipo Luminal A, Luminal B y HER-2 atendidos en un año. Se evaluaron las variables: tipo y grado his tológico, expresión PD-L1 con el clon 22C3, TILs, invasión linfovascular, tamaño tumoral, compromiso de ganglios linfáticos y metástasis. El análisis estadístico se ejecutó con la prueba de chi cuadrado y prueba de coeficiente de correlación de Spearman. Resultados : Se encontró una correlación negativa estadísticamente significativa entre TILs y PD-L1 (rho - 0.106, p 0.025), indicando que a mayor expresión de PD-L1, es menor la infiltración linfocitaria intratumo ral. En los grupos de TILs B (10-40% TILs) y C (40-90% TILs) donde se presenta marcado infiltrado inflamatorio intratumoral se evidenció mayor número de pacientes negativos para PD-L1 (CPS <10) con 16 y 10 casos res pectivamente. Para los casos TNBC se logró identificar un coeficiente de asociación negativa (rho -0.378) y con significancia estadística (p 0.01). Discusión : Se estableció la asociación de TNBC, TILs y expresión de PDL1, lo cual es importante para la instau ración de terapias diana y el desarrollo de la medicina de precisión.


Abstract Introduction : Triple negative breast cancer endophe notype (TNBC) is one of the least frequent and without therapeutic target; therefore we propose to study the correlation of PD-L1 immune checkpoint with the es tablishment of tumor microenvironment assessed by intratumoral stromal lymphocyte infiltration (TILS) and its importance in clinical practice. Methods : A retrospective case-control study was performed, with 31 cases of triple-negative infiltrat ing breast carcinoma and 57 unmatched controls of Luminal A, Luminal B and HER-2 endophenotype seen in one year. The following variables were evaluated: histologic type and grade, PD-L1 expression with clone 22C3, TILS, lymphovascular invasion, tumor size, lymph node involvement and metastasis. Statistical analysis was performed with the chi-square test and Spearman correlation coefficient test. Results : a statistically significant negative correlation was found between TILS and PD-L1 (rho - 0.106, p 0.025), indicating that the higher the expression of PD-L1, the lower the intratumoral lymphocytic infiltration. In the TILS B (10-40% TILS) and C (40-90% TILS) groups where there was a marked intratumoral inflammatory infiltrate, a greater number of patients were negative for PD-L1 (CPS <10) with 16 and 10 cases, respectively. For TNBC cases a negative association coefficient was identified (rho -0.378) with statistical significance (p 0.01). Discussion : The association between TNBC, TILS and PDL1 expression was established, which is important for the establishment of target therapies and the develop ment of precision medicine.

10.
ABCS health sci ; 49: e024202, 11 jun. 2024. tab, graf
Article in English | LILACS | ID: biblio-1555494

ABSTRACT

INTRODUCTION: Breast cancer is one of the main causes of death in women. Luminal tumors A and B show good response with hormonal treatments, tumors that overexpress HER-2 can be treated with monoclonal antibodies, whereas triple negative tumors have few treatments available because they present low or absent expression of hormone receptors and HER-2, in addition, they present worse tumor progression. Syndecans are heparan sulfate proteoglycans that have the function of interacting with growth factors, cytokines, and extracellular matrix, thus modulating important processes in tumor progression. OBJECTIVE: Analyze the expression of syndecan-4 in different subtypes of breast tumors. METHODS: Bioinformatics is a useful tool for the study of new biomarkers. In the present study, the TCGA database (514 patients) and Metabric (1,898 patients) were analyzed using the cBioportal software. Gene expression data were analyzed by RNA-Seq and Microarray from biopsies of breast tumors. RESULTS: An alteration in syndecan-4 gene expression was observed among the different subtypes of breast tumors. Patients with a triple-negative tumor had decreased expression for syndecan-4 in both databases. CONCLUSION: Syndecan-4 is a potential biomarker for breast tumor prognosis since decreased expression of syndecan-4 is related to triple-negative breast cancer.


