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Artigos Originais
Axillary lymph node aspiration guided by ultrasound is effective as a method of predicting lymph node involvement in patients with breast cancer?
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(3):118-123
03-01-2014
Summary
Artigos OriginaisAxillary lymph node aspiration guided by ultrasound is effective as a method of predicting lymph node involvement in patients with breast cancer?
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(3):118-123
03-01-2014DOI 10.1590/S0100-72032014000300005
Views97See morePURPOSE:
To assess the feasibility and diagnostic accuracy of preoperative ultrasound combined with ultrasound-guided fine-needle aspiration (US-FNA) cytology and clinical examination of axillary lymph node in patients with breast cancer.
METHODS:
In this prospective study, 171 axillae of patients with breast cancer were evaluated by clinical examination and ultrasonography (US) with and without fine needle aspiration (FNA). Lymph nodes with maximum ultrasonographic cortical thickness > 2.3 mm were considered suspicious and submitted to US-FNA.
RESULTS:
Logistic regression analysis showed no statistically significant correlation between clinical examination and pathologically positive axillae. However, in axillae considered suspicious by ultrasonography, the risk of positive anatomopathological findings increased 12.6-fold. Cohen's Kappa value was 0.12 for clinical examination, 0.48 for US, and 0.80 for US-FNA. Accuracy was 61.4% for clinical examination, 73.1% for US and 90.1% for US-FA. Receiver Operating Characteristics (ROC) analysis demonstrated that a cortical thickness of 2.75 mm corresponded to the highest sensitivity and specificity in predicting axillary metastasis (82.7 and 82.2%, respectively).
CONCLUSIONS:
Ultrasonography combined with fine-needle aspiration is more accurate than clinical examination in assessing preoperative axillary status in women with breast cancer. Those who are US-FNA positive can be directed towards axillary lymph node dissection straight away, and only those who are US-FNA negative should be considered for sentinel lymph node biopsy.
Views97
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Artigos OriginaisAxillary lymph node aspiration guided by ultrasound is effective as a method of predicting lymph node involvement in patients with breast cancer?
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(3):118-123
03-01-2014DOI 10.1590/S0100-72032014000300005
Views97See morePURPOSE:
To assess the feasibility and diagnostic accuracy of preoperative ultrasound combined with ultrasound-guided fine-needle aspiration (US-FNA) cytology and clinical examination of axillary lymph node in patients with breast cancer.
METHODS:
In this prospective study, 171 axillae of patients with breast cancer were evaluated by clinical examination and ultrasonography (US) with and without fine needle aspiration (FNA). Lymph nodes with maximum ultrasonographic cortical thickness > 2.3 mm were considered suspicious and submitted to US-FNA.
RESULTS:
Logistic regression analysis showed no statistically significant correlation between clinical examination and pathologically positive axillae. However, in axillae considered suspicious by ultrasonography, the risk of positive anatomopathological findings increased 12.6-fold. Cohen's Kappa value was 0.12 for clinical examination, 0.48 for US, and 0.80 for US-FNA. Accuracy was 61.4% for clinical examination, 73.1% for US and 90.1% for US-FA. Receiver Operating Characteristics (ROC) analysis demonstrated that a cortical thickness of 2.75 mm corresponded to the highest sensitivity and specificity in predicting axillary metastasis (82.7 and 82.2%, respectively).
CONCLUSIONS:
Ultrasonography combined with fine-needle aspiration is more accurate than clinical examination in assessing preoperative axillary status in women with breast cancer. Those who are US-FNA positive can be directed towards axillary lymph node dissection straight away, and only those who are US-FNA negative should be considered for sentinel lymph node biopsy.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Article
Polymorphisms of GSTM1 and GSTT1 genes in breast cancer susceptibility: a case-control study
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(12):569-574
02-03-2013
Summary
ArticlePolymorphisms of GSTM1 and GSTT1 genes in breast cancer susceptibility: a case-control study
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(12):569-574
02-03-2013DOI 10.1590/S0100-72032013001200007
Views48PURPOSE: This study aimed to evaluate the frequency of homozygous deletion of GSTM1 and GSTT1 genes and their combinations between patients with breast cancer and healthy individuals, associating them with disease susceptibility. METHODS: This is a case-control study in which 49 women diagnosed with breast cancer confirmed by pathological examination and 49 healthy women with no evidence of cancer and no prior family history of breast cancer were invited to participate. All of them answered a questionnaire with epidemiological data and were submitted to blood sample collection. Genomic DNA was extracted from blood, and genotyping was performed by polymerase chain reaction. Data were analyzed with SPSS 20.0. RESULTS: The frequency of null alleles for GSTM1 and GSTT1 was 58.8 and 61.7%, respectively, for patients with breast cancer, and 41.2 and 38.3%, respectively, in control patients. In homozygous deletion of the GSTM1 gene, a significantly higher frequency was found in the breast cancer cases. CONCLUSION: Breast cancer patients presented higher frequency of homozygous deletion of the GSTM1 gene compared with the control group.
