Navegando por Palavras-chave "mamografia"
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- ItemSomente MetadadadosAspectos de imagem dos sarcomas primários da mama: revisão da literatura e série de casos(Universidade Federal de São Paulo (UNIFESP), 2016-12-21) Alves, Aldo Maurici Araujo [UNIFESP]; Mello, Giselle Guedes Netto de Mello [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objective: To review the imaging aspects of primary breast sarcomas (PMS). Methods: a qualitative observational study through a series of case reports and literature revision. Cases of PMS were collected with histopathological confirmation And accessible imaging (mammography, ultrasound or magnetic resonance imaging), From two university hospitals and a private service. The literature review was Performed through the search of indexed works in the MEDLINE database. Results: 10 cases were found within the selection criteria, and their respective Findings were presented and discussed together with the literature. Conclusion: there is significant overlap between the mammographic findings, And magnetic resonance imaging of mammary carcinomas and sarcomas. However, a rapidly growing circumscribed mass without calcifications in the Mammography, without axillary lymph node involvement, complex-appearing solid-cystic On ultrasound and magnetic resonance imaging may suggest a PMS.
- ItemSomente MetadadadosAvaliação do rastreamento mamográfico oportunístico da rede SUS do estado da Paraíba no período de 2010 à 2012(Universidade Federal de São Paulo (UNIFESP), 2014-07-17) Ramos, Maria Magdala de Brito [UNIFESP]; Lederman, Henrique Manoel Lederman [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Purpose: to calculate mammograms coverage of the unifed health system of the state of Paraíba (SUS/PB) compared to other states; to analyze mammography and breast pathology results and their intercessions; to assess the BI-RADS as a predictive factor for malignancy in non-palpable breast lesions in categories 4 and 5 correlated with histopathologic results. Methods: This descriptive exploratory study of qualitative and quantitative population-based SUS/PB was carried out from 2010 to 2012 in women aged 40-69 years. In the analysis of test results were considered three dimensions: service providers, users of SUS and pathological examinations and mammograms. Coverage and the positive predictive value (PPV) were calculated. Results: Screening mammography was 98.36% and diagnostic mammography was 1.64%; BI-RADS categories 0, 1, 2, 3, 4 and 5 was 11.5%, 54%, 31%, 2%, 1.5% and 0.12%, respectively. The frequency of BI-RADS categories 4 and 5 increased considerably after 40 years; 3% of the women with mammography BI-RADS 4 and 5 had histopathological test and 1.5% had Pap tests. Regarding the evaluation of malignant neoplastic lesions size, 32% were < 2 cm, 21% between 2-5 cm, 2.3% > 5 cm and 43% without information. The mammography coverage of SUS/PB was 17%, equivalent to the state of Goiás (14%) and lesser than that of Paraná (27%) and São Paulo (58%). The PPV was 0.4%. Conclusion: The lack of information quality recorded in the data base consulted interfered impactful in evaluating the mammography, histopathology and cytopathology results and their intersections. This fact prevents a more reliable epidemiological study on the profile and evolution of the disease in the state of Paraíba.