INTRODUÇÃO: O câncer de mama corresponde a uma das principais causas de morte em mulheres. Os tumores luminais A e B apresentam boa resposta com tratamentos hormonais, os tumores que superexpressam HER-2 podem ser tratados com anticorpos monoclonais, já os tumores triplo-negativos apresentam poucos tratamentos disponíveis por apresentarem expressão baixa ou ausente dos receptores hormonais e HER-2, além de pior progressão tumoral. Os sindecans são proteoglicanos de heparam sulfato que tem função de interagir com fatores de crescimento, citocinas e matriz extracelular, modulando assim processos importantes na progressão tumoral. OBJETIVO: Analisar a expressão o sindecam-4 nos diferentes subtipos de tumores de mama. MÉTODOS: A bioinformática vem se mostrando útil para estudo de novos biomarcadores. No presente estudo, foi analisado o banco de dados TCGA (514 pacientes) e Metabric (1898 pacientes) utilizando o software cBioportal. Foram analisados os dados de expressão gênica por RNA-Seq e Microarray. RESULTADOS: Foi verificada alteração de expressão gênica do sindecam-4 entre os diferentes subtipos de tumores de mama. Pacientes com tumor triplo-negativo tiveram a expressão diminuída para sindecam-4 em ambos os bancos de dados. CONCLUSÃO: Foi verificado que sindecam-4 parece ser um potencial biomarcador em tumores de mama, a expressão diminuída de sindecam-4 parece estar relacionada a um pior prognóstico.


Subject(s)
Humans , Breast Neoplasms , Biomarkers, Tumor , Gene Expression , Syndecan-4 , Computational Biology
11.
Rev. colomb. obstet. ginecol ; 75(2): 4187, Apr.-June 2024. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1583575

ABSTRACT

RESUMEN Objetivos: Presentar un caso de una lesión en mama de origen metastásico a partir de un adenocarcinoma gástrico de células en anillo de sello (AGCES), y hacer una revisión sistemática (RS) de la literatura sobre la epidemiología, el diagnóstico, tratamiento y pronóstico de las pacientes con este tipo de lesiones mamarias. Materiales y métodos: Se reporta el caso de una paciente que acudió a una institución de referencia y alta complejidad en Bogotá por un nódulo en mama derecha. La paciente tenía el antecedente de un AGCES tratado quirúrgicamente, con quimioterapia y radioterapia adyuvante, tres años atrás. Se identificaron adenopatías axilares bilaterales. La biopsia del nódulo reportó un adenocarcinoma con patrón de células en anillo de sello. Posteriormente, por medio de la tomografía por emisión de positrones, se identificaron metástasis en otras localizaciones. La paciente falleció a los 10 meses. Se realizó una RS de la literatura, incluyendo estudios de cohorte, reportes y series de casos de pacientes con AGCES metastásico a la mama, que presentaran información sobre la epidemiología, las características clínicas, radiológicas e histopatológicas, el tipo de tratamiento recibido y pronóstico de esta enfermedad. Resultados: Se identificaron 363 referencias, de las cuales 26 cumplieron los criterios de elegibilidad. El AGCES metastásico a la mama predominó en el continente asiático (75,9 %). La edad media de presentación fue de 42,5 años. En el 62 % de los casos esta condición se manifestó clínicamente como un nódulo mamario. Desde el punto de vista radiológico, la mayoría de las lesiones mamarias se presentaron como uno o varios nódulos de características sospechosas (55,2 %). En la biopsia de las lesiones mamarias, la positividad para citoqueratina 7 y citoqueratina 20 ocurrió en el 41,4 % y 37,9 % de los casos, respectivamente. Solo el 31 % de las pacientes fueron llevadas a algún tipo de cirugía de mama. Falta información sobre el tratamiento y pronóstico del AGCES metastásico a la mama. Conclusiones: Toda paciente con antecedente de cáncer que presente un nódulo o cambios clínicos en la mama debe ser llevada a una biopsia mamaria para descartar secundarismo. Es importante realizar más estudios prospectivos sobre este tipo de presentación del AGCES para definir los efectos del tratamiento y el pronóstico de este subgrupo de pacientes.


ABSTRACT Objectives: To determine the general state of scientific evidence published in the last 20 years on gastric signet ring cell (SRC) adenocarcinoma metastatic to the breast, and present a case. Materials and methods: The case of a patient who attended a high-complexity reference institution in Bogotá for a breast metastasis from a gastric SRC adenocarcinoma is reported. A Systematic Review of the literature was carried out, including cohort studies, reports and case series of patients with gastric SRC adenocarcinoma metastatic to the breast, which will present information on the epidemiology, clinical, radiological and histopathological characteristics, and the treatment and prognostic of this disease. Results: There were identified 363 references, twenty-six of which met the eligibility criteria. Gastric SRC adenocarcinoma metastatic to the breast predominated in the Asian continent (75.9%). The mean age at presentation was 42.5 years. In 62% (n=18) of cases this condition manifested clinically as a breast mass. From a radiological point of view, the majority of breast lesions presented as one or several nodules with suspicious characteristics (55.2%; n=16). In the biopsy of breast lesions, positivity for cytokeratin 7 and cytokeratin 20 occurred in 41.4% (n=12) and 37.9% (n=11) of cases, respectively. Only nine patients (31%) underwent any type of breast surgery. There is a lack of information on the treatment and prognosis of gastric SRC adenocarcinoma metastatic to the breast. Conclusions: The frequency of cases of gastric SRC adenocarcinoma metastatic to the breast published in the last 20 years is low. The general practitioner and the gynecologist could be the first medical professionals to face this rare condition, so knowing it and suspecting it is essential, especially if we take into account that the median overall survival of these patients is low.

