Repercussions of the COVID-19 pandemic on breast cancer actions in a Brazilian state / Repercusiones de la pandemia de COVID-19 en las acciones contra el cáncer de mama en un estado brasileira / Repercussões a pandemia da COVID-19 nas ações do câncer de mama em um Estado Brasileiro

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.

Tumor budding in invasive breast carcinoma: an emerging prognostic factor

Background: Tumor budding refers to single or small cluster of tumor cells detached from the main tumor mass in histological sections. In colon cancer high tumor budding is associated with worse prognosis and correlates with metastatic lymph nodes. We studied tumor budding in modified radical mastectomy specimens to evaluate its utility as a prognostic factor by correlating high tumor budding score with known prognostic markers of breast cancer like axillary lymph nodal metastasis, clinical staging, tumor size, lymphovascular invasion, hormonal status and pathological grading. Aim was to evaluate tumor budding in invasive breast carcinoma and to describe clinical features and histopathological spectrum of Invasive Breast Carcinoma with/without lymph node metastasis on H&E slides. Secondly, to find association between grades of tumor budding and various clinical, gross, microscopic and immunohistochemical variables. Methods: The present study is a cross sectional study of 70 modified radical mastectomy specimens from June 2018 to Dec 2022. Along with tumor budding various prognostic parameters like hormonal markers, pathological grading and clinical grading were evaluated. Immunohistochemical marker Pancytokeratin was utilized for counting the tumor buds, wherever necessary. Statistical Analysis: Chi Square test was utilized to study significant differences between variables, p<0.05 was considered statistically significant. Results: A high tumor budding score (?4/HPF) had significant association with axillary lymph node involvement and clinical staging. Conclusions: In our study we detected the association of high tumor budding, PTB in invasive breast carcinoma with axillary lymph node involvement and clinical staging. Hence our results highlight the importance of tumor budding as a prognostic factor and submit that this histological feature could be included in diagnostic protocols just as in carcinoma of the colon.

Endodermal sinus tumor of ovary with metastasis from breast carcinoma: a case report

Endodermal sinus tumor is malignant germ cell tumor of ovary. Endodermal sinus tumours (EST) also know as yolk sac tumor are rare about 1% of ovarian malignancies and highly malignant tumours occurring primarily in children and young women. Overall survival is poor. In present case patient was breast cancer survivor and completed her treatment for breast cancer 10 years back. Later on she developed rapidly growing bilateral ovarian mass. Tumor markers of epithelial ovarian tumor were raised. Gross examination was suggestive of Krukenberg tumor and on histopathological examination that was suggestive of endodermal sinus tumor, Finally, Immunohistochemistry helped to conclude the diagnosis of metastatic ovarian tumor from breast carcinoma.

Robinson抯 cytological grading of breast carcinoma: it抯 prognostic implications and correlation with bloom Richardson抯 histological grading of breast cancer

Background: Cytological grading on aspirates of breast carcinoma is a useful tool for surgical maneuver and prognosis. The aim of the study is to find out the utility of grading in malignant breast tumors using Robinson抯 cytological grading on FNAC and correlating it with modified bloom-Richardson抯 histopathological grading of breast carcinoma along with lymph node status assessment post-operatively by histopathological examination. Methods: This prospective study was carried out in 40 cases of invasive duct carcinoma of breast for a period of one and half year duration from December-2019 to July-2021. This study was done in department of pathology, Surat municipal institute of medical education and research (SMIMER), Surat. In all these cases the cytological diagnosis was confirmed by histological examination. All cases were graded by using Robinson抯 grading system. All these cases were also correlate with bloom Richardson抯 grading system on histopathology in mastectomy specimen. Result: Robinson抯 cytological grading correlated well with bloom Richardson抯 histopathological grading. In this study of forty cases, thirty-three cases (82.5%) show concordance between cytologic and histologic grading system. Rest of the seven cases (17.5%) show discrepancy. Conclusions: Thus, In the most of the cases, cytological grading of breast carcinomas correlate with histopathological grading and may be useful as a prognostic marker. It was concluded that the cytological grading should be included in all FNAC reports. So that appropriate decision regarding the preoperative neoadjuvant chemotherapy can be made and overtreatment of low-grade cancers has been avoided.

