Oncoguía de cáncer de mama 2020

2020 ◽  
Vol 2 (2) ◽  
pp. 126-144
Author(s):  
Juan Enrique Bargalló Rocha ◽  
Nereida Esparza Arias ◽  
Daniel Rivera ◽  
Raúl Ramírez ◽  
Rodrigo Espinosa ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Social Workers ◽  
Health Problem ◽  
Biological Therapy ◽  
Systemic Treatment ◽  
Clinical Stage ◽  
World Health ◽  
Cáncer De Mama ◽  
Multidisciplinary Management ◽  
Advanced Stages

Breast cancer is a world health problem, and in our country is generally diagnosed in advanced stages. Departamento de Tumores Mamarios from Instituto Nacional de Cancerología developed Oncoguía de cáncer de mama 2020 based on a consensus methodology conducted among its members: clinical oncologists, surgical oncologists, radiation therapists, nurses, and social workers. Such specialists carry out multidisciplinary management (detailed in this Oncoguía) through a clinical assessment performed by Unidad Funcional, and it is based on surgery, radiotherapy, and systemic treatment, either adjuvant, neoadjuvant or palliative. The systemic management also includes chemotherapy, hormone blockade, and biological therapy. These guidelines also include algorithms to make decisions in every clinical stage

scholarly journals Comparative Study on the Clinicopathological Profiles of Breast Cancer Among Iraqi and British Patients

2018 ◽  
Vol 11 (1) ◽  
pp. 177-191
Author(s):  
Nada A.S. Alwan ◽  
David Kerr ◽  
Dhafir Al-Okati ◽  
Fransesco Pezella ◽  
Furat N. Tawfeeq
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Clinical Stage ◽  
Ethnic Disparities ◽  
Her2 Status ◽  
Lymph Node Status ◽  
Tumor Characteristics ◽  
Her2 Positive ◽  
Control Plan ◽  
Advanced Stages

Background:Breast cancer is the most common cancer in Iraq and the United Kingdom. While the disease is frequently diagnosed among middle-aged Iraqi women at advanced stages accounting for the second cause of cancer-related deaths, breast cancer often affects elderly British women yielding the highest survival of all registered malignancies in the UK.Objective:To compare the clinical and pathological profiles of breast cancer among Iraqi and British women; correlating age at diagnosis with the tumor characteristics, receptor-defined biomarkers and phenotype patterns.Methods:This comparative retrospective study included the clinical and pathological characteristics of (1,940) consecutive female patients who were diagnosed with invasive breast cancer from 2014 to 2016 in Iraq (Medical City Teaching Hospital, Baghdad: 635 cases) and UK (John Radcliffe, Oxford and Queen's, BHR University Hospitals: 1,305 cases). The studied parameters in both groups comprised the age of the patient at the time of diagnosis, breast cancer histologic type, grade, tumor size, lymph node status, clinical stage at presentation, Estrogen Receptor (ER), Progesterone Receptor (PR) and HER2 positive tumor contents and the receptor-defined breast cancer surrogate subtypes.Results:The Iraqi patients were significantly younger than their British counterparts and exhibited higher trend to present at advanced stages; reflected by larger size tumors and frequent lymph node involvement compared to the British (p<0.00001). They also had worse receptor-defined breast cancer subtypes manifested by higher rates of hormone receptor (ER/PR) negative, HER2 positive tumor contents, Triple Positive and Triple Negative phenotypes (p<0.00001). Excluding HER2 status, the significant differences in the clinical and tumor characteristics between the two populations persisted after adjusting for age among patients younger than 50 years.Conclusion:The remarkable differences in the clinical and tumor characteristics of breast cancer between the Iraqi and British patients suggest heterogeneity in the underlying biology of the tumor which is exacerbated in Iraq by the dilemma of delayed diagnosis. The significant ethnic disparities in breast cancer profiles recommend the prompt strengthening of the national cancer control plan in Iraq as a principal approach to the management of the disease.

