Assessment of pathological response of breast cancer in patients undergoing neoadjuvant chemotherapy in a refferal hospital in Amazonas State

Introduction: The therapeutic options for breast cancer are diverse. Increasingly, treatments are established on an individual basis, depending on a series of variables ranging from age to the molecular profile of the tumor. When neoadjuvant chemotherapy (NAC) is necessary, adequate clinical evaluation (CE) and control examinations, such as breast ultrasound (US) and mammography (MMG), are of fundamental importance, as it is necessary to reevaluate the tumor lesion to determine an individualized surgical treatment, with the aim of performing breast-conserving surgery within the available techniques. This study sought to evaluate the pathological response of patients undergoing neoadjuvant chemotherapy, analyzing the presence or absence of tumor reduction by relating the physical examination with imaging methods (MMG and US), taking the anatomopathological examination measurements as the gold standard, thus intending to identify the best method for evaluating the pathological response. Methods: This was a prospective, observational, analytical cohort study. The study included 41 patients diagnosed with breast cancer detected by mammography and ultrasound (MMG and US) followed by biopsy, who underwent neoadjuvant chemotherapy (NAC) and surgery. The measurements of the malignant breast lesions obtained by CE, MMG and US were compared with the anatomopathological measurements on biopsy as the gold standard. Results: Pearson's correlation coefficient was the statistical method used for evaluation, finding a value of 0.49 between the anatomopathological examination and CE, 0.47 between the anatomopathological examination and MMG and 0.48 between the anatomopathological examination and US (p<0.05). Conclusions: CE, MMG and US showed a moderate correlation with anatomopathological measurement, in addition to a moderate correlation between them, demonstrating equivalence in the pre-surgical definition of the size of the breast tumor after NAC, being complementary to each other to define a measure of greater accuracy of the tumor in breast cancer. (AU)

Human papillomavirus prevalence and frequency of sexually transmitted diseases in encarcered women by self-sampling approach.

OBJECTIVE: This study aimed to assess the sociodemographic and clinical profile of women deprived of their liberty and to identify the prevalence of sexually transmitted diseases and human papillomavirus through self-sampling samples. METHODS: This is an epidemiological, cross-sectional, observational, and descriptive study of the prevalence and correlation of the diagnosis of human papillomavirus infection in 268 encarcered women in Amazonas submitted to self-sampling from June 2019 to September 2020 using the genotyping analysis. Patients with positive and inconclusive results were evaluated by commercialized PCR to detect pathogens causing sexually transmitted diseases. The sample size used was based on a convenience sample. RESULTS: In 268 women, human papillomavirus DNA was detected in 87 (32.5%) of them. Sexually transmitted diseases were detected in 30 (34.48%) of the 87 women with a positive or inconclusive result for human papillomavirus. Women with more than three pregnancies had a higher risk of human papillomavirus detection (p=0.004). CONCLUSION: The prevalence of human papillomavirus and other sexually transmitted diseases in encarcered women in Amazonas is 32.5 and 34.48%, respectively. Most women were single (60.4%) and reported having had more than 15 partners (90.8%).

Human papillomavirus prevalence and frequency of sexually transmitted diseases in encarcered women by self-sampling approach

SUMMARY OBJECTIVE: This study aimed to assess the sociodemographic and clinical profile of women deprived of their liberty and to identify the prevalence of sexually transmitted diseases and human papillomavirus through self-sampling samples. METHODS: This is an epidemiological, cross-sectional, observational, and descriptive study of the prevalence and correlation of the diagnosis of human papillomavirus infection in 268 encarcered women in Amazonas submitted to self-sampling from June 2019 to September 2020 using the genotyping analysis. Patients with positive and inconclusive results were evaluated by commercialized PCR to detect pathogens causing sexually transmitted diseases. The sample size used was based on a convenience sample. RESULTS: In 268 women, human papillomavirus DNA was detected in 87 (32.5%) of them. Sexually transmitted diseases were detected in 30 (34.48%) of the 87 women with a positive or inconclusive result for human papillomavirus. Women with more than three pregnancies had a higher risk of human papillomavirus detection (p=0.004). CONCLUSION: The prevalence of human papillomavirus and other sexually transmitted diseases in encarcered women in Amazonas is 32.5 and 34.48%, respectively. Most women were single (60.4%) and reported having had more than 15 partners (90.8%).

Impact of the immunohistochemical panel on patients with breast cancer diagnosis cared for in a referral hospital in the state of Amazonas

Objective: To demonstrate the time between the diagnosis of the disease, the result of the immunohistochemical panel and the beginning of specialized treatment in patients diagnosed with breast cancer seen at the Foundation Center of Oncology of the State of Amazonas, from June to November 2018 and in the same period of 2019. Methods: The study was part retrospective, based on data from medical records, and part prospective, based on data from patients, and we evaluated the time between diagnosis from the immunohistochemical panel and the beginning of specialized treatment in breast cancer patients. Results: 170 patients diagnosed with breast cancer were included, 71 from June to November 2018 and 99 breast cancer patients seen from June to November 2019. The median time between diagnosis and immunohistochemistry results of all patients was 36 days, and comparing the two groups of patients, it was observed that for half of the 2018 patients, the time was less than 105 days, while for half of the 2019 patients, it was less than 27 days. If the times between the result of the immunohistochemical panel and the start of personalized treatment in both groups were compared, it was seen that the median time until the start of treatment was longer for patients in 2018, 94.5 days versus 79 days for patients in 2019. Conclusion: There was a decrease in the time between the diagnosis and the result of the molecular panel in 2019 compared to 2018. Achieving this result more quickly provided the choice of personalized treatment for each patient, having an important impact on survival in that population.