Artigos Originais Archives - Page 2 of 81 - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(10):503-507
DOI 10.1590/S0100-72032009001000006
PURPOSE: to evaluate the impact of hysterectomy on the sexuality of women with uterine leiomyoma. METHODS: prospective study including 33 sexually active women, with ages from 35 to 50 years old, with orgasmic experience and with a fit stable partner. All the women were submitted to two instruments for the evaluation or their sexuality: Sexual Quotient - Female Version (SQF) and Sexual Satisfaction Inventory - Female Version (SSIF). Both instruments were applied by the same examiner, before and six months after the hysterectomy. RESULTS: the SQF has shown that 39.4% of the patients presented deterioration in the sexual intercourse, even though there has not been found an association between the SQF results before and after hysterectomy (χ2= 0.6; degree of freedom=12; p=0.05). The mean scores obtained after the application of the SSIF have shown significant deterioration in the following parameters: sexual satisfaction (p=0.03); expression of feminine sensuality (p=0.01); vaginismus/dyspareunia (p=0.02) and anorgasmia (p=0.04). CONCLUSIONS: it seems that hysterectomy has a negative impact on women's sexual life, with reports of decreased libido, arousal and orgasmic capacity.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(10):503-507
DOI 10.1590/S0100-72032009001000006
PURPOSE: to evaluate the impact of hysterectomy on the sexuality of women with uterine leiomyoma. METHODS: prospective study including 33 sexually active women, with ages from 35 to 50 years old, with orgasmic experience and with a fit stable partner. All the women were submitted to two instruments for the evaluation or their sexuality: Sexual Quotient - Female Version (SQF) and Sexual Satisfaction Inventory - Female Version (SSIF). Both instruments were applied by the same examiner, before and six months after the hysterectomy. RESULTS: the SQF has shown that 39.4% of the patients presented deterioration in the sexual intercourse, even though there has not been found an association between the SQF results before and after hysterectomy (χ2= 0.6; degree of freedom=12; p=0.05). The mean scores obtained after the application of the SSIF have shown significant deterioration in the following parameters: sexual satisfaction (p=0.03); expression of feminine sensuality (p=0.01); vaginismus/dyspareunia (p=0.02) and anorgasmia (p=0.04). CONCLUSIONS: it seems that hysterectomy has a negative impact on women's sexual life, with reports of decreased libido, arousal and orgasmic capacity.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(10):508-512
DOI 10.1590/S0100-72032009001000007
PURPOSE: to check epidemiological data from a breast diagnostic clinic. METHODS: mammographies from 35,041 patients were studied, within a period of 2 years and 7 months, from 2004 to 2006, 32,049 (91.5%) of them from screening, and 2,992 from symptomatic patients (8.5%). The calculated parameters were: detection rate of the screening patients, percentage of cancer among the symptomatic patients, rate of biopsy indication, percentage of minimal, in situ, and stage 0-1 carcinomas, recall rate, and predictive value of mammographies considered as abnormal and of biopsies' indications in screening patients. RESULTS: 228 diagnoses of breast cancer were made, 111 in screening patients (0.34% detection rate) and 117 in symptomatic patients (3.91% detection rate). The number of biopsies' recommendations among screening patients was 544 (1.7% of those patients). There were 28% of minimal carcinomas, 10% of in situ carcinomas and 93% of stage 0-1 carcinomas among the screening patients. Recall rate was 19%. Positivity of mammographies considered as abnormal (VPP1) was 1.65%. The rate of biopsies' positivity (VPP2) was 21.9%. CONCLUSIONS: this study brings important epidemiological data for the audit of mammographic screening, rare among us. Data have been analyzed as compared to what is recommended by the literature, the detection rate and the percentage of minimal and in situ carcinomas found being comparable to the established values, but with the VPP value lower than the ideal.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(10):508-512
DOI 10.1590/S0100-72032009001000007
