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1.
Rev. Asoc. Méd. Argent ; 137(1): 11-14, mar. 2024. ilus
Article in Spanish | LILACS | ID: biblio-1552846

ABSTRACT

Los LNH constituyen la segunda neoplasia más frecuente en pacientes con VIH. Estas neoplasias están ligadas a la inmunodeficiencia, suelen ser de período de latencia prolongado y más frecuentes en hombres. Más del 95% de estas neoplasias son de fenotipo B, de alto grado de malignidad, extranodales y representan la causa de muerte en un 12% al 16% de los casos. El linfoma no Hodgkin primitivo de mama (LPM) es una entidad infrecuente, que representa el 2,2% de todos los linfomas extranodales y el 0,5% de todas las neoplasias malignas de la mama. Se presenta una mujer con sida y linfoma primario de mama. (AU)


NHL is the second most common neoplasm in patients with HIV. It is linked to immunodeficiency, tends to have a long latency period and is more common in men. More than 95% of these neoplasms are of phenotype B, high-grade, extranodal and are the cause of death in 12% to 16% of cases. Primitive non-Hodgkin lymphoma of the breast is a rare entity, accounting for 2.2% of all extranodal lymphomas and 0.5% of all breast malignancies. A woman with AIDS and primary breast lymphoma is presented. (AU)


Subject(s)
Humans , Female , Adult , Breast Neoplasms/diagnosis , Lymphoma, B-Cell/pathology , Acquired Immunodeficiency Syndrome/complications , Vincristine/therapeutic use , Breast Neoplasms/drug therapy , Prednisone/therapeutic use , Antineoplastic Combined Chemotherapy Protocols , Doxorubicin/therapeutic use , Lymphoma, B-Cell/drug therapy , Acquired Immunodeficiency Syndrome/drug therapy , Antiretroviral Therapy, Highly Active , Cyclophosphamide/therapeutic use , Efavirenz, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination/therapeutic use
2.
Article in Portuguese | LILACS | ID: biblio-1442376

ABSTRACT

Objetivos: investigar o impacto da pandemia no rastreamento do câncer de mama no Sistema Único de Saúde e comparar os dados obtidos com os de outros países. Métodos: foi realizado um estudo observacional transversal quantitativo, com dados provenientes do Sistema de Informação do Câncer ­ SISCAN sobre o número de mamografias feitas de 2014 a 2022 por mulheres, no Brasil. Resultados: os dados referentes à mamografia na população de risco elevado demonstraram uma queda de 38,39% de 2019 para 2020. Enquanto na mamografia de rastreamento a queda foi ligeiramente maior, de 39,18% nesse mesmo período. Em relação à mamografia diagnóstica, a redução foi de 33,15%, e na mamografia de população-alvo, o ápice foi em 2019 com 2.721.075. Em contrapartida, a realização de mamografia em pacientes já tratadas, teve uma menor queda, de 9,35%. Conclusões: observou-se uma queda significativa no número de mamografias realizadas em 2019 e 2020, o que poderá acarretar em diagnósticos tardios da doença e piores prognósticos (AU).


Objectives: investigating the impact of the pandemic on breast cancer screening in the Unified Health System, in addition to comparing the data obtained from other countries. Methods: a quantitative cross-sectional observational study was carried out, with references from the Cancer Information System - SISCAN on the number of mammograms performed from 2014 to 2022 by women in Brazil. Results: data regarding mammography in the high-risk population showed a drop of 38,39% from 2019 to 2020. While in screening mammography, the decline was slightly more significant, at 39.18% in the same period. Regarding diagnostic mammography, the reduction was 33.15%, and in target population mammography, the peak was in 2019 with 2.721.075. On the other hand, the performance of mammography in patients already treated had a smaller decrease of 9.35%. Conclusions: there was a significant reduction in the number of mammograms performed in 2019 and 2020, which might lead to a late diagnosis of the disease and a worse prognosis (AU),


Subject(s)
Humans , Female , Breast Neoplasms/diagnosis
3.
FEMINA ; 51(4): 228-232, 20230430.
Article in Portuguese | LILACS | ID: biblio-1512396

ABSTRACT

PONTOS-CHAVE As lesões mamárias compreendem uma ampla variedade de diagnósticos que apresentam comportamentos diversos. As lesões mamárias podem ser classificadas como lesões benignas, de potencial de malignidade indeterminado (B3), carcinoma in situ e carcinoma invasor. Na era da medicina personalizada, individualizar e obter um diagnóstico preciso faz grande diferença no desfecho final da paciente, principalmente no caso do câncer de mama. Exames de imagem direcionados e de qualidade, métodos de biópsia adequadamente selecionados e análises de anatomopatologia convencional, imuno-histoquímica e até molecular são determinantes no diagnóstico e no manejo das pacientes.


Subject(s)
Humans , Female , Breast Diseases/diagnosis , Breast Neoplasms/diagnosis , Molecular Diagnostic Techniques/instrumentation , Axilla/diagnostic imaging , Immunohistochemistry/methods , Magnetic Resonance Imaging/methods , Mammography , Mammary Glands, Human/diagnostic imaging , Cell Biology
4.
Int. j. morphol ; 41(1): 25-29, feb. 2023. tab, graf
Article in English | LILACS | ID: biblio-1430513

ABSTRACT

SUMMARY: Digit ratio established in utero is positivelly correlated with intrauterine level of estrogen. Since the breast cancer is related to excessive and prolonged exposure to estrogen, digit ratio might be considered as useful marker in breast cancer risk assessment. The aim of the present study was to compare digit ratios in breast cancer patients and healthy controls. The study group consisted of 98 breast cancer patients aged between 29 to 84 years while the control group included 141 healthy women aged between 21 and 67 years. After collecting anamnestic data concerning menopausal status, the length of second and fourth fingers were measured and the digit ratios were calculated for both hands, as well as the difference between right and left digit ratio. Digit ratio was significantly higher on right hand in breast cancer patients compaired to healthy controls (1.003±0.05 vs. 0.990±0.03). Right digit ratio showed better predictive capacity for the breast cancer development then the left (AUC:0.609 vs. 0.541). Negative statistically significant correlation between right digit ratio and the age of breast cancer diagnosis was observed (r=-0.271). Higher values of right digit ratio in women with breast cancer when compared to healthy women suggest their higher prenatal estrogen exposure that confirms the importance of digit ratio determination in breast cancer risk assessment.


