scholarly journals Benign breast tumors: epidemiological profile and therapeutic conduct at the escola paulista de medicina

Mastology ◽  
2020 ◽  
Vol 30 (Suppl 1) ◽  
Author(s):  
João Bueno Vitor Peixoto ◽  
Joaquim Teodoro Araújo ◽  
Simone Elias ◽  
Afonso Celso Pinto Nazário ◽  
Gil Facina
Keyword(s):  
Breast Cancer ◽  
Family History ◽  
Medical Records ◽  
Dropout Rate ◽  
Sao Paulo ◽  
São Paulo ◽  
History Of ◽  
Epidemiological Profile ◽  
Epidemiological Characteristics

Introduction: Breasts represent an important site for the development of diseases. It is known that 80% of the palpable masses of the breast are of benign origin. Benign breast diseases range from inflammatory to neoplastic processes. Objectives: to evaluate the clinical and epidemiological characteristics of patients diagnosed with benign breast tumor at the Mastology outpatient clinic of the Universidade Federal de São Paulo (UNIFESP). Methods: 1,532 medical records, available on the electronic platform PEP-HUHSP through the ICD D24 (benign breast cancer) and N63 (unspecified breast nodule), of patients referred to the service between July 2008 and July 2017 were reviewed. After applying exclusion criteria, 403 medical records were submitted to data collection and tabulation in Excel, followed by statistical analysis using the IBM SPSS Statistics 23 software. The study in question was approved by the Research Ethics Committee of UNIFESP (CEP UNIFESP), in the Teaching and Research Coordination of Hospital São Paulo – Hospital Universitário/UNIFESP (CoEP of HSP-HU/UNIFESP) and exempted from the application of the Informed Consent by the same organs. Results: In the 9-year period, the following results were obtained: mean age was 39.3 years. Comorbidities: smoking (16.4%), SAH (16.8%) and dyslipidemia (6.3%). Family history of breast and/or ovarian cancer accounted for 16.6%. Mean age of menarche and menopause, respectively, were 12.7 and 42.5 years. Causes of referral: "alteration in image examination" (38.3%), "lump in the breast" (33.3%), "follow-up due to previous nodules" (16.5%). Anatomopathological report: fibroadenoma (41%), breast cysts (16%), phylloid tumors (3%), and papilloma (1%). Mean number of consultations per patient until discharge or abandonment of follow-up: three. Choice behavior: expectant (85.2%). Conclusion: The epidemiological profile of patients referred to the UNIFESP tertiary mastology service was mainly composed of women of childbearing age and nulliparous women, whose main comorbidities were smoking and SAH, in the great majority with no family history of breast cancer. Regarding the consultation, the main reason for referral is the findings on imaging exams, and, specially, patients would bring their breast USG along, which surpassed mammography by 34.1%. The choice for biopsy was restricted, present in approximately 1/3 of the cases, but pointed out that the most prevalent nodule is fibroadenoma, followed by phylloid and papilloma tumors. Nevertheless, there was a predilection for expectant conduct. On average, there were regular follow-ups for 1.5 years, followed by a significant dropout rate.

scholarly journals Evaluation of General, Pathological, and Radiological Features of Male Breast Cancer

2020 ◽  
Vol 17 (3) ◽  
Author(s):  
Fariba Zarei ◽  
Fereshte Bagheri ◽  
Amin Dehdashtian ◽  
Majid Akrami
Keyword(s):  
Breast Cancer ◽  
Survival Time ◽  
Male Breast Cancer ◽  
Medical Records ◽  
Male Breast ◽  
Treatment Modalities ◽  
Time Interval ◽  
Number Of Patients ◽  
History Of

