Metabolic syndrome in women with breast cancer: scope review / Síndrome metabólica em mulheres com câncer de mama: revisão de escopo

Objective: To synthesize evidence involving pathophysiological and clinical-epidemiological linking mechanisms in women with breast cancer and metabolic syndrome. Method: This is a structured scoping review according to the Joanna Briggs Institute and was conducted in the PubMed, BDENF, LILACS, IBECS, CUMED, WPRIM, BINACIS, and Embase databases. This review is registered in the Open Science Framework. Result: Regarding the level of evidence of the included studies, moderate and strong evidence levels were predominant. There were no weak evidence findings in this research. The chronic inflammatory state of breast adipose tissue in patients with obesity can worsen the negative impact on cancer cells, directly affecting survival and recurrence. Unexplained weight gain or loss is associated with shorter survival in women with breast cancer, highlighting the need for specific guidance during treatment. Conclusion: Metabolic syndrome is associated with the risk of breast cancer; however, massive weight loss during active disease can be associated with a worse prognosis and should therefore be prevented. Patients should be advised to maintain a stable weight during chemotherapy and to receive guidance on adequate nutrition and physical activity to increase muscle mass

Objetivo: Sintetizar as principais evidências envolvendo os mecanismos de ligação fisiopatológico e clínico-epidemiológico em mulheres com câncer de mama e a síndrome metabólica. Método: Trata-se de uma revisão de escopo estruturada conforme o Instituto Joanna Briggs, realizado nas bases de dados PubMed, BDENF, LILACS, IBECS, CUMED, WPRIM, BINACIS e Embase. Esta revisão encontra-se protocolada no Open Science Framework. Resultado: Com relação ao nível de evidência dos estudos inclusos, houve predominância para níveis fortes de evidência. Não houve achados de evidência fraca nesta pesquisa. O estado inflamatório crônico do tecido adiposo mamário em casos de obesidade pode agravar o impacto negativo nas células cancerígenas, afetando diretamente a sobrevida e recorrência. Ganho ou perda de peso inexplicável estão associados a uma menor sobrevida em mulheres com câncer de mama, sublinhando a necessidade de orientações específicas durante o tratamento. Conclusão: A síndrome metabólica esta associada ao risco de câncer de mama, entretanto, a perda maciça de peso durante a doença ativa pode ser um fator de pior prognóstico, devendo assim, ser realizada de forma preventiva. Os pacientes devem ser orientados a manter um peso estável durante a quimioterapia e receber orientações sobre alimentação adequada e atividade física em busca de aumento de massa muscular

Técnica de Puckett en el tratamiento de mamas tuberosas con lipotransferencia complementaria / The Puckett Technique for Treating Tuberous Breasts with Complementary Lipotransfer

Introducción: La mama tuberosa es una anomalía congénita de la mama que se presenta en la pubertad y es relativamente frecuente. Objetivo: El objetivo de este artículo es dar a conocer el resultado estético del tratamiento quirúrgico de esta afección con la técnica de Pukett sin incluir el implante mamario, con lipotransferencia complementaria. Presentación del caso: Se presenta una paciente femenina, de 25 años de edad, con mama tuberosa grado 4. Se le realiza corrección con técnica de Pukett sin implantes mamarios y en su lugar se usa grasa autóloga. Luego de corregir las anomalías que conforman esta malformación se obtuvo una mama armoniosa sin complicaciones. Conclusión: La técnica de Pukett combinada con lipotransferencia ofrece resultados estéticos y estables en el tratamiento de la mama tuberosa(AU)

Introduction: Tuberous breast is a congenital breast anomaly that presents at puberty and is relatively frequent. Objective: The aim of this article is to report the aesthetic outcome after treating this condition surgically using the Puckett technique without breast implant, with complementary lipotransfer instead. Case presentation: The is presented of a 25-year-old female patient with grade-4 tuberous breast. She is performed a correction using the Puckett technique without breast implants; autologous fat is used instead. After correcting the anomalies that make up this malformation, a harmonious breast was obtained without complications. Conclusion: The Puckett technique combined with lipotransfer offers aesthetic and stable outcomes in the treatment of tuberous breast(AU)

Reparação e corporeidade: a reconstrução mamária em questão / Repairment and corporeality: breast reconstruction in question

Resumo Por se tratar de um tumor sólido, a cirurgia do câncer de mama sempre será necessária. Em algumas ocasiões, diante do avanço local da doença, a mastectomia, ou seja, a retirada completa da mama, pode ser necessária. Para atenuar as alterações corporais causadas pela mastectomia, a reconstrução mamária é uma possibilidade de reparação local e uma alterativa de reaproximação do que socialmente se considera um corpo reestabelecido. Este artigo, em forma de ensaio, parte de uma breve pesquisa em bases de dados científicos, interligando reconstrução mamária e representações sociais. Encontramos uma possível lacuna de problematização do que seria um corpo normal e reparado e quais seriam as forças que interferem na decisão de uma mulher recorrer às cirurgias ditas reparadoras. Ao questionarmos as diferentes visões do que é ou não um corpo saudável, abordamos teóricos como Foucault, Butler e Le Breton, para uma compreensão ampliada dos conceitos de corporeidade.

