ABSTRACT
This study aimed to determine the waiting time from the diagnosis to the first breast cancer treatment at the University Hospital in southern Brazil to verify if the law #12,732/12 is being respected and to identify the impact of this waiting time on breast cancer progression. A retrospective, quantitative, and indirect approach was carried out by reviewing the medical records of 118 patients who underwent oncologic breast surgery at the University Hospital, an exclusive public service, from January 1st 2012 to December 31st 2016. Data analysis revealed that the average waiting time was 104.4 days and the median was 92.5 days. Of the patients who started their treatment by surgery, 85.1% waited for more than 60 days. Meanwhile, 67.6% of the patients who underwent neoadjuvant chemotherapy, started the treatment within 60 days. In addition, the waiting time was not significant for relapse outcomes, metastatic disease, and death due to breast cancer. These results demonstrate the need for proposals that can reduce waiting times to the first treatment, especially if the indication is surgery.
Subject(s)
Breast Neoplasms , Waiting Lists , Brazil , Breast Neoplasms/surgery , Breast Neoplasms/therapy , Female , Humans , Mastectomy , Retrospective StudiesABSTRACT
OBJETIVO: Analisar a eficácia e a ocorrência de complicações, além do tempo de permanência hospitalar e as perdas sanguíneas. MÉTODOS: Trinta pacientes foram selecionadas, alternada e consecutivamente, em um dos grupos (15 no Grupo Curetagem e 15 no Grupo de Aspiração manual intrauterina). As variáveis analisadas foram: eficácia do método, ocorrência de complicações, tempo pré-procedimento, tempo de execução do procedimento, tempo pós-procedimento e tempo total de permanência hospitalar, além de hematócrito e hemoglobina, medidas antes e após o procedimento. As pacientes foram avaliadas clinicamente 10 a 14 dias após o procedimento. Para a análise estatística, foram aplicados testes paramétricos e não-paramétricos e o nível de significância admitido foi de p>0,05. RESULTADOS: Ambos os métodos foram eficazes e não foi registrada nenhuma complicação. As perdas sanguíneas foram semelhantes e o tempo de permanência hospitalar foi significativamente menor no Grupo de Aspiração Manual Intrauterina (p=0,03). CONCLUSÃO: a aspiração manual intrauterina é tão eficaz e segura quanto à curetagem uterina, com a vantagem de necessitar menor tempo de permanência hospitalar, o que aumenta a resolutividade do método, melhorando a qualidade da assistência a essas pacientes.
PURPOSE: To analyze the effectiveness and occurrence of complications, in addition to hospitalization time and blood losses. METHODS: Thirty patients were assigned alternatively and consecutively to one of two groups (15 to the Curettage Group and 15 to the Manual Vacuum Aspiration Group). The following variables were analyzed: effectiveness of the method, occurrence of complications, time before the procedure, time of execution of the procedure, time after the procedure, and total time of hospital permanence, in addition to hematocrit and hemoglobin, which were measured before and after the procedure. Patients were evaluated clinically 10 to 14 days after the procedure. Parametric and nonparametric tests were used for statistical analysis, with the level of significance set at p>0.05. RESULTS: Both methods were efficient and no complications were recorded. Blood losses were similar in the two groups, but the hospitalization time was significantly shorter for the Manual Vacuum Aspiration Group (p=0.03). CONCLUSION: Manual vacuum aspiration is as efficient and safe as uterine curettage, with the advantage of requiring shorter hospitalization, which increases the resolution of the method, improving the quality of care for these patients.
Subject(s)
Adult , Female , Humans , Pregnancy , Abortion, Incomplete/surgery , Vacuum Extraction, Obstetrical , Curettage , Pregnancy Trimester, First , Prospective StudiesABSTRACT
PURPOSE: To analyze the effectiveness and occurrence of complications, in addition to hospitalization time and blood losses. METHODS: Thirty patients were assigned alternatively and consecutively to one of two groups (15 to the Curettage Group and 15 to the Manual Vacuum Aspiration Group). The following variables were analyzed: effectiveness of the method, occurrence of complications, time before the procedure, time of execution of the procedure, time after the procedure, and total time of hospital permanence, in addition to hematocrit and hemoglobin, which were measured before and after the procedure. Patients were evaluated clinically 10 to 14 days after the procedure. Parametric and nonparametric tests were used for statistical analysis, with the level of significance set at p>0.05. RESULTS: Both methods were efficient and no complications were recorded. Blood losses were similar in the two groups, but the hospitalization time was significantly shorter for the Manual Vacuum Aspiration Group (p=0.03). CONCLUSION: Manual vacuum aspiration is as efficient and safe as uterine curettage, with the advantage of requiring shorter hospitalization, which increases the resolution of the method, improving the quality of care for these patients.
