875 resultados para Câncer de mama


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Pós-graduação em Psicologia do Desenvolvimento e Aprendizagem - FC

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Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB

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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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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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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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Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB

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Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB

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Introduction: Health indicators tend to be altered due to the participation of people in social networks. Objective: To find out ideas of individuals belonging to Portuguese speaking communities in Toronto, Canada, about the possibility of creating a social support network for women experiencing breast cancer. Method: Nineteen participants of the present ethnographic and critical study answered to questions, providing their opinions regarding to the social support network and its positive and negative aspects. Also, the participants suggested other possible individuals who could participate and help in the creation of such network. Discussions were transcribed, analysed and coded using qualitative software called Atlas ti 6.0. Results: The main components for the creation of the social support network were: the demystification of breast cancer and its prevention, emphasis in health education, dissemination of the need of volunteers and a direct social support to those women. The positive aspects were the participation of oldest women as social leaders and the utilization of schools and religious institutions for publicity. Negative aspects that were perceived as barriers are: the belief that breast cancer is a disease lived by women, the lack of knowledge about its cure and rehabilitation, as well as a collective sensitiveness to it. Also, about the participation of community leaders, the suggestions were: diplomats, priests and pastors, schools directors and communication entrepreneurs. Conclusion: The creation of the social support network should consider the cultural sensitiveness and the inner diversity of the consulted Portuguese speaking communities. Due to the insufficient number of Angolan participants to sustain a major analysis, a special recommendation was that Angolan social leaders and professionals should be invited to design the structure of such network according to their specific cultural traits.

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Breast cancer (BC) is the most common malignancy in women worldwide, with one million new cases confirmed each year. This study aimed at identifying the knowledge of patients? relatives concerning the risk factors (RF) for BC. It is a descriptive quantitative study carried out in the Chemotherapy Technical Division of a University Hospital in São Paulo state, Brazil, from September to October 2006. Only female (30) relatives were included due to the fact that BC is more frequent in females. The major RF cited were family history for BC 33.3% (10), smoking 16.6% (5), alcoholic-drink consumption 10% (3), animal-fat-rich diet 3.3% (1). Other factors such as not breastfeeding, environmental factors, use of oral contraceptives and hormone-replacement therapy were mentioned by 10% (3) of the relatives. It was concluded that the relatives of patients undergoing chemotherapeutic treatment showed to have little knowledge concerning RF for BC. Hence, it is important to rethink the inclusion of the health education process in the family scenario. This issue reaches far beyond thesimple transmission of information. Healthcare professionals and nurses in particular, must focus on these individuals? social context, values, beliefs and needs.

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This study, clinical, prospective, randomized study was conducted from August 2004 to February 2008 in a convenience sample of 60 women who underwent breast surgery with axillary dissection, divided into two groups (n = 30). The GI (Guidance Kit with different textures, to perform at home) and GII (control). The objective was to analyze the effect of home orientation in patients after surgery for breast cancer complaining of numbness, evaluation, and the conventional esthesiometer. The surface sensitivity was assessed by monofilament Semmes-Weinstein and evaluation using conventional two test tubes with hot water (38 to 43o C) and cold (16 to 27o C), paintbrush, needle. The GI was subjected to 10 sessions and assessments in both 3 times. The M1 (pre intervention), the M2 (post-intervention) after 10 sessions of physical therapy intervention and M3 (washout) after 3 months the second time for assessment. The region targeted for evaluation and intervention was the sensory nerve dermatome intercostobrachial. In the test of Goodman (conventional assessment) there was improvement in both groups, the P1, during the thermal evaluation. The t-test of student (esthesiometer) there was improvement in P2 only in GI (p = 0.003) between points 1 and 2 while the time 3 (p = 0.121 and p = 0.733 respectively). It was concluded that there were divergent and opposite results after examining the effect of home orientation in the nerve dermatome intercostobrachial, evaluation, and the conventional esthesiometer.