Breast disease in men in metropolitan São Paulo - Brazil.

Although rare, breast cancer in males represents 1% of all cancer in men, and has shown increasing incidence in 25 years. To analyze age, gender, type of procedure performed and diagnosis of all cases of breast diseases in a public hospital in Sao Paulo, Brazil, with special focus on men. Cross-sectional study of breast surgery in 2010-2014 at Hospital Municipal Universitario de Sao Bernardo do Campo, Brazil. In the period 999 breast surgery were carried out. Patients with benign diseases were about 30 years old and patients with malignant diseases were over 50. Most surgical procedures performed on men were on the benign condition of gynaecomastia (n=21). The prevalence of breast cancer in the male population attending the public health system in Sao Bernardo was 0.27 (per 100,000). There was a single record of malignant disease in men, a 65 years old man, with histological diagnosis of ductal carcinoma. Surgical pathology of the breast in men is a rare event, and accounts for about 2.4% of mammary surgery in the municipality of São Bernardo do Campo. Awareness is necessary for health professionals and the media, regarding breast pathologies in the male population, to reduce the prejudice in the search for an early diagnosis of a condition so strongly linked to the female for the majority of people.

Motion correction and myocardial perfusion SPECT using manufacturer provided software. Does it affect image interpretation?

PURPOSE: Myocardial perfusion SPECT is an excellent tool for the assessment of coronary artery disease (CAD); however, it is affected by several artifacts, such as patient motion during acquisition, which increases false-positive rates. Therefore, the purpose of this work is to analyze changes in perfusion scores after motion-correction software application. METHODS: The population included 160 (99m)Tc-sestamibi CAD studies, divided into two groups: with and without perfusion defects, equally divided into subgroups according to movement during standard acquisition. A Siemens ECAM 180 was used for processing without correction and with automatic and manual e.soft 2.5 modalities. Visual interpretation as well as QPS software was compared using Pearson correlation and kappa agreement statistics. RESULTS: Moderate agreement was observed between SPECT interpretations after motion correction versus the original report, according to the presence of perfusion defects. Manual correction using the software obtained the lowest agreements. Perfusion summed stress scores (SSS) correlation from different processing modalities versus non-corrected studies differed significantly independent of the degree of motion. Mean SSS in 40 patients with no motion was 3.9 + or - 3.9 when no correction was applied; with automatic correction was 8.8 + or - 10 (p = 0.03) and with manual correction was 3.1 + or - 3.5 (p = ns versus non-corrected). Automatic correction was better when applied to patients with mild to moderate motion. In those with mild or no motion, software overestimated or created new perfusion defects. CONCLUSION: Motion-correction software must be used with caution when trying to optimize myocardial perfusion SPECT based on individual analysis. Acquisition should be always repeated in cases with severe motion and in no or mild motion it seems preferable to avoid correction.

Experiência do servico de quimioterapia da Faculdade de Medicina da Fundaçäo ABC com pacientes portadoras de neoplasias mamárias / Preliminary experience of the medical oncology service of ABC foundation school of medicine with breast cancer patients

Durante o período de agosto de 1996 a maio de 1998, atendemos o total de 91 pacientes portadores de neoplasias mamárias referidas ao nosso serviço. A idade média foi de 53,9 anos, sendo que 57 destas mulheres tinham idade inferior a 55 anos. A distribuiçäo percentual dos estágios clínicos das pacientes foi:I-1,1, II-17,6, IIIa-14,3, IIIb-24,2 e IV=42,9. Aproximadamente 90 das pacientes foram tratadas com quimioterapia, 67,3 com cirurgia e 53,8 com radioterapia. Observou-se curiosamente, uma correlaçäo significativa entre o estágio clínico e a idade da paciente(p=0,0093). Pacientes mais idosas tinham estágios mais avançados da doença. Conclui-se que a populaçäo das pacientes por nós assistidas durante este período é jovem e apresenta casos avançados da doença. Portanto, medidas preventivas como auto-exame, consultas periódicas e mamografia devem ser enfática e urgentemente preconizadas para esta populaçäo