Background: Male breast cancer (MBC) is an infrequent disease and a scarcely researched topic. Since the incidence of male breast cancer is increasing and so far, management advices have been concluded from results of trials in female patients, there has been a growing interest in this field of research. Objectives: In this study, we aimed to evaluate the general, radiological and pathological features of MBC patients. Patients and Methods: We retrospectively reviewed the medical records of MBC patients who had been referred to breast clinic, Shahid Motahari in Shiraz, Iran, between 2005 and 2018. Data regarding general characteristics of patients such as demographic information, age, and also past history of any cancer, family history of breast cancer, mammogram and ultrasound findings, stage, size and location of tumor, histopathology of tumor, metastasis, treatment modalities and follow-up time were attained by reviewing medical records. Results: Fifty-one patients with MBC were included with the mean age of 58.4 years. Invasive ductal carcinoma was the most prevalent pathologic type. By use of the Kaplan Meier survival estimate, survival probability of patients for each time interval after diagnosis was calculated. There was a decline over time until about 85 months after diagnosis when it reached a plateau state above 50%. Age, human epidermal growth factor receptor 2 (HER2) and metastasis showed to lower the survival time by increasing the hazard ratio. Only 13 patients had mammography and 22 had an ultrasound, which are less than 50% of the total number of patients. Conclusions: This study showed that there is still unfulfilled need to evaluate MBC in order to find the best management guidelines such as screening in high risk populations, diagnosis, treatment, and follow-up. Risk factor evaluation, survival time, and diagnostic radiologic modalities have not been well assessed in MBC so far.

scholarly journals Survival and prognostic factors of breast cancer in women in the state of São Paulo

Mastology ◽  
2020 ◽  
Vol 30 (Suppl 1) ◽  
Author(s):  
Raissa Janine de Almeida ◽  
Carolina Terra de Moraes Luizaga ◽  
Cristiane Murta-Nascimento
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Clinical Stage ◽  
Sao Paulo ◽  
The State ◽  
Rank Test ◽  
São Paulo ◽  
Historical Cohort ◽  
Female Population

Introduction: Breast cancer is the first most common malignancy in the female population worldwide. Monitoring the survival of women with breast cancer has been a strategy often adopted at the international level as a measure to assess public policy progress for disease control. Objectives: To estimate the probability of five-year survival and to investigate the prognostic factors of women with breast cancer included in the São Paulo State Cancer Hospital Records Base (RHC-SP), established in 2000 and maintained by the Oncocentro Foundation of São Paulo (Fundação Oncocentro de São Paulo – FOSP). Material and methods: This is a historical cohort. The sample consisted of women with breast cancer diagnosed between 2002 and 2012 and included in the RHC-FOSP. The event studied was specific mortality from breast cancer. Live cases at the end of follow-up (December 31st, 2017), loss of follow-up and those who died from causes other than breast cancer were considered censures on the date of the last contact or date of death. Survival analysis was performed using the Kaplan-Meyer method and the survival curves were compared using the log-rank test. Hazard ratios (HR) and respective 95% confidence intervals (95%CI) were also estimated using the Cox's proportional hazards model. This study was approved by the Human Research Ethics Committee of the School of Medicine of Botucatu, UNESP. Results: In the period between 2002‒2012, 53,146 cases of invasive breast cancer were registered at RHC-FOSP. The median age of women at diagnosis was 55.9 years. By the end of the follow-up (December 31st, 2017), 20,683 patients died and 71.4% were due to breast cancer. The probability of specific survival for the entire cohort at 5 and 10 years was 76.1% (95%CI 75.7‒76.5%) and 64.8% (95%CI 64.2‒65.3%), respectively. In the multivariate analysis, the factors associated with the prognosis were: age at diagnosis, year of diagnosis, educational level, grouped clinical stage and histological type. Conclusion: Specific survival for breast cancer in the state of São Paulo is significantly associated with several characteristics. The knowledge of these characteristics can contribute to the development of public policies in the area.