Key-words Breast neoplasmsCase-control studiesDisease susceptibilityGenetic predisposition to diseaseGlutathione transferaseSee moreViews48This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
ArticlePolymorphisms of GSTM1 and GSTT1 genes in breast cancer susceptibility: a case-control study
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(12):569-574
02-03-2013DOI 10.1590/S0100-72032013001200007
Views48PURPOSE: This study aimed to evaluate the frequency of homozygous deletion of GSTM1 and GSTT1 genes and their combinations between patients with breast cancer and healthy individuals, associating them with disease susceptibility. METHODS: This is a case-control study in which 49 women diagnosed with breast cancer confirmed by pathological examination and 49 healthy women with no evidence of cancer and no prior family history of breast cancer were invited to participate. All of them answered a questionnaire with epidemiological data and were submitted to blood sample collection. Genomic DNA was extracted from blood, and genotyping was performed by polymerase chain reaction. Data were analyzed with SPSS 20.0. RESULTS: The frequency of null alleles for GSTM1 and GSTT1 was 58.8 and 61.7%, respectively, for patients with breast cancer, and 41.2 and 38.3%, respectively, in control patients. In homozygous deletion of the GSTM1 gene, a significantly higher frequency was found in the breast cancer cases. CONCLUSION: Breast cancer patients presented higher frequency of homozygous deletion of the GSTM1 gene compared with the control group.
Key-words Breast neoplasmsCase-control studiesDisease susceptibilityGenetic predisposition to diseaseGlutathione transferaseSee moreThis is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Article
Localization of metastasis within the sentinel lymph node biopsies: a predictor of additional axillary spread of breast cancer?
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(11):483-499
01-10-2013
Summary
ArticleLocalization of metastasis within the sentinel lymph node biopsies: a predictor of additional axillary spread of breast cancer?
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(11):483-499
01-10-2013DOI 10.1590/S0100-72032013001100002
Views109See morePURPOSE: To explore the relationship between morphological characteristics and histologic localization of metastasis within sentinel lymph nodes (SLN) and axillary spread in women with breast cancer. METHODS: We selected 119 patients with positive SLN submitted to complete axillary lymph node dissection from July 2002 to March 2007. We retrieved the age of patients and the primary tumor size. In the primary tumor, we evaluated histologic and nuclear grade, and peritumoral vascular invasion (PVI). In SLNs we evaluated the size of metastasis, their localization in the lymph node, number of foci, number of involved lymph nodes, and extranodal extension. RESULTS: Fifty-one (42.8%) patients had confirmed additional metastasis in non-sentinel lymph nodes (NLSN). High histologic grade, PVI, intraparenchymatous metastasis, extranodal neoplastic extension and size of metastasis were associated with positive NLSN. SLN metastasis affecting the capsule were associated to low risk incidence of additional metastasis. After multivariate analysis, PVI and metastasis size in the SLN remained as the most important risk factors for additional metastasis. CONCLUSIONS:The risk of additional involvement of NSLN is higher in patients with PVI and it increases progressively according the histologic localization in the lymph node, from capsule, where the afferent lymphatic channel arrives, to the opposite side of capsule promoting the extranodal extension. Size of metastasis greater than 6.0 mm presents higher risk of additional lymph node metastasis.
Views109This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
ArticleLocalization of metastasis within the sentinel lymph node biopsies: a predictor of additional axillary spread of breast cancer?