Breast panel biomarker changes after neoadjuvant chemotherapy in breast cancer

Objectives@#The aim of this study is to evaluate the breast panel biomarker changes and tumor intrinsic subtype after neoadjuvant chemotherapy among patients with residual invasive breast carcinoma whose breast specimens were processed at St. Luke’s Medical Center - Quezon City SLMC-QC) from 1 January 2017 to 30 June 2023.@*Methodology@#Cases of residual invasive breast carcinoma status post neoadjuvant systemic therapy were identified by retrospective review of cases. The baseline characteristics, type of biopsy and resection procedures, pre – and post–neoadjuvant ER, PR and HER2 status and pre – and post–neoadjuvant tumor intrinsic subtype were analyzed using frequency and percentage. The comparison of the changes in pre- and post-neoadjuvant breast panel biomarkers were analyzed by using McNemar test while the changes in the intrinsic tumor subtype was done using Wilcoxon signed-rank test.@*Results@#This study encompassed a total of 43 cases of residual invasive breast carcinoma following neoadjuvant systemic therapy. The data disclosed shifts in the breast molecular profile and intrinsic subtype post-administration of neoadjuvant systemic therapy. The alterations in hormone receptor status, ER and PR, were observed in 11.6% of cases, while HER-2 status exhibited changes in 2.3%. A 14% change in the tumor intrinsic subtype is observed. Among the initial 18 Luminal A cases, 1 transitioned to Luminal B, and among the 6 Luminal B cases, 2 become HER2 enriched subtypes. Furthermore, among the initial 12 HER2 enriched cases, three shifted to Luminal B, while all triple-negative cases remained unchanged after chemotherapy.@*Conclusion@#Based on our findings, alterations in the molecular profile of breast tumors, including shifts in intrinsic subtype after neoadjuvant chemotherapy (NAC), could impact patient prognosis. While the data generated from this study may not exhibit statistical significance, its clinical relevance is noteworthy. In summary, retesting of breast biomarkers in the resection specimen is recommended to accurately ascertain the appropriate use of targeted therapy.

Correlation of peritumoral edema with aggressiveness of breast invasive ductal carcinoma in magnetic resonance imaging / 中国现代医生

Objective To investigate the correlation between the characteristics of peritumoral edema and the aggressiveness of breast invasive ductal carcinoma in preoperative magnetic resonance imaging(MRI).Methods A total of 79 patients(79 lesions)who underwent radical mastectomy in the First Affiliated Hospital of Ningbo University from January 2020 to May 2021 and were pathologically diagnosed as invasive ductal carcinoma were included in invasive ductal carcinoma group,and 45 patients(49 lesions)with benign breast lesions were included in benign lesion group during the same period.The difference of peritumoral edema between two groups and the relationship between different pathological features of invasive ductal carcinoma and peritumoral edema were compared.Results The peritumoral edema in benign lesion group was significantly less severe than that in invasive ductal carcinoma group(χ2=25.330,P<0.05).The tumor size of invasive ductal carcinoma group was positively correlated with the degree of peritumoral edema(r=0.381,P<0.05).There were significant differences in molecular type,histological grade,T stage,lymph node metastasis and Ki-67 expression level among patients with different peritumoral edema grades(P<0.05).Ki-67 expression level and the number of lymph node metastasis were positively correlated with the degree of peritumoral edema(r=0.348,0.273,P<0.05).Conclusion The degree of peritumoral edema in MRI correlates with the aggressiveness of breast invasive ductal carcinoma and can be used as one of the tools to evaluate breast carcinoma.

Temporal changes in the incidence of ductal carcinoma in situ in Goiânia, Brazil: a population-based study

Introduction: Mammography screening has resulted in a considerable increase in the diagnosis of early-stage tumors in various countries. However, most available data refer to high-income countries, hospital-based studies, or studies with limited followup. Therefore the aim of this study was to determine the incidence of ductal carcinoma in situ (DCIS) in Goiânia, Brazil. Methods: Ecological study among residents of the city of Goiânia, Brazil. We included all the DCIS cases registered at the Goiânia populationbased cancer registry between 1994 and 2010. Crude incidence and age-standardized incidence rates (using the world standard population) were calculated. Poisson regression was used to analyze temporal changes, with the average annual percent change (AAPC) in the crude and age-standardized incidence rates being calculated. Results: There were 261 cases of DCIS, with an annual incidence rate that ranged from 0.58 to 4.21 per 1,000 women (crude and standardized) over the period. The number of cases of DCIS in the 40­49 and 60­69-years age groups increased significantly (p<0.01). The AAPC of the crude incidence rate for the period was 11.88% per year (95%CI 9­15; p<0.01) and the standardized rate was 11.89% per year (95%CI 9­15; p<0.01). Conclusions: The incidence of DCIS in Goiânia increased between 1994 and 2010, possibly due to improved mammography screening. The present study, which was conducted in a consolidated population-based cancer registry (PBCR) and involved an extensive follow-up time, could contribute towards increasing epidemiological knowledge on DCIS and its variations around the world. (AU)