12.
Estud. Interdiscip. Envelhec. (Online) ; 29: 1-16, maio.2024. tab
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1586065

ABSTRACT

Avaliar os efeitos de um programa de exercícios físicos domiciliares na qualidade de vida de idosas com câncer de mama em tratamento com hormonioterapia. Ensaio clínico randomizado, com 75 idosas com câncer de mama, realizado em um Hospital Geral do Recife, Brasil, de abril a novembro de 2015. Para um programa de exercícios físicos domiciliares, durante 12 semanas, foram alocadas 38 idosas (GI: Grupo Intervenção) e 37 (GC: Grupo Controle). Um manual de exercícios físicos e DVD foram previamente desenvolvidos e distribuídos. Foi utilizado o questionário EORTC-QLQ-C30 para avaliação da qualidade de vida. Nos resultados, foi observada após 12 semanas, melhora da qualidade de vida global nas idosas inseridas no GI, e piora nas do GC. Em relação à escala de domínios funcionais, foram observadas diferenças estatisticamente significativas intergrupos (p<0.01), com melhora para o GI emtodos os domínios analisados. Verificou-se melhora intragrupo (p<0.01) nas pacientes do GI referentes as funções física, emocional e social. O GC apresentou piora estatisticamente significativa intragrupo (p<0.01) para as escalas funcionais física, desempenho de papeis e emocional. Observou-se melhora estatisticamente significativa intergrupos para as pacientes inseridas no GI (p<0.01) para todos os sintomas analisados. Melhora intragrupo nos sintomas referidos pelas pacientes do GI (p<0.01), relacionados à fadiga, náusea, dor, perda de apetite e constipação, e piora dos sintomas (p<0.01) para as idosas do GC relacionado à fadiga e dor. Como conclusão, o programa de exercícios físicos domiciliares mostrou eficácia para melhorar a qualidade de vida em idosas com câncer de mama em tratamento.(AU)


Evaluate effects of a program of physical exercises at home on the quality of life of elderly women with breast cancer undergoing with hormone therapy treatment. Randomized clinical trial, with 75 elderly women with breast cancer, carried out at a General Hospital in Recife, Brazil, from April to November 2015. For a home physical exercise program, for 12 weeks, 38 elderly women (IG: Intervention Group) and 37 (CG: Control Group) were allocated. A physical exercise manual and DVD were previously developed and distributed. The EORTC-QLQ-C30 questionnaire was used to assess quality of life. In the results, after 12 weeks, an improvement in the overall quality of life was observed in the elderly women included in the IG, and a worsening in the CG. Regarding the scale of functional domains, statistically significant differences were observed between groups (p<0.01), with improvement for IG in all domains analyzed. There was an intragroup improvement (p=0.01) in IG patients regarding physical, emotional and social functions. The CG showed statistically significant intragroup worsening (p<0.01) for the physical, role performance and emotional functional scales. There was a statistically significant improvement between groups for patients included in IG (p<0.01) for all analyzed symptoms. Intragroup improvement in symptoms reported by patients in the IG (p<0.01), related to fatigue, nausea, pain, loss of appetite and constipation, and worsening of symptoms (p<0.01) for the elderly women in the CG related to fatigue and pain. Inconclusion, the home physical exercise program was effective in improving the quality of life of elderly women with breast cancer undergoing treatment. (AU)


Subject(s)
Male , Female , Aged , Aged, 80 and over , Palliative Care , Breast Neoplasms , Aged , Exercise , Physical Fitness
13.
Rev. Fac. Cienc. Méd. (Quito) ; 49(2): 50-58, Mayo 27, 2024.
Article in Spanish | LILACS | ID: biblio-1556302