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(11):483-499
01-10-2013DOI 10.1590/S0100-72032013001100002
Views109See morePURPOSE: To explore the relationship between morphological characteristics and histologic localization of metastasis within sentinel lymph nodes (SLN) and axillary spread in women with breast cancer. METHODS: We selected 119 patients with positive SLN submitted to complete axillary lymph node dissection from July 2002 to March 2007. We retrieved the age of patients and the primary tumor size. In the primary tumor, we evaluated histologic and nuclear grade, and peritumoral vascular invasion (PVI). In SLNs we evaluated the size of metastasis, their localization in the lymph node, number of foci, number of involved lymph nodes, and extranodal extension. RESULTS: Fifty-one (42.8%) patients had confirmed additional metastasis in non-sentinel lymph nodes (NLSN). High histologic grade, PVI, intraparenchymatous metastasis, extranodal neoplastic extension and size of metastasis were associated with positive NLSN. SLN metastasis affecting the capsule were associated to low risk incidence of additional metastasis. After multivariate analysis, PVI and metastasis size in the SLN remained as the most important risk factors for additional metastasis. CONCLUSIONS:The risk of additional involvement of NSLN is higher in patients with PVI and it increases progressively according the histologic localization in the lymph node, from capsule, where the afferent lymphatic channel arrives, to the opposite side of capsule promoting the extranodal extension. Size of metastasis greater than 6.0 mm presents higher risk of additional lymph node metastasis.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Artigos Originais
Evalution of body posture in women with breast cancer
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(5):215-220
07-05-2013
Summary
Artigos OriginaisEvalution of body posture in women with breast cancer
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(5):215-220
07-05-2013DOI 10.1590/S0100-72032013000500005
Views78See morePURPOSE: To evaluate the body posture of women submitted to treatment for breast cancer, to identify the postural changes in the first three months after surgery and to investigate the correlation of these findings with the woman's age and type and side of surgery. METHODS: A longitudinal study that monitored the postural changes of 39 women who underwent mastectomy and quadrantectomy. Postural evaluation was performed using the technique of biophotogrammetry before surgery, after drain removal and three months after surgery. Statistical analysis was performed using parametric and nonparametric tests, with the level of significance set at p<0.05. RESULTS: The average age of the women studied was 50±10.5 years, 48.8% underwent mastectomy and the left breast was operated in 61.5% of them . There was no statistically significant difference in the women's posture during the study period. However, the pelvis and trunk of women submitted to quadrantectomy showed better alignment (90°) compared to the women submitted to mastectomy (91.3°). The women submitted to surgery in the left breast had shoulder elevation and ipsilateral inclination of the trunk within a short period of time. CONCLUSION: Postural changes were correlated with the type and side of surgery. The follow-up of this group after completion of treatment is needed to clarify long-term postural changes.
Views78This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Artigos OriginaisEvalution of body posture in women with breast cancer
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(5):215-220
07-05-2013DOI 10.1590/S0100-72032013000500005
Views78See morePURPOSE: To evaluate the body posture of women submitted to treatment for breast cancer, to identify the postural changes in the first three months after surgery and to investigate the correlation of these findings with the woman's age and type and side of surgery. METHODS: A longitudinal study that monitored the postural changes of 39 women who underwent mastectomy and quadrantectomy. Postural evaluation was performed using the technique of biophotogrammetry before surgery, after drain removal and three months after surgery. Statistical analysis was performed using parametric and nonparametric tests, with the level of significance set at p<0.05. RESULTS: The average age of the women studied was 50±10.5 years, 48.8% underwent mastectomy and the left breast was operated in 61.5% of them . There was no statistically significant difference in the women's posture during the study period. However, the pelvis and trunk of women submitted to quadrantectomy showed better alignment (90°) compared to the women submitted to mastectomy (91.3°). The women submitted to surgery in the left breast had shoulder elevation and ipsilateral inclination of the trunk within a short period of time. CONCLUSION: Postural changes were correlated with the type and side of surgery. The follow-up of this group after completion of treatment is needed to clarify long-term postural changes.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Article
Volume of breast tissue excised during breast-conserving surgery in patients undergoing preoperative systemic therapy
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(5):221-225
07-05-2013
Summary
ArticleVolume of breast tissue excised during breast-conserving surgery in patients undergoing preoperative systemic therapy
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(5):221-225
07-05-2013DOI 10.1590/S0100-72032013000500006
Views115See morePURPOSE: We aimed to determine whether clinical examination could adequately ascertain the volume of tissue to be resected during breast-conserving surgery after neoadjuvant therapy. METHODS: We reviewed the clinical reports of 279 patients with histologically diagnosed invasive breast carcinomas treated with neoadjuvant therapy followed by surgery or with primary surgery alone. We estimated volumes of excised tissues, the volume of the tumor mass and the optimal volume required for excision based on 1 cm of clear margins. The actual excess of resected volume was estimated by calculating the resection ratio measured as the volume of the resected specimen divided by the optimal specimen volume. The study endpoints were to analyze the extent of tissue resection and to ascertain the effect of excess resected tissue on surgical margins in both groups of patients. RESULTS: The median tumor diameter was 2.0 and 1.5 cm in the surgery and neoadjuvant therapy groups, respectively. The median volume of resected mammary tissue was 64.3 cm³ in the primary surgery group and 90.7 cm³ in the neoadjuvant therapy group. The median resection ratios in the primary surgery and neoadjuvant therapy groups were 2.0 and 3.3, respectively (p<0.0001). Surgical margin data were similar in both groups. Comparison of the volume of resected mammary tissues with the tumor diameters showed a positive correlation in the primary surgery group and no correlation in the neoadjuvant therapy group. CONCLUSION: Surgeons tend to excise large volumes of tissue during breast-conserving surgery after neoadjuvant therapy, thereby resulting in a loss of the correlation between tumor diameter and volume of the excised specimen.