Abstract 12688: Long Term Use of Calcium Channel Blockers and Risk of Breast Cancer Development

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Uyen T Lam ◽  
Stacey Knight ◽  
Tami L Bair ◽  
Viet T Le ◽  
Joseph B Muhlestein ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Family History ◽  
Calcium Channel ◽  
Calcium Channel Blockers ◽  
Positive Family History ◽  
Channel Blockers ◽  
Increased Risk ◽  
History Of ◽  
Incident Breast Cancer

Introduction: Calcium channel blockers (CCBs) are a mainstay in treating hypertension (HTN). Recently, Li et-al published a population based case-control study (JAMA 2013; 289:2354) reporting CCB use to be associated with incident breast cancer (odds ratio 2.6). We prospectively analyzed 2 Intermountain Healthcare (IHC) databases (db) to confirm or refute this provocative report. Methods: Two separate analyses were conducted using general patients (GP) seen at IHC and patients undergoing coronary angiography (CV) at IHC facilities. Subjects were females aged 50-70 with no history of breast cancer. Those prescribed CCB were matched 1:1 to subjects not on CCB based on age, race, tobacco, alcohol, body mass index, HTN and follow up time. Multivariable Cox proportional hazards regression was used for the primary analysis of time to incident breast cancer by CCB use adjusting for history of other cancers and family history of breast cancer. Results: A total of 2612 GP subjects (cases/controls) and 1106 CV subjects (cases/controls) were studied. In the GP db, there was a statistically significant increased risk of breast cancer for subjects using CCB (HR=1.58; 95% CI: 1.10-2.26). Risk was also associated with a positive family history (HR=2.79; 1.96-3.97) and a personal history of cancer (HR=1.87; 1.07-3.26). Breast cancer predominantly developed in <5 y of follow up (64% of cases). However, a reverse relationship was found in the CV db, where the HR was 0.51 (95% CI: 0.27-0.97). This observation was found despite consistent associations with several secondary outcomes, including for incident diabetes, coronary and renal disease. Conclusion: A modest association between CCB use and incident breast cancer was observed in the GP db, but results were not reproducible in the CV db. Given lack of a credible mechanism and failure of previous randomized CCB studies to detect a signal, we interpret these modest and conflicting associations to likely represent uncorrected confounding, e.g. prescriber bias or drug interactions. Similarly, we believe the results of Li et-al may represent confounding. Given the important role of CCBs in clinical medicine, further studies are warranted, including randomized trials to assess CCB safety with respect to breast cancer risk.

Image-guided biopsy of non-palpable breast lesions: Experience of a university hospital in Mexico City.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11098-e11098
Author(s):  
Daniela Morales-Espinosa ◽  
Lilian Monica Navarro-Garcia ◽  
Dan Green ◽  
Daniel Motola ◽  
Gabriela Alvarado-luna ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Family History ◽  
Mexico City ◽  
Medical Records ◽  
University Hospital ◽  
Past Medical History ◽  
Image Guided ◽  
History Of ◽  
Advanced Stages ◽  
Palpable Breast

e11098 Background: Breast cancer is the most common cancer in women in Mexico. It is mostly diagnosed at advanced stages. Objective: To describe the experience of image-guided biopsies of non-palpable breast tumors in a University Hospital in Mexico City. Methods: Medical records from the Radiology and Oncology Department (January 2007 - April 2011) were reviewed. Patients with incomplete medical records as well as those lacking imaging control and pathology report were excluded. Results: A total of 123 medical records were obtained,12 were excluded. The median age was 50 years (rank 21-88). Most patients were asymptomatic. Medical indications leading to biopsy: see table below. Of the studied population, 56% had a family history of any type of cancer; 40% had a family history of breast cancer. Nine patients had a past medical history positive for breast cancer, 8 patients had a past medical history of any type of cancer. 26 patients were nulligravid and 60 post-menopausal; of which 27 had received hormone replacement therapy. 24 patients had positive contraceptive use. Most patients were catalogued as BIRADs 4A. From all the imaged-marked lesions, only 18 were malignant; 72% of which were carcinoma in situ. Most procedures were ambulatory; only 15 patients had to be admitted. The complications rate was very low (6%), 1 procedure-related infection, 3 seromas and 3 hematomas. Conclusions: Imaging-guided biopsies are a safe, with very low morbidity, accessible procedure. It helps to prompt effective treatment; especially in patients with non-palpable lesions who would otherwise not be diagnosed until advanced stages. [Table: see text]