La proporción de dígitos establecida en el útero, se correlaciona positivamente con el nivel intrauterino de estrógeno. Dado que el cáncer de mama está relacionado con una exposición excesiva y prolongada a los estrógenos, la proporción de dígitos podría considerarse un marcador útil en la evaluación del riesgo de cáncer de mama. El objetivo del presente estudio fue comparar proporciones de dígitos en pacientes con cáncer de mama y controles sanos. El grupo de estudio consistió en 98 pacientes con cáncer de mama con edades comprendidas entre los 29 y los 84 años, mientras que el grupo de control incluyó a 141 mujeres sanas con edades comprendidas entre los 21 y los 67 años. Después de recopilar datos anamnésticos sobre el estado menopáusico, se midió la longitud de los dedos segundo y anular y se calcularon las proporciones de los dedos para ambas manos, así como la diferencia entre la proporción de los dedos derecho e izquierdo. La proporción de dígitos fue significativamente mayor en la mano derecha en pacientes con cáncer de mama en comparación con controles sanos (1,003 ± 0,05 frente a 0,990 ± 0,03). La proporción del dígito derecho mostró una mejor capacidad predictiva para el desarrollo de cáncer de mama que el izquierdo (AUC: 0.609 vs. 0.541). Se observó una correlación estadísticamente significativa negativa entre la proporción de dígitos derechos y la edad del diagnóstico de cáncer de mama (r=-0,271). Los valores más altos de la proporción de dígitos derechos en mujeres con cáncer de mama en comparación con mujeres sanas sugieren una mayor exposición prenatal a estrógenos que confirma la importancia de la determinación de la proporción de dígitos en la evaluación del riesgo de cáncer de mama.


Subject(s)
Humans , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Breast Neoplasms/diagnosis , Breast Neoplasms/pathology , Fingers/anatomy & histology , ROC Curve , Sensitivity and Specificity , Age Factors , Digit Ratios
5.
Online braz. j. nurs. (Online) ; 22(supl.1): e20236635, 03 fev 2023. ilus
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1437014

ABSTRACT

OBJETIVO: Protocolo de revisão de escopo que será conduzida de acordo com a metodologia do Joanna Briggs Institute (JBI) para mapear e caracterizar evidências disponíveis sobre o uso de intervenções baseadas em mindfulness para manejo da dor em pessoas com diagnóstico de câncer de mama, nas diferentes etapas de tratamento. MÉTODO: Serão incluídos estudos realizados em mulheres adultas com 18 anos ou acima, que tenham recebido diagnóstico de câncer de mama e que passaram por intervenções baseadas em atenção plena direcionadas para manejo da dor. Será considerado o contexto clínico das participantes. Incluiremos artigos de estudos quantitativos e qualitativos, além da chamada literatura cinzenta, sem limites de idioma e tempo. Será utilizada uma estratégia de pesquisa em 3 etapas. As bases de dados utilizadas serão PubMed, CINAHL, Web of Science, BVS, PsycInfo e Google Scholar. Os resultados serão apresentados de forma gráfica e resumo narrativo, redigidos de acordo com o PRISMA-ScR.


OBJECTIVE: A scope review protocol that will be conducted according to the Joanna Briggs Institute (JBI) methodology to map and characterize available evidence on the use of mindfulness-based interventions for pain management in people diagnosed with breast cancer throughout different stages of treatment. METHOD: Studies conducted in adult women aged 18 years or older, who have received a diagnosis of breast cancer and who have undergone mindfulness-based interventions aimed at pain management will be included. The clinical context of the participants will be considered. We will include articles from quantitative and qualitative studies, in addition to the so-called grey literature, with no limits on language and time. A 3-step research strategy will be used. The following databases will be used: PubMed, CINAHL, Web of Science, VHL, PsycInfo, and Google Scholar. The results will be presented in a graphic and narrative summary, written in accordance with PRISMA-ScR.


Subject(s)
Humans , Female , Breast Neoplasms/diagnosis , Chronic Pain , Pain Management , Mindfulness , Cancer Pain
6.
Mastology (Online) ; 332023. graf, tab
Article in English | LILACS | ID: biblio-1433829

ABSTRACT

Breast cancer is associated with high frequency and mortality in Brazilian women. There have been limited studies portraying the characteristics of breast cancer cases in the countryside of the state of Minas Gerais for a long period of time, a fact that will allow us to better understand the epidemiology of these tumors. This descriptive study aims to analyze the epidemiology and clinical features of patients with breast cancer treated at a public health service facility in Lavras, MG. Methods: This is a transversal study with 299 women diagnosed with breast cancer between 2002 and 2022, based on data collection from medical records and subsequent descriptive analysis. Results: There were a total of 317 cases, and 299 were eligible for the study. The mean age at diagnosis was 54.2 years, and 36.1% of the patients were under 50 years old at diagnosis. Positive family history was found in 17.0% of the patients. The diagnosis was made by clinical alteration detected on physical examination in 71.5% of cases, and lump was the most frequent type of lesion (89.0%). Invasive carcinoma was 93.1% of the cases, and the mean tumor size was 28.6 mm. The average time between first medical appointment and diagnosis was 63.2 days, and between diagnosis and beginning of treatment was 39.6 days. Conclusions: This study showed that a significant number of cases occurred in women outside the recommended age for screening in Brazil. Diagnosis was predominantly performed by clinical examination, with delays in obtaining the histological diagnosis, and the stage at diagnosis was high, and these facts were associated with the health system limitations (AU)