Breast mass - An uncommon clinical manifestation of ovarian carcinoma: A case report and brief literature review

Metastasis from non-mammary malignant neoplasms to the breast is rare and represents 0.2%-1.3% of all breast malignancies. Fine needle aspiration cytology (FNAC) is the first line of investigation for any breast lump and cyto-morphological appearance of primary breast malignancies is well documented. Occasionally metastasis to the breast may be the initial presentation and can masquerade clinically as primary breast malignancy. The present case describes the clinical and cytological challenges in an unusual case of ovarian carcinoma with initial presentation as breast mass, mimicking as inflammatory carcinoma. In cytology the breast lesion was initially misdiagnosed as primary breast carcinoma and subsequently diagnosed as metastatic ovarian carcinoma based on core needle biopsy findings, aberrant immuno-profile and clinical findings; thus making the complex case worthy of discussion.

Collagen content and C-X-C motif chemokine ligand 12 expression in neoplastic breast stroma

SUMMARY OBJECTIVE: This study aimed to evaluate the expression of C-X-C motif chemokine ligand 12 and its C-X-C chemokine receptor type 4, and the tumor-stroma ratio using collagen stromal content of breast cancer samples, correlating it with clinicopathological data. METHODS: Through a retrospective cohort study, samples were obtained from female patients, over 18 years of age, with the disease in stages 1-4, who underwent mastectomy or lumpectomy. The biopsies were provided by the Oncology sector of the Hospital das Clínicas of Universidade Federal de Pernambuco, Recife city, in 2011-2014, including samples of invasive ductal carcinoma, ductal carcinoma in situ, or benign changes (fibroadenoma and hypertrophy), which were analyzed between 2020 and 2022 by immunohistochemistry for the expression of stromal cell characteristics. Collagen content was tested by Gomori staining and digital analysis of images. RESULTS: Absence of stromal expression of C-X-C motif chemokine ligand 12 was associated with longer disease-free survival (disease-free survival=0.481), and expression of C-X-C chemokine receptor type 4 was associated with lower disease-free survival. An association was observed between clinicopathological variables and stromal expression of chemokines, that is, an association of stromal C-X-C motif chemokine ligand 12 with histological grade, angiolymphatic invasion, and an association between C-X-C chemokine receptor type 4 expression and histological grade. Analyses of digital pixels images of collagen and tumor cells showed a lower percentage of collagen in the invasive ductal carcinoma samples (39%), unlike samples without neoplasms (78%). CONCLUSION: Low expression of C-X-C motif chemokine ligand 12 may be associated with a worse prognosis for breast cancer. Collagen staining analyzed using digital images represents an opportunity for clinical application and is indicative of the prognosis of the tumor microenvironment in breast carcinoma.

Clinico-pathological profile of female breast cancer in Kashmir: an institutional experience

Background: Breast cancer is the most common cancer among women and one of the most important causes of death among them. The present study tries to evaluate the demographic, clinical, and pathological profile of female breast cancer patients in Kashmir Methods: This study was done in government medical college Srinagar, department of radiation oncology. A retrospective review of 84 patients of breast cancer treated between January 2021 and March 2023 was done. Results: A total of 84 patients were taken for this study. Most patients presented in the 4th and 5th decade of life with a mean age of 45.5± 8.58. 50% of the patients were having T2 followed by 19.04% having T4 and 16.66% having T1 while 14.28 % had T3 stage. 32.1% of patients were having N0 nodal status, 25.0% were having N3 followed by 23.80% had N1 and 19.04% had N2 nodal disease.52.38% were having stage II and 36.90% were having stage III and 4.76% were having stage IV. 85.71% were having invasive ductal carcinoma, 9.52% were having invasive lobular carcinoma and 4.76% were having medullary carcinoma. 23.80% of patients were Triple +, 27.38 % of patients were Triple Negative, 25.0% were ER+/ PR+. Conclusions: The incidence of female breast cancer was more in the age group of 41–50 years. Stage II was more followed by Stage III. The most common histopathology type was invasive ductal carcinoma. Triple negativity was seen more in our patients.