ABSTRACT

Introducción: El cáncer de mama masculino es una patología infrecuente que re-presenta menos del 1% de la patología mamaria maligna, con una edad media de diagnóstico de 67 años. Tiene un peor pronóstico que el cáncer de mama femenino debido a su alto origen genético y baja sospecha, desencadenando diagnósticos inadecuados y tardíos, y disminuyendo la supervivencia a mediano y largo plazo.Objetivo: Describir el caso clínico de un paciente masculino con diagnóstico de cáncer de mama, abordando la presentación clínica, los métodos diagnósticos, el tratamiento oncoespecífico, y la evolución clínica y quirúrgica. Presentación del caso: Se presenta un paciente masculino de 52 años, con evi-dencia de lesión exofítica en mama derecha más ganglio axilar ipsilateral, con diag-nóstico confirmado de patología de cáncer de mama estadio clínico cT4bN1Mx. Se plantea un manejo multidisciplinario: quimioterapia neoadyuvante y mastecto-mía radical derecha. Finalmente recibe tratamiento oncoespecífico y radioterapia con evolución favorable.Discusión: El cáncer de mama masculino tiene una baja incidencia respecto a la mujer, por lo que su sospecha diagnóstica se ve limitada. En etapas iniciales el diagnóstico es inespecífico debido a las pocas manifestaciones clínicas, pero deberá respaldarse en métodos imagenológicos, análisis anatomopatológico e in-munohistoquímico para guiar el tratamiento oncoespecífico.Conclusión: El cáncer de mama masculino posee una sospecha diagnóstica limi-tada que requiere un manejo multidisciplinario específico. La correcta estadifica-ción de la patología depende del seguimiento clínico y un análisis inmunohistoquí-mico oportuno, para un tratamiento adecuado con mejores resultados clínicos y altas tasas de supervivencia.


Introduction: Male breast cancer is an infrequent pathology; it represents less than 1% of malignant breast pathology, with an average age of diagnosis of 67 years. It has a worse prognosis than female breast cancer, due to its high genetic origin and low suspicion, which leads to inadequate and late diagnosis, becoming evident in advanced stages, decreasing survival in the medium and long term.Objective: To describe the clinical case of a patient diagnosed with breast cancer, addressing the clinical presentation, diagnostic methods, oncospecific treatment, as well as the corresponding clinical and surgical evolution.Case presentation: We present a 52-year-old male patient, with evidence of exophytic lesion in right breast plus ipsilateral axillary node, with diagnosis confir-med by pathology report of breast cancer, clinical stage: cT4bN1Mx. A multidisci-plinary management is proposed, initially the patient receives neoadjuvant chemo-therapy, then undergoes a surgical procedure: radical right mastectomy. Finally, she receives oncospecific treatment in the specialties of clinical oncology and radiothe-rapy, with favorable evolution.Discussion: Male breast cancer has a low incidence compared to women, so its diagnostic suspicion is limited. In initial stages the diagnosis is unspecific due to the few clinical manifestations, but should be supported by imaging methods and confirmatory methods, an anatomopathological and immunohistochemical analy-sis, to guide oncospecific treatment. Conclusions: Male breast cancer, is an infrequent pathology with limited diagnos-tic suspicion, which requires specific multidisciplinary management. It is important to have a continuous medical follow-up of the patient, to achieve at the time of diagnosis a correct clinical and immunohistochemical staging, which allows to fo-cus on the appropriate management and treatment, with better clinical outcomes and better survival rates.


Subject(s)
Humans , Male , Middle Aged , Mastectomy, Radical , Men , Breast Neoplasms/diagnosis , Medical Oncology
14.
Med. UIS ; 37(1): 53-76, ene.-abr. 2024. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1582618

ABSTRACT

Resumen Introducción: A nivel mundial el cáncer de mama representa aproximadamente el 24,5 % de los casos nuevos de cáncer en mujeres. Afecta los componentes físico, psicológico y emocional, impacta el desempeño laboral y el rol familiar y social. Objetivo: Describir los perfiles ocupacionales previo al diagnóstico de cáncer de mama en mujeres residentes permanentes del municipio de Medellín - Colombia. Metodología: Estudio con enfoque cuantitativo, de tipo observacional, descriptivo. Se incluyeron 254 mujeres diagnosticadas con cáncer de mama invasivo y primario en los años 2020 y 2021, atendidas en cinco instituciones de salud del municipio de Medellín. Se realizó análisis univariado para describir las características sociodemográficas y ocupacionales de la población y análisis de correspondencias múltiples para identificar los perfiles ocupacionales. Resultados: Se identificó que antes del diagnóstico, el mayor porcentaje de las participantes eran amas de casa (41,7 %), seguido por trabajadoras de áreas administrativas y afines como abogadas e ingenieras electrónicas y de sistemas (13,4 %). En el análisis de correspondencias múltiples, a partir de dos dimensiones que explicaron el 22,5 % de la varianza, se identificaron tres perfiles principales y un cuarto perfil no específico. El 18 % de las participantes se encontraban en el perfil I, representado por mujeres amas de casa y desempleados con bajos ingresos económicos y bajo nivel educativo. Conclusión: El principal perfil ocupacional previo al diagnóstico de las mujeres con cáncer de mama incluidas en el estudio estuvo representado por amas de casa con bajas condiciones económicas y educativas.


