Effects of non-surgical periodontal therapy on the cytokine profile in gingival crevicular fluid of breast cancer patients with periodontitis undergoing chemotherapy.

OBJECTIVE: This study evaluated the effect of non-surgical periodontal therapy (NSPT) on the cytokine profile in gingival crevicular fluid (GCF) in patients with breast cancer and periodontitis. METHODS: Forty patients were allocated into the periodontitis group (P) (n = 20) and breast cancer with periodontitis group (BC/P) (n = 20). Two days before the removal of infectious foci from the oral cavity and NSPT, as well as periodontal reevaluations, C-reactive protein, neutrophils (103µL), and platelets (103µL), were evaluated. The following cytokines in GCF, interleukin (IL)-4, IL-10, IL-2, IL-6, IL-1ß, tumor necrosis factor-alpha (TNF-α), interferon-gamma (IFN-γ), and transforming growth factor-ß (TGF-ß) were evaluated by the Luminex assay at baseline, and 45 and 180 days after therapy. Cytokine levels were analyzed for correlations with the clinical parameters: clinical attachment level (CAL), probing depth (PD), bleeding on probing (BOP), and plaque index (PI). RESULTS: After NSPT, IL-2, TNF-α, and TGF-ß were downregulated (p<0.05) in the BC/P. In the P group, INF-γ, IL-2, and TNF-α were downregulated (p<0.05), and TGF-ß was increased (p<0.05). At 180 days, IL-6 in GCF was significantly positively correlated with PD and CAL (r=0.45, r=0.56) in the BC/P (p<0.05). In the P group, IL-1ß in GCF was positively correlated with PD and CAL (r=0.56, r=0.59) at 45 days (p<0.05). CONCLUSION: NSPT, before the start of chemotherapy, helps to reduce the inflammatory markers associated with the activity of periodontal disease, favoring a less inflammatory pattern, to avoid the exacerbation of periodontitis.

Preliminary Results of Non-Surgical Periodontal Treatment in Patients With Breast Cancer Undergoing Chemotherapy.

BACKGROUND: Although priority is often given to treat the cancer itself, focus should also be directed to prevention and improvement of oral complications that may occur as a result of cancer and/or its treatment. This study compares periodontal treatment results in healthy patients and patients with breast cancer undergoing chemotherapy by monitoring clinical conditions and C-reactive-protein (CRP) levels. METHODS: Thirty-five participants were allocated to one of two groups: patients with periodontitis (P) (n = 18) and patients with breast cancer and periodontitis (CAN/P) (n = 17). The following clinical parameters were assessed at baseline and 45, 90, and 180 days after non-surgical periodontal treatment (NSPT): 1) probing depth (PD); 2) clinical attachment level (CAL); 3) plaque index (PI); 4) gingival index (GI); 5) CRP; and 6) complete blood count. Clinical parameters and CRP levels were statistically analyzed. RESULTS: P and CAN/P groups presented a statistically significant decrease in PD after NSPT at 45, 90, and 180 days compared with baseline (P <0.05). There was a CAL gain in the P group and a significant reduction in PI and GI at 45, 90, and 180 days for both groups (P <0.05). At 180 days after NSPT treatment, the CAN/P group showed a higher number of residual pockets (P <0.05) compared with the P group (46.48 ± 26.80 and 7.58 ± 7.40, respectively). The P group demonstrated a significant reduction in CRP levels at 45 and 180 days after NSPT compared with baseline (P <0.05), whereas this reduction was not observed in the CAN/P group. CONCLUSION: Patients with breast cancer who were undergoing chemotherapy responded to periodontal non-surgical therapy, although with less favorable results than patients with periodontitis without cancer, and may require additional or adjunctive periodontal treatments.

Trastuzumab use during pregnancy: long-term survival after locally advanced breast cancer and long-term infant follow-up.

Here, we describe the case of a patient diagnosed with locally advanced breast cancer 8 years ago. Her treatment course was neoadjuvant chemotherapy, followed by mastectomy and then adjuvant radiotherapy and trastuzumab (TTZ). During the use of adjuvant targeted therapy, an incidental pregnancy was diagnosed. Four years later, she developed bone and cerebral metastases, and since then, she has received courses of TTZ, capecitabine, lapatinib, and radiotherapy with intermittent control of the disease. Her 7-year-old son presents a normal physical and long-term neurological developmental curve according to specialized evaluation. This case is unique for several reasons: the patient received the highest dose of TTZ yet described during pregnancy (4400 mg); there has been a long period of disease-free survival after treatment for locally advanced breast cancer and long overall survival despite successive disease progressions during the metastatic phase of the disease (97 months), and there was a monitored pediatric follow-up period (7 years).

DNA repair genes XRCC1 and XRCC3 polymorphisms and their relationship with the level of micronuclei in breast cancer patients.