CLINICOPATHOLOGICAL STUDY IN TRIPLE NEGATIVE BREAST CANCER

Background and Objectives: - Carcinoma Breast is most common malignancy in females in USA and second among cases deaths in females (after lung cancer). There is considerable geographic , ethnic and racial variability in Breast cancer in evidence with about 5 fold variation throughout the world. Triple negative breast cancer is a heterogonous disease diagnosed by Immune Histo Chemistry (IHC).Triple Negative Breast cancer is characterized by tumor that do not express ER or PR and HER2neu . Proto typical Triple Negative Brest cancer is aggressive in nature and associate with poor prognosis. The Objectives of this study is to analyse the clinical and Pathological features of Triple Negative Breast Cancer and compare the result with similar studies in literature. Fifty Methods:- cases Triple negative Breast Cancer were included in this study. Clinical and pathological features and treatment were noted. Incidence Result:- of Triple Negative Breast Cancer was 35%. The median age of presentation was 45yrs. There were 4% males Triple negative Breast cancer cases out of female patients, most of patients were Pre (or) Perimenopausal(65%). 4% patients had family history of malignantly. Most common stage of presentation was stage III (46%). In Stage IV, Lung and bone metastasis was common. Ten Patients received Neoadjuvant chemo therapy (NACJ) and disease progressed in 4% while on Neoadjuvant chemotherapy, Even though 45 patients had surgery only 34 were eligible to received Adjuvant Radiotherapy. Total of 18% Patients had either progressive disease while on treatment (8%) (or) recurrence 10%. Eighteen percent patients died due to the disease. 33% patients on follow up. There were more Invasive Duct Cell carcinoma (IDCC) cases with medullary differentiations (or) Purse medullary Carcinomas (12%). No deaths Occur in the medullary variants TNBC. Majority of the tumor were high grade margins were negative in most of the cases. Incidence of Tri Inclusion:- ple negative breast cases was higher than western literature but comparable to Indian Studies. The age of Presentation was about 10 years younger than western data. Triple Negative Breast cancer was more common in young, pre (or) perimenopausal women. Small number of patients had family history, majority were state II (or) III. There was high number of progressive disease, recurrence and death while on the study (or) within less than 1 yr of treatment. Triple Negative Breast cancer is very aggressive disease with relatively better prognosis in the medullary variant Triple Negative Breast Cancer.

Sentinel lymph node biopsy after nipple?sparing mastectomy in early postoperative period: Is it feasible?

Background: Axillary lymph node status is one of the most important prognostic factors for breast cancer. Sentinel lymph node biopsy (SLNB) after mastectomy is highly controversial. There is not enough data about SLNB in the early period after nipple?sparing mastectomy (NSM). This study investigated the feasibility of SLNB in the early postoperative period of NSM. Materials and Methods: Patients who were operated on for breast cancer in Acibadem Maslak Hospital between 2009 and 2018 were searched retrospectively. Results of SLNB as the second session in patients whose final pathology report revealed breast carcinoma after contralateral/bilateral prophylactic mastectomy and mastectomy for benign lesions were evaluated. Results: In the early period (median 14 days) after NSM, SLNB was performed by intradermal radioisotope injection in five patients with occult breast cancer in contralateral/bilateral prophylactic mastectomy and in one patient with preoperatively suspicious mass which yielded breast cancer at final pathology. In five (80%) patients, SLNB was performed, whereas in one patient axillary lymph node dissection (ALND) was performed due to the undetectability of SLN. In one patient, micrometastasis was observed, whereas no metastasis was observed in other patients including the one who underwent ALND. No complication due to SLNB was detected. No recurrence and distant metastasis were detected in a mean follow?up of 42.82 (19�) months. While SLNB did not change the treatment of patients with contralateral occult carcinoma, other patients had hormonal therapy due to negative SLNB. Conclusion: SLNB in the early postoperative period of NSM can be performed by intradermal radioisotope injection. However, further studies are needed to determine the feasibility of SLNB in the early postoperative period of NSM

Vascular Endothelial Growth Factor Expression in Breast Carcinoma and its Association with Expression of Estrogen Receptors, Progesterone Receptors and HER-2/neu and Molecular Subtypes