Assessment of breast cancer risk in BRCA carriers with ovarian cancer: Evaluation of data from longitudinal observation.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e13062-e13062
Author(s):  
Tamar Safra ◽  
Barliz Waissengrin ◽  
Deanna Gerber ◽  
Rinat Bernstein Molho ◽  
Amnon Amit ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Ovarian Cancer ◽  
Family History ◽  
Prophylactic Mastectomy ◽  
Brca Mutation ◽  
Ashkenazi Jews ◽  
Luminal A ◽  
Luminal B ◽  
History Of

e13062 Background: To confirm data from older studies reporting reduced risks of breast cancer (BC) in BRCA mutated (BRCA+) ovarian cancer (OC) patients and to re-evaluate BC surveillance and/or prophylactic mastectomy in OC patients. Methods: Data on 430 BRCA+ mutation carriers diagnosed with OC between 2000 and 2017 in 6 medical centers (one in the USA and five in Israel) were analyzed. Data included demographics, breast surveillance type, family history, BRCA mutation types, timing of BC diagnosis (before or after OC diagnosis) and family history of cancer. Results: Median age at diagnosis of OC was 55.4 years (range, 31.3-90) and median follow-up was 4.6 years. Most patients were BRCA1 (66.6%), and 35.7% had 185delAG. Most patients (68.4%) were Ashkenazi Jews, 27.4% had a family history of BC and 16.5% were diagnosed with BC before OC. Five percent developed BC following OC diagnosis with a median time to BC diagnosis of 68 months (range, 11-210). Of those diagnosed with BC, 50% had triple-negative BC, 40% had luminal B ER+, PR-, Her2-neg and 10% had luminal A -ER+, PR+, her2-neg. There was a non-significant increase in BC after OC, and in BC prior to OC diagnosis; there was no correlation of BC with family history. No definite deaths from BC were recorded. Conclusions: The incidence of BC after OC diagnosis in the BRCA+ population at a median follow-up of 4.6 years is consistent with prior series. Prophylactic bilateral Surveillance measures should be re-evaluated in this population and may only be needed in long-term disease-free survivors and/or subpopulations to be identified. Clinical trial information: 07-146.

Efficacy of Contralateral Prophylactic Mastectomy in Women With a Personal and Family History of Breast Cancer

2001 ◽  
Vol 19 (19) ◽  
pp. 3938-3943 ◽  
Author(s):  
Shannon K. McDonnell ◽  
Daniel J. Schaid ◽  
Jeffrey L. Myers ◽  
Clive S. Grant ◽  
John H. Donohue ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Family History ◽  
Risk Reduction ◽  
Contralateral Breast Cancer ◽  
Prophylactic Mastectomy ◽  
Contralateral Prophylactic Mastectomy ◽  
Contralateral Breast ◽  
Breast Cancers ◽  
History Of