- ItemSomente MetadadadosConhecimento de mulheres atendidas em um ambulatório de mastologia sobre o autoexame, rastreamento e fatores de risco do câncer de mama(Universidade Federal de São Paulo (UNIFESP), 2015-01-31) Watanabe, Andrea Yumi [UNIFESP]; Nazario, Afonso Celso Pinto Nazario [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: Breast cancer is one of the main public health problems in Brazil. It is the most common type of cancer affecting women in the majority of the country?s regions. Early diagnosis is a fundamental factor for a successful treatment and prognosis. Today there are three strategies in this regard: breast self-examination, clinical breast examination and mammography. In Brazil, yearly clinical examination and mammography are the recommended strategies. And, although there is noevidence that breast self-examination (BSE) reduces mortality, it is widely encouraged, since little more than half of the Brazilian women have access to mammography and breast clinical examination. Due to the high incidence of breast cancer, media is constantly talking about this subject. However, information is often inaccurate, causing myths to arise. Objective: Evaluate the knowledge of patients at breast health clinic of UNIFESP-EPM about breast self-examination and its practice, and evaluate knowledge about screening and risk factors for breast cancer. And correlate these results to demographics variables of the studied population.Methods: 202 female patients were interviewed, chosen randomly among those who awaited at the Breast Health Clinic of UNIFESP-EPM. They were given a structured questionnaire, which included socio-demographic variables and questions to assess the knowledge about breast self-examination, screening and risk factors for breast cancer. Results: The majority of patients knew about the existence of the breast selfexam (93,1%). However, only 9,4% had an adequate knowledge about it. Most of the patients performed BSE (64,9%), but only 20,3% did it properly. Among the ones who did not perform the self-exam, 36,2% stated that they forgot about it. Only 21,8% of the interviewees demonstrated knowledge about the most recommended screening method, the age they should start to be screened at and how often they should be screened. 17,3% had adequate knowledge about risk factors for breast cancer. The analysis of the socio-demographic variables revealed that older women, who had been through the menopause and who have had lower education had a better knowledge of the proper execution of BSE. Women who had been through the menopause also demonstrated to have better knowledge about it. Women with more years of education had less knowledge about the mammographic screening. Conclusion: Overall, the patients did not exhibit adequate knowledge about the self-exam, the mammographic screening and the risk factors for breast cancer. They also did not perform BSE properly, specially among more educated patients. These data show that public information campaigns about BSE and, above all, mammography should be reinforced, regardless of the patient?s level of education or income.
- ItemSomente MetadadadosCorrelação entre mamografia, escore de cálcio e doença coronariana em mulheres assintomáticas de risco intermediário pelo escore de framingham(Universidade Federal de São Paulo (UNIFESP), 2015) Timbo, Luciana Satiro [UNIFESP]; Szarf, Gilberto Szarf [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objectives: to correlate the presence and intensity of breast arterial calcifications (BAC) with the coronary calcium score (CCS) and the risk of developing myocardial ischemia, stroke, heart attack and death from coronary causes in five years in patients at intermediate risk by Framingham criteria. Methods: 45 patients at intermediate risk with previous indication of routine mammography, performed CCS. Each method was analyzed separately by specialist physicians without knowledge of the results. The presence and intensity of BAC were graded as follows: absent (no vascular calcifications); slight (one vascular segment), moderate (one whole vessel) and severe (two or more vessels). CCS was rated at zero, slight (1-100), moderate (101-300) and severe (greater than 300). The data were compared using appropriate statistical tools. The patients will be followed for five years. Results: the mean age was 59,6 years. The finding of BAC was diagnosed in 15 patients (4 slight, 3 moderate and 8 severe), 38, not present. The CCS was abnormal in 20 cases (10 slight, 6 moderate and 4 severe) and equal to zero in 33. There was predominance of absence of BAC and zero CCS in patients with low Framingham score. It was observed that exists a statistically significant association (p <0.05) between the presence of intramammary and coronary vascular calcifications. Intensity correlation between methods was not found. Among the risk factors evaluated for coronary artery disease, there was association statistically significant (p <0.05) between age and breast arterial calcfications, as well as age and coronary calcifications. So far, no cardiovascular event was noted. Conclusions: there is relationship between BAC and CCS in women at intermediate risk of cardiovascular disease; intensity correlation between methods was not significant; in the first 20 months of this ongoing research, no case of myocardial ischemia, stroke, heart attack and death from coronary causes was observed