Background: The management of breast carcinoma depends on several molecular markers and tumor stages. In the last decades, estrogen receptors (ER), progesterone receptors (PR), and HER-2/neu have shown good therapeutic responses. Among other molecular markers, vascular endothelial growth factor (VEGF) is becoming more widely used as a prognostic indicator in patients with breast carcinoma. Anti-VEGF therapy already has been proven as an effective chemotherapeutic agent in some other carcinomas. The study aimed to find out the immunohistochemical expression of Vascular Endothelial Growth Factor (VEGF) in breast carcinoma and its possible correlation with the expression of ER, PR, and HER-2/neu and molecular subtypes to evaluate its prognostic value. Material & Methods: This study was conducted in the Department of Pathology, BIRDEM General Hospital, Dhaka, from March 2018 to January 2020. In this study, 45 diagnosed cases of breast carcinoma were enrolled. Slides of all cases were stained with ER, PR, HER-2/neu, and VEGF antibodies following the avidin-biotin-peroxidase staining method. Results: Among 45 cases, 60% showed positive immunohistochemical expression of VEGF. Most of these cases (71.1%) were ER/PR positive. VEGF did not show a significant association with other molecular markers or molecular subtypes. Conclusion: Although, the potential prognostic value of VEGF has not been confirmed. Based on the findings of the current study, it can be assumed that VEGF plays an important role in the pathogenesis of breast cancer. So, it may serve as a useful biomarker for immuno-targeting therapy in patients with breast cancer.

Lymph node metastasis after neoadjuvant chemotherapy

Neoadjuvant therapy refers to the systemic treatment of breast cancer prior to definitive surgical from size reduction before conservation therapy. Response to neoadjuvant chemotherapy is evaluated by the change in tumor size from pretreatment clinical and or radiologic measurement to post-treatment status. The spectrum of response to neoadjuvant chemotherapy varies from complete response, partial response, to non-response. This concept is the same in breast tumors as well as axillary lymph nodes. The presented case is a known case of Triple Negative Invasive Ductal carcinoma with Axillary involvement Right Breast since November 2020 and had undergone NeoadjuvantChemotherapy till February 2021,followed by surgical intervention in October 2022.

BRCA1 promoter methylation & its immunohistochemical correlation in sporadic breast cancer

Background & objectives: Studies have shown that apart from hereditary breast carcinomas, breast cancer susceptibility gene 1 (BRCA1) mutations conferring to its loss are seen in sporadic breast carcinomas (SBC) as well. The aim of the present study was to assess BRCA1 methylation in females presenting at King George’s Medical University, Lucknow, with SBC by both immunohistochemistry (IHC) and methylation PCR with respect to hormonal profile and various morphological prognostic parameters. The primary objective was to look for the association between BRCA1 protein expression and DNA promoter methylation. Methods: 81 mastectomy specimens from SBC of invasive breast carcinoma (no special type) were included in this study. After a detailed morphological assessment, formalin fixed paraffin embedded tissue from a representative tumour area was selected for BRCA1 IHC by heat-mediated antigen retrieval under high pH and DNA extraction and further bisulphate treatment. BRCA1 was studied for methylation by methylated and unmethylated PCR-specific primers. Results: BRCA1 promoter methylation was present in 42/81 (51.9%) participants, with significant BRCA1 protein loss (72.7%; P=0.002). A significant association between BRCA1 loss and hormonal profile was found (P=0.001); maximum in triple negative breast carcinoma (TNBC) (72%; 18/25). Most of the TNBC also harboured methylation (68%). Although not significant grade II and III tumours, lymph vascular invasion, ductal carcinoma in situ, and nodal metastasis (?3) were seen in a higher percentage in methylated tumours. Mortality in SBC was significantly associated with BRCA1 loss (30.3%; P=0.024). Interpretation & conclusions: Study results highlight the concept of “BRCAness” in SBC as well. Hence, we can confer that identification of BRCA1 loss in SBC can make it a perfect candidate for poly ADP- ribose polymerase inhibitors or cisplatin-based therapy like hereditary ones.