Subject(s)
Humans , Female , Adult , Middle Aged , Aged , Breast Neoplasms/diagnosis , Breast Neoplasms/pathology , Breast Neoplasms/epidemiology , Brazil/epidemiology , Breast Neoplasms , Cross-Sectional Studies , Retrospective Studies
7.
Epidemiol. serv. saúde ; 32(1): e2022563, 2023. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1421413

ABSTRACT

Objective: to analyze treatment delay and the flow of care for women with breast cancer in Brazil in 2019 and 2020. Method: this was a follow-up study of breast cancer cases available from the Oncology Panel; a chi-square test and multilevel logistic regression were performed in order to analyze the explanatory variables associated with delay (greater than 60 days) in starting treatment. Results: 22,956 cases (54.5%) with delay in treatment were identified in 2019 and 17,722 (48.7%) in 2020; the Southeast region (54.6%) had the greatest proportion of delay; delay was greater when treatment was provided outside the municipality of residence and lower in 2020 compared to 2019; most outward flows were to the capital cities in the same Federative Units of residence. Conclusion: strategies to reduce cancer treatment delay and optimize health care networks in the Federative Units should be prioritized.


Resumen Objetivo: analizar la demora en el tratamiento y el flujo asistencial de mujeres con cáncer de mama en Brasil en 2019 y 2020. Método: estudio de seguimiento de los casos de cáncer de mama disponibles en el Panel de Oncología. Para analizar las variables explicativas asociadas al retraso (mayor de 60 días) en el inicio del tratamiento se realizó la prueba de chi-cuadrado y la regresión logística multinivel. Resultados: se identificaron 22.956 casos (54,5%) en 2019 y 17.722 (48,7%) en 2020 con retraso en el tratamiento. La región Sudeste (54,6%) tuvo mayor proporción de atraso, siendo mayor cuando se realizó fuera del municipio de residencia y menor en 2020 en relación a 2019. Los flujos externos, en su mayoría, ocurrieron en las capitales de las mismas Unidades de la Federación (UFs) de residencia. Conclusión: se deben priorizar estrategias que reduzcan el intervalo de tiempo hasta el inicio del tratamiento del cáncer y optimicen las redes de atención de salud en los estados.


Objetivo: analisar o atraso para o tratamento e o fluxo assistencial de mulheres com câncer de mama no Brasil em 2019 e 2020. Métodos: estudo de seguimento de casos de câncer de mama disponibilizados no PAINEL-Oncologia; para analisar as variáveis explicativas associadas ao atraso (maior que 60 dias) no início do tratamento, realizou-se teste qui-quadrado e regressão logística multinível. Resultados: identificaram-se 22.956 casos (54,5%) em 2019 e 17.722 (48,7%) em 2020, com atraso para o tratamento; a região Sudeste (54,6%) teve maior proporção de atraso, que foi maior quando o tratamento foi realizado fora do município de residência, e menor em 2020, comparando-se a 2019; os fluxos externos, em sua maioria, ocorreram para as capitais das mesmas Unidades da Federação (UFs) de residência. Conclusão: estratégias que diminuam o intervalo de tempo até o início do tratamento oncológico e otimizem as redes de atenção em saúde nas UFs devem ser priorizadas.


Subject(s)
Humans , Female , Adult , Middle Aged , Aged , Breast Neoplasms/diagnosis , Breast Neoplasms/therapy , Time-to-Treatment , Health Services Accessibility , Socioeconomic Factors , Brazil/epidemiology , Health Information Systems , Social Determinants of Health
8.
Chinese Journal of Biotechnology ; (12): 1425-1444, 2023.
Article in Chinese | WPRIM | ID: wpr-981147

ABSTRACT

The estimated new cases of breast cancer (BC) patients were 2.26 million in 2020, which accounted for 11.7% of all cancer patients, making it the most prevalent cancer worldwide. Early detection, diagnosis and treatment are crucial to reduce the mortality, and improve the prognosis of BC patients. Despite the widespread use of mammography screening as a tool for BC screening, the false positive, radiation, and overdiagnosis are still pressing issues that need to be addressed. Therefore, it is urgent to develop accessible, stable, and reliable biomarkers for non-invasive screening and diagnosis of BC. Recent studies indicated that the circulating tumor cell DNA (ctDNA), carcinoembryonic antigen (CEA), carbohydrate antigen 15-3 (CA15-3), extracellular vesicles (EV), circulating miRNAs and BRCA gene from blood, and the phospholipid, miRNAs, hypnone and hexadecane from urine, nipple aspirate fluid (NAF) and volatile organic compounds (VOCs) in exhaled gas were closely related to the early screening and diagnosis of BC. This review summarizes the advances of the above biomarkers in the early screening and diagnosis of BC.


Subject(s)
Humans , Female , Biomarkers, Tumor , Early Detection of Cancer , Breast Neoplasms/diagnosis , Prognosis , MicroRNAs/genetics
9.
Rev. bras. ginecol. obstet ; 45(9): 535-541, 2023. tab
Article in English | LILACS | ID: biblio-1521774

ABSTRACT

Abstract Objective Breast cancer (BC) biomarkers, such as hormone receptors expression, are crucial to guide therapy in BC patients. Antiandrogens have been studied in BC; however, limited data are available on androgen receptor (AR) expression test methodology. We aim to report the core needle biopsy (CNB) accuracy for AR expression in BC. Methods Patients diagnosed with stage I-III invasive BC from a single institution were included. Androgen receptor expression was evaluated by immunohistochemistry (IHC) using 1 and 10% cutoff and the AR expression in surgical specimens (SS) was the gold standard. Kappa coefficients were used to evaluate the intraprocedural agreement. Results A total of 72 patients were included, with a mean age of 61 years old and 84% were Luminal A or B tumors. The prevalence of AR expression in all BC samples was 87.5% using a cutoff ≥ 10% in SS. With a cutoff value ≥ 1%, CNB had an accuracy of 95.8% (Kappa value = 0.645; 95% confidence interval [CI]: 0.272-1.000; p< 0.001) and 86.1% (Kappa value = 0.365; 95% CI: 0.052-0.679; p< 0.001) when ≥ 10% cutoff was used for AR positivity. Androgen receptor expression in CNB (cutoff ≥ 1%) had a sensitivity of 98.5%, specificity of 60%, positive predictive value of 97.0%, and a negative predictive value of 76.9% in the detection of AR expression in SS. Conclusion Core needle biopsy has good accuracy in evaluating AR expression in BC. The accuracy of CNB decreases with higher cutoff values for AR positivity.