Views115This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
ArticleVolume of breast tissue excised during breast-conserving surgery in patients undergoing preoperative systemic therapy
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(5):221-225
07-05-2013DOI 10.1590/S0100-72032013000500006
Views115See morePURPOSE: We aimed to determine whether clinical examination could adequately ascertain the volume of tissue to be resected during breast-conserving surgery after neoadjuvant therapy. METHODS: We reviewed the clinical reports of 279 patients with histologically diagnosed invasive breast carcinomas treated with neoadjuvant therapy followed by surgery or with primary surgery alone. We estimated volumes of excised tissues, the volume of the tumor mass and the optimal volume required for excision based on 1 cm of clear margins. The actual excess of resected volume was estimated by calculating the resection ratio measured as the volume of the resected specimen divided by the optimal specimen volume. The study endpoints were to analyze the extent of tissue resection and to ascertain the effect of excess resected tissue on surgical margins in both groups of patients. RESULTS: The median tumor diameter was 2.0 and 1.5 cm in the surgery and neoadjuvant therapy groups, respectively. The median volume of resected mammary tissue was 64.3 cm³ in the primary surgery group and 90.7 cm³ in the neoadjuvant therapy group. The median resection ratios in the primary surgery and neoadjuvant therapy groups were 2.0 and 3.3, respectively (p<0.0001). Surgical margin data were similar in both groups. Comparison of the volume of resected mammary tissues with the tumor diameters showed a positive correlation in the primary surgery group and no correlation in the neoadjuvant therapy group. CONCLUSION: Surgeons tend to excise large volumes of tissue during breast-conserving surgery after neoadjuvant therapy, thereby resulting in a loss of the correlation between tumor diameter and volume of the excised specimen.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Artigos Originais
Venous and lymphatic alterations in women with lymphedema after axillary lymphadenectomy in breast cancer treatment
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(4):171-177
06-06-2013
Summary
Artigos OriginaisVenous and lymphatic alterations in women with lymphedema after axillary lymphadenectomy in breast cancer treatment
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(4):171-177
06-06-2013DOI 10.1590/S0100-72032013000400007
Views107See morePURPOSE: To evaluate changes in the venous axillary-subclavian and lymphatic systems of women with lymphedema after axillary lymphadenectomy for breast cancer treatment. METHODS: This was a case series involving 11 women with unilateral upper limb lymphedema after axillary lymphedenectomy for the treatment of breast cancer. The study was carried out in the Mastology Program of the Clinical Hospital of the Federal University of Goiás, Goiânia, GO, during the period between March 2010 and March 2011. Doppler velocimetry ultrasonography was used to detect the presence of venous changes in the subclavian and axillary veins. Lymphatic changes were evaluated by lymphoscintigraphy in both upper limbs. Fisher's exact test was used for the comparison between limbs. RESULTS: Subclavian vein flow volume in the upper limb with lymphedema was significantly different from that in the contralateral limb (p<0.001), 54.6% of the women had increased flow. In the axillary vein, 45.4% had increased flow and 45.4% had decreased flow, with a statistically significant difference (p<0.01) between limbs. Compared to the contralateral limb, significant lymphatic changes (p<0.05) were also found in the vessel route (not visualized), number of lymphatic vessels (none), axillary lymph nodes (absent) and dermal reflux (present). In the contralateral upper limb without lymphedema, no venous or lymphatic alterations were encountered. CONCLUSION: The women subjected to axillary lymphadenectomy for the treatment of breast cancer presented both venous and lymphatic changes in the upper limb with lymphedema.