Abstract Introduction: Worldwide, breast cancer represents approximately 24.5 % of new cases of cancer in women. It affects the physical, psychological and emotional components, impacts work performance and family and social roles. Objective: To describe the occupational profiles prior to the diagnosis of breast cancer in women permanent residents of Medellín -Colombia. Methodology: Study with a quantitative, observational, descriptive approach. 254 women diagnosed with invasive and primary breast cancer in the years 2020 and 2021, treated in five health institutions in the municipality of Medellín, were included. Univariate analysis was performed to describe the sociodemographic and occupational characteristics of the population and multiple correspondence analysis to identify occupational profiles. Results: Before the diagnosis, the highest percentage of the participants were housewives (41.7 %), followed by workers in administrative and related areas such as lawyers and electronic and systems engineers (13.4 %). In the multiple correspondence analysis, from two dimensions that explained 22.5 % of the variance, three main profiles and a fourth non-specific profile were identified; 18 % of the participants were in profile I, represented by housewives and unemployed women with low income and low educational level. Conclusion: The main occupational profile prior to diagnosis of the women with breast cancer included in the study was represented by housewives with low economic and educational conditions.

15.
Article | IMSEAR | ID: sea-237056

ABSTRACT

Introduction: Breast cancer is a public health problem, characterized by an uncontrolled growth of malignant cells in breast tissue and the most common type of cancer among women, representing one of the main causes of death in the world. Objective: To carry out an epidemiological profile and trend of breast cancer in the municipalities of Belém and Ananindeua, state of Pará, Amazonia. Methods: This is an ecological, time-series, retrospective, descriptive, quantitative and analytical study, where data were collected from the Population-Based Cancer Registry/State Department of Public Health of the State of Pará in partnership with the Ophir Loyola Hospital (RCBP/SESPA/HOL). Results: The sociodemographic profile, the variable married (marital status) had the highest number of cases and percentage in 1712 (37%), followed by data without information 1214 (26%), followed by the single variable with 1079 (23%). In addition, the brown race was in first place with 1627 (35%) total cases, in schooling the data without information had the highest quantity in 1638 (35%), followed by high school (Old High School) in 1172 (25%). In tumor morphology, infiltrating ductal carcinoma was significant in 3309 (71%), followed by carcinoma without other specifications (NOS) with 284 (6%), in third place malignant neoplasm in 245 (5%). Regarding topography, in the total number of cases, breast was in first place with 2779 (60%), then the upper outer quadrant of the breast in 727 (16%), in third place invasive lesion of the breast 515 (11%), while in the two municipalities Belém had higher cases 3872, compared to Ananindeua 787. Conclusion: The data presented, as well as the epidemiological indicators of breast cancer, such as the trend of the disease, the coefficients of determination, correlation and mortality, were significant, thus elucidating a public health problem, since the epidemiological panorama in the cities of Belém and Ananindeua is increasing.

16.
Rev. Finlay ; 14(1)mar. 2024.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1565154

ABSTRACT

El cáncer de mama en coraza constituye una de las formas clínicas de presentación de las metástasis cutáneas del cáncer mamario. Es de aparición poco frecuente, sobre todo, en el sexo masculino. Se presenta el caso de un paciente de sexo masculino, de 74 años de edad, de color de piel negra, con antecedente de diabetes e hipertensión arterial que acudió a consulta de mastología provincial por presentar desde hacía algunos meses dolor discreto y unas lesiones pruriginosas en la mama derecha. Además de otros exámenes se le realizó biopsia escisional de pequeño fragmento de la lesión con estudio por parafina que informó metástasis cutánea de un carcinoma mamario en coraza según su forma de presentación clínica. Se muestra el caso porque no se localizó ninguna publicación en la provincia Cienfuegos ni en el país de un caso en el sexo masculino, por lo cual se considera de interés para el personal médico la publicación de este reporte.


Shell breast cancer is one of the clinical forms of presentation of cutaneous metastases of breast cancer. It is rare, especially in males. The case of a 74-year-old male patient with black skin color, with a history of diabetes and high blood pressure, who attended a provincial mastology consultation for a few months of mild pain and pruritic lesions on his neck, is presented the right breast. In addition to other examinations, an excisional biopsy of a small fragment of the lesion was performed with a paraffin study, which reported cutaneous metastasis of a shell breast carcinoma according to its clinical presentation. The case is shown because no publication was found in the province of Cienfuegos or in the country of a male case, which is why the publication of this report is considered of interest to medical personnel.