Resumo Objetivo Biomarcadores, como a expressão de receptores hormonais, são cruciais para guiar a terapia de pacientes com câncer de mama. Apesar de ter sido estudado, poucos dados estão disponíveis sobre o método de testagem. Buscamos avaliar a precisão da biópsia com agulha de grande calibre (CNB, na sigla em inglês) para a expressão de receptores androgênicos (AR, na sigla em inglês) no câncer de mama. Métodos Foram incluídos pacientes de uma única instituição diagnosticados com câncer de mama invasivo estágio I-III. A expressão de AR foi avaliada por imunohistoquímica, com valores de cutoff de 1 e 10%. A expressão de AR em espécimes cirúrgicos foi o padrão ouro. O coeficiente Kappa foi usado para avaliar a concordância entre procedimentos. Resultados Foi incluído um total de 72 pacientes, com idade média de 61 anos; 84% eram tumores luminais A ou B. A prevalência da expressão de AR em todas as amostras foi de 87.5%, com cutoff ≥ 10%. Com um valor de cutoff ≥ 1%, a CNB teve precisão de 95.8% (Kappa = 0.64; intervalo de confiança [IC] 95%: 0.272-1.000; p< 0.001) e 86.1% (Kappa = 0.365; CI95%: 0.052-0.679]; p< 0.001) quando um cutoff ≥ 10% foi usado para AR positivo. A expressão de AR na CNB (cutoff ≥ 1%) teve a sensibilidade de 98.5%, especificidade de 60%, valor preditivo positivo de 97.0% e valor preditivo negativo de 76.9% na detecção. Conclusão -Biópsia com agulha de grande calibre tem uma boa precisão em avaliar a expressão de AR no câncer de mama. A precisão do método cai com valores elevados de cutoff para AR positivo.


Subject(s)
Humans , Female , Breast Neoplasms/diagnosis , Immunohistochemistry , Receptors, Androgen , Biomarkers, Tumor , Biopsy, Large-Core Needle
10.
Article in Spanish | LILACS, CUMED | ID: biblio-1536306

ABSTRACT

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)


Subject(s)
Humans , Female , Pyrogallol/antagonists & inhibitors , Breast Neoplasms/diagnosis , Carcinoma, Ductal, Breast/epidemiology , Biopsy, Fine-Needle/methods , Enzyme Inhibitors/analysis , Correlation of Data
11.
Biol. Res ; 56: 1-1, 2023. ilus, tab
Article in English | LILACS | ID: biblio-1420299

ABSTRACT

Cell cycle is one of the main cellular mechanisms involved in tumor progression. Almost all of the active molecular pathways in tumor cells directly or indirectly target the cell cycle progression. Therefore, it is necessary to assess the molecular mechanisms involved in cell cycle regulation in tumor cells. Since, early diagnosis has pivotal role in better cancer management and treatment, it is required to introduce the non-invasive diagnostic markers. Long non-coding RNAs (LncRNAs) have higher stability in body fluids in comparison with mRNAs. Therefore, they can be used as efficient non-invasive markers for the early detection of breast cancer (BCa). In the present review we have summarized all of the reported lncRNAs involved in cell cycle regulation in BCa. It has been reported that lncRNAs mainly affect the cell cycle in G1/S transition through the CCND1/CDK4-6 complex. Present review paves the way of introducing the cell cycle related lncRNAs as efficient markers for the early detection of BCa.


Subject(s)
Humans , Female , Breast Neoplasms/diagnosis , Breast Neoplasms/genetics , Breast Neoplasms/pathology , RNA, Long Noncoding/genetics , RNA, Long Noncoding/metabolism , Cell Cycle/genetics , Cell Division , Cell Cycle Checkpoints
12.
Rev. Bras. Saúde Mater. Infant. (Online) ; 23: e20220326, 2023. tab, graf
Article in English | LILACS | ID: biblio-1507325

ABSTRACT

Abstract Objectives: to analyze the impact of the covid-19 pandemic on screening, diagnosis and treatment of breast cancer in Pernambuco, Northeastern Brazil. Method: cross-sectional study, based on secondary data from consultations with a mastologist, ultrasound, mammogram, biopsies, new cases, chemotherapy, radiotherapy and surgery, carried out in women for the screening, diagnosis and treatment of breast cancer, from January to December of the years 2019 to 2021. Results: the covid-19 pandemic reduced consultations with mastology (46.3%), ultrasounds (34.8%), mammogram (41.5%), biopsy (49.6%), new cases 45.7 % and surgery 34.6% in 2020 compared to 2019. On the other hand, with the exception of consultations with a mastologist and surgeries, all services where a significant reduction was observed in 2020, increased significantly in 2021 and returned to the same level of production in the pre-pandemic period. The pandemic did not negatively affect the supply of chemotherapy and radiotherapy. Conclusions: the findings of this study indicate negative impacts on breast cancer care, due to covid-19, during the first year of the pandemic, especially in consultations with a mastologist and surgery, which continued with low production in 2021. It is reasonable to assume that the reduction observed in procedures may reflect an increase in late diagnoses and a higher mortality rate in the coming years


