Contribución de los estudios por imágenes en el diagnóstico de cáncer de mama

RESUMEN El cáncer de mama es el más frecuente en las mujeres y representa la segunda causa de muerte entre las féminas. Resulta fundamental la prevención mediante los programas de pesquizaje. El diagnóstico por imagen de este tumor ha evolucionado en los últimos años. En mamografía, se han incorporado las técnicas digitales, los aparatos de ultrasonidos son de mejor calidad y la resonancia magnética ha adquirido mayor protagonismo entre todos los algoritmos diagnósticos, no obstante, la mamografía sigue representando el examen de elección para la detección de este tipo de neoplasia en la población general. El objetivo del presente artículo es describir los aspectos imagenológicos de importancia que contribuyen al diagnóstico del cáncer de mama, para ello se realizó una revisión de la bibliografia, en diferentes bases de datos con el descriptor de estudios por imágenes en el cáncer de mama.

ABSTRACT Breast cancer is the most common in women and represents the second leading cause of death. Prevention through screening programs is essential. Imaging of this tumor has evolved in recent years. In mammography, digital techniques have been incorporated, ultrasound machines are of better quality and magnetic resonance imaging has acquired greater prominence among all diagnostic algorithms, however, mammography continues to represent the test of choice for the detection of this type of neoplasia in the general population. The aim of this article is to describe the important imaging aspects that contribute to the diagnosis of breast cancer, for this, a review of the literature was carried out in different databases with the descriptor of imaging studies in breast cancer.

4-OHT inhibits cell migration by reversal of eMT in triple negative breast cancer cells / 中国医师进修杂志

Objective To investigate whether 4-OHT could decrease the ability of invasion and metastasis by reversal of EMT in TNBC. Methods Inverted microscope was used for observing cell morphological change. Cell migration ability was measured using transwell assay. Expression of E-cadherin, Vimentin and Actin proteins were analyzed by Western blot. The distribution of E-cadherin and Vimentin were analyzed by immune- fluorescence microscopy. Relative levels of miR-200c were measured by Real-time PCR. Transient transfection was performed using Lipofectamine 2000 reagent. Animal model was established to test the migration rate of lung metastasis and metastase focals. The HE staining was performed in mice lung tissue using Immunohistochemistry to confirm the metastasis. Results 4-OHT upregulates E-cadherin expression, downregulates vimentin expression to reverse EMT in TNBC cells. 4-OHT decreases migration ability of MDA-MB-231 and MCF-7/ADR cells by transwell test to 59.4% and 43.2% ; The migration ability of cells decrease to 66.7% . 4-OHT up-regulates the expression of miR-200c in MDA-MB-231 and MCF-7/ADR cells to 280% and 450%. Inhibits expression of miR-200c, 4-OHT cannot decrease migration ability of TNBC cells. Conclusions 4-OHT could decrease the ability of invasion and metastasis, up-regulate miR-200c and reverse EMT in TNBC.

Relationship between micro-calcification and prognostic factors in breast cancer patients / 肿瘤

Objective: To investigate the correlation between the prognosis of breast cancer patients and mammographic calcification. Methods: A total of 1 035 breast cancer patients with complete clin ical information were in cluded in this study. According to mammographic calcification before operation, the patients were divided into calcification group and non-calcification group, and then the expressions of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor-2 (HER-2) were compared between two groups. The influence of calcification on the positive expression rates of ER, PR and HER-2 and the relationship between calcification and tumor size, axillary lymph node status, histological grade, molecular classification and prognosis were analyzed. Results: The rate of calcification in the patients with axillary node metastasis was significantly higher than that in the patients without lymphatic metastasis [53.6% (199/371) vs 47.1% (312/663)] (P 0.05). In survival analysis, there was no obvious difference between the calcification group and non-calcification group. Conclusion: The breast cancer with micro-calcification shown on mammographic X-ray images was associated with the expression of HER-2, molecular typing and axillary lymph node status. The calcification is likely to have no effect on the survival of patients.

Effect of VEGF overexpression on the Bcl-2 of TAMs/MCF-7 cell co-culture system / 中国现代普通外科进展

Objective:To explore the effect of VEGF overexpression on the Bcl-2 of TAMs /MCF-7 cell co-culture system.Methods:Application of PMA and IL-4 cells induced THP-1 cell differentiation into TAMs in vitro;TAMs and MCF-7 cell were co-cultured in non-contact Transwell system.MCF-7 cells' proliferation status after co-culture were detected by MTT method;Effect of VEGF over-expression in co-cultured system on Bcl-2 level s in the two cell lines by Western blot assay.Results:PMA and IL-4 induced THP-1 cell become TAMs in vitro.After co-cultured with TAMs 24 h,48 h,MCF-7 cell's proliferation activity increased by 16.16 ％ and 33.99％ vs the control group respectively.TAMs,MCF-7 cells were added VEGF and the supematant of co-culture system respectively,then Bcl-2 levels in both cells were significantly higher,the difference was statistically significant (P＜0.05).Conclusions Tumors secrete VEGF and other chemokines to recruit and activate TAMs.Proliferation,apoptosis and progression of tumor was affected by VEGF/Bcl-2 paracrine loop in tumor microenvironment.