PURPOSE: To estimate the efficacy of contralateral prophylactic mastectomy in women with a personal and family history of breast cancer. PATIENTS AND METHODS: We followed the course of 745 women with a first breast cancer and a family history of breast and/or ovarian cancer who underwent contralateral prophylactic mastectomy at the Mayo Clinic between 1960 and 1993. Family history information and cancer follow-up information were obtained from the medical record, a study-specific questionnaire, and telephone follow-up. Life-tables for contralateral breast cancers, which consider age at first breast cancer, current age, and type of family history, were used to calculate the number of breast cancers expected in our cohort had they not had a prophylactic mastectomy. RESULTS: Of the 745 women in our cohort, 388 were premenopausal (age < 50 years) and 357 were post- menopausal. Eight women developed a contralateral breast cancer. Six events were observed among the premenopausal women, compared with 106.2 predicted, resulting in a risk reduction of 94.4% (95% confidence interval [CI], 87.7% to 97.9%). For the 357 postmenopausal women, 50.3 contralateral breast cancers were predicted, whereas only two were observed, representing a 96.0% risk reduction (95% CI, 85.6% to 99.5%). CONCLUSION: The incidence of contralateral breast cancer seems to be reduced significantly after contralateral prophylactic mastectomy in women with a personal and family history of breast cancer.

Female patients with soft tissue sarcoma are at a higher risk for developing breast cancer

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 10071-10071
Author(s):  
I. Jiveliouk ◽  
R. Geva ◽  
M. Inbar ◽  
O. Merimsky
Keyword(s):  
Breast Cancer ◽  
Family History ◽  
General Population ◽  
Median Survival ◽  
Second Primary ◽  
Female Patients ◽  
History Of ◽  
Therapeutic Radiation ◽  
Breast Cancer Family History

10071 Background: An increased incidence of MPM has been reported in association with STS. In a series of 1350 adults with STS almost 10% were diagnosed with additional primaries. The incidence of breast cancer (BC) in the general population is 97/105,(Israel-Cancer-Registry) and the incidence of STS is 1.5/105 (Enzinger&Weiss). It is expected that approx. 1.5/105 × 97/105 of the general population will have both BC and STS. Methods: A retrospective search of the database of approx. 1,350 adult STS patients, who were referred, diagnosed, or treated at our center between 1995- 2005. Results: A group of 132 patients (F=62) with STS had at least one additional malignancy. Twenty-five (25/62=40%) had BC, before or after STS. A family history of malignancy was reported by 8/25 patients (32%), 3 with a specific breast cancer family history. STS types varied. Sixteen (16/25) patients had breast cancer as their first primary, 9 as their second or third. Of 17 patients with first primary BC, the sarcoma appeared in the RT field in 2, and in 1 it appeared in a lymphedematous ipsilateral arm. Of eight patients with first primary sarcoma, only one got chemotherapy prior to the diagnosis of BC. Median interval between 1st to 2nd malignancy was 6.9 years (0.7–31y) when the BC was diagnosed first, and 3.8y (0–47y) when the BC was the second. Exposure to carcinogens, or therapeutic radiation and cytotoxics, given for the 1st tumor prior to the 2nd tumor, was recorded in 58%. The incidence of BC among all patients (females + males) with STS-first (in our database) followed by a second malignancy is 8/58 (14%), or 7/23 (30%) female patients with STS-first, or 25/890 (3%) of all female patients with STS in the registry of STS. The incidence of STS among the BC patients is rather low, and most of the cases in this series are not therapy related (14/17). The median survival of patients with BC-first was 312 months, versus 383 months for STS-first (p=NS). Among patients with BC-first, the median survival of patients with RT related sarcoma was 265 months, versus 312 months for RT unrelated STS (p= 0.6). Conclusions: Second primary BC in patients with STS-first is higher than the expected incidence of BC for this population. Screening for BC should be incorporated into the regular follow-up of patients with STS. No significant financial relationships to disclose.

