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  • Original Article

    Upper limbs exercises during radiotherapy for breast cancer and quality of life

    Rev Bras Ginecol Obstet. 2010;32(3):133-138

    Summary

    Original Article

    Upper limbs exercises during radiotherapy for breast cancer and quality of life

    Rev Bras Ginecol Obstet. 2010;32(3):133-138

    DOI 10.1590/S0100-72032010000300006

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    PURPOSE: to assess the influence of physiotherapy performed during radiotherapy (RT) on the quality of life (QL) of women under treatment for breast cancer. METHODS: this was a randomized clinical trial conducted on 55 women under RT treatment, 28 of whom were assigned to a group submitted to physiotherapy (PG) and 27 to the control group receiving no PG (CG). The physiotherapy technique used for PG was kinesiotherapy for the upper limbs using 19 exercises actively performed, with a series of ten rhythmic repetitions or stretching movements involving flexion, extension, abduction, adduction, internal and external shoulder rotation, separate or combined. QL was evaluated using the Functional Assessment of Cancer Therapy-Breast (FACT-B), at the beginning and at the end of RT and six months after the end of RT. The physiotherapy sessions were started concomitantly with RT, 90 days after surgery, on average. RESULTS: there was no difference between subgroups regarding the following subscales: physical well-being (p=0.8), social/family well-being (p=0.3), functional well-being (p=0.2) and breast subscale (p=0.2) at the three time points assessed. A comparison of the emotional subscale applied at the three evaluations demonstrated a better behavior of PG as compared to CG (p=0.01), with both groups presenting improvement on the breast subscale between the beginning and the end of RT (PG p=0.0004 and CG p=0.003). There was improvement in FACT-B scores at the end of RT in both groups (PG p=0.0006 and CG p=0.003). However, at the sixth month after RT, this improvement was maintained only in PG (p=0,005). QL assessed along time by the FACT B (p=0.004) and the Trial Outcome Index (TOI) (sums of the physical and functional well-being subscales and of the breast subscale) was better for PG (p=0.006). There was no evidence of negative effects associated with the exercises. CONCLUSIONS: the execution of exercises for the upper limbs was beneficial for QL during and six months after RT.

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  • Original Article

    Endogenous sexual steroids and gonadotrophins in women with or without endometrial carcinoma: a comparative clinical study

    Rev Bras Ginecol Obstet. 1998;20(5):267-271

    Summary

    Original Article

    Endogenous sexual steroids and gonadotrophins in women with or without endometrial carcinoma: a comparative clinical study

    Rev Bras Ginecol Obstet. 1998;20(5):267-271

    DOI 10.1590/S0100-72031998000500006

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    Objective:To analyze the levels of endogenous sexual steroids and gonadotrophin in women with and without endometrial cancer. Methodology:We developed a clinical comparative study on 20 postmenopausal women with endometrial cancer and 20 postmenopausal women without endometrial cancer. The age, the postmenopausal time and the index of body mass were used as matching variables. The plasma levels of the endogenous sexual steroids were measured using radioimmunoassay and immunoenzymatic methods. For the statistic analysis we used the Student's t test. Results: The levels of androstenedione (A), total testosterone (t) and free testosterone (TL) were higher in the women with endometrial cancer, and those of the luteinic hormone (LH) were significantly lower values in these women. We also observed that the ratio (E1/A) showed significantly lower in the group of women with cancer, while the ratio (E2/E1) did not present any differences between groups. Conclusions: We emphasize the potentiality of sexual steroids and gonadotrophins in the genesis of endometrial adenocarcinoma in postmenopausal women.

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  • Original Article

    Ductal carcinoma in situ and invasive carcinoma in the same breast: evaluation of the nuclear grade and the expressions of proteins p53 and C-erbB-2 and estrogen receptors

    Rev Bras Ginecol Obstet. 2004;26(6):435-439

    Summary

    Original Article

    Ductal carcinoma in situ and invasive carcinoma in the same breast: evaluation of the nuclear grade and the expressions of proteins p53 and C-erbB-2 and estrogen receptors

    Rev Bras Ginecol Obstet. 2004;26(6):435-439

    DOI 10.1590/S0100-72032004000600003

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    OBJECTIVES: The aim of the present study was to evaluate the nuclear grade, the expressions of p53 and c-erbB-2 proteins, and the estrogen receptors (ER) of 38 women with ductal carcinoma in situ (DCIS) and invasive carcinoma of the same breast. METHODS: the protein profile of 38 women was investigated in a descriptive and retrospective study, through the immune-histochemical technique. The cut-off limit for positive staining was chosen at 10% or more of positive cells for p53 and c-erbB-2 proteins and for ER. The analysis of the concordance between the expressions of proteins and the nuclear grade was done by the kappa coefficient, according to Landis and Koch's criteria. MacNemar's test was used to assess the differences between the two groups. RESULTS: there was a perfect concordance in the expression of p53 proteins (kappa coefficient = 1.00) and almost a perfect concordance for c-erbB-2 proteins, ER and nuclear grade (kappa coefficients = 0.84, 0.89 and 0.89) between in situ and invasive elements of the same tumor. CONCLUSION: there was no difference between the expressions of p53 and c-erbB-2 proteins, ER and nuclear grade in the DCIS and invasive carcinoma of the same breast.

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  • Original Article

    Evaluation of breast cancer response to chemotherapy: role of ultrasound and Doppler

    Rev Bras Ginecol Obstet. 2002;24(7):447-452

    Summary

    Original Article

    Evaluation of breast cancer response to chemotherapy: role of ultrasound and Doppler

    Rev Bras Ginecol Obstet. 2002;24(7):447-452

    DOI 10.1590/S0100-72032002000700004

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    Purpose: to compare the size of locally advanced breast tumors through clinical examination, mammography, and ultrasound, and describe the parameters of color Doppler ultrasound evaluated before and after primary chemotherapy. Methods: it was a prospective and descriptive clinical study. Eighteen women with the diagnosis of breast carcinoma, with clinical primary tumors of 50 mm or larger, were submitted to palpation, mammography, ultrasound and color Doppler ultrasound at the moment of diagnosis and after 3 cycles of chemotherapy. The response was considered present when there was a clinical decrease of 50% or more and an ultrasonographic decrease of 25% or more, and absent when there was a clinical decrease less than 50% and ultrasonographic decrease less than 25%. A descriptive statistical analysis and Wilcoxon test were used. Results: regarding the size of the tumors, the method whose results were closer to pathological examination was the clinical examination after chemotherapy, when compared with sizes on ultrasound and mammography. The mammography helped to evaluate 44% of the cases before chemotherapy (8/18). In the cases where the response was absent, the Doppler showed a significant increase of the flow and a decrease of resistance and pulsatility index. In the cases where the response was present (9 cases), the Doppler did not show any significant change regarding the studied parameters. Conclusion: clinical examination was the most efficient method to evaluate the decrease of the volume of tumors submitted to neoadjuvant chemotherapy when compared with ultrasound and mammographic examinations. Doppler showed increase of the flow in the cases of absent response.

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