167 resultados para Mama : Patologia


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Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB

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Pós-graduação em Ciências Biológicas (Genética) - IBB

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PURPOSE: To analyze the time between the first symptom and treatment in patients treated for breast cancer in public hospitals in the Federal District. METHODS: This was a cross-sectional analysis. We interviewed 250 women diagnosed with breast cancer treated in six hospitals of the State Department of Health of the Federal District from November 2009 to January 2011. The time intervals studied were the time between the detection of the symptoms and treatment subdivided into intervals until and after the first medical appointment. The variables were: age, menopausal status, color, educational level, average monthly household income, origin, reason for the initial consultation, staging, tumor size, laterality, metastasis to axillary lymph nodes, neoadjuvant chemotherapy, and type of surgery. The Mann-Whtney test was used to assess the association of these variables with the time intervals until treatment. RESULTS: The mean age was 52 years, with a predominance of white women (57.6%), from the Federal District (62.4%), with a family income of up to 2 minimum wages (78%), and up to four years of schooling (52.4%). The staging of the disease ranged from II to IV in 78.8% of the women. The time between the first symptom and treatment was 229 days (median). After detection of the first symptom, 52.9% of the women attended a consultation within 30 days and 88.8% took more than 90 days to start treatment. Women with elementary school education had a greater delay to the start of treatment (p=0.049). CONCLUSIONS: There was a significant delay to start treatment of women with breast cancer in public hospitals of the Federal District, suggesting that efforts should be made to reduce the time needed to schedule medical appointments and to diagnose and treat these patients.

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OBJETIVO: Avaliar a viabilidade e acurácia diagnóstica da ultrassonografia pré-operatória combinada com biopsia por agulha fina (US-PAAF) e do exame clínico da axila em pacientes com câncer de mama.MÉTODOS: Neste estudo prospectivo 171 axilas de pacientes com câncer de mama foram avaliadas pelo exame clínico e ultrassonografia (US) com e sem biopsia por agulha fina (PAAF). Os linfonodos com espessura cortical maior que 2,3 mm na ultrassonografia foram considerados suspeitos e submetidos a US-PAAF.RESULTADOS: A análise de regressão logística não mostrou correlação estatisticamente significativa entre exame clínico e axilas positivas no exame patológico. Em relação à avaliação axilar com US, o risco de achados anatomopatológicos positivos aumentou 12,6 vezes, valor Kappa de Cohen foi de 0,12 para exame clínico, 0,48 para US e 0,80 para US-PAAF. A acurácia foi de 61,4% para o exame clínico, 73,1% para os US e 90,1% para US-PAAF. Análise Receiver Operating Chracteristics (ROC) mostrou que uma espessura de 2,75 mm cortical correspondeu à mais elevada sensibilidade e especificidade na predição metástase axilar (82,7 e 82,2%, respectivamente).CONCLUSÕES: A US combinada com aspiração por agulha fina é mais precisa que o exame clínico na avaliação do status axilar no pré-operatório em mulheres com câncer de mama. Aquelas que são US-PAAF positivo podem ser direcionadas para esvaziamento linfonodal axilar imediatamente, e somente aqueles que são US-PAAF negativos devem ser considerados para biópsia de linfonodo sentinela.

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Pós-graduação em Medicina Veterinária - FMVZ

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Breast cancer has received an increasing attention because it is one of the most common cancer type and a leading cause of morbity and mortality among women worldwide. This disease has been considered as a heterogeneous condition, demonstrating a large spectrum of clinical and histopathological variability. In the last two decades, several studies have been conducted to identify new molecular markers of cancer cells, including the alterations of DNA methylation, which is the major epigenetic mechanism associated with the control of gene expression. The hypermethylation of promoter-associated CpG islands contributes to the loss of function of several cancer-related genes, including those encoding to the estrogen receptor (ESR) and progesterone receptor (PGR). This study aimed to determine the methylation patterns of CpG islands of the genes encoding the estrogen receptor α (ESR1 gene, promoters A and B), estrogen receptor β (ESR2 gene) and progesterone receptor (PGR gene, promoter A and B) in 15 cell lines derived from breast cancer. The DNA methylation analysis was based on the “Methylation Specific-Polymerase Chain Reaction” (MSP), which provides a qualitative assessment of the methylation status of a specific CpG island. The results revealed heterogeneous data: the promoter region of ESR1A showed complete methylation in one cell line (BT549) and only two cell lines showed partial methylation (MDA-MB-231 and MDA-MB-453), while the others lineages presented unmethylated alleles. The promoter region of isoform ESR1B was unmethylated in the cell lines BT549, SKBR3 and T47D; partial methylation were observed in the cell lines MDA-MB- 231, MCF-7 and ZR-75-30, while the others cell lines presented complete methylation. All lineages showed complete or partial methylation of the ESR2 gene. The methylation pattern of the promoter A of the PGR ...(Complete abstract click electronic access below)