Abstract Breast cancer surgery will always be necessary as it is a solid tumor. Due to the local advancement of the disease, some cases may require a mastectomy, i.e., the complete removal of the breast. To mitigate the bodily changes, breast reconstruction offers a possibility for local repair and an alternative to what is socially considered as a +reestablished body. This essay is based on a brief search in scientific databases linking breast reconstruction and social representations. We found a possible gap in the problematization of what a normal, repaired, reconstructed body would be and what the subjective forces would be that interfere in a woman's decision to resort to what are known as reparative surgeries. By questioning the different views on what constitutes a healthy body, we draw on Foucault, Butler, and Le Breton for a broader understanding of the concepts of corporeality.

Evaluation de la qualité de vie après mastectomie pour cancer du sein au CHU Gabriel Touré / Evaluation of the quality of life after mastectomy for breast cancer at the Gabriel Touré university hospital

Les thérapeutiques oncologiques entraînent des répercussions sur la qualité de vie des patientes. Cette qualité de vie constitue un élément cardinal dans le parcours de soins de malades. Nous avons initié ce travail pour évaluer la qualité de vie après mastectomie. Matériel et méthode : Nous avons réalisé une étude transversale descriptive sur une période de 5ans allant de janvier 2016 à décembre 2020 au service de chirurgie générale au CHU Gabriel Touré. Nous avons inclus tous les patients opérés pour cancer du sein avec preuve histologique et ayant subi une mastectomie et acceptant de répondre au questionnaire. Résultat : Le questionnaire QLQC3O est une échelle spécifique au cancer utilisée pour établir le score sur la qualité de vie comme beaucoup d'autres mais à la différence d'être plus simple, facile d'utilisation et plus utilisé. Nous avons enregistré 79 cas de mastectomie pour cancer du sein. La prévalence de la mastectomie était de 5,8%. L'âge médian était de 58 ans. Les patientes avaient au moins un enfant dans 92,38%. Le carcinome canalaire de type non spécifique était le type histologique le plus fréquent avec 87,33%.Les effets secondaires de la mastectomie affectent le domaine des symptômes ont constitué l'étape la plus difficile à supporter avec p value non significatif. Ces situations ont sérieusement affecté l'estime de soi. Parmi les effets secondaires affectant la qualité de vie (52 cas), les troubles digestifs (22 cas) étaient au 1er plan suivis de dyspnée (7 cas) et des difficultés financières (8 cas) qui ont abouti à la vente de biens. Conclusion : La place de la qualité de vie reste incontestable dans la stratégie thérapeutique et son évaluation améliore quant au choix thérapeutique.

Oncology therapies have repercussions on the quality of life of patients. This quality of life is a cardinal element in the care pathway of patients. We initiated this work to assess the quality of life after mastectomy. Material and method: We carried out a descriptive cross-sectional study over a period of 5 years from January 2016 to December 2020 in the General Surgery Department of the Gabriel Touré University Hospital. We included all patients who had undergone surgery for breast cancer with histological evidence and who had undergone a mastectomy and agreed to answer the questionnaire. Results: The QLQC3O questionnaire is a cancer-specific scale used to establish the quality of life score like many others, but with the difference that it is simpler, easier to use and more widely used. We have recorded 79 cases of mastectomy for breast cancer. The prevalence of mastectomy was 5.8%. The median age was 58 years. Patients had at least one child 92.38%. Non-specific ductal carcinoma was the most common histological type with 87.33%.The side effects of mastectomy affect the area of symptoms were the most difficult stage to bear with p value not significant. These situations have seriously affected self-esteem. Among the side effects affecting quality of life (52 cases), digestive disorders (22 cases) were in the first place, followed by dyspnea (7 cases) and financial difficulties (8 cases) which resulted in the sale of goods. Conclusion: The place of quality of life remains undeniable in the therapeutic strategy and its evaluation improves the therapeutic choice

Comparison of medical image interpretation time between conventional and automated methods of breast ultrasound

