Modelos de cura: aplicação ao cancro da mama feminino

A Análise de Sobrevivência tem como objetivo o estudo do tempo desde um instante inicial bem definido até ao acontecimento de determinado evento. Por exemplo, poderá ser o tempo de vida de um indivíduo desde o momento em que lhe é diagnosticada uma doença até a sua morte ou cura. Com a evolução da medicina, começou a se verificar a existência de indivíduos para os quais nunca se observava o acontecimento de interesse e designaram-se esses indivíduos por curados, imunes, ou não suscetíveis. Assim, da Análise de Sobrevivência clássica surgem os modelos de cura. Neste trabalho, aplicaram-se estes conceitos a uma base de dados referentes a 833 mulheres diagnosticadas com cancro da mama, entre 1998 e 2005. Verificou-se a existência de um risco de morte maior em mulheres na faixa etária dos 50 a 59 anos. Comprovou-se que o estadiamento tem um papel preponderante em relação ao prognóstico, sendo que, quanto mais avançado o estadio pior o prognóstico. Dos tratamentos a que os doentes foram submetidos, a realização de cirurgia é indicativa de um melhor prognóstico, assim como a realização de hormonoterapia e de radioterapia. No entanto, este último tratamento não se revelou estatisticamente significativo para o modelo de regressão de Cox. A realização de quimioterapia apenas reflete um melhor prognóstico nos primeiros dois anos, o que já não acontece a partir dai. Esta caraterística inesperada ficou-se a dever à esperança de vida que o tratamento oferece aos doentes no estadio IV e da associação entre a existência de gânglios metastizados e o agravamento do prognóstico, no caso do estadio II. O modelo de cura foi aplicado apenas ao grupo de mulheres no estadio IV, pois só neste caso se admitiu que o tempo de follow-up era suficiente, obtendo-se uma taxa de cura de 7;4%.

Simulador radiográfico antropomórfico de mama humana

Mammography is a diagnostic imaging method in which interpretation depends on knowledge of radiological aspects as well as the clinical exam and pathophysiology of breast diseases. In this work a mammography phantom was developed to be used for training in the operation of mammographic x-ray equipment, image quality evaluation, self-examination and clinical examination of palpation. Polyurethane was used for the production of the phantoms for its physical and chemical properties and because it is one of the components normally used in prostheses. According to the range of flexibility of the polyurethane, it was possible to simulate breasts with higher or lower amount of adipose tissue. Pathologies such as areolar necrosis and tissue rejection due to surgery reconstruction after partial mastectomy were also simulated. Calcifications and nodules were simulated using the following materials: polyethylene, poly (methyl methacrylate), polyamide, polyurethane and poly (dimethyl silicone). Among these, polyethylene was able to simulate characteristics of calcification as well as breast nodules. The results from mammographic techniques used in this paper for the evaluation of the phantoms are in agreement with data found in the literature. The image analyses of four phantoms indicated significant similarities with the human skin texture and the female breast parenchyma. It was possible to detect in the radiographic images produced regions of high and low radiographic optical density, which are characteristic of breasts with regions of different amount of adipose tissue. The stiffnesses of breast phantoms were adjusted according to the formulation of the polyurethane which enabled the production of phantoms with distinct radiographic features and texture similar to human female breast parenchyma. Clinical palpation exam of the phantoms developed in this work indicated characteristics similar to human breast in skin texture, areolar region and parenchyma

Abordagem inicial de lesões mamárias por biopsia helicóide: estudo experimental

OBJECTIVE: Evaluating the kit-Bh performance in carrying out of breast biopsies. METHODS: They were randomly selected a sample of 30 patients with breast cancer undergoing mastectomy, based on the results of a pilot study from February 2008 to April 2010. They were excluded women with had not palpable, stone-hard consistency tumors, previous surgical manipulation or that contains liquid. Using the helicoid biopsy Kit (kit Bh) and an equipment Core biopsy with cannula and needle and 14 gauge respectively, it was collected a fragment of sound equipment in the area and in tumors in each specimen, totaling 120 fragments for histological study. For data analysis, it was defined a 95% confidence level and used the SPSS-13 version, the Kappa index and the parametric Student t test. RESULTS: Mean age of patients was 51.6 years (± 11.1 years). The infiltrating ductal carcinoma showed a higher incidence, 26 cases (86.7%). The Core biopsy had a sensitivity of 93.3%, specificity of 100% and accuracy 96.7%, while the helicoid biopsy had a sensitivity of 96.7%, specificity of 100% and accuracy 98.3%. By comparing the histology of tumors and the fragments of biopsies, there was high degree of agreement in diagnoses (kappa of 0.93 with p <0.05) CONCLUSION: Both devices provided the histological diagnosis of lesions with high accuracy. Results of this study showed that the helicoid biopsy is a reliable alternative in 22 the preoperative diagnosis of breast lesions. Further studies in vivo better will define the role of Kit Bh in the diagnosis of these lesions

