scholarly journals Evaluación endometrial vía histeroscopia en pacientes con cáncer de mama – receptores hormonales positivos, tratadas con hormonoterapia

2020 ◽  
Vol 80 (04) ◽  
pp. 312-321
Author(s):  
Carlos Lugo ◽  
◽  
Nazira Monsalve

Objective: To know via hysteroscopy the endometrial pathology associated with the use of hormone therapy in patients with breast cancer. Methods: Research design: non-experimental, longitudinal, trend; based on patients who come randomly, from January to July 2014, to the consultation of Los Andes University Hospital. Results: The mean age of the patients was 55.3 years, mean time of menopause 8.03 years; 8 (26.6%) patients had associated chronic arterial hypertension and diabetes mellitus II, and 10% of the patients had arterial hypertension. The most common endometrial alterations were: 46.7 % endometrial polyps, 13.3 % simple hyperplasia without atypia, 6.6 % leiomyomas. Among 5 (16.6%) users of exemestane (all with normal ultrasound), 3 (10%) had endometrial polyps and 2 (6.7%) negative biopsies. Among the 23 (76.7%) patients taking tamoxifen, 9 (30%) had thickened endometrium, 12 (40%) normal ultrasound and 2 (6.7%) other findings; 10 (33.3 %) had polyps (6 with normal ultrasound and 4 with endometrial thickening) and 3 endometrial hyperplasia (all with thickened endometrium). Two patients receiving both treatments, one had hyperplasia and one had polyps (both with thickened endometrium). The population studies in 60% were luminal B breast cancer; 1 (3.3 %) patient had a vagal reflex as a complication of the procedure. Conclusion: Histeroscopic findings most often diagnosed were endometrial polyps, simple hyperplasia without atypia and submucosal myomas. Keywords: Hysteroscopy, endometrium, tamoxifen, cancer, breast.

2021 ◽  
Vol 32 (2) ◽  
pp. 155-159
Author(s):  
M Alcaide Lucena ◽  
CJ Rodríguez González ◽  
S de Reyes Lartategui ◽  
R Gallart Aragón ◽  
MT Sánchez Barrón ◽  
...  

Resumen Los avances recientes en el campo de la biología molecular y la secuenciación del genoma se han traducido en una nueva clasificación del cáncer de mama, que busca mayor precisión y se correlaciona mejor con el riesgo de recaída de la enfermedad y la respuesta al tratamiento. Establece cuatro subtipos de cáncer de mama: luminal A, luminal B, HER 2 positivo y triple negativo, siendo el subtipo luminal A el de mejor pronóstico, y el triple negativo, el de peor pronóstico. Si combinamos la clasificación clásica histológica con la nueva molecular, nos permite encuadrar a estas pacientes de una forma más precisa en función del riesgo, definiendo así un manejo terapéutico adaptado.


2020 ◽  
Vol 66 (1) ◽  
Author(s):  
Monique Binotto ◽  
Gilberto Schwartsmann

Introdução: O câncer de mama pode alterar a qualidade de vida relacionada à saúde das pacientes. Objetivo: Compreender o impacto da quimioterapia para câncer de mama na qualidade de vida relacionada à saúde de pacientes. Método: Trata-se de uma revisão integrativa da literatura, compreendendo artigos publicados entre 2007 e 2019, disponíveis nas bases de dados PubMed, LILACS e SciELO. Analisaram-se 25 artigos na íntegra. Resultados: Os questionários mais frequentemente utilizados nos estudos foram o European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30) e o módulo complementar European Organization for Research and Treatment of Cancer Breast Cancer-specific Quality of Life Questionnaire (EORTC QLQ-BR23). Em relação às alterações da qualidade de vida, a saúde global diminui durante a quimioterapia, mas pode melhorar após o término do tratamento. O aumento dos sintomas é relatado em diversos estudos e prejudicou a qualidade de vida relacionada à saúde das pacientes. Entretanto, os sintomas diminuem após o término da quimioterapia, exceto para algumas escalas. As escalas de imagem corporal, função sexual e funcionamento físico pioram ao longo do tratamento. A qualidade de vida mental/psicológica tem oscilações durante o tratamento, assim como a escala sobre as relações sociais. Conclusão: A qualidade de vida relacionada à saúde de mulheres com câncer de mama é afetada negativamente pelo tratamento quimioterápico, expressando maior impacto nas escalas de sintomas.


