Quais as características propostas pelo BIRADS-US que melhor diferenciam nódulos malignos dos benignos?

OBJETIVO: analisar qual das características propostas pelo BIRADS-US tem maior impacto na diferenciação das lesões benignas das malignas. MÉTODOS: estudamos as características ultra-sonográficas do BIRADS em 384 nódulos submetidos à biópsia percutânea no período de fevereiro de 2003 a dezembro de 2006. Utilizou-se, para o exame, o aparelho Logic 5, com transdutor linear multifreqüencial de 7,5-12 MHz. A análise ultra-sonográfica do nódulo foi baseada no BIRADS-US levando em conta: forma, orientação, margem, limites da lesão, ecogenicidade, características acústicas posteriores, o tecido circunjacente e a presença de calcificações. Estes dados foram submetidos à análise estatística com modelo de regressão logística. Para o estudo de associação entre estas variáveis utilizamos o teste do c² e também calculamos a sensibilidade e a especificidade das variáveis tecido ao redor, calcificações, efeito posterior, limite da lesão e orientação. RESULTADOS: as lesões benignas representaram 42,4% e as malignas, 57,6%. A análise por regressão logística encontrou odds ratio (OR) aumentado para câncer de 7,7 vezes quando o tecido ao redor esteve alterado, de 6,2 vezes quando houve presença das microcalcificações no interior das lesões, de 1,9 quando o efeito acústico foi sombra, de 25,0 vezes quando houve o halo ecogênico e de 7,1 vezes quando a orientação foi não paralela. CONCLUSÕES: dentre as características estudadas, o limite da lesão, representado pela presença ou não do halo ecogênico, é o mais importante diferenciador das massas benignas das malignas.

Avaliação das pressões respiratórias máximas e expansibilidade pulmonar em pacientes portadoras de câncer de mama e submetidas a tratamento cirúrgico

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Alterações mamográficas em mulheres que vivem com HIV-aids

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

Análise da ocorrência de metástase intraocular e pulmonar em cadelas portadoras de carcinoma mamário e correlação com mutação e expressão de E-caderina

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

Profile of thyroid hormones in breast cancer patients

Estrogen involvement in breast cancer has been established; however, the association between breast cancer and thyroid diseases is controversial. Estrogen-like effects of thyroid hormone on breast cancer cell growth in culture have been reported. The objective of the present study was to determine the profile of thyroid hormones in breast cancer patients. Serum aliquots from 26 patients with breast cancer ranging in age from 30 to 85 years and age-matched normal controls (N = 22) were analyzed for free triiodothyronine (T3F), free thyroxine (T4F), thyroid-stimulating hormone (TSH), antiperoxidase antibody (TPO), and estradiol (E2). Estrogen receptor ß (ERß) was determined in tumor tissues by immunohistochemistry. Thyroid disease incidence was higher in patients than in controls (58 vs 18%, P < 0.05). Subclinical hyperthyroidism was the most frequent disorder in patients (31%); hypothyroidism (8%) and positive anti-TPO antibodies (19%) were also found. Subclinical hypothyroidism was the only dysfunction (18%) found in controls. Hyperthyroidism was associated with postmenopausal patients, as shown by significantly higher mean T3 and T4 values and lower TSH levels in this group of breast cancer patients than in controls. The majority of positive ERß tumors were clustered in the postmenopausal patients and all cases presenting subclinical hyperthyroidism in this subgroup concomitantly exhibited Erß-positive tumors. Subclinical hyperthyroidism was present in only one of 6 premenopausal patients. We show here that postmenopausal breast cancer patients have a significantly increased thyroid hormone/E2 ratio (P < 0.05), suggesting a possible tumor growth-promoting effect caused by this misbalance.

Polymorphisms of estrogen receptor-α gene in Brazilian women with high breast density after menopause

The association of genetic polymorphism in the estrogen receptor alpha (ERα) gene and risk for diseases including breast cancer (BC) has been the subject of great interest. Objective: Checking on women with high breast density after menopause, the frequency of the Pvull and Xbal polymorphisms of the ERα gene and the correlation between them and the known risk factors for breast cancer. Method: Observational study with 308 women between 45 and 65 years old with high breast density, without hormonal therapy, menstruation for a year or more, breast and ovarian cancer history. It was characterized in clinical history and physical examination: menarche, menopause, parity, family history of BC, smoking, alcohol intake and body mass index. Results: The allelic and genotypic frequencies for ERα-Pvull and Xbal: p=43.99%; p=56.01%; pp=32.14%; Pp=47.73% and PP=20.13%; X=41.56%; x=58.44%; xx=33.44%; Xx=50.00% and XX=16.56%, respectively. The most frequent risk factors for BC: menarche before 12 years old (35.38%), nulliparity or first child after 28 years old (41.66%), family history of BC (19.16%) and overweight/obesity (62.01%). Conclusion: Allelic and genotypic distribution similar to literature. The risk factors for BC were more prevalent in women with high breast density but without significant associations with these polymorphisms. © 2013 Informa UK Ltd. All rights reserved.

Triiodothyronine and breast cancer

The thyroid hormones (THs), triiodothyronine (T3) and thyroxine (T4), are essential for survival; they are involved in the processes of development, growth, and metabolism. In addition to hyperthyroidism or hypothyroidism, THs are involved in other diseases. The role of THs in the development and differentiation of mammary epithelium is well established; however, their specific role in the pathogenesis of breast cancer (BC) is controversial. Steroid hormones affect many human cancers and the abnormal responsiveness of the mammary epithelial cells to estradiol (E2) in particular is known to be an important cause for the development and progression of BC. The proliferative effect of T3 has been demonstrated in various types of cancer. In BC cell lines, T3 may foster the conditions for tumor proliferation and increase the effect of cell proliferation by E2; thus, T3 may play a role in the development and progression of BC. Studies show that T3 has effects similar to E2 in BC cell lines. Despite controversy regarding the relationship between thyroid disturbances and the incidence of BC, studies show that thyroid status may influence the development of tumor, proliferation and metastasis.