Subject(s)
Abortion, Incomplete/surgery , Vacuum Extraction, Obstetrical , Adult , Curettage , Female , Humans , Pregnancy , Pregnancy Trimester, First , Prospective StudiesABSTRACT
OBJETIVO: analisar a expressão da metaloproteinase da matriz 9 (MMP-9) e do fator de crescimento vascular endotelial (VEGF) em um grupo de pacientes com câncer primário de mama, e correlacioná-los entre si e com outros indicadores de prognóstico. MÉTODOS: estudo transversal que analisou a expressão da MMP-9 e do VEGF em 88 casos consecutivos de tumores primários de mama. As amostras foram obtidas de pacientes portadoras de câncer primário de mama, submetidas a tratamento cirúrgico no Hospital de Clínicas de Porto Alegre da Universidade Federal do Rio Grande do Sul, no período de janeiro de 2000 a dezembro de 2004. A técnica de imuno-histoquímica, usando o complexo avidina-biotina-peroxidase, foi aplicada para avaliar a imunoreação dos antígenos nos tumores. A expressão qualitativa das proteínas foi avaliada por meio da observação da intensidade da coloração acastanhada dos anticorpos no citoplasma das células malignas, considerando positiva quando pelo menos uma célula tumoral apresentava coloração nítida e inequívoca para cada um destes marcadores. Para a determinação do escore qualitativo (0=ausente, 1=fraca, 2=média e 3=forte), foi considerada a intensidade da coloração citoplasmática mais forte na lâmina, independente do número de células coradas. A expressão quantitativa foi determinada pela percentagem média de células coradas, observadas em pelo menos dez campos microscópicos. A quantificação final da expressão da MMP-9 e do VEGF foi feita por meio da aplicação do algoritmo HSCORE=Σ[(I+1)]xPC, no qual I e PC representam a intensidade da coloração e a percentagem das células coradas, respectivamente. RESULTADOS: a MMP-9 e o VEGF apresentaram alto percentual de positividade nos tumores estudados. A expressão final mostrou escore mediano de 180 e 190, respectivamente. Quando se comparou a expressão da MMP-9 e do VEGF com as variáveis "idade", "diâmetro tumoral", "tipo histológico", "grau histológico", "linfonodo axilar" e "invasão...
PURPOSE: to analyze the expression of matrix metalloproteinase-9 (MMP-9) and of vascular endothelial growth factor (EVGF) in a group of patients with primary breast cancer, and correlate them to one another and with other prognostic indicators. METHODS: transversal study that has analyzed the expression of MMP-9 and of VEGF in 88 consecutive cases of primary breast tumors. The samples were obtained from patients with primary breast cancer, submitted to surgical treatment in the Clinical Hospital of Porto Alegre of the Universidade Federal do Rio Grande do Sul, from January 2000 to December 2004. An immunohistochemical technique has been applied, using the avidin-biotin-peroxidase complex to evaluate the antigen immunoreactions in the tumors. The qualitative expression of proteins has been assessed through the observation of the brownish stain intensity of antibodies in the cytoplasm of malignant cells, when at least one of the tumoral cells presented clear and unequivocal staining with each of those markers. To determine the qualitative score (0=absent, 1=weak, 2=average and 3=strong), the stronger cytoplasmatic staining intensity on the glass slide has been taken into consideration, independently of the stained cells. The quantitative expression was determined by the average percentage of stained cells, observed in at least ten microscopic fields. The MMP-9 and VEGF final quantification expression has been done by the application of the HSCORE=Σ[(I+1)]xPC, where I and PC represent the staining intensity and the percentage of stained cells, respectively. RESULTS: MMP-9 and VEGF presented a significant correlation in the tumors studied. The final expression has shown a median score of 180 and 190, respectively. When MMP-9 and VEGF expression were compared with the variables "age", "tumoral diameter", "histological type", "histological grade", "axillary lymph node" and "vascular invasion", it was impossible to find any significant...
Subject(s)
Humans , Female , Breast Neoplasms , Vascular Endothelial Growth Factor A/analysis , Immunohistochemistry , Matrix Metalloproteinase 9/analysis , PrognosisABSTRACT
PURPOSE: to analyze the expression of matrix metalloproteinase-9 (MMP-9) and of vascular endothelial growth factor (EVGF) in a group of patients with primary breast cancer, and correlate them to one another and with other prognostic indicators. METHODS: transversal study that has analyzed the expression of MMP-9 and of VEGF in 88 consecutive cases of primary breast tumors. The samples were obtained from patients with primary breast cancer, submitted to surgical treatment in the Clinical Hospital of Porto Alegre of the Universidade Federal do Rio Grande do Sul, from January 2000 to December 2004. An immunohistochemical technique has been applied, using the avidin-biotin-peroxidase complex to evaluate the antigen immunoreactions in the tumors. The qualitative expression of proteins has been assessed through the observation of the brownish stain intensity of antibodies in the cytoplasm of malignant cells, when at least one of the tumoral cells presented clear and unequivocal staining with each of those markers. To determine the qualitative score (0=absent, 1=weak, 2=average and 3=strong), the stronger cytoplasmatic staining intensity on the glass slide has been taken into consideration, independently of the stained cells. The quantitative expression was determined by the average percentage of stained cells, observed in at least ten microscopic fields. The MMP-9 and VEGF final quantification expression has been done by the application of the HSCORE=Sigma[(I+1)]xPC, where I and PC represent the staining intensity and the percentage of stained cells, respectively. RESULTS: MMP-9 and VEGF presented a significant correlation in the tumors studied. The final expression has shown a median score of 180 and 190, respectively. When MMP-9 and VEGF expression were compared with the variables 'age', 'tumoral diameter', 'histological type', 'histological grade', 'axillary lymph node' and 'vascular invasion', it was impossible to find any significant correlation. Compared to one another, MMP-0 and VEGF have presented a positive correlation (rho=0.23; p=0.03). The axillary lymph node positivity has presented a positive correlation with the larger tumoral diameter (2.7+/-1.1 cm; p<0.01) and with the presence of vascular invasion (84.1%; p<0.01). CONCLUSIONS: The present results do not show correlation between the MMP-9 and VEGF with the selected prognostic indicators, but shown a significant correlation between one another.