MRI features of mucinous breast carcinoma / 中国医学影像技术

Objective To explore MRI features of mucinous breast carcinoma.Methods MR data of 34 patients with mucinous breast carcinoma confirmed by histopathology were analyzed retrospectively,including lesions morphology,maximum diameter,T1WI and T2WI signal characteristics,features of internal reinforcement,time-intensity curve (TIC) type,DWI and ADC characteristics.Results There were 22 cases of pure tumors and 12 mixed tumors;21 cases were mass types,6 cases were non-mass types,and 7 cases were multiple nodular types.On T1WI,there were low signal intensity in 22 case,equal signal in 10 cases,and mixed high signal in 2 cases.On fat suppression T2WI,20 cases showed high signal,13 cases showed mixed high signal and 1 case showed low signal,and 19 cases showed low signal fiber separation inside.Dynamic contrast enhancement showed typical circinate enhancement in 11 cases.TIC of 11 cases were wash-in types,18 cases were lateau types and 5 cases were wash-out types.Conclusion MRI features of mucinous breast carcinoma has certain characteristics.MRI is helpful to diagnosis of mucinous breast carcinoma

Prevalência de linfedema após tratamento de câncer de mama em pacientes com sobrepeso / La prevalencia de linfedema tras tratamiento de cáncer de mama en mujeres con sobrepeso / Prevalence of lymphedema after breast cancer treatment in overweight patients

RESUMO O câncer de mama é a neoplasia de maior ocorrência no mundo, e o linfedema é uma das complicações mais frequentes do tratamento. O aumento do índice de massa corporal é um dos fatores de risco para linfedema após o tratamento do câncer de mama. O objetivo deste estudo foi verificar a incidência de linfedema em mulheres mastectomizadas com sobrepeso e obesidade. Os resultados mostraram que o risco de linfedema em mulheres com sobrepeso e obesidade foi quatro vezes maior (Odds Ratio, OR=3,887). Quanto maior o índice de massa corporal, maior a probabilidade de linfedema, com aumento do risco relativo de 40% para obesidade II.

RESUMEN El cáncer de mama es la neoplasia que más ocurre en el mundo, y el linfedema es una de las complicaciones más frecuentes de su tratamiento. El aumento del índice de masa corporal es uno de los factores de riesgo para el linfedema tras el tratamiento de cáncer de mama. El propósito de este estudio fue verificar la incidencia de linfedema en mujeres sometidas a mastectomía y que están con sobrepeso y obesidad. Los resultados mostraron que el riesgo de linfedema en mujeres con sobrepeso y obesidad ha sido cuatro veces mayor (Odds ratio, OR=3,887). Cuanto mayor es el índice de masa corporal, mayor es la probabilidad de linfedema, con aumento de riesgo de 40% para obesidad II.

ABSTRACT Breast cancer is the neoplasia with the highest incidence in the population worldwide, and lymphedema is one of the most frequent complications in the treatment. Body mass index increase is one of the risk factors for lymphedema after breast cancer treatment. The objective of this study was to verify the incidence of lymphedema in mastectomized women with overweight and obesity. The risk of lymphedema in women with overweight and obesity was four times greater (Odds Ratio, OR = 3.887). The higher the body mass index, the higher was the probability of lymphedema, with increase in the relative risk of 40% for obesity II.

Habilidades del cuidador primario de mujeres mastectomizadas / Habilidades do cuidador primário de mulheres mastectomizadas / Mastectomized women primary caregiver's abilities

Objetivo. Describir las habilidades del cuidador primario (CP) en términos de conocimiento, valor y paciencia del de mujeres mastectomizadas. Metodología. En 2010 se llevó a cabo un estudio descriptivo de tipo transversal en una muestra de 100 cuidadores primarios del Instituto Nacional de Cancerología de la Ciudad de México. Para la medición de la habilidad se utilizó el instrumento “Inventario de habilidad de cuidado”, que tiene tres subescalas: conocimiento, valor y paciencia. Se estimaron las correlaciones entre la sumatoria de los términos, comparándolas con las variables sociodemográficas. Resultados. El 41% de los CP fueron hombres, casados en un 77%; predominantemente fueron hijos (41%) o esposos (32%) del paciente. La edad mediana del CP, fue 43 años. En las habilidades del cuidador se encontró: alta puntuación para las dimensiones de conocimiento y paciencia, y baja para la de valor. Se identificó una correlación significativa entre las dimensiones de conocimiento y paciencia, mientras que la correlación de valor y paciencia fue menor. Conclusión. Las habilidades más importantes con que debe contar el CP son el conocimiento y la paciencia; el valor no mostró tal relevancia.