Avaliação dos efeitos da atividade física na prevenção do estresse oxidativo e do câncer de mama

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Análise de depoimentos de mulheres mastectomizadas sobre o câncer de mama

The breast cancer is the most incident neoplasia in Brazilian women, configure as important cause of female death in Brazil. Its magnitude is go to be consider as a disease that go out the biological and numerical, extending of the subjective dimension and interrelationships of society and socials experiences, to into in knowledge and practices. Linking of the growing older process, the breast cancer extend as social, economical and cultural dimensions, madding in plot of socials relationships, through that acquire mean. In the context of the high expectative of live and the high number of older age persons, consider that that the high number of years had lived correspond the exposition of this individuals to corporate of the ambientals aggressions and own processes of human constitution of natural wear, like as chronicle-degenerate disease, the example is cancer. In the perspective, we collected narratives of mastectomies women with 60 age or so, about the breast cancer, the body and the growing older process, had has as objectives to reflexes about relatives questions, the comprehension about cancer, like experience, had lived and mean in the context of action and interaction of mastectomies older women, and to comprehend like women interrelationships and respond the changes that grow up of the disease and the growing older process in the everyday of their lives. Through of the narratives. We know that the disease is an initial information that take a form through successives approximation between women with their reality, since the family from hospital institution. The breast cancer to be continue a disease who cause a lot of apprehension and fear, getting and changing the ill s live as marked form. Have dad the body and the growing older process genteels and redimensions by disease, women need to define news and multiples functions due to the contingency that the disease impose

Assistência a mulher com câncer de mama em um cenro de referência no Estado da Paraíba

The assistance to women who have breast cancer is studied in a Reference Center in Paraiba and also the way this assistance is performed in a School Hospital maintained by SUS (Single Health System) is questioned. Breast cancer demands institutional organization, provision of financial, material and human resources, requiring, from the health system, effective assistance with new technologies which make it possible for the population their access to specialized medical services although it not always is able to guarantee those services nor the rights which the legislation granted them, inhibiting a proper relationship between the health professional and the patient. The theme is discussed through a transdisciplinary knowledge view and has as its theoretical referential the contribution of classical and contemporary authors from the human and social sciences and, as an empirical research strategy, the structured interview. The objectives of the research were: identify how the assistance to women with breast cancer is carried on at a Reference Center on Oncology in Campina Grande, Paraiba, identifying their difficulties and their satisfaction with the received assistance; draw up a profile of the women with breast cancer who were assisted in this Reference Center; understand their gynecological and obstetric antecedents, life styles, age group and stage of the disease when the treatment started; check their knowledge about their rights and which benefits they had received. Most women ranged between 40 and 59 years old (63%), which corresponds to the risk range of developing breast cancer. As to their occupations, 38.3% were housewives and 30.1% retired, whose family income was among those who received between less than a minimum salary and one minimum salary (58.2%). This population was mainly constituted of married women (60.2%), whose most frequent schooling was an incomplete elementary school (27.6%) and complete elementary school (24.1%), which added up to 51.6%. It was observed that the majority of the women seemed to be satisfied with the assistance received, noting that a minimum care was enough to define this satisfaction, although it is perceived that the access to the health system does not ensure the ideal attention conditions they need; it was verified that the availability of the services and the assistance itself are seen (in the local culture) as a favor and not as a right. It is also observed that only 30% of the women mentioned that they knew about their rights and the most mentioned ones were the disease assistance (13%), the medicines (13%) and the treatment (12%), which represent the most important triad to face the disease and around which the oncologic assistance most focus on. It is concluded that the condition of the users´ minimum existential of a public health unit and the condition of belonging to a lower social stratum were variables that influenced the respondents´ satisfaction in relation to the assistance received but the importance of the Reference Center for the women with breast cancer´s assistance for the whole region cannot be denied as well as the need to broaden the way the policy of the oncologic assistance in Brazil in the local realm is seen