PURPOSE: to check epidemiological data from a breast diagnostic clinic. METHODS: mammographies from 35,041 patients were studied, within a period of 2 years and 7 months, from 2004 to 2006, 32,049 (91.5%) of them from screening, and 2,992 from symptomatic patients (8.5%). The calculated parameters were: detection rate of the screening patients, percentage of cancer among the symptomatic patients, rate of biopsy indication, percentage of minimal, in situ, and stage 0-1 carcinomas, recall rate, and predictive value of mammographies considered as abnormal and of biopsies' indications in screening patients. RESULTS: 228 diagnoses of breast cancer were made, 111 in screening patients (0.34% detection rate) and 117 in symptomatic patients (3.91% detection rate). The number of biopsies' recommendations among screening patients was 544 (1.7% of those patients). There were 28% of minimal carcinomas, 10% of in situ carcinomas and 93% of stage 0-1 carcinomas among the screening patients. Recall rate was 19%. Positivity of mammographies considered as abnormal (VPP1) was 1.65%. The rate of biopsies' positivity (VPP2) was 21.9%. CONCLUSIONS: this study brings important epidemiological data for the audit of mammographic screening, rare among us. Data have been analyzed as compared to what is recommended by the literature, the detection rate and the percentage of minimal and in situ carcinomas found being comparable to the established values, but with the VPP value lower than the ideal.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(9):427-432
DOI 10.1590/S0100-72032009000900002
PURPOSE: to evaluate the repercussion of portal hypertension in the indexes of the ovarian, uterine and luteus body periphery arterial resistance, at the medium luteal phase of the menstrual cycle. METHODS: in an observational study with transversal cohort, 28 patients with hepatosplenic schistosomiasis mansoni, submitted to splenectomy and ligation of the left gastric vein (HESO), a similar group of 28 patients who had not had the surgery (HESNO) and 29 healthy volunteers (HV) were submitted to Doppler fluxmetry in the medium luteal phase of the menstrual cycle. Pourcelot's resistance index has been used as RI=[(S-D)/S], in which S means the highest systolic speed, and D, the end of diastole. The best record in the ascendant branch of the uterine artery, in the ovarian artery, when accessible, or in the intraovarian artery, was chosen. When the luteus body was present, the RI was measured in its periphery. The data obtained were analyzed by Kruskal-Wallis and Mann-Whitney tests. RESULTS: there was no significant difference among the groups, concerning the mean RI of the ovarian arteries (Kruskal-Wallis, p=0.50). There was a tendency for higher right uterine artery RI in the HESNO group (Kruskal-Wallis, p<0.07), but it was similar in the left uterine artery (Kruskal-Wallis, p=0.14). Arterial RIs significantly lower have been observed in the luteus body periphery, when compared to the contralateral ovarian arteries in all the groups (Mann-Whitney, p<0.0001). CONCLUSIONS: there was no difference among the groups, regarding the ovarian and uterine RIs. The portal hypertension in patients with hepatosplenic schistosomiasis does not affect the natural phenomenon of arterial RI decrease in the ovary where ovulation occurs.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(9):427-432
DOI 10.1590/S0100-72032009000900002
PURPOSE: to evaluate the repercussion of portal hypertension in the indexes of the ovarian, uterine and luteus body periphery arterial resistance, at the medium luteal phase of the menstrual cycle. METHODS: in an observational study with transversal cohort, 28 patients with hepatosplenic schistosomiasis mansoni, submitted to splenectomy and ligation of the left gastric vein (HESO), a similar group of 28 patients who had not had the surgery (HESNO) and 29 healthy volunteers (HV) were submitted to Doppler fluxmetry in the medium luteal phase of the menstrual cycle. Pourcelot's resistance index has been used as RI=[(S-D)/S], in which S means the highest systolic speed, and D, the end of diastole. The best record in the ascendant branch of the uterine artery, in the ovarian artery, when accessible, or in the intraovarian artery, was chosen. When the luteus body was present, the RI was measured in its periphery. The data obtained were analyzed by Kruskal-Wallis and Mann-Whitney tests. RESULTS: there was no significant difference among the groups, concerning the mean RI of the ovarian arteries (Kruskal-Wallis, p=0.50). There was a tendency for higher right uterine artery RI in the HESNO group (Kruskal-Wallis, p<0.07), but it was similar in the left uterine artery (Kruskal-Wallis, p=0.14). Arterial RIs significantly lower have been observed in the luteus body periphery, when compared to the contralateral ovarian arteries in all the groups (Mann-Whitney, p<0.0001). CONCLUSIONS: there was no difference among the groups, regarding the ovarian and uterine RIs. The portal hypertension in patients with hepatosplenic schistosomiasis does not affect the natural phenomenon of arterial RI decrease in the ovary where ovulation occurs.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(9):447-452