Objective. To describe the abilities in care, mastectomized women primary caregivers (PC) have, in terms of knowledge, value and patience. Methodology. Cross sectional descriptive study carried out in 2010 in the National Institute of cancerology in Mexico City. A sample of 100 primary caregivers was used. For the abilities measurement the instrument “caring abilities inventory”, which has 3 subscales, Knowledge, value and patience, was used. Correlations were estimated among the sum of the terms comparing them with the sociodemographic variables. Results.41% of the PC were men, 77% were married, 41% were the patient’s children and 32% their couple, most of them had a paid job. Caregivers mean age was 43 years. Regarding caregiver abilities a high score for the dimensions knowledge and patience, and a low score for value was found. The correlation between value and patience was low. Conclusion. The most important abilities caregivers must have are knowledge and patience. Value didn’t show such relevance.

Objetivo. Descrever as habilidades no cuidado em termos de conhecimento, valor e paciência do cuidador primário (CEP) de mulheres mastectomizadas. Metodologia. Em 2010 se levou a cabo um estudo descritivo de tipo transversal numa mostra de 100 cuidadores primários do Instituto Nacional de Cancerologia da Cidade do México. Para a medição da habilidade se utilizou o instrumento “Inventário de habilidade de cuidado”, que tem três sub-escalas: conhecimento, valor e paciência. Estimaram-se as correlações entre a sumatória dos termos, comparando-as com as variáveis sócio-demográficas. Resultados. O 41% dos CEP foram homens, casados num 77%; predominantemente foram filhos (41%) ou esposos (32%) do paciente, e a maioria tinham um trabalho remunerado. A média de idade do CEP foi de 43 anos. Nas habilidades do cuidador se encontrou: alta pontuação para as dimensões de conhecimento e paciência, e baixa para a de valor. Identificou-se uma correlação significativa entre as dimensões de conhecimento e paciência, enquanto a correlação de valor e paciência foi menor. Conclusão. As habilidades mais importantes com do que deve contar o CEP são o conhecimento e a paciência; o valor não mostrou tal relevância.

Effect of gemcitabine plus cisplatin in advanced breast cancer with anthracycines and /or taxanes resistance / 中国癌症杂志

Background and purpose:Ever since the use of anthracycine and /or taxanes-based regimen for the adjuvant and/or neoadjuvnat chemotherapy of breast cancer,there have few sensitive agents for advanced breast cancer(ABC)when it occurs drug resistance to anthracycine and /or taxanes.The aim of this study is to evaluate the effect of gemcitabine plus cicplatin in advanced breast cancer after the failure of treatment with anthracycines and /or taxanes.Methods:From May,2005 to Jan 2007,34 ABC cases with anthracycine and/or taxanes resistance were treated with GEM(1000 mg/m2.day1,day8)and DDP(30 mg/m2,day 1 to day 3)every 3 weeks.A median of 5 cycles(2-6 cycles)of the treatment was delivered.All cases were followed up more than 6 months.Results:3 cases(8.8%)had complete response(CR),13 cases(38.2%)had partial response(PR),while 12 cases(35.3%)had stable disease(SD)and progressive disease(PD)was 6 cases(17.7%);the overall response rate was 47.0%.The median time to progression(TTP)was 6.5 months,grade 3/4 diarrhoea and thrombocytopenia were main side effects.Conclusions:GEM plus DDP are effective in the treatment of advanced breast cancer with anthracycine and/or taxanes resistance.

Gemcitabine plus cisplatin for the treatment of anthracycine-resistant advanced breast cancer / 中国癌症杂志

Purpose:To evaluate the efficacy and safety of combination chemotherapy of gemcitabine(GEM) and cisplatin(DDP) for anthracycine(ANT)-resistant advanced breast cancer(ABC). (GEM 1 200 mg/m 2 on day1 and 8,DDP 30mg/m 2 on day 3 to 5 in cycles of 21 days) Methods:From January 2000 to April 2003,fifty patients with ANT-resistant ABC were treated with combination chemotherapy of GEM and DDP. The median number of cycles was 3(range 2-4). Results:The overall response rate was 42.6%,The median time to progression was 4.5 months. The main side effect included gastrointestinal and hematologic toxicities,related grade 3 to 4 clinical adverse effect was nausea and vomiting in 12 cases (24%),anemia in 2 cases (4), leukopenia in 7 cases (14%),neutropenia in 4 cases (8%) and thrombocytopenia in 16 cases (32%).Conclusions:GEM and DDP combination is active in ANT-resistant ABC with an acceptable toxicity pattern and may well represent an interesting therapeutic choice after ANT regimen.