Breast cancer (BC) is the most prevalent type worldwide, besides being one of the most common causes of death among women. It has been suggested that sporadic BC is most likely caused by low-penetrance genes, including those involved in DNA repair mechanisms. Furthermore, the accumulation of DNA damage may contribute to breast carcinogenesis. In the present study, the relationship between two DNA repair genes, viz., XRCC1 (Arg399Gln) and XRCC3 (Thr241Met) polymorphisms, and the levels of chromosome damage detected in 65 untreated BC women and 85 healthy controls, was investigated. Chromosome damage was evaluated through micronucleus assaying, and genotypes determined by PCR-RFLP methodology. The results showed no alteration in the risk of BC and DNA damage brought about by either XRCC1 (Arg399Gln) or XRCC3 (Thr241Met) action in either of the two groups. Nevertheless, on evaluating BC risk in women presenting levels of chromosome damage above the mean, the XRCC3Thr241Met polymorphism was found to be more frequent in the BC group than in the control, thereby leading to the conclusion that there is a slight association between XRCC3 (241 C/T) genotypes and BC risk in the subgroups with higher levels of chromosome damage.

Basal levels of DNA damage detected by micronuclei and comet assays in untreated breast cancer patients and healthy women.

Breast cancer is the second most frequent type of cancer worldwide and is the most common malignant disease among women. Risk factors for breast cancer include early menarche, late menopause, hormonal therapies, exposure to environmental pollutants, smoking and alcohol use. However, increased or prolonged exposure to estrogen is the most important risk factor. It has been suggested that accumulation of DNA damage may contribute to breast carcinogenesis. Epidemiological studies suggest that cytogenetic biomarkers such as micronuclei in peripheral blood lymphocytes may predict cancer risk because they indicate genomic instability in target tissues. The objective of the present study was to evaluate the frequencies of micronuclei and the extent of DNA damage detected by comet assay in peripheral blood lymphocytes of untreated breast cancer patients and healthy women. The study was conducted using peripheral blood lymphocytes from 45 women diagnosed for Ductal "in situ" or invasive breast carcinoma and 85 healthy control women. Micronuclei and comet assays were performed to detect spontaneous DNA damage. The results showed that micronuclei frequencies and tail intensity, detected by comet assay, were significantly higher in the breast cancer group than in controls. The levels of DNA damage were similar in smokers and non-smokers, and aging did not influence the frequencies of micronuclei or tail intensity values observed in either group. In conclusion, the present work demonstrates higher levels of DNA damage in untreated breast cancer patients than in healthy women.

DNA repair genes XRCC1 and XRCC3 polymorphisms and their relationship with the level of micronuclei in breast cancer patients

Breast cancer (BC) is the most prevalent type worldwide, besides being one of the most common causes of death among women. It has been suggested that sporadic BC is most likely caused by low-penetrance genes, including those involved in DNA repair mechanisms. Furthermore, the accumulation of DNA damage may contribute to breast carcinogenesis. In the present study, the relationship between two DNA repair genes, viz., XRCC1 (Arg399Gln) and XRCC3 (Thr241Met) polymorphisms, and the levels of chromosome damage detected in 65 untreated BC women and 85 healthy controls, was investigated. Chromosome damage was evaluated through micronucleus assaying, and genotypes determined by PCR-RFLP methodology. The results showed no alteration in the risk of BC and DNA damage brought about by either XRCC1 (Arg399Gln) or XRCC3 (Thr241Met) action in either of the two groups. Nevertheless, on evaluating BC risk in women presenting levels of chromosome damage above the mean, the XRCC3 Thr241Met polymorphism was found to be more frequent in the BC group than in the control, thereby leading to the conclusion that there is a slight association between XRCC3 (241 C/T) genotypes and BC risk in the subgroups with higher levels of chromosome damage.

A importancia da mastoplastia reducional reconstrutiva na formaçäo do mastologista / The importance of the reconstructive reduction mammaplasty in the background of the mastologist

O profissional médico que busca especializar-se em Mastologia deve ter um conhecimento global da mama incluindo os aspectos funcionais, nosológicos, psicológicos, sociais, sexuais e estéticos, e esta abordagem completa da mama implica no conhecimento de técnicas cirúrgicas que permitam, preferencialmente, manter as mamas o mais estético possível com funcionalidade. O objetivo deste trabalho é mostrar como essa abordagem é feita, para o aprendizado destas técnicas. Diversas técnicas de abordagem foram utilizadas: Pitanguy (P), Gerardo Peixoto (GP), 5º Pedículo de Liacir Ribeiro (LR), Periareolar a Sampaio Góes (SG). A classificaçao das mamas segundo Bozzola serviu para optarmos por uma ou outra técnica. Foram 26 cirurgias realizadas em pacientes com média de 28 anos de idade. A queixa mais freqüente foi de mamas grandes e dor nas costas. O peso médio retirado foi de 540 g e o maior volume foi de 2.000 g. A maioria das mamas com segmento AM negativo de 0-4 foi operada por técnica de P (15 casos). Houve 2 casos de infecçao. Somente uma paciente teve tecido normal; as demais, alateraçoes fibrocísticas e adenose. O aprendizado de técnicas de mastoplastia reducional permite ao neófito da Mastologia um domínio da abordagem da mama, permitindo-lhe ressecar segmentos mamários quando necessários preservando sua funcionalidade e estética.