17.
Rev. méd. Urug ; 40(1): e203, mar. 2024.
Article in Spanish | LILACS, BNUY | ID: biblio-1551013

ABSTRACT

Introducción: el cáncer de mama es el tumor maligno más frecuente y la primera causa de muerte por cáncer en mujeres en Uruguay y en el mundo. La evidencia epidemiológica sugiere que el cáncer de mama en diferentes grupos de edades se comportaría como patologías distintas. El objetivo de este trabajo es caracterizar el cáncer de mama en Uruguay para diferentes estratos de edades. Material y método: se analizaron las tendencias temporales de la incidencia de cáncer de mama en mujeres en Uruguay en el período 2002-2019, y de la mortalidad por esta causa en 1990-2020. Para el quinquenio 2015-2019, se analiza además la distribución de estadios al diagnóstico y de perfiles biológicos (luminales, triple negativos y HER2 positivos). Se analizan tres segmentos de edades: mujeres de 20 a 44 años, de 45 a 69 y de 70 y más años. Resultados: las tasas de incidencia para el conjunto de edades se presentaron estables en el período 2002-2019, mientras que la mortalidad presenta una tendencia decreciente en el período 1990-2020. En las mujeres menores de 45 años se encuentra un aumento en la incidencia, con mortalidad que decrece hasta el 2010, seguido de una estabilización de las tasas; en las mujeres de 45 a 69 años la incidencia se mantiene estable y la mortalidad decrece; en las mayores de 70 años, la incidencia decrece mientras la mortalidad se mantiene estable. Más del 70% de los casos se diagnostican en estadios I y II. Los tumores luminales (receptores hormonales positivos, HER2 negativos) son el subtipo más frecuente para todos los grupos, la proporción de tumores con estas características aumenta con la edad, mientras decrece la proporción de HER2 positivo y triple negativo. Conclusión: en las mujeres uruguayas el cáncer de mama presenta características diferenciales para las tres franjas de edades analizadas.


Introduction: Breast cancer is the most common malignant tumor and the leading cause of cancer death in women in Uruguay and worldwide. Epidemiological evidence suggests that breast cancer in different age groups behaves as distinct pathologies. The objective of this work is to characterize breast cancer in Uruguay for different age groups. Method: Temporal trends in the incidence of breast cancer in women in Uruguay are analyzed for the period 2002-2019, along with mortality trends for this cause from 1990 to 2020. For the five-year period 2015-2019, the distribution of stages at diagnosis and biological profiles (Luminal, Triple-negative, and Her2 positive) is also analyzed. Three age segments are analyzed: women aged 20 to 44 years, 45 to 69 years, and 70 years and older. Results: The incidence rates for all age groups remained stable during the period 2002-2019, while mortality showed a decreasing trend in the period 1990-2020. In women under 45, there is an increase in incidence, with mortality decreasing until 2010, followed by a stabilization of rates; in women aged 45 to 69, incidence remains stable and mortality decreases; in those over 70, incidence decreases while mortality remains stable. More than 70% of cases are diagnosed at stages I and II. Luminal tumors (hormone receptor positive, Her2 negative) are the most frequent subtype for all age groups. The proportion of tumors with these characteristics increases with age, while the proportion of Her2 positive and triple-negative tumors decreases. Conclusions: In Uruguayan women, breast cancer presents differential characteristics for the three age groups analyzed.


Introdução: O câncer de mama é o tumor maligno mais comum e a principal causa de morte por câncer em mulheres no Uruguai e no mundo. Evidências epidemiológicas sugerem que o câncer de mama se comportaria como patologias distintas em diferentes faixas etárias. O objetivo deste trabalho é caracterizar o câncer de mama no Uruguai para diferentes faixas etárias. Materiais e Métodos: São analisadas as tendências temporais da incidência de câncer de mama em mulheres no Uruguai no período 2002-2019 e a mortalidade por esta causa no período 1990-2020. Para o quinquénio 2015-2019 são também analisadas a distribuição dos estádios ao diagnóstico e os perfis biológicos (Luminal, Triplo negativo e Her2 positivo). São analisados três segmentos etários: mulheres dos 20 aos 44 anos, dos 45 aos 69 anos e dos 70 anos ou mais. Resultados: As taxas de incidência para todas as idades permaneceram estáveis no período 2002-2019 enquanto a mortalidade apresentou tendência decrescente no período 1990-2020. Nas mulheres com menos de 45 anos verifica-se um aumento da incidência, com uma redução da mortalidade até 2010, seguida de uma estabilização das taxas; nas mulheres de 45 a 69 anos, a incidência permanece estável e a mortalidade diminui; nas pessoas com mais de 70 anos, a incidência diminui enquanto a mortalidade permanece estável. Mais de 70% dos casos são diagnosticados nos estágios I e II. Os tumores luminais (receptor hormonal positivo, Her2 negativo) são o subtipo mais comum para todos os grupos sem do que a proporção de tumores com essas características aumenta com a idade, enquanto a proporção de (Her2 positivo e triplo negativo) diminui. Conclusão: Nas mulheres uruguaias, o câncer de mama apresenta características diferenciadas para as três faixas etárias analisadas.