DOI 10.1590/S0100-72032009000900005
PURPOSE: to compare the effects of functional electrostimulation of the pelvic floor and therapy with cones in women with stress urinary incontinence (SUI). METHODS: randomized clinical study for which 45 patients with SUI were selected. The effects of functional electrostimulation of the pelvic floor were evaluated in the SUI treatment of 24 women, with the use of clinical data (micturition diary, pad test and a questionnaire about quality of life - I-QoL). The patients were submitted to two 20' weekly sessions for four consecutive months, under the supervision of a physiotherapist. The electrode used had 10 cm length and 3.5 cm width with a double metallic ring and a cylindrical shape, positioned in the medium third of the vagina. The electric parameters used were: intensity varying from 10 to 100 mA and 50 Hz of fixed frequency, with pulse duration of 1 ms. Also, we evaluated 21 patients who were submitted to vaginal cone treatment. The cone therapy was done with two 45 minute sessions per week. The cones' weight varied from 20 to 100 gr. RESULTS: there was no difference between the outcomes of electrostimulation of the pelvic floor and the vaginal cones for the treatment of SUI (p>0.05). After four months, there was a significant improvement in the I-QoL index of the patients treated both with electrostimulation (40.3 versus 82.9) or with the cones (47.7 versus 84.1). There was a significant decrease in pad weight in both groups, measured before and after the treatment (28.5 and 32 g versus 2.0 and 3.0 g for the electrostimulation and cone group, respectively). Finally, there was a significant decrease in the number of urinary leakage evaluated by the micturition diary in both groups (p<0.0001). CONCLUSIONS: both electrostimulation and vaginal cones were effective in the treatment of women with SUI.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(9):447-452
DOI 10.1590/S0100-72032009000900005
PURPOSE: to compare the effects of functional electrostimulation of the pelvic floor and therapy with cones in women with stress urinary incontinence (SUI). METHODS: randomized clinical study for which 45 patients with SUI were selected. The effects of functional electrostimulation of the pelvic floor were evaluated in the SUI treatment of 24 women, with the use of clinical data (micturition diary, pad test and a questionnaire about quality of life - I-QoL). The patients were submitted to two 20' weekly sessions for four consecutive months, under the supervision of a physiotherapist. The electrode used had 10 cm length and 3.5 cm width with a double metallic ring and a cylindrical shape, positioned in the medium third of the vagina. The electric parameters used were: intensity varying from 10 to 100 mA and 50 Hz of fixed frequency, with pulse duration of 1 ms. Also, we evaluated 21 patients who were submitted to vaginal cone treatment. The cone therapy was done with two 45 minute sessions per week. The cones' weight varied from 20 to 100 gr. RESULTS: there was no difference between the outcomes of electrostimulation of the pelvic floor and the vaginal cones for the treatment of SUI (p>0.05). After four months, there was a significant improvement in the I-QoL index of the patients treated both with electrostimulation (40.3 versus 82.9) or with the cones (47.7 versus 84.1). There was a significant decrease in pad weight in both groups, measured before and after the treatment (28.5 and 32 g versus 2.0 and 3.0 g for the electrostimulation and cone group, respectively). Finally, there was a significant decrease in the number of urinary leakage evaluated by the micturition diary in both groups (p<0.0001). CONCLUSIONS: both electrostimulation and vaginal cones were effective in the treatment of women with SUI.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(9):440-446
DOI 10.1590/S0100-72032009000900004