Resumo Objetivos: analisar o impacto da pandemia da covid-19 nos atendimentos para rastreamento, diagnóstico e tratamento do câncer de mama em Pernambuco, Nordeste do Brasil. Métodos: estudo transversal, com base em dados secundários de consultas com mastologista, ultrassonografia, mamografia, biópsias, casos novos, quimioterapia, radioterapia e cirurgia, realizadas em mulheres para o rastreamento, diagnóstico e tratamento do câncer de mama, de janeiro a dezembro dos anos 2019 a 2021. Resultados: a pandemia da covid-19 reduziu as consultas com a mastologia (46,3%), ultrassonografias (34,8%), mamografia (41,5%), biópsia (49,6%), casos novos 45,7% e cirurgia 34,6% no ano de 2020 em relação ao ano de 2019. Por outro lado, com exceção das consultas com mastologista e cirurgias, todos os serviços onde se observou redução significativa em 2020, aumentaram significativamente em 2021 e voltaram ao patamar de produção do período pré-pandemia. A pandemia não afetou negativamente a oferta de quimioterapia e radioterapia. Conclusões: os achados deste estudo apontam impactos negativos na atenção ao câncer de mama, em decorrência da covid-19, durante o primeiro ano da pandemia, sobretudo nas consultas com mastologista e cirurgia, que continuaram com baixa produção em 2021. É razoável supor que a redução constatada nos procedimentos poderá refletir em um aumento de diagnósticos tardios e maior taxa de mortalidades nos próximos anos.


Subject(s)
Humans , Female , Breast Neoplasms/diagnosis , Breast Neoplasms/therapy , COVID-19/epidemiology , Brazil/epidemiology , Medical Records , Oncology Service, Hospital
13.
Article in English | LILACS | ID: biblio-1517540

ABSTRACT

Objective: To present the updated recommendations of the Brazilian College of Radiology and Imaging Diagnosis, the Brazilian Society of Mastology and the Brazilian Federation of Gynecology and Obstetrics Associations for breast cancer screening in Brazil. Methods: Between January 2012 and July 2022, searches for scientific evidence published in MEDLINE, Embase, Cochrane Library, EBSCO, CINAHL and LILACS were carried out. The recommendations were based on this evidence, with the consensus of a committee of experts from the three institutions. Recommendations: The annual mammography screening is recommended for normal-risk patients aged between 40 and 74 years. For women aged more than 75 years, it is reserved for those whose life expectancy is longer than seven years. Women whose risk is higher than normal, such as those with dense breasts, personal history of atypical lobular hyperplasia, classic in situ lobular carcinoma, atypical ductal hyperplasia, women undergoing breast cancer treatment or thoracic irradiation before the age of 30, or those with genetic mutation or strong family history, benefit from complementary screening, being considered in an individual manner. Tomosynthesis is an evolution of mammography and should be considered in screening whenever accessible and available


Subject(s)
Humans , Female , Breast Neoplasms/diagnosis , Mass Screening , Societies, Medical , Brazil
14.
Arq. ciências saúde UNIPAR ; 26(3): 964-975, set-dez. 2022.
Article in Portuguese, French | LILACS | ID: biblio-1399515

ABSTRACT

O câncer de mama é o segundo tipo de câncer mais incidente no mundo. Após o diagnóstico, inúmeras são as alterações e os sentimentos que vêm à tona na vida da mulher, desde a descoberta até a recuperação. Diante disso, objetivou-se analisar os saberes e sentimentos de mulheres mastectomizadas sobre o câncer de mama. Trata-se de estudo descritivo com abordagem qualitativa, realizado no Grupo Amigos do Peito, localizado na cidade de Cajazeiras, estado da Paraíba, Brasil. As participantes do estudo foram dez mulheres que compõem o grupo. Para a coleta de dados utilizou- se de entrevista semiestruturada que foram posteriormente analisadas por meio do Discurso do Sujeito Coletivo. A análise dos discursos permitiu a compreensão de três categorias que norteavam sobre saberes e sentimentos vivenciados por mulheres mastectomizadas frente ao câncer, a saber: Fragilidades na definição do câncer de mama; Sentimentos originados pela descoberta da doença; e Sentimentos negativos decorrentes da mastectomia. A própria mulher diagnosticada com a neoplasia não apresenta conhecimento sobre o assunto, porém, expõe características negativas à doença. Além disso, o impacto causado pelo diagnóstico da doença e pelo tratamento cirúrgico é imenso, tendo em vista que a doença traz consigo uma série de transformações na vida, corpo e mente da mulher. Destarte, as mulheres entrevistadas não conseguiam definir a neoplasia da mama com precisão e apresentaram sentimentos negativos relacionados ao câncer e a realização da mastectomia. Contudo, os resultados das ações educativas mostraram-se satisfatórios, e possibilitaram que a mulher se sentisse mais segura e acolhida.


Breast cancer is the second most common type of cancer in the world. After the diagnosis, there are countless changes and feelings that come to light in a woman's life, from discovery to recovery. Therefore, the objective was to analyze the knowledge and feelings of mastectomized women about breast cancer. This is a descriptive study with a qualitative approach, carried out at Grupo Amigos do Peito, located in the city of Cajazeiras, state of Paraíba, Brazil. The study participants were ten women who make up the group. For data collection, semi-structured interviews were used, which were later analyzed through the Collective Subject Discourse. The analysis of the speeches allowed the understanding of three categories that guided the knowledge and feelings experienced by mastectomized women in the face of cancer, namely: Weaknesses in the definition of breast cancer; Feelings caused by the discovery of the disease; and Negative feelings resulting from the mastectomy. The woman diagnosed with the neoplasm does not have knowledge on the subject, however, she exposes negative characteristics to the disease. In addition, the impact caused by the diagnosis of the disease and the surgical treatment is immense, given that the disease brings with it a series of transformations in the woman's life, body and mind. Thus, the women interviewed were not able to define breast cancer precisely and had negative feelings related to cancer and the performance of mastectomy. However, the results of the educational actions proved to be satisfactory, and made it possible for the woman to feel more secure and welcomed.