Aspectos clínico e cirúrgicos do tumor mamário canino: clinical and surgical evolution

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

Estudo clínico, histopatológico e imunoistoquímico de neoplasias mamárias em cadelas

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

The maspin expression in canine mammary tumors: an immunohistochemical and molecular study

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

Ações de detecção precoce do câncer de mama realizadas por profissionais da estratégia saúde da família

This study is an exploratory descriptive study with a quantitative approach. The objective was to identify the actions for the early detection of breast cancer conducted by the health professionals of the Family Health Strategy in the Trairi region of the State of Rio Grande do Norte, Brazil. The research was conducted in nine municipalities of the region. Data were collected by means of a questionnaire with 52 Family Health Strategy professionals, 30 nurses and 22 physicians, that work in the region. Analysis was conducted using descriptive statistics. The results were organized and discussed in three areas: Knowledge about the early detection of breast cancer; Actions for early detection detection of breast cancer, and Difficulties experienced in the screening actions for breast cancer. The results indicate that these professionals (100%) have knowledge of the signs and symptoms of breast cancer and that the majority (96,2%) conduct screening actions in accordance with the recommendations of the Ministry of Health. However, a considerable number (55,8%) of these professionals encounters difficulties while conducting the screening procedures in his work setting. The difficulties varied from those of a personal nature to those of access to the procedure, such as the unavailability of sufficient quotas of screening exams. We conclude that the majority of health professionals execute the screening actions for breast cancer in their work settings according to the recommendations of the Ministry of Health, even though they encounter difficulties in the conclusion of the mammography and ultrasound exams, essential procedures in the early detection of breast cancer. We understand that these professionals demonstrate knowledge of secondary prevention even though they do not execute all the actions necessary for early detection primarily because they are impeded by the blockage of access to exam quotas. We conclude that, in spite of the difficulties experienced, the procedures for the early detection of breast cancer are being executed by the majority of the Family Health Strategy professionals in the Trairí region, specifically the clinical examination of the breast, orientation of breast self examination, requests for mammography and ultra sound examinations. Measures are needed that can mediate the difficulties, that will permit the realization of secondary prevention procedures with the population at risk in the region. We suggest training and actualization courses on the complete screening process that includes a wide discussion of the new legislation that provides the mammography exam for women over 40 years. We believe that the acquisition of such a work perspective for the early detection of breast cancer, along with knowledge of health vigilance and of breast cancer, will enhance integral health care of women that constitutes an aim of the nurse and the family health team

Expressão Imuno-histoquímica das proteínas GLUT-1 e HIF-1α em lesões vasculares de mucosa oral

The correct histological diagnosis of vascular lesions in the oral mucosa is critical, especially in defining the treatment and prognosis, as some vascular lesions show spontaneous involution and others do not show such behavior. This study analyzed the expression immunohistochemistry of human glucose transporter protein (GLUT-1), in oral benign vascular tumors and to reclassify such lesions according to with his immunoexpression. In addition, we evaluated the immunohistochemical expression of hypoxia-inducible factor 1 alpha (HIF-1α), the main transcription factor involved in cellular adaptation to hypoxia. We analyzed 60 cases of benign oral vascular tumors: 30 cases with histological diagnosis of HEM and 30 cases of oral pyogenic granuloma (PG). The results of this research showed that of the 30 lesions initially classified as HEM, only 7 showed immuno-positivity for GLUT-1, remaining with the initial diagnosis. The remaining 23 were reclassified as vascular malformation (VM) (13 cases) and PG (10 cases). All cases in the sample with an initial diagnosis of PG were negative for GLUT-1, demonstrating the accuracy of histological diagnosis of these lesions. Concerning to the immunoexpression of HIF-1α, the Mann-Whitney test revealed a statistically significant difference between the cases of GP and MV (p = 0.002), where the median of GP (m=78) was higher than the MV (m=53). Based on these results, this study showed that a histological diagnosis alone is not always sufficient for the correct diagnosis of oral HEM and that HIF-1α participates in the pathogenesis of vascular lesions

Estudo da expressão imuno-histoquímica das proteínas MMP-9, MMP-13 e TIMP-1 em ameloblastomas e tumores odontogênicos ceratocistos