PURPOSE: to verify the occurrence ratio of pica in pregnant women and its impact on the mother and newborn health. METHODS: prospective study with 227 adult pregnant women and their newborns treated at the Maternity School of Universidade Federal do Rio de Janeiro, between 2005 and 2006. Pica has been considered as the ingestion of inedible substances or atypical food combinations. The data was collected was done by medical chart review and interview. RESULTS: Pica was referred to by 14.4% of the women, 42.1% of whom practiced it daily. The onset occurred in the second gestational trimester in 46.7% of the cases, and, in the third trimester, in 30% of them. Among the alleged reasons, 65% of the women were unable to give them, 15% declared relief of nausea and heartburn and 10% reported reduced stress and anxiety. The practice in the previous gestation/puerperium was referred to by 15% of the women. Pica was not associated with the maternal anthropometric condition, the skin color, the marital status, the maternal schooling and the presence of parasitosis. There was no difference between the average of the total family income and the number of gestations for the women who did or did not have pica. Pica was associated with gestational anemia (p<0.009) and gestational intercurrences (OR=3.5; CI95%=1.6-7.9). As for the baby, pica did not interfere in the health parameters at birth: weight, gestational age and intercurrences. CONCLUSIONS: pica must be investigated at prenatal assistance and recognized as a risk factor for the mother's health.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(9):440-446
DOI 10.1590/S0100-72032009000900004
PURPOSE: to verify the occurrence ratio of pica in pregnant women and its impact on the mother and newborn health. METHODS: prospective study with 227 adult pregnant women and their newborns treated at the Maternity School of Universidade Federal do Rio de Janeiro, between 2005 and 2006. Pica has been considered as the ingestion of inedible substances or atypical food combinations. The data was collected was done by medical chart review and interview. RESULTS: Pica was referred to by 14.4% of the women, 42.1% of whom practiced it daily. The onset occurred in the second gestational trimester in 46.7% of the cases, and, in the third trimester, in 30% of them. Among the alleged reasons, 65% of the women were unable to give them, 15% declared relief of nausea and heartburn and 10% reported reduced stress and anxiety. The practice in the previous gestation/puerperium was referred to by 15% of the women. Pica was not associated with the maternal anthropometric condition, the skin color, the marital status, the maternal schooling and the presence of parasitosis. There was no difference between the average of the total family income and the number of gestations for the women who did or did not have pica. Pica was associated with gestational anemia (p<0.009) and gestational intercurrences (OR=3.5; CI95%=1.6-7.9). As for the baby, pica did not interfere in the health parameters at birth: weight, gestational age and intercurrences. CONCLUSIONS: pica must be investigated at prenatal assistance and recognized as a risk factor for the mother's health.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(9):433-439
DOI 10.1590/S0100-72032009000900003
PURPOSE: the main goal of this study is to evaluate the emotional conditions among mothers of newborns with visible malformation (Group M) and mothers of eutrophic newborns (Group E) soon after birth. METHODS: twenty-two mothers from the Group M were matched by age and number of children to 22 mothers of the Group E. They were assessed through the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI). The data were complemented by interviews and analyses of the medical files of both mother and child. RESULTS: the results have shown significant differences in the mean scores of the three subscales (trait anxiety, state anxiety, dysphoria/depression) between the two groups of mothers. In terms of clinical signs, there were a significantly larger percentage of mothers from Group M identified with depression and anxiety after the child's birth, and for both conditions when compared with mothers from Group E. Although the results may reflect characteristics of the maternal personality, the trait anxiety was significantly more evident in mothers of malformed children, especially due to the child's health condition, its referral to the ICU and his/her condition regarding their future life. CONCLUSION: the percentage of mothers with clinical depression and anxiety suggests the need for either individual or group support to attend the needs of the mothers and mitigate the adverse effects of stressors throughout the child's development. Support should also be provided during pregnancy, when the mothers currently receive the news about the malformation.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(9):433-439
DOI 10.1590/S0100-72032009000900003