El cáncer de mama es el segundo tipo de cáncer más frecuente en el mundo. Tras el diagnóstico, son innumerables las alteraciones y sentimientos que afloran en la vida de la mujer, desde el descubrimiento hasta la recuperación. Por lo tanto, este estudio tuvo como objetivo analizar el conocimiento y los sentimientos de las mujeres mastectomizadas sobre el cáncer de mama. Se trata de un estudio descriptivo con enfoque cualitativo, realizado en el Grupo Amigos do Peito, ubicado en la ciudad de Cajazeiras, estado de Paraíba, Brasil. Las participantes en el estudio fueron diez mujeres que componen el grupo. Para la recolección de datos, se utilizaron entrevistas semiestructuradas que posteriormente fueron analizadas a través del Discurso del Sujeto Colectivo. El análisis de los discursos permitió comprender tres categorías que orientaron sobre el conocimiento y los sentimientos experimentados por las mujeres mastectomizadas que se enfrentan al cáncer, a saber Fragilidades en la definición del cáncer de mama; Sentimientos originados por el descubrimiento de la enfermedad; y Sentimientos negativos derivados de la mastectomía. La propia mujer diagnosticada con la neoplasia no presenta conocimientos sobre el tema, sin embargo, expone características negativas a la enfermedad. Además, el impacto causado por el diagnóstico de la enfermedad y el tratamiento quirúrgico es inmenso, teniendo en cuenta que la enfermedad trae consigo una serie de transformaciones en la vida, el cuerpo y la mente de la mujer. Por lo tanto, las mujeres entrevistadas no fueron capaces de definir el cáncer de mama con precisión, y presentaron sentimientos negativos relacionados con el cáncer y con la realización de la mastectomía. Sin embargo, los resultados de las acciones educativas fueron satisfactorios y permitieron a la mujer sentirse más segura y aceptada.


Subject(s)
Humans , Female , Adult , Middle Aged , Women/psychology , Breast Neoplasms/psychology , Knowledge , Emotions , Mastectomy/psychology , Breast Neoplasms/diagnosis , Women's Health
15.
Rev. cuba. cir ; 61(3)sept. 2022.
Article in Spanish | LILACS, CUMED | ID: biblio-1441517

ABSTRACT

Introducción: El carcinoma adenoide quístico es una neoplasia maligna poco común y a menudo agresiva, que puede surgir en una variedad de órganos portadores de glándulas. Objetivo: Caracterizar la presentación de una neoplasia maligna agresiva infrecuente, el carcinoma adenoide quístico. Caso clínico: Paciente de 56 años que acudió a cuerpo de guardia con lesión en cuero cabelludo correspondiente con cilindroma maligno. Se estudia posteriormente y se constataron además lesiones a nivel de mamas, colon y recidiva en el cuero cabelludo, que dieron como resultado carcinoma adenoide quístico. Conclusiones: Es infrecuente; realizar su diagnóstico conlleva un alto índice de sospecha y su diagnóstico es histopatológico. Su pronóstico depende de la localización primaria y tiende a ser muy agresivo cuando se localiza fuera de la mama(AU)


Introduction: Adenoid cystic carcinoma is an uncommon and often aggressive malignant neoplasm that can arise in a variety of gland-bearing organs. Objective: To characterize the presentation of an uncommon aggressive malignancy, adenoid cystic carcinoma. Clinical case: 56-year-old patient who presented to the on-call department with a lesion on the scalp corresponding to malignant cylindroma. She was subsequently studied and lesions were also found in the breast, colon and recurrence in the scalp, which resulted in adenoid cystic carcinoma. Conclusions: It is infrequent; making its diagnosis involves a high index of suspicion and its diagnosis is histopathological. Its prognosis depends on the primary location and it tends to be very aggressive when located outside the breast(AU)


Subject(s)
Humans , Female , Middle Aged , Breast Neoplasms/diagnosis , Carcinoma, Adenoid Cystic/diagnosis
16.
Rev. méd. Urug ; 38(3): e38305, sept. 2022.
Article in Spanish | LILACS, BNUY | ID: biblio-1409862

ABSTRACT

Resumen: Introducción: en Uruguay el cáncer de mama (CM) ocupa el primer lugar en incidencia y mortalidad por cáncer en la mujer. Objetivo: conocer la implementación del tamizaje del CM en la práctica clínica habitual y el grado de adhesión a las recomendaciones planteadas en el año 2015 por el Ministerio de Salud Pública (MSP) para la detección temprana del CM entre los médicos del primer nivel de atención. Material y métodos: se trata de un estudio observacional descriptivo y transversal. Se aplicó una encuesta dirigida a médicos del primer nivel de atención, de carácter anónimo. Resultados: se incluyeron 169 médicos, 89,4% (151) considera que el uso de la mamografía de tamizaje disminuye la mortalidad por CM, 54,4% (92) indica la mamografía a partir de los 40 años de edad y 38,5% (65) a partir de los 50 años. El 56,8% (96) indica la mamografía cada 2 años en la población de mujeres que se encuentran entre 50 y 69 años. El 65,7% de los encuestados (111) conoce la guía nacional y 47,9% (81) la utiliza, mientras que el 18,9% (32) utiliza recomendaciones de otras sociedades científicas. Conclusión: el presente estudio evidenció que los médicos del primer nivel de atención hacen un uso correcto de las distintas herramientas de tamizaje del CM. Se necesitan medidas activas para desarrollar programas educativos para el personal de salud, que podrían permitirles difundir conocimientos e influir positivamente en las actitudes de los pacientes.