Abstract Objective: To compare the medical image interpretation's time between the conventional and automated methods of breast ultrasound in patients with breast lesions. Secondarily, to evaluate the agreement between the two methods and interobservers. Methods: This is a cross-sectional study with prospective data collection. The agreement's degrees were established in relation to the breast lesions's ultrasound descriptors. To determine the accuracy of each method, a biopsy of suspicious lesions was performed, considering the histopathological result as the diagnostic gold standard. Results: We evaluated 27 women. Conventional ultrasound used an average medical time of 10.77 minutes (± 2.55) greater than the average of 7.38 minutes (± 2.06) for automated ultrasound (p<0.001). The degrees of agreement between the methods ranged from 0.75 to 0.95 for researcher 1 and from 0.71 to 0.98 for researcher 2. Among the researchers, the degrees of agreement were between 0.63 and 1 for automated ultrasound and between 0.68 and 1 for conventional ultrasound. The area of the ROC curve for the conventional method was 0.67 (p=0.003) for researcher 1 and 0.72 (p<0.001) for researcher 2. The area of the ROC curve for the automated method was 0. 69 (p=0.001) for researcher 1 and 0.78 (p<0.001) for researcher 2. Conclusion: We observed less time devoted by the physician to automated ultrasound compared to conventional ultrasound, maintaining accuracy. There was substantial or strong to perfect interobserver agreement and substantial or strong to almost perfect agreement between the methods.

Radioterapia previa a la mastectomía para facilitar la reconstrucción mamaria inmediata / Premastectomy Radiation Therapy to Facilitate Immediate Breast Reconstruction

Les explicaré cómo la radiación complica la reconstrucción mamaria, particularmente en pacientes que necesitan una mastectomía. Tradicionalmente solemos administrar la radiación después de nuestra cirugía y, a menudo, en los Estados Unidos, Europa y en otros lugares, cuando sabemos que el paciente va a necesitar radioterapia postmastectomía, no recibirá ninguna reconstrucción. De hecho, en nuestro estudio clínico en el MD Anderson, solo alrededor del 50% de las pacientes recibió su reconstrucción cuando la deseaban, debido a las complicaciones de la radiación. Sabemos que la reconstrucción diferida tiene un gran efecto psicológico inmediato para la paciente que se hace una mastectomía que no está balanceada. Por supuesto que este es un resultado muy lindo, pero hubiera sido muy bueno si hubiéramos podido preservar su simetría y darle una reconstrucción inmediata. Esto lo hizo un colega mío del que verán muchas fotos, Mark Schaverien, que es un cirujano de mama del Reino Unido que vino al MD Anderson para aprender cirugía microvascular, ahora es profesor y participa en todos nuestros estudios clínicos y reconstrucciones

TAILORx, RxPONDER y direcciones futuras para la prueba Oncotype DX Breast Recurrence Score / TAILORx, RxPONDER and Future Directions for the Oncotype DX Breast Recurrence Score Test

Soy oncóloga clínica y como ustedes escucharon, estuve en la Universidad del Sur de California durante 30 años, como directora del Programa de Cáncer de Mama. Pero ahora soy empleada de una empresa que se llama Exact Sciences, que produce Oncotype DX, por eso tengo un conflicto de intereses. Dentro de los múltiples temas que trataré en estos treinta minutos, primero voy a revisar las nuevas actualizaciones sobre el estudio TAILORx, hablaré del estudio RXPONDER y los datos nuevos que provienen de allí y, debido a que el porcentaje de la población judía en Argentina es alto, quisiera hablar de datos que quizás no conozcan con respecto a tener la mutación BRCA1 o BRCA2 germinal y el Oncotype. Quiero hablar de las Guías NCCN y de ASCO para estos clasificadores y también de brechas de la evidencia y hacia dónde vamos con el Oncotype para ayudar a las pacientes con cáncer de mama. Como muchos de ustedes saben y como ya se habló en la última presentación, todos los estudios genómicos disponibles, el Oncotype, el Mammaprint, EndoPredict, son todos para pronóstico. Si uno le da al paciente una terapia endócrina, nos va a ayudar a entender cuál es el riesgo remanente. El único estudio predictivo es el Oncotype DX, en base a múltiples datos

Aspectos Morfológicos de la Mama. Una Revisión de la Literatura / Morphological Aspects of the Breast. A Literature Review