PURPOSE: the main goal of this study is to evaluate the emotional conditions among mothers of newborns with visible malformation (Group M) and mothers of eutrophic newborns (Group E) soon after birth. METHODS: twenty-two mothers from the Group M were matched by age and number of children to 22 mothers of the Group E. They were assessed through the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI). The data were complemented by interviews and analyses of the medical files of both mother and child. RESULTS: the results have shown significant differences in the mean scores of the three subscales (trait anxiety, state anxiety, dysphoria/depression) between the two groups of mothers. In terms of clinical signs, there were a significantly larger percentage of mothers from Group M identified with depression and anxiety after the child's birth, and for both conditions when compared with mothers from Group E. Although the results may reflect characteristics of the maternal personality, the trait anxiety was significantly more evident in mothers of malformed children, especially due to the child's health condition, its referral to the ICU and his/her condition regarding their future life. CONCLUSION: the percentage of mothers with clinical depression and anxiety suggests the need for either individual or group support to attend the needs of the mothers and mitigate the adverse effects of stressors throughout the child's development. Support should also be provided during pregnancy, when the mothers currently receive the news about the malformation.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(9):453-460
DOI 10.1590/S0100-72032009000900006
PURPOSE: to evaluate the effects of the administration of two synthetic steroids in the uterus morphology and in the reproductive parameters of adult female rats. METHODS: divided into four experimental groups: control (C; physiological solution); treated with nandrolone decanoate (DN; 7.5 mg/kg of body weight); with a testosterone esters compound (T; 7.5 mg/kg); and simultaneously with DN and T (7.5 mg/kg of each steroid), in a single intraperitoneal weekly dose, for eight weeks. Five females of each group were sacrificed and the uterine horns were collected, weighted and prepared for histological and morphometrical evaluation. The remaining rats were mated with normal male rats for reproductive parameters evaluation, composing the groups treated during the pre-gestational period. Another group of 20 female rats were treated during the gestational period (7th-14th days). For data analysis, the Kruskal-Wallis non-parametric variance analysis was used, followed by the test of Dunn or of Student-Newman-Keus (5% significance level). RESULTS: there was a significant body weight increase in the androgenized females (ND: 305±50; T: 280±35; ND+T: 275±30 versus C: 255±22 g; p<0.05). Uterine weight was not affected by the steroidal treatment (ND: 0.6±0.2; T: 0.4±0.04; ND+T: 0.7±0.1 versus C: 0.4±0.09 g). All the androgenized females presented estral acyclicity and endometrium characterized by papilliferous luminal lining, oedematous stroma with hemorrhagic areas and secretory activity. There were changes in the morphometrical thickness parameters of the luminal epithelium, myometrium and perimetrium in the androgenized groups. None of the female rats got pregnant when treated with steroids in the pre-gestational period and the treatment during organogenesis affected negatively the reproductive parameters. CONCLUSIONS: steroidal agents alter the uterine structure and impair fertility and gestational outcome in female rats.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(9):453-460
DOI 10.1590/S0100-72032009000900006
PURPOSE: to evaluate the effects of the administration of two synthetic steroids in the uterus morphology and in the reproductive parameters of adult female rats. METHODS: divided into four experimental groups: control (C; physiological solution); treated with nandrolone decanoate (DN; 7.5 mg/kg of body weight); with a testosterone esters compound (T; 7.5 mg/kg); and simultaneously with DN and T (7.5 mg/kg of each steroid), in a single intraperitoneal weekly dose, for eight weeks. Five females of each group were sacrificed and the uterine horns were collected, weighted and prepared for histological and morphometrical evaluation. The remaining rats were mated with normal male rats for reproductive parameters evaluation, composing the groups treated during the pre-gestational period. Another group of 20 female rats were treated during the gestational period (7th-14th days). For data analysis, the Kruskal-Wallis non-parametric