Ameloblastomas and keratocystic odontogenic tumors (KOT) represent odontogenic lesions that, despite their benign nature, are distinguished by a distinct biological behavior, characterized by locally aggressive growth and recurrent episodes. The gnathic bone resorption caused by the growth of these lesions is a key to the expansion of the same, both being mediated by osteoclastic cells like enzymatic activity of various matrix metalloproteinases (MMPs) factor. The expression of stimulatory factors and inhibitors of bone resorption has been correlated with the development of these lesions, with emphasis to some MMPs such as collagenases and gelatinases and tissue inhibitors of metalloproteinases (TIMPs), among others. Based on the premise that stimulatory and inhibitory factors of osteolytic processes can be decisive for the growth rate of intraosseous odontogenic lesions, this experiment evaluated the immunoreactivity of MMP-9, -13 and TIMP-1 protein in the epithelium and mesenchyme of ameloblastoma and the KOT specimens, by a quantitative analysis of the immunoreactivity cells. Statistical analysis was performed using the Mann-Whitney and Wilcoxon tests with a significance level set at 5 %. Immunohistochemical expression of MMP-9, -13 and TIMP-1 was observed in 100% of cases both in the epithelium and in mesenchyme. The immunoreactivity in the epithelium of KOT and ameloblastomas revealed a predominance of score 3 for MMP-9 (p=0.382) and MMP-13 (p=0.069) and no statistically significance for TIMP-1, the latter being significantly higher immunoreactivity in ameloblastomas. In the mesenchyme, there was a higher score immunoreactivity of MMP-13 (p=0.031) in ameloblastomas in relation to KOT, whereas for MMP-9 and TIMP-1 no statistically significant difference (p=0.403 was observed, p=1.000). The calculation of the ratio of scores revealed expression of proteins in general, similarity of the lesions, a significant predominance of equal expression of TIMP-1 and MMP-9 was observed only in the epithelium of ameloblastoma. The marked immunostaining of MMP-9 , MMP-13 and TIMP-1 in epithelium and mesenchyme of the lesion indicate that these proteins involved in ECM remodeling required for tumor progression, however, specific differences in the expression of some of these proteins, are not sufficient to suggest differences in the biological behavior of ameloblastomas and KOTs

Estudo in vitro dos efeitos da BMP-2 e do seu antagonista Noggin sobre a proliferação e migração celulares em carcinoma epidermóide de língua

Oral squamous cell carcinoma (OSCC) is the most prevalent malignancy in the oral cavity and reach a large number of individuals, has become an important public health problem. Studies have demonstrated changes in pathway components BMP in various types of cancers as prostate, colon, breast, gastric and OSCCs. Is the current knowledge that these proteins may exert pro-tumor effect in more advanced stages of neoplastic development coming to favor progression and invasion tumor. The inhibition of the signaling pathway BMP-2 through its antagonists, have shown positive results of antitumor activity and use of Noggin may be a novel therapeutic target for cancer. Given this evidence and the few studies with BMP-2, Noggin and OSCC, the objective of this research was to evaluate the effect of BMP-2 and its antagonist Noggin on proliferation and migration cell in line of cell cultures of human tongue squamous cell carcinoma (SCC25). The study was divided in three groups, a control group, where SCC25 cells suffered no treatment, a BMP-2 group, in which cells were treated with 100ng/ml of BMP-2 and a group of cells that were treated with 100ng/ml of Noggin. For the proliferation assay and cell cycle were established three time intervals (24, 48 and 72 hours). Proliferative activity was investigated by trypan blue and cell cycle analysis by staining with propidium iodide flow cytometry. The potential for migration / invasion of SCC25 cells was performing by a cell invasion assay using Matrigel in a 48-hour interval. The proliferation curve showed a higher proliferation in cells treated with BMP-2 in 72 hours (p < 0.05), and lower overgrowth and cell viability in Noggin group. Recombinant proteins favored a greater percentage of cells in cell cycle phase Go/G1 with a statistically significant difference in the interval of 24 hours (p < 0.05). BMP- 2 produced a greater invasion of cells studied as well as its antagonist Noggin inhibits invasion of cells (p < 0.05). Thus, these results indicate that BMP-2 promotes malignant phenotype, dues stimulates proliferation and invasion of SCC25 cells and, its antagonist Noggin may be an alternative treatment, due to inhibit the tumor progression