scholarly journals Breast cancer in women: characterization of cases included in the hospital cancer records of the state of São Paulo and factors associated with advanced stadiums

Mastology ◽  
2020 ◽  
Vol 30 (Suppl 1) ◽  
Author(s):  
Raissa Janine de Almeida ◽  
Arthur Felipe Decker ◽  
Carolina Terra de Moraes Luizaga ◽  
Cristiane MurtaNascimento
Keyword(s):  
Breast Cancer ◽  
Clinical Stage ◽  
Sao Paulo ◽  
Age At Diagnosis ◽  
Outcome Variable ◽  
São Paulo ◽  
Female Population ◽  
Level Of Education ◽  
Factors Associated ◽  
Advanced Stages

Introduction: Breast cancer is a worldwide public health problem, being the most common malignancy in the female population. It is a potentially curable disease if diagnosed early. The advanced stage at the time of diagnosis is associated with increased morbidity and low survival of these women. Objectives: To describe the sociodemographic, clinical, and anatomopathological characteristics of breast cancer cases in women included in the São Paulo State hospital cancer database (registros hospitalares de câncer de São Paulo – RHC-SP), established in 2000 and maintained by the Fundação Oncocentro de São Paulo (FOSP) and to investigate the factors associated with the clinical stage at the time of diagnosis. Material and methods: The study design was a series of cases. The sample consisted of women with breast cancer diagnosed between 2000-2014 and included in the RHC-FOSP. The outcome variable was the clinical stage (stage 0-II versus III-IV). The explanatory variables were: age at diagnosis and education level. This study was approved by the Human Research Ethics Committee of the Botucatu Medical School, UNESP. Results: The study included 84,987 women with in situ and invasive breast cancer diagnosed between 2000-2014. The mean age of women at diagnosis was 56.7 years (95%CI 56.6–56.8 years). Sixty-five percent of the cases have complete elementary school or less and the most frequent histological type was ductal carcinoma (77.2%). During the study period, there was a small decrease in the proportion of tumors in more advanced stages, from 39.8% in 2000 to 32.6% in 2014. There was a statistically significant association between the variables age at diagnosis and level of education with the clustered clinical stage of women. Women of older age and those with a higher level of education had reduced odds ratios for tumors in more advanced stages at the time of diagnosis. Conclusion: These findings may contribute to the development of policies for the identification of breast tumors at an earlier stage.

scholarly journals Early detection of breast cancer: influencing factors in treatment

2011 ◽  
Vol 5 (10) ◽  
pp. 2337 ◽  
Author(s):  
Carine Avelar Rubi Pereira ◽  
Leila Luíza Conceição Gonçalves ◽  
Ana Maria De Almeida ◽  
Alessandro Henrique Da Silva Santos ◽  
Ângela Maria Melo Sá Barros ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Detection ◽  
Combined Modality Therapy ◽  
Cáncer De Mama ◽  
Chemotherapy Treatment ◽  
Calidad De Vida ◽  
Advanced Stages ◽  
Las Mujeres ◽  
The City