La glándula mamaria tiene su origen embriológico, posteriormente se diferencia histológica y anatómicamente; a lo largo del tiempo se han ido descubriendo nuevos hallazgos, además de nueva terminología. El objetivo de este trabajo consistió en describir la actualización en los aspectos morfológicos de la glándula mamaria. Se realizó una búsqueda de artículos en diferentes fuentes primarias y secundarias de la literatura científica como: Pubmed, Embase, WOS, Scopus, Scielo obteniendo 623 publicaciones, seleccionado 53 para su revisión y 17 incluidos. La mama se ha ido actualizando en los aspectos morfológicos; Los conductos se ubican cercanos a la areola y al pezón donde desembocan directamente, las ramificaciones de los conductos se ubican cercanos a la areola; los pezones tienen entre 15 y 20 lóbulos, de los cuales sólo 5-9 son verdaderos orificios del conducto mamario, no existen senos lactíferos por lo que la leche desemboca directamente en el pezón, en cuanto a la inervación de la mama son inervados por las ramas cutáneas anterior y lateral de los nervios intercostales. La evidencia existente demuestra la necesidad de realizar estudios permanentes en el ámbito de la morfología, como fue descrito en este artículo de revisión sobre la mama. En diferentes aspectos, tales como términos, funciones y estructuras. Está información es importante para, la formación de pregrado, post grado, y su utilización en la clínica, identificación de patologías, clínicas de lactancia, entre otros.

SUMMARY: The mammary gland has its embryological origin, later it differentiates histologically and anatomically; over time new findings have been discovered, as well as new terminology. The aim of this work was to describe the update on the morphological aspects of the mammary gland. A search for articles was carried out in different primary and secondary sources of scientific literature such as: Pubmed, Embase, WOS, Scopus, Scielo, obtaining 623 publications, 53 selected for review and 17 included. The breast has been updated in morphological aspects; the ducts are located close to the areola and the nipple where they open directly, the branches of the ducts are located close to the areola; the nipples have between 15 and 20 lobes, of which only 5- 9 are true mammary duct orifices, there are no lactiferous sinuses, so the milk flows directly into the nipple, in terms of innervation of the breast they are innervated by the anterior and lateral cutaneous branches of the intercostal nerves. The existing evidence demonstrates the need for permanent studies in the field of morphology, as described in this review article on the breast. In different aspects, such as terms, functions and structures. This information is important for undergraduate and postgraduate training, and its use in the clinic, identification of pathologies, lactation clinics, among others.

Mama supranumeraria: resección mediante técnica abierta con dren versus sin dren / Supranumerary breast: resection by open technique with drain vs without drain

Introducción. El tejido mamario accesorio es una anomalía congénita que se presenta en el 2-6 % de la población femenina. En este tejido se pueden desarrollar las mismas patologías que en la mama normal. El manejo curativo es la resección quirúrgica. El objetivo de este estudio fue comparar los resultados de la técnica de resección vía abierta de tejido mamario accesorio con dren vs sin dren. Métodos. Se realizó un estudio observacional tipo cohorte retrospectivo, teniendo en cuenta dos grupos de pacientes con tejido mamario accesorio: a uno de ellos se les realizó resección quirúrgica mediante técnica abierta con dren y al otro grupo sin dren. Además, se incluyó un brazo prospectivo donde se evaluó la calidad de vida y la satisfacción de las pacientes con el resultado posoperatorio mediante el uso de la herramienta Breast-Q. Resultados. Se recolectó la información de 82 pacientes, la mayoría mujeres; 22 se intervinieron con técnica con dren y 60 con técnica sin dren. 13,6 % de los pacientes presentaron complicaciones tempranas, siendo la infección de sitio operatorio la más frecuente (36,4 %). En general, las complicaciones fueron más comunes en el grupo con dren (40,9 % vs 3,4 %), con una diferencia estadísticamente significativa (p=0,000). La calidad de vida fue similar en ambos grupos. Conclusiones. Los pacientes a quienes se les realizó resección de mama supernumeraria y se dejó un sistema de drenaje en el lecho de disección presentaron más complicaciones posoperatorias que las pacientes a quienes no se les dejó dren

Introduction. Accessory breast tissue is a congenital anomaly that occurs in 2-6% of the female population. It can develop the same pathologies that in the normal breast. The curative management of this pathology is surgical resection. The objective of this study was to compare the results of the accessory breast tissue open resection technique with a drain vs without a drain. Methods. An observational retrospective cohort study was conducted considering two groups of patients with accessory breast tissue: one of them underwent surgical resection using an open technique with a drain and the other group without a drain. In addition, a prospective arm where the quality of life and satisfaction of the patients with the postoperative result was evaluated by the Breast-Q tool. Results. Eighty-two patients were included, most of them women; 22 were operated with open technique with drain and 60 without drain. 13.6% of patients presented early complications, with surgical site infection being the most frequent (36.4%) and, in general, complications were more common in the group with drain (40.9% vs 3.4%) with a statistically significant difference (p=0.000). Quality of life was similar in both groups.Conclusions. Patients who undergo supernumerary breast resection and leaving drainage in the dissection bed present more postoperative complications compared to those without drain