Márgenes quirúrgicos en afeitado de cavidad en cuadrantectomía por cáncer de mama / Surgical margins in shaved cavity in quadrantectomy for breast cancer in Medellín, Colombia

Resumen OBJETIVOS: Determinar la utilidad del afeitado de la cavidad de la cuadrantectomía por cáncer de mama en la reducción de reoperación y explorar sus factores asociados y describir las características sociodemográficas y clínicas de las pacientes. MATERIALES Y MÉTODOS: Estudio de cohorte, retrospectivo y descriptivo efectuado entre el 1 enero de 2017 y el 31 de diciembre de 2018 en pacientes mayores de 18 años con diagnóstico histológico de carcinoma invasivo e in situ de mama a quienes se practicó cuadrantectomía con afeitado de todos los márgenes de la cavidad. Se trata del registro de las pacientes de un cirujano de Medellín, Colombia. Se recopilaron datos demográficos, clínicos, paraclínicos y se analizaron con estadística descriptiva. RESULTADOS: Se incluyeron 194 pacientes con edad media de 61.6 años. Los márgenes fueron negativos en el 85.6% (n = 161) y positivos en el 14.4% (n = 28). La cavidad afeitada estaba afectada en el 16% (n = 31), no se requirió reintervención en el 95.9% (n = 186) y se reintervinieron 4.1% (n = 8). La reducción de la reintervención fue del 10.3% (n = 20%). Los factores asociados con márgenes positivos fueron: marcación con arpón (OR = 1.19; IC95%: 1.07-1,32; p = 0.04), tumor multifocal (OR = 3.95; IC95%: 2.29-6.81; p = 0.00), afeitado afectado (OR = 3.26; IC95%: 1.75-6.04). Entre los grupos no se encontró mayor riesgo de recurrencia local (OR = 0.85; IC95%: 0.80-0.90; p = 0.35). CONCLUSIONES: El afeitado de todos los márgenes de la cavidad de la cuadrantectomía tuvo una reducción en la tasa de márgenes afectados y disminución de las reintervenciones. Los factores asociados con márgenes positivos fueron: marcación con arpón, tumor multifocal y el daño del afeitado; no hubo mayor riesgo de recurrencia.

Abstract OBJECTIVES: To determine the usefulness of quadrantectomy cavity shaving for breast cancer in reducing reoperation and to explore its associated factors and describe sociodemographic and clinical data of the patients. MATERIALS AND METHODS: A retrospective, descriptive, retrospective cohort study conducted between January 1, 2017 and December 31, 2018 in patients older than 18 years with histologic diagnosis of invasive and in situ breast cancer who underwent quadrantectomy with shaving of all cavity margins. This is the registry of patients of a surgeon in Medellin, Colombia. Demographic, clinical, and paraclinical data were collected and analyzed using descriptive statistics. RESULTS: 194 patients with a mean age of 61.6 years were included. The margins were negative in 85.6% (n = 161) and positive in 14.4% (n = 28). The shaved cavity was involved in 16% (n = 31), no reintervention was required in 95.9% (n = 186), and 4.1% (n = 8) underwent reintervention. The reduction in reoperation was 10.3% (n=20). Factors associated with positive margins were: harpoon marking (OR = 1.19; 95%CI: 1.07-1.32; p = 0.04), multifocal tumor (OR = 3.95; 95%CI: 2.29-6.81; p = 0.00), affected shave (OR = 3.26; 95%CI: 1.75-6.04). No increased risk of local recurrence was found between groups (OR = 0.85; 95%CI: 0.80-0.90; p = 0.35). CONCLUSIONS: Shaving all margins of the quadrantectomy cavity was associated with a lower rate of involved margins and fewer reinterventions. Factors associated with positive margins were: harpoon marking, multifocal tumor, and shave damage; there was no increased risk of recurrence.

Asociación entre el diagnóstico de carcinoma mamario y la actividad de la enzima lactoperoxidasa sérica / Association between the diagnosis of mammary carcinoma and serum lactoperoxidase enzyme activity

