Analysis of the R72P polymorphism of the TP53 gene in patients with invasive ductal breast carcinoma.

Breast cancer is the most common neoplasia as well as the main cause of cancer-related death among women, experiencing a 0.5% increase in incidence per year. The disease results from a series of mutations in the DNA development and repair genes. Approximately 50% of human carcinomas present mutations in the TP53 gene. Polymorphisms of TP53 include codon 72 containing either arginine (CGC) or proline (CCC). Such polymorphisms may be involved in the susceptibility and predisposition to cancer, presenting a widely variable ethnic and geographic distribution. The arginine homozygous genotype seems to be a significant risk factor for breast cancer. The purpose of this study was to determine the frequency of the R72P polymorphism of the TP53 gene in patients with invasive ductal breast cancer from southern Brazil, where this type of cancer has a high incidence, as well as its association with breast carcinoma and clinicopathological characteristics. Seventy-six patients suffering from invasive ductal breast cancer and 80 controls were analyzed, and samples were evaluated by PCR followed by restriction enzyme digestion. No statistical differences in terms of the genotype frequency (P=0.707) or the arginine and proline allele frequencies (P=0.469) involving codon 72 were found in patients compared to controls. Thus, statistical analysis did not suggest any association between the R72P polymorphism of the TP53 gene and invasive ductal carcinoma in the population studied. Additionally, no significant association with the clinicopathological characteristics presented by the breast carcinoma patients was found.

Microsmetástase no linfonodo sentinela do câncer de mama: prognóstico e manejo / Breast cancer sentinel node micrometastase: prognosis and management

O status dos linfonodos axilares permanece fundamental na decisão do estadiamento, prognóstico e tratamento no câncer de mama. A biópsia do linfonodo sentinela já está incorporada ao manejo cirúrgico, conseguindo predizer com boa acurácia o risco do envolvimento axilar. Essa técnica permitiu qualificar a análise histopatológica do sentinela e, cada vez mais, depósitos tumorais nesse linfonodo, identificados como micrometástases (dimensões de 0,2 a 2 mm), são valorizados na terapêutica do câncer de mama. São controversos o real significado clínico e o tratamento cirúrgico ideal das micrometástases no linfonodo sentinela. A tendência atual é de se proceder ao esvaziamento axilar e indicar tratamento sistêmico adjuvante nos casos em que houver micrometástases no gânglio sentinela, porém não nas situações em que são encontradas apenas células tumorais isoladas. O nomograma do Memorial Hospital pode ser uma ferramenta útil neste cenário para a tomada de decisões individuais. Esta questão provavelmente terá uma resposta após os resultados de grandes ensaios clínicos em andamento.

Axillary modal status remains as the most important parametermin breast cancer staging, prognosis and treatment. Sentinel node biopsy is now a standard procedure in the surgical management and an excellent risk predictor of axillary involvement. The detailed sentinel node histopathological analysis has lead to the increasing discovery of tumoral deposits defined as micrometastases. The real biological significance of these micrometastases and their treatment are controversial in the literature. The current trend is to proceed with full axillary dissection and prescribe adjuvant treatment when micrometastases are found. However, isolated tumor cells are detected these treatments are unnecessary. The Memorial Hospital nomogram could be an useful tool for individual decisions in the clinical setting. Answers to this question will probably be provided after the results of large ongoing randomized clinical

Gigantomastia / Gigantomastia

A gigantomastia é um desenvolvimento anormal e rápido da glândula mamária, de grandes proporçöes e de etiologia desconhecida, mais observada na mulher jovem, que pode ocorrer durante a gravidez ou adolescência. Säo relatados quatro casos diagnosticados no Serviço de Mastologia do Hospital de Clínicas de Porto Alegre, no período de 1985 a 1995. Além de caracterizar melhor esta patologia, que causa grandes transtornos de ordem física e psicológica, os autores destacam os aspectos do diagnóstico, complicaçöes, tratamento e associaçäo com outras enfermidades.