Author(s):  
Fatma Khinaifis Al-thoubaity

Background: Triple-negative breast cancer (TNBC) is a hostile sub-type consisting of nearly 10-20 % of breast cancer patients. TNBC has been known to have a poor prognosis and overall survival (OS) compared to many other breast cancer tumors categories. These tumors are highly aggressive and have a higher risk of early recurrence. Nevertheless, no evidence exists to date and this is also the situation in Saudi Arabia. Recently, it was found to be a heterogeneous disease. Objective: To subtype breast cancer (BC) following the recent advance molecular classification, and to ascertain the correlation of those sub-types with pathological parameters and to study triple-negative breast cancer and its correlation with other subtypes and its association with recurrence and poor prognosis. Methods: The study was performed on 740 breast cancer patients at the Department of Pathology, King Abdulaziz University Hospital (KAUH), Jeddah, Kingdom of Saudi Arabia diagnosed between 2005 to 2018. The parameters like Estrogen receptor (ER), Progesterone receptor (PR), and human epidermal growth factor receptor immunostaining were analyzed semi-quantitatively to establish the HER-2, triple-negative, molecular subtypes of luminal A and B in paraffin-embedded sections of BC. We review the histopathology report, tumor invasion, grade, margin, type of surgery, recurrence, metastases, and survival rate. Results: The most common sub-types were luminal B (19.7%), followed by triple-negative breast cancer (10.9%) and HER2-positive (9.5%), whereas luminal A was the least common subtype (8.1 %). In luminal A majority of their age less than or equal to 50 years, most of these subtypes have tumor invasion, 59.2% of triple-negative breast cancer had positive axillary lymph node involvement. 63.4 % of triple-negative breast cancer had grade 3 tumors most of the recurrence in luminal B. Conclusion: The biological behaviors of each molecular subtype is likely to be with characteristic pathological features. In addition to molecular sub-typing and further prognostic indicators, might be useful in investigating the prognosis and management of BC patients. The early diagnosis and screening of BC are recommended in our population.


2020 ◽  
Vol 12 ◽  
pp. 175883592097532
Author(s):  
Lorena Incorvaia ◽  
Daniele Fanale ◽  
Marco Bono ◽  
Valentina Calò ◽  
Alessia Fiorino ◽  
...  

Background: Several available data suggest the association between specific molecular subtypes and BRCA1/2 mutational status. Previous investigations showed the association between BRCA1/2 pathogenic variants (PVs) in specific genomic regions and phenotypic variations of cancer relative risk, while the role of PV type and location in determining the breast cancer (BC) phenotypic features remains still unclear. The aim of this research was to describe the germline BRCA1/2 PVs in triple-negative breast cancer (TNBC) versus luminal-like BC and their potential leverage on BC phenotype. Patients & methods: We retrospectively collected and analyzed all clinical information of 531 patients with BC genetically tested for germline BRCA1/2 PVs by Next-Generation Sequencing analysis at University Hospital Policlinico “P. Giaccone” of Palermo (Sicily) from January 2016 to February 2020. Results: Our results corroborate the evidence that BRCA1-related tumors often have a profile which resembles the TNBC subtype, whereas BRCA2-associated tumors have a profile that resembles luminal-like BC, especially the Luminal B subtype. Interestingly, our findings suggest that the PVs identified in TNBC were not largely overlapping with those in luminal-like tumors. Differences in the frequency of two PVs potentially associated with different molecular tumor subtypes were observed. BRCA1-633delC was detected with relatively higher prevalence in patients with TNBC, whereas BRCA2-1466delT was found mainly in Luminal B tumors, but in no TNBC patient. Conclusion: Future studies examining the type and location of BRCA1/2 PVs within different molecular subtypes are required to verify our hypothesis and could provide an interesting insight into the complex topic of genotype–phenotype correlations. Additionally, a more in-depth understanding of the potential correlations between BRCA PVs and clinical and phenotypic features of hereditary BC syndrome patients could be the key to develop better strategies of prevention and surveillance in BRCA-positive carriers without disease.


Mastology ◽  
2020 ◽  
Vol 30 (Suppl 1) ◽  
Author(s):  
Andre Hideo Motoki ◽  
Daniel de Araújo Brito Buttros ◽  
Heloisa Maria de Luca Vespoli ◽  
Eduardo Carvalho Pessoa ◽  
Eliana Aguiar Petri Nahas