Fundamento: La enzima lactoperoxidasa tiocianato es una proteína producida por células epiteliales en los acinos mamarios. Los carcinomas de la mama constituyen un tipo de cáncer que se origina por la transformación maligna de las células acinares de la mama y se caracterizan por el crecimiento y multiplicación descontrolado. Por tanto, podría existir una correlación entre el cáncer de mama y el aumento de la actividad sérica de la lactoperoxidasa. Objetivo: Determinar la asociación entre el diagnóstico de carcinoma mamario y la actividad aumentada de la enzima lactoperoxidasa sérica en muestras de pacientes que han sido atendidos en el Hospital Oncológico María Curie de Camagüey en el periodo de abril a agosto del 2022. Métodos: Se desarrolló un estudio correlacional en el Centro de Inmunología y Productos Biológicos de Camagüey, en el período de abril a agosto del 2022. Se empleó la citología por aspiración con aguja fina para el diagnóstico histopatológico del carcinoma mamario y se determinó la actividad de la enzima lactoperoxidasa sérica mediante el método del pirogalol salicilato. Se emplearon las pruebas t de student y chi-cuadrado para el análisis estadístico de los datos. Resultados: El carcinoma ductal infiltrante fue el subtipo de cáncer más frecuente con un 94,1 por ciento del total de las muestras. Se encontraron diferencias significativas entre los grupos de muestras analizadas p ( 0.000. De un total de 34 muestras positivas, 32 presentaron aumento de la actividad enzimática. Conclusiones: Hubo asociación entre el diagnóstico de carcinoma mamario y niveles aumentados de la enzima lactoperoxidasa sérica(AU)

Background: The enzyme lactoperoxidase thiocyanate is a protein produced by epithelial cells in the mammary acini. Breast carcinomas are a type of cancer that originates from the malignant transformation of the acinar cells of the breast and are characterized by uncontrolled growth and multiplication. Therefore, there could be a correlation between breast cancer and increased serum lactoperoxidase activity. Objective: To determine the association between the diagnosis of mammary carcinoma and the increased activity of the serum lactoperoxidase enzyme in samples of patients who have been treated at the Maria Curie Oncology Hospital in Camagüey from April to August 2022. Methods: A correlational study was developed at the Center for Immunology and Biological Products of Camagüey, from April to August 2022. Fine-needle aspiration cytology was used for the histopathological diagnosis of mammary carcinoma and the activity of serum lactoperoxidase enzyme by the pyrogallol salicylate method. Student's t and chi-square tests were used in the statistical analysis of the data. Results: Infiltrating ductal carcinoma was the most frequent subtype of cancer with 94,1 percent of the total samples. Significant differences were found between the groups of samples analyzed p ( 0,000. Of a total of 34 positive samples, 32 showed increased enzyme activity. Conclusions: There was an association between the diagnosis of mammary carcinoma and increased levels of the serum lactoperoxidase enzyme(AU)

Molecular subtypes of invasive breast carcinoma of no special type, their correlation with histopathological features, Ki 67 index and tumor budding: A retrospective comparative study

Context: Tumor budding (TB), poorly differentiated clusters (PDCs), and Ki 67 index are proven adverse prognostic factors in breast carcinoma. Though the relation of Ki 67 index with molecular subtypes of breast carcinoma have been extensively studied, there is very limited information on the role of TB and PDCs. Aims: To grade TB, PDCs, and Ki 67 index and assess histological features and relationship of all these with molecular subtypes of invasive breast carcinoma of no special type. Methods and Material: Retrospective study of 148 cases from 1/1/2019 to 30/12/2019. Division of molecular groups – Luminal A, Luminal B, Her2 neu positive, and triple-negative breast carcinomas (TNBC), and Ki 67 index grades based on St Gallen criteria, intratumoral and peritumoral TB and PDC grades as per the International Tumor Budding Consensus Conference (ITBCC) criteria for colon and correlation between these and other histological features with the molecular subtypes were done. Statistical Analysis: Chi-square test, univariate and multivariate logistic regression models were used. Results: Significant correlation was seen between TB and lymphovascular emboli, Luminal B tumors with high-grade TB and PDCs, Her 2 neu positive and TNBC tumors with low-grade TB, circumscribed tumor margins, tumor necrosis, and Luminal B, Her 2 neu positive and TNBC tumors with larger tumor size and high nuclear grades.Conclusions: TB and PDCs are useful in the prognostication of Luminal A and B tumors when the Ki 67 index values are low/intermediate. Her 2 neu positive and TNBC tumors have a high nuclear grade with necrosis and no association with TB or PDCs.