ABSTRACTObjective: to identify which early detection measures that the women had access to, in which way the neoplasm was detected and clinic stage it was found. Method: forty women undergoing chemotherapy treatment in the city of Aracaju, Sergipe state, Brazil were interviewed from March through October 2009 by an applied questionnaire after free and informed patients’ consent. Method: descriptive-exploratory study with a quantitative approach and the data analysis was done by EPI6 software version 6. The Research Ethics Committee of Sergipe Federal University approved this research via the protocol CAAE-1533.0.000.107-08. The sample consisted of 44 women who underwent chemotherapy for breast cancer enrolled in outpatient oncology Results: number of women with breast cancer has grown quickly. The results showed deficiency in early detection that had reflected in more frequency of aggressive surgical intervention and pre-surgical treatment because of advanced stages and the presence of metastases. Conclusion: the necessity to execute early detection should be recognized by administrators and health professionals to offer less aggressive treatments that result in a greater quality of life and better prognosis. Descriptors: breast neoplasm’s; diagnosis; combined modality therapy; prognosis.RESUMOObjetivo: identificar as medidas de detecção precoce a que as mulheres com diagnóstico de câncer de mama tiveram acesso, de que forma a neoplasia foi descoberta e em que estadio clínico se apresentava. Método: estudo de caráter descritivo-exploratório com abordagem quantitativa, realizado na clínica Onco Hematos Cirurgia, em Aracaju, Sergipe-SE. O período para a coleta dos dados com um instrumento de pesquisa abrangeu os meses de março a outubro de 2009, após aprovação do projeto pelo Comitê de Ética em Pesquisa da Universidade Federal de Sergipe com CAAE-1533.0.000.107-08. A amostra foi constituída por 44 mulheres que realizavam quimioterapia para câncer de mama, cadastradas no ambulatório de oncologia. Os resultados foram apresentados por meio de números absolutos e percentuais obtidos a partir de tabulação do software EPI6, versão 6 e foram comparados com estudos sobre o tema em literatura nacional e internacional. Resultados: o índice de mulheres com câncer de mama tem crescido vertiginosamente. Os resultados revelaram deficiência na detecção precoce que se refletiu na maior frequência de intervenção cirúrgica agressiva e tratamento pré-cirúrgico devido ao estadiamento avançado e presença de metástases. Conclusão: a necessidade da realização das ações de detecção precoce deve ser reconhecida por gestores e profissionais de saúde para que se ofereçam tratamentos menos agressivos que resultem em maior qualidade de vida e melhor prognóstico. Descritores: neoplasias da mama; diagnóstico; terapia combinada; prognóstico.RESUMENObjectivo: identificar las medidas de detección precoz que las mujeres tenían acceso, como se detectó la neoplasia y que estratificación clínica se ha encontrado. Método: cuarenta cuatro mujeres que realizan tratamiento de quimioterapia en la ciudad Aracaju, el estado del Sergipe, Brasil fueran entrevistadas entre marzo y octubre de 2009 por búsqueda aplicada después de autorización de los pacientes libre e esclarecida. Enfoque de carácter descriptivo-exploratorio, se pronunció sobre datos cuantitativos y el análisis fue hecho por el software EPI6 la versión 6. El Comité de Ética del Pesquisa de la Universidad Federal de Sergipe aprobó el estudio por el parecer nº CAAE-1533.0.000.107-08. Resultados: número de mujeres con cáncer de mama crece rápidamente. Los resultados mostraron que la deficiencia en la detección temprana había reflejado en la frecuencia de intervención quirúrgica más agresiva y el tratamiento pre-quirúrgico debido a estratificación avanzada y la presencia de metástasis. Conclusión: la realización de acciones de detección temprana debe ser reconocida por los administradores y profesionales de la salud para ofrecer tratamientos menos agresivos que resulta  en una mayor calidad de vida y un mejor pronóstico. Descriptores: neoplasias de la mama; diagnóstico; terapia combinada; pronóstico.

scholarly journals Time to Start Adjuvant Systemic Treatment in Breast Cancer; a Retrospective Cohort Study

2017 ◽  
Vol 6 (2) ◽  
pp. 60
Author(s):  
Amal Rayan ◽  
Hosam A. Hasan
Keyword(s):  
Breast Cancer ◽  
Adjuvant Treatment ◽  
Systemic Treatment ◽  
University Hospital ◽  
World Health ◽  
Optimal Time ◽  
Time Intervals ◽  
Free Survival ◽  
Adjuvant Systemic Treatment ◽  
The Impact