Recomendações para o rastreamento do câncer de mama no Brasil do Colégio Brasileiro de Radiologia, da Sociedade Brasileira de Mastologia e da Federação Brasileira das Associações de Ginecologia e Obstetrícia / Recommendations for breast cancer screening in Brazil from the Brazilian College of Radiology, the Brazilian Society of Mastology and the Brazilian Federation of Gynecology and Obstetrics Associations

Objetivo: Apresentar a atualização das recomendações do Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, da Sociedade Brasileira de Mastologia e da Federação Brasileira das Associações de Ginecologia e Obstetrícia para o rastreamento do câncer de mama no Brasil. Materiais e Métodos: Foram feitas buscas das evidências científicas publicadas nas bases Medline, EMBASE, Cochrane Library, EBSCO, CINAHL e Lilacs, entre janeiro de 2012 e julho de 2022. As recomendações foram baseadas nessas evidências, mediante consenso da comissão de especialistas das três entidades. Recomendações: O rastreamento mamográfico anual é recomendado para as mulheres de risco habitual entre 40 e 74 anos. Acima de 75 anos, deve ser reservado para as que tenham expectativa de vida maior que sete anos. Mulheres com risco maior que o habitual, entre elas as com mamas densas, com história pessoal de hiperplasia lobular atípica, carcinoma lobular in situ clássico, hiperplasia ductal atípica, tratamento de câncer de mama ou de irradiação no tórax antes dos 30 anos ou, ainda, portadoras de mutação genética ou com forte história familiar, beneficiam-se do rastreamento complementar, sendo consideradas de forma individualizada. A tomossíntese é uma evolução da mamografia e deve ser considerada no rastreamento, sempre que acessível e disponível. (AU)

Objective: To present the update of the recommendations of the Brazilian College of Radiology, the Brazilian Society of Mastology and the Brazilian Federation of Gynecology and Obstetrics Associations for breast cancer screening in Brazil. Materials and Methods: Scientific evidence published in Medline, Embase, Cochrane Library, Ebsco, Cinahl and Lilacs between January 2012 and July 2022 was searched. Recommendations were based on this evidence, by consensus of the expert committee of the three entities. Recommendations: Annual mammographic screening is recommended for women aged between 40 and 74 years old. Above 75 years should be reserved for those with a life expectancy greater than seven years. Women at higher than usual risk, including those with dense breasts, a personal history of atypical lobular hyperplasia, classic lobular carcinoma in situ, atypical ductal hyperplasia, treatment for breast câncer, chest irradiation before age 30, carriers of genetic mutation or with a strong family history, benefit from complementary screening, being considered individually. Tomosynthesis is an evolution of mammography and should be considered in screening, whenever accessible and available. (AU)

Caracterización clínica-epidemiológica de pacientes menores o iguales a 40 años con cáncer de mama / Clinical-epidemiological characterization of patients under or equal to 40 years old with breast cancer

El cáncer de mama se encuentra dentro de los tres primeros cánceres diagnosticados en las mujeres a nivel mundial. En las mujeres menores de 40 años ocupa el primer puesto de incidencia. Alrededor de 146 000 nuevos casos son diagnosticados en mujeres menores de 40 años a nivel global. Objetivo. Identificar las características epidemiológicas y clínicas de las pacientes con edad menor o igual a 40 años con diagnóstico de cáncer de mama en un hospital de tercer nivel especializado en la atención de la mujer. Metodología. Estudio transversal descriptivo. Se recolectó información de 60 expedientes de pacientes con diagnóstico de cáncer de mama con edad menor o igual de 40 años diagnosticados entre enero 2019 y diciembre 2020. Resultados. El mayor número de casos se encontró en las mujeres entre 39 y 40 años (18,3 %, cada uno). El 60 % era del área urbana; el 80 % de las pacientes tenía una paridad entre uno a cuatro hijos; el 40 % de se encontraba con sobrepeso y el 58 % no tenía antecedentes familiares de cáncer de mama. El estadio clínico más frecuente fue IIIA. El diagnóstico histopatológico más común fue carcinoma de mama invasivo de tipo no especial (91,6 %), pobremente diferenciado, con receptores para estrógeno y progesterona positivos. Conclusión. Las mujeres con edad menor o igual a 40 años, con cáncer de mama, son pacientes procedentes del área urbana, con sobrepeso, con uno a cuatro hijos y sin antecedentes familiares de cáncer de mama; con presentación clínica inicial en etapas localmente avanzadas, con diagnóstico de carcinoma de mama invasivo de tipo no especial, pobremente diferenciado y receptores para estrógeno y progesterona positivos

