Navegando por Palavras-chave "Segmental mastectomy"
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- ItemAcesso aberto (Open Access)Cirurgia mamária em mulheres com câncer de mama metastático. Revisão sistemática Cochrane e metanálise(Universidade Federal de São Paulo (UNIFESP), 2018-06-28) Tosello, Giuliano Tavares [UNIFESP]; Riera, Rachel [UNIFESP]; http://lattes.cnpq.br/0591884301805680; Tosello, Giuliano Tavares; Universidade Federal de São Paulo (UNIFESP)Objective: To evaluate the efficacy of breast surgery in patients with metastatic breast cancer. Methods: A systematic review was conducted according to the Cochrane methodology. The electronic search was performed on February 22, 2016, using the MeSH terms "breast neoplasms", "mastectomy" and "analysis, survival" in the following electronic databases: the Cochrane Breast Cancer Specialized Register, CENTRAL, MEDLINE (by PubMed), EMBASE (by OvidSP), LILACS, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform. Hand search on citation reference lists and contact with study authors to identify additional studies completed the search procedures. Randomized clinical trials with women diagnosed with metastatic breast cancer, comparing breast surgery associated with systemic therapy versus systemic therapy, were included. Two independent researchers evaluated the studies obtained in the electronic search regarding the eligibility criteria and the risk of bias. The risk of bias in the included studies was assessed by the Cochrane Risk of Bias tool. The quality of the evidences was evaluated using the GRADE tool. The risk ratio (RR) was used to measure the treatment effect for dichotomous outcomes, mean differences (MD) for continuous outcomes, and risk ratio (HR) for timetoevent outcomes. Confidence intervals of 95% (95% CI) were calculated for these measures. The primary outcome was overall survival and quality of life. Secondary outcomes were progressionfree survival (local and distance control), breast cancerspecific survival and toxicity from local therapy. Results: Two randomized clinical trials involving 624 participants were included. Breast surgery did not improve the overall survival of women with metastatic cancer (HR = 0.83, 95% CI 0.531.31, very lowquality evidence), but the progressionfree survival site was 78% better (HR = 0.22, 95% CI 0.08 0.57, low quality evidence), and metastatic progressionfree survival worsened by 40% (HR 1.42, 95% CI 1.081.86, moderate quality evidence). Conclusion: Based on poor quality evidence from two randomized clinical trials, it is not possible to reach definitive conclusions about the risks and benefits of breast surgery in women with metastatic breast cancer.
- ItemAcesso aberto (Open Access)Depression and conservative surgery for breast cancer(Faculdade de Medicina / USP, 2010-01-01) Medeiros, Mauriceia Costa Lins de [UNIFESP]; Veiga, Daniela Francescato [UNIFESP]; Sabino Neto, Miguel [UNIFESP]; Abla, Luiz Eduardo Felipe [UNIFESP]; Juliano, Yara; Ferreira, Lydia Masako [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade do Vale do Sapucaí Department of BiostatisticsBACKGROUND: Depression is prevalent among women and associated with reduced quality of life, and therefore it is important to determine its incidence in adult women, especially in those with breast cancer. OBJECTIVE: To determine the occurrence of depression in women who underwent conservative surgery for breast cancer with or without breast reconstruction. METHODS: Seventy-five women aged between 18 and 65 years were enrolled. Patients had undergone conservative surgery for breast cancer with immediate breast reconstruction (n = 25) or without breast reconstruction (n = 25) at least one year before the study. The control group consisted of 25 women without cancer, but of similar age and educational level distribution as the other two groups. The Beck Depression Inventory was used to measure depression. The collected data were assessed using analysis of variance and the χ2 test. RESULTS: There were no significant differences between groups in age (p = 0.72) or educational level (p = 0.20). A smaller number of patients had undergone the menopause (p = 0.02) in the control group than in other groups. There were no significant differences in occurrence of depression between groups (χ2=9.97; p = 0.126). CONCLUSÍON: Conservative surgery for breast cancer did not affect the occurrence of depression in women, regardless of whether breast reconstruction was performed.
- ItemSomente MetadadadosEvaluations of aesthetic outcomes of oncoplastic surgery by surgeons of different gender and specialty: A prospective controlled study(Churchill Livingstone, 2011-10-01) Veiga, Daniela F. [UNIFESP]; Veiga-Filho, Joel [UNIFESP]; Ribeiro, Leda M.; Archangelo-Junior, Ivanildo; Mendes, Denise A.; Andrade, Vanessa O.; Caetano, Leci V.; Campos, Fabiola S. M.; Juliano, Yara; Ferreira, Lydia M. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Univ Vale do SapucaiThis prospective trial was designed to assess aesthetic outcomes of oncoplastic surgery. Standardized photographs were taken of 45 breast cancer patients undergoing oncoplastic surgery, preoperatively and Sand 12 months postoperatively (oncoplastic group), and of 45 patients treated by conservative surgery without breast reconstruction (control group). Photographs were assessed by senior male and female physicians, 2 breast surgeons and 2 plastic surgeons. Aesthetic outcomes were evaluated using patients' own assessments (rated 0 to 10) and scoring by panelists (using 0 to 10 global rating scales and a subscales system). Patients in both groups scored the aesthetic outcomes better than physicians did. Panelists and patients considered aesthetic outcomes of oncoplastic group better than control group outcomes. Patients and plastic surgeons attributed progressively higher grades to outcomes of oncoplastic group at 6 and 12 months postoperatively: breast surgeons did not. Overall, female physicians and breast surgeons scored better the aesthetic outcomes of both groups. (C) 2011 Elsevier B.V. All rights reserved.