Background: According to the World Health Organization (WHO), early diagnosis of cancer was associated with increasing rates of survival for cancers as breast, cervix, mouth, larynx, colon, rectum and skin. Still the optimal time to start adjuvant treatment after definitive surgery is uncertainAim of study: to evaluate the impact of delay to start adjuvant treatment in different biologic subtypes of breast cancer on treatment outcomes as regard response, failure free survival (FFS).Patients and methods: It involved 107 patients with nonmetastatic breast cancer presented to clinical oncology department, Assiut university hospital from January 2011 to December 2012, and were eligible for adjuvant systemic treatment, The time from surgery to the start of 1st cycle of adjuvant systemic treatment was calculated, then this time was divided into three time intervals; ≤30 days, >30 - ≤60 days, and >60 days.Results: 41.1%, 45.8%, 13.1% of patients received adjuvant treatment within 30 days, <30-60 days, and more than 60 days respectively, the median failure free survival was 50±2.104 months (95% CI=45.877-54.125) and was significantly decreased with increasing the time but not significantly differed between different time intervals in the whole study patients, nor in different biologic subtypes except luminal B, patients started early adjuvant treatment, relapsed late with significant effect of different time intervals on the time to relapse, local and distant relapses (P<0.000, P<0.001, P<0.02).Conclusion: Adjuvant systemic treatment for breast cancer should be initiated as early as possible better within 30 days of surgery because of significant poor effect of delay to initiate adjuvant treatment on FFS and TTR.

scholarly journals Perfil clínico-epidemiológico de mulheres com neoplasia de mama atendidas no Hospital Regional de Referência no município de Araguaína-TO no período de 2000 a 2015

2016 ◽  
Vol 2 (2) ◽  
pp. 283
Author(s):  
Maianna Macêdo de Sousa ◽  
Sabrina Barreto Figueredo ◽  
Reinaldo Magalhães Fernandes
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Early Detection ◽  
Regional Hospital ◽  
Alcoholic Beverages ◽  
World Health ◽  
Cáncer De Mama ◽  
Unknown Etiology ◽  
Data Generation ◽  
Epidemiological Profile

O câncer de mama é uma neoplasia rara antes dos 35 anos de idade, acometendo em cerca de 99% as mulheres. Ainda possui etiologia desconhecida, no entanto apresenta alguns fatores de risco importantes, tais como: menarca precoce antes dos 12 anos, menopausa tardia acima de 50 anos, primeira gestação acima de 35 anos, nuliparidade, idade, fatores genéticos, além de fatores relacionados à estilo de vida como consumo de tabaco e histórico de consumo de bebidas alcoólicas. No Brasil, o câncer de mama também é o mais incidente (excluídos os tumores de pele não melanoma) em mulheres de todas as regiões, exceto na região Norte, onde o câncer do colo do útero ocupa a primeira posição. De acordo com a Organização Mundial de Saúde (OMS) como ação de prevenção secundária, ou seja, de detecção precoce do câncer de mama, são mencionadas três estratégias complementares entre si, que são: o auto-exame das mamas, o exame clínico e a mamografia, sendo que tais fatores podem ser influenciados pelo nível de escolaridade das mulheres. É incomum a associação com fatores hereditários, sendo de suma importância a detecção e tratamento precoces adequados de forma a contribuir para um prognóstico favorável. Objetivo: Descrever o perfil clínico-epidemiológico das Neoplasias de Mama em pacientes do sexo feminino atendidas no Hospital Regional de Referência de Araguaína-TO, no período de 2000-2015. Metodologia: Quanto à natureza o estudo pode ser classificado como quantitativo, pois se baseará na geração de dados e na análise crítica dos mesmos. Será de caráter descritivo, retrospectivo e documental realizado no Hospital Regional de Referência de Araguaína através de informações que serão coletadas por meio da análise de fichas do Registro Hospitalar do Câncer disponibilizadas pelo Instituto Nacional do Câncer (INCA).Palavras-chave: Câncer de Mama – perfil clínico-epidemiológico e fatores de risco ABSTRACTBreast cancer is a rare neoplasm before 35 years of age, affecting approximately 99% women. Still has unknown etiology, however presents some important risk factors, such as: early menarche before 12 years, late menopause above 50 years, first pregnancy above 35 years, nulliparity, age, genetic factors, in addition to factors related to lifestyle as the consumption of tobacco and history of consumption of alcoholic beverages. In Brazil, breast cancer is also the most incident (excluding non-melanoma skin tumors) in women of all regions, except in the northern region, where the cervical cancer occupies the first position. According to the World Health Organization (WHO) as secondary prevention action, i.e. for early detection of breast cancer, are mentioned three complementary strategies among themselves, which are: the breast self-exam, the clinical examination and mammography, being that such factors may be influenced by the level of education of women. It is uncommon to association with hereditary factors and highlighted the importance of early detection and treatment appropriate to contribute to a favorable prognosis. Objective: To describe the clinical-epidemiological profile of Breast Neoplasms in female patients answered the Regional Hospital of reference in the municipality of Araguaína- TO, in the period 2000-2015. Methodology: As to the nature of the study can be classified as quantitative, because it is based on data generation and critical analysis of the same. Will be a descriptive, retrospective and documentary checks carried out at the Regional Hospital of reference in the municipality of Araguaína- TO through the information that will be collected by means of the analysis of the connectors of the Cancer Hospital Registry made available by the National Cancer Institute. Keywords: Breast Cancer - clinical- epidemiological profile and risk factors