Breast Breast cancer is among the first three cancers diagnosed in women worldwide. In women younger than 40 years old it occupies the first place in incidence. About 146 000 new cases are diagnosed globally in women under 40 years old. Objective. To identify the epidemiological and clinical characteristics of patients under or equal to 40 years old, diagnosed with breast cancer in a tertiary hospital specialized in women's care. Methodology. Descriptive cross-sectional study. Information was collected from 60 clinical records of patients diagnosed with breast cancer with an age less than or equal to 40 years old, between January 2019 and December 2020. Results. The highest number of cases was found in women between 39 and 40 years old (18.3 % each). Sixty percent were from the urban area; 80 % of the patients had parity between one and four children; 40 % were overweight and 58 % had no family history of breast cancer. The most frequent clinical stage was IIIA. The most common histopathological diagnosis was invasive breast carcinoma of non-special type (91.6 %), poorly differentiated with positive estrogen and progesterone receptors. Conclusion. Women aged less than or equal to 40 years old, with breast cancer, are patients from urban areas, overweight, with one to four children and no family history of breast cancer, with initial clinical presentation in locally advanced stages, with a diagnosis of invasive breast carcinoma of non-special type, poorly differentiated and positive estrogen and progesterone receptors

Sobrepeso e obesidade entre mulheres e associação com características demográficas e obstétricas entre usuárias de uma unidade de saúde especializada / Overweight and obesity between women and association with demographic and obstetric characteristics among users of a specialized health unit

Resumo Introdução O excesso de peso é um fator de risco para doenças crônicas. Objetivo Estimar a prevalência de sobrepeso e obesidade, e investigar sua associação com variáveis demográficas, socioeconômicas e reprodutivas e com comportamentos relacionados à saúde entre mulheres usuárias de unidade de atenção especializada. Método Estudo transversal com mulheres em atendimento por mastologista. O estado nutricional foi classificado por meio do índice de massa corporal. Foram utilizados modelos de regressão logística multinomial brutos e ajustados, com estimativa de razões de chance (RC) e intervalos de confiança de 95% (IC95%). A eutrofia foi considerada como categoria de referência. Resultados Participaram 182 mulheres com média de idade de 51 anos. A prevalência de sobrepeso foi de 34,1% (IC95% 27,1-41,0) e de obesidade foi de 31,8% (IC95% 25,0-38,7). Apresentaram maiores chances de obesidade as mulheres: com 60 anos ou mais, que exerciam atividade remunerada, que tiveram menarca antes dos 13 anos e com três ou mais gestações. Após análise ajustada, permaneceram associadas à maior chance de obesidade a menarca antes dos 13 anos (RC 4,40; IC95% 1,76-10,99) e três ou mais gestações (RC 8,50; IC95% 2,14-33,70). Conclusão Verificou-se elevada prevalência de sobrepeso e obesidade entre as participantes, associada às características reprodutivas.

Abstract Background Overweight is a risk factor for chronic diseases. Objective To estimate the prevalence of overweight and obesity and to investigate its association with demographic, socioeconomic, reproductive and health behaviors related among women users of specialized care units. Method Cross-sectional study with women in care by a mastologist. Nutritional status was classified by Body Mass Index (BMI). Gross and adjusted multinomial logistic regression models were used, to estimate an Odds Ratios (OR) and 95% Confidence Intervals (95% CI). Eutrophy was considered as a reference category. Results 182 women with a mean age of 51 years. The prevalence of overweight was 34.1% (CI 95% 27.1-41.0) and obesity was 31.8% (CI 95% 25.0-38.7). Women were more likely to be obese: 60 years of age or older, who were gainfully employed, who had menarche before age 13, and with three or more pregnancies. After adjusted analysis, they remained associated with a greater chance of the development of obesity to menarche before 13 years (OR 4.40 CI 95% 1.76-10.99) and three or more pregnancies (OR 8.50 CI 95% 2.14-33.70). Conclusion There was a high prevalence of overweight and obesity among the participants, associated with reproductive characteristics.