Risk Factors of Breast Cancer Among Women – A Cross-Sectional Study in Selected Slums of Bhubaneswar City, India

Background: Breast carcinoma is the most commonly diagnosed cancer (27·7%) and the leading cause of death (23·5%) among women in India as per GLOBOCAN 2018. There is considerable evidence that breast cancer risk is related to certain modifiable and nonmodifiable lifestyle factors. Thus, this study was conducted to estimate the prevalence of risk factors of breast cancer in women of age group 18-70 years in selected urban slums.Methodology: This community based cross sectional study was conducted in selected 13 urban slums of Bhubaneswar which comes under the field practice area of Department of Community Medicine, Bhuba-neswar, IMS and SUM Hospital Bhubaneswar, Odisha from September 2018 to October 2020. Data were entered to an excel sheet and SPSS software version 20 was used for analysis. Results: Among the total population of 300, the mean age of the study subjects was 42 + 12 years rang-ing from 20 to 69 years. Married women in the study were 95.3%. Including both modifiable and non-modifiable risk factors, 57% of the participants were having risk factors of breast cancer. Conclusion: Women need to be aware of both modifiable and non-modifiable risk factors for breast can-cer to adopt appropriate practices for prevention of Breast cancer.

Perfil dos casos de câncer de mama entre acometidos no acre período de 2015 a 2019 ­ um estudo transversal / Profile of breast cancer cases between affected in acre period from 2015 to 2019 - a cross-sectional study / Perfil de los casos de cáncer de mama entre las personas afectadas en el período acre de 2015 a 2019 - un estudio transversal

Este estudo teve como objetivo analisar o perfil dos casos de câncer de mama no estado do Acre no período de 2015 a 2019. Trata-se de um estudo quantitativo com delineamento transversal. A amostra foi constituída por todos os casos de câncer de mama registrados no Acre e inseridos no Departamento de Informática do Sistema Único de Saúde (DATASUS) no período de 2015 a 2019. Foram identificados no período 293 casos da doença, com maior número de casos registrados no ano de 2019 (25,0%), sendo a maioria do sexo feminino (98,0%), na faixa etária de 40 a 49 anos (29,0%). O tempo decorrido desde o diagnóstico até o início do tratamento foi de mais de 60 dias (51,0%). A modalidade terapêutica mais utilizada foi a quimioterapia (55,0%). O local da realização do tratamento ocorreu capital do estado Rio Branco (80,0%). A maior parte dos acometidos, ainda encontra-se em tratamento (56,0%), no entanto (44,0%) evoluiu para óbito. O aumento da doença com o passar dos anos é notável no Acre. É importante destacar que ações voltadas para a prevenção e controle do câncer de mama continuam sendo fundamentais para auxiliar na diminuição do número de casos, como o rastreamento e diagnóstico precoce.

This study aimed to analyze the profile of breast cancer cases in the state of Acre in the period from 2015 to 2019. This is a quantitative study with a cross-sectional design. The sample consisted of all breast cancer cases registered in Acre and inserted in the Informatics Department of the Unified Health System (DATASUS) in the period from 2015 to 2019. In the period 293 cases of the disease were identified, with a greater number of cases registered in 2019 (25.0%), with the majority being female (98.0%), aged 40 to 49 years (29.0%). The time elapsed from diagnosis to the start of treatment was more than 60 days (51.0%). The most used therapeutic modality was chemotherapy (55.0%). The place where the treatment was performed took place in the state of Rio Branco (80.0%). Most of the people affected are still under treatment (56.0%), however (44.0%) died. The increase in the disease over the years is notable in Acre. It is important to highlight that actions aimed at the prevention and control of breast cancer continue to be fundamental to assist in reducing the number of cases, such as screening and early diagnosis.

Este estudio tuvo como objetivo analizar el perfil de los casos de cáncer de mama en el estado de Acre en el período de 2015 a 2019. Se trata de un estudio cuantitativo con diseño transversal. La muestra consistió en todos los casos de cáncer de mama registrados en Acre e ingresados en el Departamento de Informática del Sistema Único de Salud (DATASUS) en el período de 2015 a 2019. En el periodo se identificaron 293 casos de la enfermedad, siendo el mayor número de casos registrados en 2019 (25,0%), siendo la mayoría mujeres (98,0%), en el grupo de edad de 40 a 49 años (29,0%). El tiempo transcurrido desde el diagnóstico hasta el inicio del tratamiento fue superior a 60 días (51,0%). La modalidad terapéutica más utilizada fue la quimioterapia (55,0%). El lugar donde se realizó el tratamiento fue Rio Branco, la capital del estado (80,0%). La mayoría de los pacientes afectados siguen en tratamiento (56,0%), sin embargo, (44,0%) fallecieron. El aumento de la enfermedad a lo largo de los años es notable en Acre. Es importante destacar que las acciones dirigidas a la prevención y control del cáncer de mama siguen siendo fundamentales para ayudar a reducir el número de casos, como el cribado y el diagnóstico precoz.