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Mammary cancer is a multifactorial disease that is believed to be caused by genetic and environmental factors. Among the environmental factors, pyrethroids appear to be able to participate in carcinogenesis through several mechanisms, and have been shown to be associated to mammary tumors in canines. In order to investigate the possible rule of pyrethroid on DNA lesion in mammary tissue we compare the comet assay results between mammary tumor bearing dogs with and without pyrethroid associated to the peri mammary adipose tissue or the tumor itself. The pyrethroids presence was assessed by High Performance Liquid Chromatography (HPLC) and the DNA damage was assessed by the comet assay as previously described. Despite of correlation between DNA damage and tumor histologic aggressiveness, association between the severity of DNA damage and different types of mammary carcinoma was not found. Although pyrethroids were present in 22% of tumors and peritumoral adipose tissue, no difference in the degree DNA damage between the exposed and non exposed cells to pyrethroids were found. As future perspectives for this work, our group will evaluate the relationship of pyrethroids presence in tumors with its angiogenic potential. Angiogenesis evaluation will be based on presence of vascular endothelial growth factor (VEGF) in the tumor cells, and microvessel counts

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The study analyzed contours of the thoracic region of patients undergoing radiotherapy of breast tumors in Hospital Manuel de Abreu of Bauru (institution 1) and the Hospital da Faculdade de Medicina of Botucatu (Institution 2). Were prepared isodose curves corresponding to the contours of the patient, which were presented for radiotherapists doctors both hospital services that enabled the choice of the curve isodose that provides the best distribution of radiation dose in the irradiated volume. Some boundaries were digitized in one institution and sent for preparation of isodose lines in the institution 2, both curves plotted in each of the institutions and for the same contour, were compared, showing that the methodology of Curves of distance is feasible and reliable, while optimizing the routine procedures regarding the handling of isodose plans provided by different radiation equipment. It compares the calculation of the exposure time determined using the isodose curve selected by calculating the value obtained considering the PDP at the point of the middle line of separation between the internal and external fields, the difference between the two methods for determining exposure time was around 2.4%. A study on the angle of the radiation beam at the input field (region breast-air) was conducted showing that, once known a tangent angle of the input beam, one can estimate the angle of the wedge filter used in some procedures for uniformity of dose within the irradiated volume compensation and the lack of tissue in the treatment volume. A comparative study between the isodose curves produced manually with the curves obtained in a two-dimensional computer system, the computer system showed that provides further information regarding the dose gradient within the irradiated volume, in addition to reducing the time spent in preparing the curves isodose

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O evento de splicing alternativo tem como resultado a geração de diversos produtos a partir do precursor do RNA mensageiro de um único gene, sendo o responsável, assim, pelo aumento da variedade de transcritos e proteínas existentes em uma célula. Estima-se que cerca de 90% dos genes humanos estejam sujeitos a este tipo de processamento. O funcionamento adequado do processo de splicing depende do reconhecimento correto dos limites entre trechos intrônicos e exônicos pela maquinaria enzimática, que se dá através do reconhecimento de diversos sinais, como os sítios de splicing 3’ e 5’, o trato de polipirimidina, a seqüência “branch”, e pequenas seqüências presentes em exons e introns, próximas aos sítios de splicing, que promovem ou inibem a inclusão de trechos na fita de RNA madura. É fato comprovado por diversos estudos que mutações nas seqüências sinalizadoras de splicing podem modificar o padrão de processamento de um gene. Acreditase que variações genéticas individuais possam modificar a suceptibilidade a diversas doenças, entre elas o câncer, que trata-se, atualmente, da doença que mais gera óbitos no mundo (13% do total). Recentemente, Sjoblom et al. (2006) e Wood et al. (2007) mapearam mutações não silenciosas encontradas em 1718 genes em linhagens de câncer de mama e colorretal. Neste trabalho, investigamos os efeitos dessas mutações somáticas presentes em câncer no padrão de splicing celular. Para tanto, nos focamos nas 201 mutações encontradas em quatro linhagens de câncer de mama (HCC1954, HCC1599, HCC1143 e HCC2157). A partir dos dados obtidos pela técnica de “Exon Array” (Affymetrix) e do mapeamento das mutações, foi realizada uma seleção dos genes aonde haviam mutações e eventos de splicing alternativos específicos a somente uma das linhagens celular, e cuja distância... (Resumo completo, clicar acesso eletrônico abaixo)

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The paper presents the radiometric parameters determined by the medical physicist during routine radiotherapy planning service in cases of breast cancer . The contours of the breast volume in patients undergoing radiation breast tumors at the Hospital das Clinicas, Faculty of Medicine , UNESP, Botucatu ( HCFMB ) during the year 2012 were analyzed . In order to analyze the influence of physical and radiometric parameters for the determination of the dose distribution of irradiated breast volume , four measurements of isodose curves were prepared in four different heights breast , and compared with the isodose curves plotted computationally . In the routine of planning , the medical physicist must determine the isodose curve that gives the best dose distribution homogeneity in the irradiated volume . The choice of the treatment plan can be done by dedicated computer systems , which require significantly costly investments available services having better financial support . In the Service of Medical Physics , Department of Radiotherapy , HC FMB , we use a two-dimensional software for determination of isodose curves , however , this software is out of date and frequently becomes inoperable due to the lack of maintenance and it is a closed system without feasibility of interference from computer professionals . This fact requires manual preparation of isodose curves , which are subject to uncertainties due to the subjectivity in the clinical interpretation of medical radiation oncologist and medical physicist responsible for planning , plus dispendiar significant calculation time . The choice of the optimal isodose curve depends on the energy of the radiation beam , the geometry and dimensions of the irradiated area . The contours of the breast studied in this work evaluations showed that , for a given energy input , such as the energy of 1.25 MeV of gamma radiation Unit Telecobaltoterapia , the determination of the percentage depth dose ( PDP ) ...