variance analysis was used, followed by the test of Dunn or of Student-Newman-Keus (5% significance level). RESULTS: there was a significant body weight increase in the androgenized females (ND: 305±50; T: 280±35; ND+T: 275±30 versus C: 255±22 g; p<0.05). Uterine weight was not affected by the steroidal treatment (ND: 0.6±0.2; T: 0.4±0.04; ND+T: 0.7±0.1 versus C: 0.4±0.09 g). All the androgenized females presented estral acyclicity and endometrium characterized by papilliferous luminal lining, oedematous stroma with hemorrhagic areas and secretory activity. There were changes in the morphometrical thickness parameters of the luminal epithelium, myometrium and perimetrium in the androgenized groups. None of the female rats got pregnant when treated with steroids in the pre-gestational period and the treatment during organogenesis affected negatively the reproductive parameters. CONCLUSIONS: steroidal agents alter the uterine structure and impair fertility and gestational outcome in female rats.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(9):461-467
DOI 10.1590/S0100-72032009000900007
PURPOSE: to evaluate the expression of erbB-2 and of the estrogen and progesterone (ER/P) hormonal receptors in the transition regions between the in situ and the invasive fractions of ductal breast neoplasia (ISDC and IDC, respectively). METHODS: Eighty-five cases of breast neoplasia, containing contiguous ISDC and IDC areas, were selected. Histological specimens from the ISDC and the IDC areas were obtained through the tissue microarray (TMA) technique. The erbB-2 and the ER/PR expressions were evaluated through conventional immunohistochemistry. The McNemar's test was used for the comparative analysis of the expressions of erbB-2 protein and the ER/PR in the in situ and invasive regions of the tumors. The confidence intervals were set to 5% (p=0.05). Intraclass correlation coefficients (ICC) were calculated to assess the cross-tabulation agreement of the erbB-2 and the ER/PR expression in the ISDC and the IDC areas. RESULTS: the erbB-2 expression has not differed between the ISDC and the IDC areas (p=0.38). Comparing the two areas in each case, there was agreement in the expression of erbB-2 (ICC=0.64), PR (ICC=0.71) and ER (ICC=0.64). Restricting the analysis to tumors with the in situ component harboring necrosis (comedo), the ICC for erbB-2 was 0.4, compared to 0.6 for the whole sample. In this select group, the ICC for PR/ER did not differ substantially from those obtained with the complete dataset: as for the ER, ICC=0.7 (versus 0.7 for the entire sample) and for PR, ICC=0.7 (versus 0.6 for the entire sample). CONCLUSIONS: our findings suggest that the erbB-2 and the ER/PR expressions do not differ in the contiguous in situ and invasive components of breast ductal tumors.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(9):461-467
DOI 10.1590/S0100-72032009000900007
PURPOSE: to evaluate the expression of erbB-2 and of the estrogen and progesterone (ER/P) hormonal receptors in the transition regions between the in situ and the invasive fractions of ductal breast neoplasia (ISDC and IDC, respectively). METHODS: Eighty-five cases of breast neoplasia, containing contiguous ISDC and IDC areas, were selected. Histological specimens from the ISDC and the IDC areas were obtained through the tissue microarray (TMA) technique. The erbB-2 and the ER/PR expressions were evaluated through conventional immunohistochemistry. The McNemar's test was used for the comparative analysis of the expressions of erbB-2 protein and the ER/PR in the in situ and invasive regions of the tumors. The confidence intervals were set to 5% (p=0.05). Intraclass correlation coefficients (ICC) were calculated to assess the cross-tabulation agreement of the erbB-2 and the ER/PR expression in the ISDC and the IDC areas. RESULTS: the erbB-2 expression has not differed between the ISDC and the IDC areas (p=0.38). Comparing the two areas in each case, there was agreement in the expression of erbB-2 (ICC=0.64), PR (ICC=0.71) and ER (ICC=0.64). Restricting the analysis to tumors with the in situ component harboring necrosis (comedo), the ICC for erbB-2 was 0.4, compared to 0.6 for the whole sample. In this select group, the ICC for PR/ER did not differ substantially from those obtained with the complete dataset: as for the ER, ICC=0.7 (versus 0.7 for the entire sample) and for PR, ICC=0.7 (versus 0.6 for the entire sample). CONCLUSIONS: our findings suggest that the erbB-2 and the ER/PR expressions do not differ in the contiguous in situ and invasive components of breast ductal tumors.