Subject(s)
Breast Neoplasms , Incidence , Mortality , Age Groups , Neoplasm Staging , Uruguay/epidemiology
18.
Enferm. foco (Brasília) ; 15(supl.1): 1-7, mar. 2024.
Article in Portuguese | LILACS, BDENF | ID: biblio-1532840

ABSTRACT

Objetivo: Identificar como ocorrem as práticas de prevenção e de rastreio do câncer de mama e de colo uterino realizadas por enfermeiros que atuam na Atenção Primária à Saúde do Rio Grande do Sul. Métodos: Trata-se de um estudo de abordagem qualitativa e de natureza analítica e compreensiva. Realizou-se entrevistas semiestruturadas. Os dados foram submetidos à análise de conteúdo do tipo temática proposta por Minayo. Os colaboradores foram 58 enfermeiros atuantes na Atenção Primária à Saúde. Resultados: Os resultados apontam que as práticas se desenvolvem em um contexto de crescente autonomia profissional e de protagonismo da Enfermagem. Aspectos como proximidade e vínculo com a comunidade, outros procedimentos e ações ofertadas nos atendimentos, incluindo a condução clínica/terapêutica, na vigência de sinais e sintomas de infecção, condizem com uma atenção mais ampla às necessidades de saúde e de cuidado às mulheres. Conclusão: O estudo evidencia a importância do respaldo de protocolos para a atuação segura das práticas dos enfermeiros da Atenção Básica, visando a prevenção e rastreio do câncer de mama e de colo uterino. Esses instrumentos devem ser de fácil acesso e constantemente atualizados a fim de garantir a padronização preconizada pelo Ministério da Saúde. (AU)


Objective: To identify how the breast and cervical cancer prevention and screening practices performed by nurses working in Primary Health Care in the state of Rio Grande do Sul occurs. Methods: This is a qualitative study with an analytical and comprehensive nature. The collaborators were 58 nurses working in Primary Health Care. Results: The results indicate that the practices are developed in a context of increasing professional autonomy and the role of Nursing. Aspects such as proximity and bonding with the community, other procedures and actions offered in the consultations, including clinical/therapeutic management in cases of signs and symptoms of infection, are consistent with a broader attention to women's health and care needs. Conclusion: The study highlights the importance of supporting protocols for the safe performance of Primary Care nurses' practices, aiming at the prevention and screening of breast and cervical cancer. These documents must be easily accessible and constantly updated in order to guarantee the standardization recommended by the Ministry of Health. (AU)


Objetivo: Identificar cómo las prácticas de prevención y detección del cáncer de mama y cervicouterino son realizadas por enfermeros que actúan en la Atención Primaria de Salud en Rio Grande do Sul. Métodos: Se trata de un estudio cualitativo de carácter analítico y comprensivo. Los colaboradores fueron 58 enfermeros que actuaban en la Atención Primaria de Salud. Resultados: Los resultados indican que las prácticas se desarrollan en un contexto de aumento de la autonomía profesional y del papel de la Enfermería. Aspectos como la proximidad y el vínculo con la comunidad, otros procedimientos y acciones que se ofrecen en las consultas, incluido el manejo clínico/terapéutico en casos de signos y síntomas de infección, son consistentes con una atención más amplia a las necesidades de salud y cuidado de las mujeres. Conclusión: El estudio destaca la importancia de protocolos para la actuación segura de las prácticas de los enfermeros de Atención Primaria, con el objetivo de la prevención y el tamizaje del cáncer de mama y de cuello uterino. Estos instrumentos deben ser de fácil acceso y constantemente actualizados para garantizar la estandarización recomendada por el Ministerio de Salud. (AU)


Subject(s)
Nursing Research , Breast Neoplasms , Uterine Cervical Neoplasms , Disease Prevention , Practice Patterns, Nurses'
19.
Rev. bras. cir. plást ; 39(1): 1-7, jan.mar.2024. ilus
Article in English, Portuguese | LILACS-Express | LILACS | ID: biblio-1525811