Evaluación Y Manejo De La Enfermedad Temprana Y Localmente Avanzada: 1er Consenso Nacional Del Cáncer De Mama de la Sociedad Panameña de Oncología (SPO)

2019 ◽  
Vol 39 (02) ◽  
Author(s):  
Alejandro Crismatt Zapata ◽  
Moises Cukier Barahona ◽  
Erick Arauz ◽  
Irma Barrera ◽  
Maylin Ruiz ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Advanced Breast Cancer ◽  
Systemic Treatment ◽  
Advanced Disease ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Local Treatment ◽  
Cáncer De Mama ◽  
Molecular Characteristics ◽  
Treatment Surgery

[Evaluation and Management of Early and Locally Advanced Disease: 1st National Consensus of Breast Cancer of the Panamanian Society of Oncology (SPO)]<br /><br />Resumen<br />El manejo de los pacientes con cáncer de mama temprano o localmente avanzado requiere de la evaluación inicial de un grupo de médicos familiarizados con el diagnóstico, estadificación y tratamientos de estas enfermedades, de tal manera que se pueda optimizar los resultados no solamente oncológicos (Curación), sino también cosméticos. La decisión sobre el tratamiento local (cirugía y Radioterapia) y sistémico (Quimioterapia y Hormonoterapia) está basada en las características clínicas y moleculares de tumor, así como por las preferencias del paciente.<br /><br />Summary<br />The management of patients with early or locally advanced breast cancer requires the initial evaluation of a group of physicians familiar with the diagnosis, staging and treatment of these diseases, in order to optimize the results not only oncological (Healing), but also cosmetics. The decision on local treatment (surgery and Radiotherapy) and systemic treatment (Chemotherapy and Hormonotherapy) is based on the clinical and molecular characteristics of the tumor, as well as on the patient's preferences.<br /><br /><br />

scholarly journals Current State of the Art in the Adjuvant Systemic Treatment of Premenopausal Patients With Early Breast Cancer

2020 ◽  
Vol 14 ◽  
pp. 117955492093181
Author(s):  
Francesca Parisi ◽  
Maria Grazia Razeti ◽  
Eva Blondeaux ◽  
Luca Arecco ◽  
Marta Perachino ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Breast Cancer ◽  
Systemic Treatment ◽  
Premenopausal Women ◽  
Specific Patient ◽  
Adjuvant Systemic Treatment ◽  
Current State ◽  
Age Related ◽  
Advanced Stages ◽  
Premenopausal Patients