Views107This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Artigos OriginaisVenous and lymphatic alterations in women with lymphedema after axillary lymphadenectomy in breast cancer treatment
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(4):171-177
06-06-2013DOI 10.1590/S0100-72032013000400007
Views107See morePURPOSE: To evaluate changes in the venous axillary-subclavian and lymphatic systems of women with lymphedema after axillary lymphadenectomy for breast cancer treatment. METHODS: This was a case series involving 11 women with unilateral upper limb lymphedema after axillary lymphedenectomy for the treatment of breast cancer. The study was carried out in the Mastology Program of the Clinical Hospital of the Federal University of Goiás, Goiânia, GO, during the period between March 2010 and March 2011. Doppler velocimetry ultrasonography was used to detect the presence of venous changes in the subclavian and axillary veins. Lymphatic changes were evaluated by lymphoscintigraphy in both upper limbs. Fisher's exact test was used for the comparison between limbs. RESULTS: Subclavian vein flow volume in the upper limb with lymphedema was significantly different from that in the contralateral limb (p<0.001), 54.6% of the women had increased flow. In the axillary vein, 45.4% had increased flow and 45.4% had decreased flow, with a statistically significant difference (p<0.01) between limbs. Compared to the contralateral limb, significant lymphatic changes (p<0.05) were also found in the vessel route (not visualized), number of lymphatic vessels (none), axillary lymph nodes (absent) and dermal reflux (present). In the contralateral upper limb without lymphedema, no venous or lymphatic alterations were encountered. CONCLUSION: The women subjected to axillary lymphadenectomy for the treatment of breast cancer presented both venous and lymphatic changes in the upper limb with lymphedema.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Article
Comparison of nuclear grade and immunohistochemical features in situ and invasive components of ductal carcinoma of breast
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(3):97-102
03-25-2013
Summary
ArticleComparison of nuclear grade and immunohistochemical features in situ and invasive components of ductal carcinoma of breast
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(3):97-102
03-25-2013DOI 10.1590/S0100-72032013000300002
Views62PURPOSE:To compare the prognostic and predictive features between in situ and invasive components of ductal breast carcinomas. METHODS:We selected 146 consecutive breast samples with ductal carcinoma in situ (DCIS) associated with adjacent invasive breast carcinoma (IBC). We evaluated nuclear grade and immunohistochemical expression of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), cytokeratin 5/6 (CK5/6), and epidermal growth factor receptor (EGFR) in both components, in situ and invasive, and the Ki-67 percentage of cells in the invasive part. The DCIS and IBC were classified in molecular surrogate types determined by the immunohistochemical profile as luminal (RE/PR-positive/ HER2-negative), triple-positive (RE/RP/HER2-positive), HER2-enriched (ER/PR-negative/HER2-positive), and triple-negative (RE/RP/HER2-negative). Discrimination between luminal A and luminal B was not performed due to statistical purposes. Correlations between the categories in the two groups were made using the Spearman correlation method. RESULTS:There was a significant correlation between nuclear grade (p<0.0001), expression of RE/RP (p<0.0001), overexpression of HER2 (p<0.0001), expression of EGFR (p<0.0001), and molecular profile (p<0.0001) between components in situ and IBC. CK 5/6 showed different distribution in DCIS and IBC, presenting a significant association with the triple-negative phenotype in IBC, but a negative association among DCIS. CONCLUSIONS: Our results suggest that classical prognostic and predictive features of IBC are already determined in the preinvasive stage of the disease. However the role of CK5/6 in invasive carcinoma may be different from the precursor lesions.
Key-words Breast neoplasmsCarcinoma, ductal, breastImmunoenzyme techniqueskeratin-5keratin-6Ki-67 antigenReceptor, erbB-2Receptors, estrogenTumor makers, biologicalSee moreViews62This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
ArticleComparison of nuclear grade and immunohistochemical features in situ and invasive components of ductal carcinoma of breast
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(3):97-102
03-25-2013DOI 10.1590/S0100-72032013000300002
Views62PURPOSE:To compare the prognostic and predictive features between in situ and invasive components of ductal breast carcinomas. METHODS:We selected 146 consecutive breast samples with ductal carcinoma in situ (DCIS) associated with adjacent invasive breast carcinoma (IBC). We evaluated nuclear grade and immunohistochemical expression of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), cytokeratin 5/6 (CK5/6), and epidermal growth factor receptor (EGFR) in both components, in situ and invasive, and the Ki-67 percentage of cells in the invasive part. The DCIS and IBC were classified in molecular surrogate types determined by the immunohistochemical profile as luminal (RE/PR-positive/ HER2-negative), triple-positive (RE/RP/HER2-positive), HER2-enriched (ER/PR-negative/HER2-positive), and triple-negative (RE/RP/HER2-negative). Discrimination between luminal A and luminal B was not performed due to statistical purposes. Correlations between the categories in the two groups were made using the Spearman correlation method. RESULTS:There was a significant correlation between nuclear grade (p<0.0001), expression of RE/RP (p<0.0001), overexpression of HER2 (p<0.0001), expression of EGFR (p<0.0001), and molecular profile (p<0.0001) between components in situ and IBC. CK 5/6 showed different distribution in DCIS and IBC, presenting a significant association with the triple-negative phenotype in IBC, but a negative association among DCIS. CONCLUSIONS: Our results suggest that classical prognostic and predictive features of IBC are already determined in the preinvasive stage of the disease. However the role of CK5/6 in invasive carcinoma may be different from the precursor lesions.