Investigation of breast pathologies in medical students and their families

Introduction: Breast diseases include benign and malignant pathologies. However, during the differential diagnosis, it is important to distinguish benign pathology, precursor lesions of breast cancer, and malignant breast neoplasm. We believe that research among medical students on the prevalence of breast pathologies in this population and their families is important in addition to identifying patients at high familial risk for breast and/or ovarian cancer and awakening the interest of other medical students in this topic. The objective of this study was to analyze the prevalence of benign and malignant breast pathologies among medical students and their families. Methods: This is a quantitative analytical cross-sectional study. Female medical students over 18 years old were included in the study. Data collection was carried out using an online questionnaire. It was approved by the Research Ethics Committee under CAAE Protocol No. 51338121.0.0000.5515, and each participant consented through the free and informed consent form (TCLE). Results: A total of 303 medical students responded to the questionnaire and were included in the study. Around 13.5% of participants reported having had some breast pathology, 76.2% of which were cases of breast lumps. The average age of participants was 22.9 years (ranging between 18 and 53 years). The average age of family members at diagnosis (a sample of 69 women) was 57.1 years (ranging between 29 and 84 years). There was an association between the prevalence of breast pathologies and a family history of breast cancer (OR=1.712 [0.818; 3.585]). Conclusion: From the results, it appears that 13.5% of the participants had already been diagnosed with breast pathology, and 20.8% of these reported a family history of breast cancer. In this way, we can affirm the contribution of the study in the evaluation of screening criteria for breast and neoplasms and thus increase the detection rate and carry out early therapy. (AU)

Subtipos intrínsecos de cáncer de mama y factores pronósticos en un centro de referencia en Medellín, Colombia. Estudio descriptivo / Intrinsic subtypes of breast cancer and prognostic factors in a reference center in Medellin, Colombia. A descriptive study

Introducción. Entre las mujeres, el cáncer de mama es el más frecuente en el mundo. Representa una enfermedad heterogénea, debido a que un mismo tipo histopatológico puede tener comportamiento biológico distinto según su clasificación molecular, aportando valor pronóstico y como predictor de la respuesta a la quimioterapia neoadyuvante. El objetivo de este estudio fue describir la distribución de los subtipos intrínsecos de cáncer de mama, y su asociación con factores pronósticos, así como las características sociodemográficas y clínicas de pacientes de la Clínica Medellín, entre 2016 y 2019. Metodología. Estudio descriptivo, retrospectivo de una base de datos institucional, en el periodo 2016 a 2019. Se analizaron los datos demográficos y clínicos de los registros médicos utilizando estadística descriptiva. Resultados. Se incluyeron en el estudio 468 historias clínicas, la mediana de edad al diagnóstico fue de 61 años, y 27 % (n=131) eran menores de 50 años. El tipo histológico más frecuente fue el ductal con un 89,1 % (n=417), y el grado histológico 2 fue el de mayor frecuencia con el 44 % (n=206) de los casos. El subtipo intrínseco más frecuente fue el luminal A con un 32,7 % (n=153), seguido por el luminal B HER2- con 30,1 % (n=141), luminal B HER2+ con 17,3 % (n=81), triple negativo con un 13 % (n=61) y, por último, el HER2 enriquecido con 6,8 % (n=32). Conclusión. La distribución de los subtipos intrínsecos del cáncer de mama en la población estudiada mostró que el subtipo luminal A fue el más frecuente, mientras que los subtipos triple negativo y HER2 enriquecido fueron los menos frecuentes

Introduction. Among women, breast cancer is the most common cancer in the world. It represents a heterogeneous disease, because the same histopathological type can have different biological behavior according to its molecular classification, providing prognostic value and as a predictor of response to neoadjuvant chemotherapy. The objective of this study was to describe the distribution of intrinsic subtypes of breast cancer, and their association with prognostic factors, as well as the sociodemographic and clinical characteristics of patients at the Clínica Medellín, between 2016 and 2019. Methodology. Descriptive, retrospective study of an institutional database, in the period 2016 to 2019. Demographic and clinical data from medical records were analyzed using descriptive statistics. Results. A total of 468 medical records were included in the study, the median age at diagnosis was 61 years, and 27% (n=131) were under 50 years of age. The most frequent histological type was ductal with 89.1% (n=417), and histological grade 2 was the most frequent with 44% (n=206) of the cases. The most frequent intrinsic subtype was luminal A with 32.7% (n=153), followed by luminal B HER2- with 30.1% (n=141), luminal B HER2+ with 17.3% (n=81), triple negative with 13% (n=61) and, finally, HER2 enriched with 6.8% (n=32). Conclusion. The distribution of the intrinsic subtypes of breast cancer in the study population showed that the luminal A subtype was the most frequent, while the triple negative and HER2-enriched subtypes were the least frequent

Magnetic resonance differential analysis for different hormone receptor expression status in HER-2-positive breast cancer / 中南大学学报(医学版)