Alcoholism in a Geriatric Outpatient Clinic of São Paulo-Brazil

1997 ◽  
Vol 9 (1) ◽  
pp. 95-103 ◽  
Author(s):  
Edson S. Hirata ◽  
Osvaldo P. Almeida ◽  
Rossana R. Funari ◽  
Eva L. Klein
Keyword(s):  
Family History ◽  
Alcohol Abuse ◽  
Outpatient Clinic ◽  
Age At Onset ◽  
Positive Family History ◽  
Sao Paulo ◽  
Elderly Subjects ◽  
São Paulo ◽  
Heavy Smoking ◽  
History Of

Alcohol abuse and dependence are an increasing health problem among the elderly, but there is only scanty information about their prevalence and associated risk factors in developing countries. The authors set out to evaluate the prevalence and associated clinical/demographic features of alcoholism in a sample of male elderly subjects attending a Geriatric Primary Health Outpatient Clinic in a State University Hospital in the City of São Paulo-Brazil. Three hundred four patients were assessed with the Brazilian version of the Michigan Alcoholism Screening Test and a semistructured questionnaire designed to investigate associated features. Lifetime alcoholism was present in 15.1% of the sample, although only 4.3% were active drinkers. Patients classified as “cases” were younger than their nonalcoholic counterparts (70.61 vs. 73.31), and there was a mild, though not significant, excess of Blacks and Mulattos among the former (32.6% vs. 15.9%). Cases were also more likely to rely on their family for financial support (59.0% vs. 43.5%) and to acknowledge a positive family history of alcoholism (51.4% vs. 31.2%). Alcohol abuse or dependence was further associated with heavy smoking (58.7% vs. 44.0%). The authors concluded that alcoholism in this Brazilian elderly sample was likely to be associated with an earlier age at onset of medical problems, financial dependence, Black/Mulatto race smoking, and positive family history of alcohol abuse/dependence. The authors suggest that the use of standardized methods of assessment of alcoholism in general medical settings may increase the detection of case and contribute to improved health measures for the management of these patients.

scholarly journals Survival and prognostic factors of patients with breast cancer in the state of São Paulo

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
R J Almeida ◽  
C T M Luizaga ◽  
J Eluf-Neto ◽  
E C Pessoa ◽  
A M M Chiarotti ◽  
...  
Keyword(s):  
Public Health ◽  
Breast Cancer ◽  
Prognostic Factors ◽  
Health Problem ◽  
Public Health Problem ◽  
Sao Paulo ◽  
São Paulo ◽  
Breast Cancer Specific Survival ◽  
Cancer Specific Survival

Abstract Introduction Breast cancer is a public health problem worldwide, being the most common malignant neoplasm in the female population. Objectives To estimate 5- and 10-year breast cancer-specific survival probabilities of patients included in the hospital-based cancer registry (HBCR) of the Fundação Oncocentro de São Paulo (FOSP, in Portuguese) and to assess the prognostic factors for this neoplasm. Methods Historical cohort study that included women with breast cancer included in HBCR-FOSP and diagnosed between 2002 and 2012. The event of interest was breast cancer-specific mortality. Living cases at the end of follow-up (December 31, 2017), loss to follow-up and death other than that due to breast cancer were considered censored on the date of the last contact or date of death. Descriptive analysis and survival analysis were performed using the Kaplan-Meyer method. Survival curves were compared using the log-rank test. Hazard ratios (HR) and their 95%CI were estimated using Cox's proportional hazards model. The study was approved by the Human Research Ethics Committee of the Botucatu Medical School, São Paulo State University, Brazil. Results 53,146 cases of invasive breast cancer were registered at HBCR-FOSP between 2002-2012. The median age at diagnosis was 55.9 years. By the end of the follow-up, 20,683 patients died, and 71.4% were due to breast cancer. The 5- and 10-year breast cancer-specific survival for the entire cohort was 76.1% (95%CI 75.7-76.5%) and 64.8% (95% CI 64.2-65.3%), respectively. In the multivariate analysis, the factors associated with prognosis were age at diagnosis, year of diagnosis, educational level, clinical stage, and histological type. Conclusions These findings may contribute to the development of policies for the identification of breast tumors at earlier stages. Key messages Breast cancer is an important public health problem in Brazil and worldwide. The findings of this study may contribute to the development of public policies for the control of breast cancer in the state of São Paulo.

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