Objective: To evaluate the association between metabolic syndrome (MS), obesity, and central fat deposition with the immunohistochemical profile (IHC) of breast cancer (BC) in postmenopausal women. Methods: A comparative cross-sectional clinical study was carried out with 63 women with recent BC and MS, compared to 126 women with recent BC, without MS (control group). Inclusion criteria were: women aged 45-75 years, amenorrhea >12 months, without previous cancer treatment, attended at a University Hospital. The groups were matched for age, time since menopause, and body mass index (BMI), in the proportion of 1 case for 2 controls, according to the sample calculation of at least 186 women in their entirety. Clinical and anthropometric data were collected; tumor size and grade and the IHC profile (ER, PR, HER2, and Ki67). By IHC convention, tumors were grouped into five subtypes: Luminal A (ER+, PR+, HER-2 -, and Ki-67 <14%); Luminal B HER-2 - (ER+, PR+ or -, HER-2 -, and Ki-67≥14%); Luminal B HER-2+ (ER+, PR+ or -, HER-2+, and any Ki-67); Non-luminal HER-2 (ER-, PR-, HER2+, and any Ki-67); and Triple-negative (ER-, PR-, HER2-, and any Ki-67). Women with three or more diagnostic criteria were considered with MS: waist circumference (WC)>88 cm; TG≥150 mg/dL; HDL cholesterol<50 mg/dL; blood pressure ≥130/85 mmHg; glucose ≥100 mg/dL. For statistical analysis, the Student’s t-test, Gamma Distribution, χ2 test and logistic regression (odds ratio–OR) were used. Results: Among the participating women, the mean age, time since menopause and BMI were: 59.0±10.6 years, 11.4±9.6 years, and 28.5±5.5 kg/m2, respectively; there was no statistical difference in the comparison between the groups. Women with MS had a higher occurrence of tumors ≤2cm when compared to those without MS (49.2 vs. 31.8%, respectively) (p=0.038). Women with MS had a higher incidence of tumors with PR-positive (p=0.046), HER2-negative (p=0.038), when compared to women without MS (79.4 vs. 65.8% and 44.5 vs. 27.8%, respectively). In obese patients (BMI≥30 kg/m2), a higher proportion of HER2 negative tumors (p=0.047) was observed when compared to non-obese women (43.9 vs. 27.7%, respectively). In the multivariate analysis, a higher risk for tumors of the Luminal B HER-2 negative subtype was observed among women with MS (OR 2.00, 95%CI 1.03‒3.89), obese (OR 2.03, 95%CI 1.06‒3.90), and with central deposition of fat (OR 1.96, 95%CI 1.01‒4.03). Conclusion: Metabolic syndrome, obesity, and central fat deposition correlate with factors of good prognosis for breast cancer, such as tumors ≤2 cm, PR+ and HER2-, in postmenopausal women.


Author(s):  
Alejandro Crismatt Zapata

<p>[Introduction. World situation of Breast Cancer]</p><p>Resumen<br />El cáncer de mama es el tumor de la mujer más diagnosticado en la gran mayoría de los países. Los factores no hereditarios son los principales impulsores de las diferencias internacionales e inter-étnicas observadas en la incidencia de este cáncer. Las tasas de incidencia del cáncer de mama han aumentado en la mayoría de los países en transición en las últimas décadas, en tanto que en la mayoría de los países más avanzados, las tasas de mortalidad por cáncer de mama han ido en descenso como resultado de la detección temprana de la enfermedad, los avances en el tratamiento y mayor accesibilidad a los servicios de salud. Los principales factores de riesgo para el cáncer de mama no son fácilmente modificables porque se derivan de exposiciones hormonales endógenas prolongadas. La prevención a través de la promoción de la lactancia materna, particularmente su mayor duración, pudiera ser beneficioso. La incidencia de cáncer de mama en Panamá se comporta de manera similar a los países con índice de desarrollo Humano en transición; ha ido en aumento en las últimas décadas como resultado del aumento en la prevalencia de los factores de riesgo conocidos y la mejoría en la recolección de datos.<br /><br />Abstract<br />Breast cancer is the most diagnosed woman's tumor in the vast majority of countries. The non-hereditary factors are the main drivers of the international and inter-ethnic differences observed in the incidence of this cancer. Breast cancer incidence rates have increased in most countries in transition in recent decades, while in most of the more advanced countries, breast cancer death rates have been declining as a result of breast cancer. early detection of the disease, advances in treatment and greater accessibility to health services. The main risk factors for breast cancer are not easily modifiable because they are derived from prolonged endogenous hormonal exposures. Prevention through the promotion of breastfeeding, particularly its longer duration, could be beneficial. The incidence of breast cancer in Panama behaves similarly to countries with a Human Development Index in transition; It has been increasing in recent decades as a result of the increase in the prevalence of known risk factors and the improvement in data collection.</p>


2019 ◽  
Vol 65 (6) ◽  
pp. 832-837
Author(s):  
Aziz Zikiryakhodzhaev ◽  
Yelena Rasskazova ◽  
Shakhnoz Khakimova