Breast cancer is the most frequent malignancy diagnosed in premenopausal women. In this age group, breast tumors tend to be diagnosed at more advanced stages and to harbor more aggressive biological features. In addition, specific age-related issues including genetic counseling, fertility preservation, impact on social and couple relationships, working life, and management of long-term side effects should be considered highly relevant when managing early breast cancer in premenopausal women. Therefore, the care of these patients is particularly complex and a multidisciplinary approach is mandatory. The present review summarizes the current state of art in the adjuvant systemic treatment of premenopausal women with early breast cancer focusing on the optimal chemotherapy, endocrine therapy, and targeted therapy approaches in this specific patient population.

STUDY OF SURGICAL MANAGEMENT AND COMPLICATIONS OF DIABETIC FOOT ULCER

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Dr. Devi Das Verma ◽  
Dr. Anil Kumar Saxena
Keyword(s):  
Health Problem ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
World Health ◽  
Foot Ulcers ◽  
Age Group ◽  
Major Health Problem ◽  
Split Skin Grafting ◽  
Foot Problems

Introduction:  Diabetes is one of the most prevalent metabolic chronic diseases due to the imbalance production of insulin. One of the studies reported that in 2010 worldwide 285 million adults had diabetes and this figure may be increase to 439 million by the year 2030. Globally Diabetic foot ulcers (DFUs) constitute major health problem in people that significantly contribute to morbidity and mortality in diabetes patients. Approximate 1.0% to 4.1% of the annual population-based incidences of a diabetic foot ulcer (DFU) were reported. Due to this the lifetime may be as high as 25%. In Asian countries diabetic foot ulcer are major problems which are different from European countries or developing countries.  From many studies reported diabetic foot problems in India are infectious and neuropathic in nature as compared to developed countries. According to World Health Organization (WHO) diabetic foot is defined as lower limb of a diabetic patient characterized by infection, potential risk of pathologic consequences ulceration or destruction of deep tissues associated with neurological abnormalities, various changes in peripheral neuropathy vasculopathy and superimposed infection that are mainly responsible foot ulceration. Ulcers are one kind of abscess which is difficult to treat because of poor wound healing that result from a combination of neuropathy, ischemia and hyperglycemia.  Aim: The main objective was to study the outcome of treatment modalities and it’s relating factors to complication in diabetic foot ulcer.  Material and method:  Total 60 diabetic foot ulcer patients with the age range from 20 to 70 years were included.  From all the patients’ detailed past and present history were recorded.  For all the patients, general, physical and local and systemic examinations were also done. Detail   laboratory examination like Fasting and Post Prandial Blood sugar levels, blood count, ECG, ESR, complete urine examination for the presence of ketone bodies and sugar, x-ray as well as culture and sensitivity of the discharge from ulcer were also done. Patients were treated with various treatment methods like conservative treatment, split skin grafting and amputation. Result: In this study male patients were more in proportion as compared to female. This study showed that maximum with the age group 14 -50 (43.3%) years old followed by 18.3% in 31-40 years old, 16.7% in 61-70 years old.  6.7% showed the least age group as 20 -30 years old.  Out of total 60 patients, 38.3% of the patients showed diabetic ulcer foot which was more whereas 15% showed diabetic gangrene foot which was least. 25% showed diabetic cellulites foot and 21.7% showed as diabetic abscess foot.  Conclusion: Globally as diabetes mellitus cases are increasing and it became rapidly the public health problem. This may be due to burden on economy, health system and on society to manage the diabetic foot problems. Diabetic foot management guidelines must be made into our practice protocols which may preventing limb loss, and decrease mortality and increase the quality of life of the patient. Hence for this it is only possible with the help of foot care education and health care workers.  Hence, foot infection is to put first and care for it like hands. Keywords: Diabetes, foot ulcers, infections, amputations.

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