Summary: Introduction: in Uruguay, breast cancer (BC) is the leading cause of cancer incidence and mortality in women. Objective: to understand the implementation of BC screening among primary care physicians in routine clinical practice and the degree of adherence to the recommendations put forward in 2015 by the Ministry of Public Health (MPH) for the early detection of BC. Materials and methods: this was a descriptive, cross-sectional, observational study. An anonymous survey was administered to physicians working in primary care. Results: 169 physicians were included, 89.4% (151) consider the use of screening mammography decreases mortality from BC, 54.4% (92) indicate mammography from 40 years of age and 38.5% (65) from 50 years of age. The majority (56.8%, 96) indicate mammography every 2 years in the population of women aged 50-69 years. Of the respondents, 65.7% (111) were aware of the national guidelines and 47.9% (81) followed them, while 18.9% (32) followed recommendations from other scientific bodies. Conclusion: this study showed that primary care physicians make correct use of the different BC screening tools. Active measures are needed to develop educational programs for healthcare personnel, which may enable them to disseminate knowledge and positively influence patients' attitudes.


Resumo: Introdução: o câncer de mama (CM) ocupa o primeiro lugar em incidência e mortalidade por câncer em mulheres no Uruguai. Objetivo: conhecer a implementação do rastreamento do CM na prática clínica de rotina e o grau de adesão às recomendações de 2015 do Ministério da Saúde Pública para detecção precoce do CM entre os médicos do primeiro nível de atenção. Material e métodos: trata-se de um estudo observacional descritivo e transversal. Foi aplicada uma pesquisa anônima destinada aos médicos do primeiro nível de atenção. Resultados: foram incluídos 169 médicos; 89,4% (151) consideram que o uso da mamografia de rastreamento diminui a mortalidade por CM, 54,4% (92) indicam mamografia a partir dos 40 anos e 38,5% (65) a partir dos 50 anos; 56,8% (96) indicam mamografia a cada 2 anos na população de mulheres entre 50 e 69 anos. 65,7% dos respondentes (111) conhecem o guia nacional e 47,9% (81) o utilizam, enquanto 18,9% (32) utilizam recomendações de outras sociedades científicas. Conclusão: este estudo mostrou que os médicos do primeiro nível de atenção fazem uso correto das diferentes ferramentas de rastreamento do CM. São necessárias medidas ativas para desenvolver programas educacionais para os profissionais de saúde, que possam permitir que eles disseminem o conhecimento e influenciem positivamente as atitudes dos pacientes.


Subject(s)
Humans , Male , Female , Physicians/statistics & numerical data , Breast Neoplasms/diagnosis , Health Knowledge, Attitudes, Practice , Mass Screening , Primary Health Care , Mammography , Cross-Sectional Studies , Surveys and Questionnaires , Guideline Adherence
17.
Rev. APS ; 25(Supl. 2): 21-39, 16/08/2022.
Article in Portuguese | LILACS | ID: biblio-1393131

ABSTRACT

Em relação à última diretriz brasileira do Instituto Nacional do Câncer/Ministério da Saúde sobre a detecção precoce do câncer de mama, destacamos as incertezas sobre a tomada de decisão compartilhada relativas a benefícios e riscos do rastreamento mamográfico. Este artigo expressa as percepções de usuárias de serviços de Atenção Primária à Saúde sobre a decisão compartilhada nesse cenário, sendo resultado de uma pesquisa qualitativa que utilizou grupos focais, como instrumentos de produção de dados, e análise de conteúdo temática, para a sistematização de resultados. As participantes revelaram não participarem dedecisão compartilhada no rastreamento mamográfico, o que nos leva a ressaltar a importância de nortear os cuidados em saúde com base em tecnologias leves, ou seja, tecnologias relacionais, e a valorizar, também, a necessidade de implementação de certos aspectos conceituais e de princípios fundamentais, que precisam ser discutidos e realçados para que a decisão compartilhada seja implementada.


According to the latest Brazilian guidelines from the National Cancer Institute/Ministry of Health on early detection of breast cancer, we highlight the uncertainties about shared decision-making concerning the benefits and risks of mammographic screening. This article expresses the perceptions of users of Primary Health Care services concerning shared decision-making in this scenario. As a result of qualitative research, it used focus groups as an instrument for data production and thematic content analysis to systematize the results. The participants revealed that there is no shared decision-making concerning mammographic screening, which leads us to emphasize that health care guidelines should be based on light technologies,that is, relational technologies. They should also discuss and highlight related conceptual aspects and fundamental principles so that shared decision-making can be implemented.


Subject(s)
Humans , Female , Primary Health Care , Breast Neoplasms/diagnosis , Mammography , Mass Screening , Decision Making, Shared , Focus Groups , Qualitative Research , Early Detection of Cancer
18.
Rev Rene (Online) ; 23: e71920, 2022. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1376111

ABSTRACT

RESUMO Objetivo verificar a associação entre as características sociodemográficas e a realização das ações de detecção precoce do câncer de mama. Métodos estudo transversal, realizado em seis unidades de atenção primária à saúde, com 400 mulheres consideradas população-alvo para ações de detecção precoce do câncer de mama. Para análise inferencial foi utilizado o Teste de Qui-quadrado de Independência (2x2). Resultados a maioria das mulheres estava entre 60 e 64 anos, eram casadas, com baixa escolaridade, sem ocupação ou plano de saúde. Foi encontrada associação significativa entre o estado civil e o intervalo entre a solicitação e a realização da mamografia (X 2 (1)= 208,185, p<0,001, Phi-coefficient = 0,902; Intervalo de Confiança: 0,0308-0,0928). Mulheres sem companheiro apresentaram prevalência 0,95 vezes maior de realizar mamografia. Conclusão houve associação da variável sociodemográfica estado civil com a realização da mamografia, em um intervalo menor de tempo, tendo como fator de proteção não possuir companheiro. Contribuições para a prática a elucidação de fatores que podem estar relacionados com a realização das ações para rastreio do câncer de mama pode sinalizar para os profissionais de saúde as pacientes que necessitam de uma maior vigilância no que concerne à presença de sinais e sintomas sugestivos do câncer de mama.