The article analyzes 472 patients diagnosed with breast cancer (breast cancer) who underwent radical subcutaneous/ skin-sparing mastectomy in combined or complex treatment. In the Department of Oncology and reconstructive plastic surgery of breast and skin mnioi them.P. A. Herzen radical skin-sparing mastectomy was performed in 255 (54.1 %) and radical subcutaneous mastectomy in 217 (45.9 %) patients. Reconstruction was carried out by autotissues, expander, followed by replacement with an endoprosthesis, as well as a combination of patches and endoprostheses. The mean age of patients was 43.8±2.2 (18-73) years. 11 (2,3±0,7 %) patients were diagnosed with relapse of breast cancer, while in 6 cases local and in 5 cases regional relapse (metastases in subclavian lymph nodes). Treatment of recurrences of breast cancer was as follows: in two cases, polychemotherapy courses were conducted, in 8 operations were performed - excision of relapse in the breast (3) and subclavian lymphadenectomy (2), removal of the reconstructed gland (3), in 1 case - radiation therapy. In 13 % recurrences of breast cancer were diagnosed at stage III OF breast cancer, the lowest percentage of relapse was 1.4 % at stage I. In luminal type A, recurrence of breast cancer was diagnosed in 1.8 %, in luminal B in 3.6 %, in triple negative type - 2.5 %, in luminal In Neg2 positive - 4.1 %. Metastases of breast cancer in our group of patients were diagnosed in 26 (5.5±1 %) patients. The highest percentage of long-term metastasis in our study revealed - 12.5 % at stage III, the lowest percentage of 3.4 at stage I breast cancer. 3-year overall survival of breast cancer patients in our group was 97.4 % (n=269).


2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Tchin Darre ◽  
Mazamaesso Tchaou ◽  
Toukilnan Djiwa ◽  
Panakinao Simgban ◽  
Ayi Kossi Amavi ◽  
...  

Background. Breast cancer in men is a rare condition, often diagnosed late. The purpose of this study was to describe its epidemiological, histopathological, and radiographic aspects in Togo. Materials and Methods. This was a descriptive retrospective study on cases of breast cancer in humans diagnosed histologically at the Laboratory of Anatomy Pathological and Imagery of the University Hospital in Lomé, over a period of 25 years (1995 to 2019). The parameters studied were epidemiological, anatomopathological, and imaging. Results. Eighty-two (82) cases were diagnosed, an annual frequency of 3.28 cases. The mean age was 45±2.5 years; the range was 27-63 years. The family history of 47 patients (57.32%) was known. Carcinomas represented the predominant histological group with predominantly nonspecific invasive carcinoma (87.5%). These cancers were diagnosed at late stages (75.71% grade II). They were mainly of luminal B profile (38.75%) and associated with mutations of the BRCA2 and BRCA1 genes in 14.63% of the cases. The lesions were classified ACR 5 in 61.5% (11/18). Two cases of breast angiosarcoma were diagnosed by the identification of CD31 markers and factor VIII in immunohistochemistry. Hormone therapy such as tamoxifen was prescribed in all luminal patients (43 patients). Radiotherapy was administered to 15 patients (18.3%), with acute toxicity in 20% of the cases. After a median follow-up of 36 months, the evolution was complete remission in 27 patients (32.93%). Conclusion. Breast cancer in men is rare, often diagnosed late with a poor prognosis.


2020 ◽  
Vol 17 (1) ◽  
pp. 73-89
Author(s):  
Noelia González Viniegra ◽  
Juan Antonio Cruzado

Objetivo: Conocer la eficacia o utilidad de la terapia de pareja en casos donde uno de los miembros de la pareja padece cáncer. Así como conocer en qué casos o en qué momentos puede ser más útil este tipo de terapia. Método: Se realizó una búsqueda sistemática en las bases de datos electrónicas: Scopus, Pubmed y PsycInfo, utilizándose palabras clave, tales como: Couple sex therapy, Cancer, Breast cancer, Prostate cancer, Couple psychological therapy, Intimacy, Clinical trial y Efficacy; y sus múltiples combinaciones. Se han incluido artículos en inglés de entre los años 2007 y 2019. Resultados: Los 11 estudios seleccionados únicamente trataban de cáncer de mama y próstata y la mayoría de ellos se lleva a cabo con una media relativamente pequeña. La mayoría de los tratamientos se aplica desde la corriente cognitivo-conductual y existen mejores resultados si el tratamiento está manualizado. En los casos de cáncer de próstata se trata con más normalidad aspectos relacionados con la sexualidad que en casos de cáncer de mama. Se observan mayores mejoras en cáncer de próstata ya que tienen que ver con aspectos sexuales además de psicológicos (pese a que con tiempo se pierdan dichas mejoras). Conclusiones: Se aprecia eficacia inicial en lo que a satisfacción de la relación y problemas sexuales en la pareja se refiere, pero estos resultados no se mantienen a lo largo del tiempo. Por lo que en general hablaríamos de una eficacia real baja.