Key-words Breast neoplasmsCarcinoma, ductal, breastImmunoenzyme techniqueskeratin-5keratin-6Ki-67 antigenReceptor, erbB-2Receptors, estrogenTumor makers, biologicalSee moreThis is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Artigos Originais
Reproductive and sexual history of women treated of breast cancer
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(2):78-83
02-07-2013
Summary
Artigos OriginaisReproductive and sexual history of women treated of breast cancer
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(2):78-83
02-07-2013DOI 10.1590/S0100-72032013000200007
Views93See morePURPOSE: To understand the reproductive and sexual life of women treated for breast cancer. METHODS: A total of 139 women with a diagnosis made at least 6 months ago were interviewed after being randomly selected in a rehabilitation service. The interviews were carried out between 2006 and 2010. The inclusion criteria were: to have used a rehabilitation service between 2006 and 2010, to be a Unified Health System user, to have been a patient at a regional hospital and to be resident in the area of DRS XIII-Ribeirão Preto, state of São Paulo. The interviewees were visited at home where a face to face questionnaire regarding sociodemographic features and questions about the disease and reproductive and sexual life was administered. For the last one, the Female Sexual Function Index instrument was used. Data were analyzed statistically by the χ² test, Fisher exact test, Student's t test, multivariate analysis by logistic regression, factorial analysis and the Cronbach's alpha. RESULTS: Most patients had between 2 to 3 children and 80% used some contraceptive. About half of them had had sexual intercourse in the last month, 45.3% had interrupted sexual intercourse during treatment and 25.9% did not. There were reports of decreasing sexual activity, although half of the interviewees had re-started sexual life during the first six months after treatment. About half presented sexual dissatisfaction. An active sexual life is associated with being younger than 40 years of age and to have a partner. No association was found between active sexual life and diagnosis and types of treatment. CONCLUSION: Sexual activity of women treated for breast cancer is not associated with the treatments, but with age and with the opportunity of having sex.
Views93This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Artigos OriginaisReproductive and sexual history of women treated of breast cancer
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(2):78-83
02-07-2013DOI 10.1590/S0100-72032013000200007
Views93See morePURPOSE: To understand the reproductive and sexual life of women treated for breast cancer. METHODS: A total of 139 women with a diagnosis made at least 6 months ago were interviewed after being randomly selected in a rehabilitation service. The interviews were carried out between 2006 and 2010. The inclusion criteria were: to have used a rehabilitation service between 2006 and 2010, to be a Unified Health System user, to have been a patient at a regional hospital and to be resident in the area of DRS XIII-Ribeirão Preto, state of São Paulo. The interviewees were visited at home where a face to face questionnaire regarding sociodemographic features and questions about the disease and reproductive and sexual life was administered. For the last one, the Female Sexual Function Index instrument was used. Data were analyzed statistically by the χ² test, Fisher exact test, Student's t test, multivariate analysis by logistic regression, factorial analysis and the Cronbach's alpha. RESULTS: Most patients had between 2 to 3 children and 80% used some contraceptive. About half of them had had sexual intercourse in the last month, 45.3% had interrupted sexual intercourse during treatment and 25.9% did not. There were reports of decreasing sexual activity, although half of the interviewees had re-started sexual life during the first six months after treatment. About half presented sexual dissatisfaction. An active sexual life is associated with being younger than 40 years of age and to have a partner. No association was found between active sexual life and diagnosis and types of treatment. CONCLUSION: Sexual activity of women treated for breast cancer is not associated with the treatments, but with age and with the opportunity of having sex.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Breast neoplasms Archives - Page 5 of 11 - Revista Brasileira de Ginecologia e Obstetrícia