ABSTRACT Objective to verify the association between sociodemographic characteristics and the performance of actions for early detection of breast cancer. Methods a cross-sectional study was carried out in six primary health care units, with 400 women considered a target population for actions for early detection of breast cancer. The Chi-square test of independence (2x2) was used for inferential analysis. Results most women were between 60 and 64 years old, married, had low education and lacked an occupation or health insurance. A significant association was found between marital status and the interval between requesting and performing a mammogram (X 2 (1) = 208.185, p<0.001, Phi-coefficient= 0.902; Confidence Interval: 0.0308-0.0928). Women without a partner had a 0.95 times higher prevalence of having a mammogram. Conclusion there was an association between the sociodemographic variable marital status and the performance of mammography in a shorter period, and not having a partner was a protective factor. Contributions to practice the elucidation of factors related to the performance of actions for breast cancer screening can signal patients who need greater vigilance regarding the presence of signs and symptoms suggestive of breast cancer.


Subject(s)
Humans , Female , Middle Aged , Breast Neoplasms/diagnosis , Early Detection of Cancer/statistics & numerical data , Sociodemographic Factors , Primary Health Care , Cross-Sectional Studies , Surveys and Questionnaires , Observational Studies as Topic
19.
ABC., imagem cardiovasc ; 35(4): eabc340, 2022. tab, ilus
Article in Portuguese | LILACS | ID: biblio-1425564

ABSTRACT

Fundamento: A cardiotoxicidade induzida por quimioterapia (CiC) é uma complicação importante entre os pacientes que recebem antraciclinas. Biomarcadores e parâmetros de imagem têm sido estudados por sua capacidade de identificar pacientes com risco de desenvolver essa complicação. O strain longitudinal global do ventrículo esquerdo (SLG-VE) tem sido descrito como um parâmetro sensível para detectar disfunção sistólica, mesmo na presença de fração de ejeção do ventrículo esquerdo (FEVE) preservada. Objetivo: avaliar o papel do SLG-VE como preditor de CiC. Métodos: O presente estudo consiste em uma análise post-hoc do estudo CECCY (Carvedilol for Prevention of ChemotherapyRelated Cardiotoxicity [Carvedilol para Prevenção da Cardiotoxicidade Relacionada à Quimioterapia]), que avaliou a prevenção primária de cardiotoxicidade com carvedilol durante quimioterapia com doxorrubicina em uma população com câncer de mama. Definiu-se cardiotoxicidade como uma redução >10% na FEVE. O SLG-VE foi obtido antes da quimioterapia em pacientes sem doença cardiovascular prévia ou anormalidades no ecocardiograma. Resultados: Trinta e um pacientes submetidos a estudo ecocardiográfico completo incluindo avaliação de SLG-VE antes da quimioterapia foram incluídos nesta análise. Um SLG-VE absoluto <16,9% antes da quimioterapia mostrou 100% de sensibilidade e 73% de especificidade para predizer cardiotoxicidade (AUC=0,85; IC 95% 0,680­0,959, p<0,001). Nesta população, os valores de FEVE antes da quimioterapia não foram preditores de CiC (IC 95% 0,478 a -0,842, p=0,17). A associação de baixos níveis séricos de SLG-VE (<17%) e BNP (>17 pg/mL) dois meses após a quimioterapia aumentou a precisão para detectar CiC de início precoce (100% de sensibilidade, 88% de especificidade, AUC=0,94; IC 95% 0,7810,995, p<0,0001). Conclusões: Nossos dados sugerem que o SLG-VE é um possível preditor de cardiotoxicidade induzida por quimioterapia. São necessários estudos maiores para confirmar a relevância clínica desse parâmetro ecocardiográfico nesse cenário clínico. (AU)


Background: Chemotherapy-induced cardiotoxicity (ChC) is an important complication among patients receiving anthracyclines. Biomarkers and imaging parameters have been studied for their ability to identify patients at risk of developing ChC. Left ventricular global longitudinal strain (LV-GLS) is a sensitive parameter for detecting systolic dysfunction despite the presence of preserved left ventricular ejection fraction (LVEF). Objective: To evaluate the role of the LV-GLS as a predictor of ChC. Methods: This was a post-hoc analysis of the Carvedilol for Prevention of Chemotherapy-Related Cardiotoxicity trial, which evaluated the primary prevention of cardiotoxicity with carvedilol during doxorubicin chemotherapy in a population of patients with breast cancer. Cardiotoxicity was defined as a reduction ≥10% in LVEF. LV-GLS was determined before chemotherapy in patients with no prior cardiovascular disease or echocardiogram abnormalities. Results: Thirty-one patients for whom a complete echocardiography study including measurement of LV-GLS was performed before chemotherapy were included in this analysis. An absolute LV-GLS<16.9% before chemotherapy showed 100% sensitivity and 73% specificity for predicting cardiotoxicity (area under the curve [AUC], 0.85; 95% confidence interval [CI], 0.680­0.959; p<0.001). In this population, LVEF values before chemotherapy did not predict ChC (95% CI, 0.478 to -0.842; p=0.17). The association of low LV-GLS (<17%) and brain-type natriuretic peptide serum levels (>17 pg/mL) at 2 months after chemotherapy increased the accuracy for detecting early-onset ChC (100% sensitivity, 88% specificity; AUC, 0.94; 95% CI, 0.781­0.995; p<0.0001). Conclusions: Our data suggest that LV-GLS is a potential predictor of ChC. Larger studies are needed to confirm its clinical relevance in this clinical setting. (AU)


Subject(s)
Humans , Male , Female , Middle Aged , Stroke Volume/drug effects , Ventricular Dysfunction, Left/diagnostic imaging , Cardiotoxicity/complications , Global Longitudinal Strain/drug effects , Breast Neoplasms/diagnosis , Echocardiography/methods , Biomarkers/analysis , Doxorubicin/therapeutic use , Anthracyclines/administration & dosage , Drug Therapy/methods , Carvedilol/toxicity , Heart Failure/prevention & control
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