2021 ◽  
Vol 11 (34) ◽  
pp. 100-109
Author(s):  
Lóris Aparecida Prado da Cruz ◽  
Mirele Savegnago Mialich ◽  
Bruna Ramos da Silva ◽  
Thais De Oliveira Gozzo ◽  
Alceu Afonso Jordão ◽  
...  

Identificar a ocorrência de obesidade, hipertensão arterial e níveis glicêmicos alterados entre mulheres com câncer de mama; avaliar a distribuição destas comorbidades em relação à idade, tempo de diagnóstico do câncer, circunferência da cintura, hormonioterapia e quimioterapia. Estudo transversal com 67 mulheres com câncer de mama. Utilizou-se um instrumento com variáveis sociodemográficas, clínicas, avaliações antropométricas e coleta de sangue para glicemia de jejum. Utilizou-se teste exato de Fisher, Mann-Whitney e Kruskal-Wallis. Dentre as participantes, 34,3% eram pré-obesas e 29,9% apresentavam parâmetros de obesidade leve a grave, 53,7% hipertensas e 20,9% diabéticas. Encontrou-se associação entre idade e hipertensão arterial; circunferência da cintura e hipertensão arterial; níveis glicêmicos e circunferência da cintura; índice de massa corpórea e circunferência da cintura; idade e diabetes mellitus; e idade e circunferência da cintura. Recomenda-se assistência que contemple ações sistematizadas integrando a avaliação e cuidados do câncer de mama e outras comorbidades.Descritores: Neoplasias Mamárias, Hipertensão, Obesidade, Glicemia. Chronic non-communicable diseases in women with breast cancerAbstract: To identify the occurrence of obesity, high blood pressure, and altered blood glucose levels among women with breast cancer; to evaluate the distribution of these comorbidities in relation to age, time since breast cancer diagnosis, waist circumference, hormone therapy, and chemotherapy. Cross-sectional study with 67 women with breast cancer. An instrument with sociodemographic and clinical variables, anthropometric assessments, and blood collection for fasting glucose was used. Fisher's exact test identified the relationship between qualitative variables and the Mann-Whitney and Kruskal-Wallis tests for continuous and categorical measures. Among the participants, 34.3% were pre-obese and 29.9% had parameters of mild to severe obesity, 53.7% were hypertensive and 20.9% were diabetic. An association was found between age and arterial hypertension; waist circumference and arterial hypertension; blood glucose levels and waist circumference; body mass index and waist circumference; age and diabetes mellitus; and age and waist circumference. The assistance that includes systematized actions is recommended, integrating the assessment and care that includes breast cancer and comorbidities.Descriptors: Mammary Neoplasms, Hypertension, Obesity, Glucose. Enfermedades crónicas no transmisibles en mujeres con cáncer de mamaResumen: Identificar la aparición de obesidad, hipertensión arterial y niveles alterados de glucosa en sangre entre las mujeres con cáncer de seno; evaluar la distribución de estas comorbilidades en relación con la edad, el tiempo transcurrido desde el diagnóstico de cáncer de mama, la circunferencia de la cintura, la terapia hormonal y la quimioterapia. Estudio transversal con 67 mujeres con cáncer de mama. Se utilizó un instrumento con variables sociodemográficas y clínicas, evaluaciones antropométricas y extracción de sangre para glucemia en ayunas. La prueba exacta de Fisher identificó la relación entre las variables cualitativas y las pruebas de Mann-Whitney y Kruskal-Wallis para medidas continuas y categóricas. Entre los participantes, 34.3% eran pre obesos y 29.9% tenían parámetros de obesidad leve a severa, 53.7% eran hipertensos y 20.9% eran diabéticos. Se encontró una asociación entre la edad y la hipertensión arterial; circunferencia de la cintura e hipertensión arterial; niveles de glucosa en sangre y circunferencia de la cintura; índice de masa corporal y circunferencia de la cintura; edad y diabetes mellitus; y edad y circunferencia de la cintura. Se recomienda asistencia que incluya acciones sistematizadas, integrando la evaluación y la atención que incluye el cáncer de mama y las comorbilidades.Descriptores: Neoplasias Mamarias, Hipertensión, Obesidad, Glucemia.


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