ABSTRACT

Introdução: A lipoenxertia é um enxerto autólogo de células do tecido celular subcutâneo, que pode ser utilizada como técnica complementar na reconstrução mamária. Diante disso, a criopreservação de células-tronco mesenquimais provenientes de tecido adiposo (CTDAs) poderia ser uma maneira de realizar a coleta em um tempo cirúrgico e após realizar a lipoenxertia de forma fracionada. O dimetilsulfóxido (DMSO) é um criopreservante utilizado em pesquisas com células, porém é potencialmente tóxico, o que impossibilitaria a utilização de CTDAs criopreservadas na prática clínica. Novos criopreservantes celulares, sem toxicidade, vêm sendo descritos na literatura científica experimental, como as substâncias L-prolina e trealose. Com isso, esse trabalho teve como objetivo avaliar a viabilidade de CTDAs criopreservadas com a combinação de L-prolina e trealose, em um período de até 90 dias. Método: Estudo experimental, no qual foram obtidas amostras de lipoaspirado provenientes de 9 pacientes. A fração celular foi processada e congelada com L-prolina (1,5M) + trealose (0,2M), ou com DMSO + soro fetal bovino (SFB), como controle. Após 30 e 90 dias, as amostras foram descongeladas e a viabilidade celular foi avaliada pela técnica de MTT. Resultados: A análise das CTDAs, após 1 e 3 meses de congelamento, indicou que as amostras tratadas com L-prolina + trealose apresentaram viabilidade semelhante àquelas preservadas com DMSO e SFB (p=0,444). Conclusão: A associação de L-prolina e trealose manteve CTDA viáveis por 30 e 90 dias de congelamento, podendo ser uma alternativa como criopreservante celular sem toxicidade e viabilizando o uso de lipoenxertia seriada.


Introduction: Fat grafting is an autologous graft of cells from subcutaneous tissue, which can be used as a complementary technique in breast reconstruction. Given this, the cryopreservation of adipose tissue-derived mesenchymal stem cells (ADMSCs) could be a way to collect them in one surgical procedure and after performing fractional fat grafting. Dimethyl sulfoxide (DMSO) is a cryopreservative used in cell research, but it is potentially toxic, which would make it impossible to use cryopreserved ADMSCs in clinical practice. New cellular cryopreservatives, without toxicity, have been described in the experimental scientific literature, such as the substances L-proline and trehalose. Therefore, this work aimed to evaluate the viability of ADMSCs cryopreserved with the combination of L-proline and trehalose over up to 90 days. Method: Experimental study in which lipoaspirate samples were obtained from 9 patients. The cellular fraction was processed and frozen with L-proline (1.5M) + trehalose (0.2M) or with DMSO + fetal bovine serum (FBS) as control. After 30 and 90 days, the samples were thawed, and cell viability was assessed using the MTT technique. Results: The analysis of ADMSCs, after 1 and 3 months of freezing, indicated that samples treated with L-proline + trehalose showed similar viability to those preserved with DMSO and SFB (p=0.444). Conclusion: The association of L-proline and trehalose kept ADMSC viable for 30 and 90 days of freezing, and could be an alternative as a cellular cryopreservative without toxicity and enabling the use of serial fat grafting.

20.
Medwave ; 24(2): e2726, 29-03-2024. ilus, tab
Article in English | LILACS | ID: biblio-1551476

ABSTRACT

INTRODUCTION: We aimed to develop a decision aid to support shared-decision making between physicians and women with average breast cancer risk when deciding whether to participate in breast cancer screening. METHODS: We included women at average risk of breast cancer and physicians involved in supporting the decision of breast cancer screening from an Academic Hospital in Buenos Aires, Argentina. We followed the International Patient Decision Aid Standards to develop our decision aid. Guided by a steering group and a multidisciplinary consultancy group including a patient advocate, we reviewed the evidence about breast cancer screening and previous decision aids, explored the patients' information needs on this topic from the patients' and physicians' perspective using semi-structured interviews, and we alpha-tested the prototype to determine its usability, comprehensibility and applicability. RESULTS: We developed the first prototype of a web-based decision aid to use during the clinical encounter with women aged 40 to 69 with average breast cancer risk. After a meeting with our consultancy group, we developed a second prototype that underwent alpha-testing. Physicians and patients agreed that the tool was clear, useful and applicable during a clinical encounter. We refined our final prototype according to their feedback. CONCLUSION: We developed the first decision aid in our region and language on this topic, developed with end-users' input and informed by the best available evidence. We expect this decision aid to help women and physicians make shared decisions during the clinical encounter when talking about breast cancer screening.


Subject(s)
Humans , Female , Adult , Middle Aged , Aged , Physicians , Breast Neoplasms/diagnosis , Decision Support Techniques , Decision Making , Early Detection of Cancer , Language
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