OBJECTIVES@#Currently, it is difficult to assess the expression status of hormone receptor (HR) in breast malignant tumors with human epidermal growth factor receptor 2 (HER-2)-positive in the early preoperative stage, and it is difficult to predict whether it is non-invasively. This study aims to explore the value of MRI on the different HR expression status (HR+/HR-) in HER-2 positive breast cancer.@*METHODS@#Thirty patients with HR+ HER-2-positive breast cancer (HR+ group) and 23 patients with HR-HER-2-positive breast cancer (HR- group) from the First Hospital of Hunan University of Traditional Chinese Medicine between January 7, 2015 and November 26, 2021 were selected as subjects, and all the patients were examined by MRI and all were confirmed by surgery or pathological biopsy puncture. The immunohistochemical staining results were used as the gold standard to analyze the basic clinical conditions, peri-lesion conditions and MRI sign characteristics in the 2 groups.@*RESULTS@#There were all significant differences in terms of mass margins, internal reinforcement features, and apparent diffusion coefficient (ADC) values between the HR+ group and the HR- group (all P<0.05). The logistic multivariate regression model showed that: when the lesion presented as a mass-type breast cancer on MRI, the internal enhancement features of the lesion were an independent predictor for differentiation in the 2 types of breast cancer [odds ratio (OR)=5.95, 95% CI: 1.223 to 28.951, P<0.05], and the mass margin (OR=0.386, 95% CI: 0.137 to 1.082, P>0.05) and ADC value (OR=0.234, 95% CI: 0.001 to 105.293, P>0.05) were not the independent predictors in distinguishing the 2 types of breast cancer.@*CONCLUSIONS@#Multiparametric MRI has good diagnostic value for HR expression status in HER-2-positive breast cancer. Combined logistic regression analysis to construct a predictive model may be helpful to the identical diagnosis.

Establishment and validation of a multigene model to predict the risk of relapse in hormone receptor-positive early-stage Chinese breast cancer patients / 中华医学杂志(英文版)

BACKGROUND@#Breast cancer patients who are positive for hormone receptor typically exhibit a favorable prognosis. It is controversial whether chemotherapy is necessary for them after surgery. Our study aimed to establish a multigene model to predict the relapse of hormone receptor-positive early-stage Chinese breast cancer after surgery and direct individualized application of chemotherapy in breast cancer patients after surgery.@*METHODS@#In this study, differentially expressed genes (DEGs) were identified between relapse and nonrelapse breast cancer groups based on RNA sequencing. Gene set enrichment analysis (GSEA) was performed to identify potential relapse-relevant pathways. CIBERSORT and Microenvironment Cell Populations-counter algorithms were used to analyze immune infiltration. The least absolute shrinkage and selection operator (LASSO) regression, log-rank tests, and multiple Cox regression were performed to identify prognostic signatures. A predictive model was developed and validated based on Kaplan-Meier analysis, receiver operating characteristic curve (ROC).@*RESULTS@#A total of 234 out of 487 patients were enrolled in this study, and 1588 DEGs were identified between the relapse and nonrelapse groups. GSEA results showed that immune-related pathways were enriched in the nonrelapse group, whereas cell cycle- and metabolism-relevant pathways were enriched in the relapse group. A predictive model was developed using three genes ( CKMT1B , SMR3B , and OR11M1P ) generated from the LASSO regression. The model stratified breast cancer patients into high- and low-risk subgroups with significantly different prognostic statuses, and our model was independent of other clinical factors. Time-dependent ROC showed high predictive performance of the model.@*CONCLUSIONS@#A multigene model was established from RNA-sequencing data to direct risk classification and predict relapse of hormone receptor-positive breast cancer in Chinese patients. Utilization of the model could provide individualized evaluation of chemotherapy after surgery for breast cancer patients.

Development in the last 20 years of anti-HER2 targeted therapy for breast cancer / 中华外科杂志

Since trastuzumab was listed and approved for breast cancer in 2002, China has entered a new epoch of targeted therapy. Over the past 20 years, anti-human epidermal growth factor receptor 2 (HER2) targeted therapy for breast cancer in China has experienced the era of single-target, tyrosine kinase inhibitors, double-target and anti-HER2 plus antibody-drug conjugate. Advancement in the anti-HER2 targeted therapy is continuously changing the treatment mode of patients with HER2 positive status and even HER2 low expression, significantly improved their prognosis. In the past 20 years, Chinese scholars have participated in international clinical researches, completed a series of registration studies of imported drugs, developed new drugs with proprietary intellectual property rights, enriched the evidence of clinical research on HER2-targeted therapy, and formed a treatment system with both international standards and Chinese characteristics. In particular, the formulation of the Chinese Society of Clinical Oncology Breast Cancer Guidelines and the Chinese expert consensus on anti-HER2 targeted treatment in breast cancer are the concentrated embodiments of Chinese wisdom.