- ItemSomente MetadadadosCorrelação entre mamografia, escore de cálcio e doença coronariana em mulheres assintomáticas de risco intermediário pelo escore de framingham(Universidade Federal de São Paulo (UNIFESP), 2013-11-29) Timbo, Luciana Satiro [UNIFESP]; Szarf, Gilberto Szarf [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objectives: to correlate the presence and intensity of breast arterial calcifications (BAC) with the coronary calcium score (CCS) and the risk of developing myocardial ischemia, stroke, heart attack and death from coronary causes in five years in patients at intermediate risk by Framingham criteria. Methods: 45 patients at intermediate risk with previous indication of routine mammography, performed CCS. Each method was analyzed separately by specialist physicians without knowledge of the results. The presence and intensity of BAC were graded as follows: absent (no vascular calcifications); slight (one vascular segment), moderate (one whole vessel) and severe (two or more vessels). CCS was rated at zero, slight (1-100), moderate (101-300) and severe (greater than 300). The data were compared using appropriate statistical tools. The patients will be followed for five years. Results: the mean age was 59,6 years. The finding of BAC was diagnosed in 15 patients (4 slight, 3 moderate and 8 severe), 38, not present. The CCS was abnormal in 20 cases (10 slight, 6 moderate and 4 severe) and equal to zero in 33. There was predominance of absence of BAC and zero CCS in patients with low Framingham score. It was observed that exists a statistically significant association (p <0.05) between the presence of intramammary and coronary vascular calcifications. Intensity correlation between methods was not found. Among the risk factors evaluated for coronary artery disease, there was association statistically significant (p <0.05) between age and breast arterial calcfications, as well as age and coronary calcifications. So far, no cardiovascular event was noted. Conclusions: there is relationship between BAC and CCS in women at intermediate risk of cardiovascular disease; intensity correlation between methods was not significant; in the first 20 months of this ongoing research, no case of myocardial ischemia, stroke, heart attack and death from coronary causes was observed
- ItemAcesso aberto (Open Access)Densidade mamográfica e polimorfismos do gene do receptor de estrogênio MspI e do receptor de progesterona PROGINS em índias do estado do Amapá(Universidade Federal de São Paulo (UNIFESP), 2013-08-28) Secco, Jose Mauro [UNIFESP]; Nazario, Afonso Celso Pinto [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Background: Mammographic density is known to be one of the main risk factors for breast cancer and presents individual variations due to various factors. It is also of scientific knowledge that the indigenous groups present less dense breasts compared with non-indigenous populations, and that breast cancer is rare in this ethnic group. This study aims to evaluate the clinical characteristics of indigenous population of the state of Amapá and also the MspI and PROGINS polymorphisms of the estrogen and progesterone receptor genes, associating them with the mammographic density in indians who had never undergone mammography. Knowing that the clinical characteristics and sex steroids affect mammographic density, we sought the finding of low mammographic density in this population and some explanation for the difference in mammographic density and in breast cancer incidence. Methods: We studied 135 women of indian ethnicity without clinical or mammographic alterations and who had never used hormone therapy. All of them were transported to the state capital Macapá to undergo interview, bilateral mammography and collection of biological material. The interview was held at the Indian House through local interpreter; mammographic density was determined by three independent observers, two subjective evaluations were based on the classification of the ACR-BI-RADS® 2003 and another was computerized (software Adobe PhotoshopÒ, v. 10.0). Blood samples were taken for DNA extraction according to the illustra Kit protocol (GE Healthcare) and then PCRRFLP (polymerase chain reaction - restriction fragment polymorphism length) was held for analysis of MspI and PROGINS polymorphisms in the estrogen and the progesterone receptor genes. Result: High agreement was found in mammographic density between observers through Pearson's correlation coefficients R, Spearman Correlation and Kappa, with p = 0.001. We found 82% of Indian women with not dense breasts and 18% with dense breasts, with a mean age of 50.4 years. The clinical characteristics associated with mammographic density were age (p = 0.0001), FSH levels (p < 0.001) and estrogen levels (p < 0.01). There was no statistical difference between the groups of dense and not dense breasts for PROGINS and ER-MspI polymorphisms genotypes. Conclusion: Mammographic density in indian women is predominantly low, regardless of menopausal status. Mammographic density is significantly associated with age menopausal status, FSH and E2 levels in this population. The PROGINS polymorphism was found in 3.7% of the women and Mspl in 84.4%. No correlation was found of polymorphism with mammographic density.
- ItemSomente MetadadadosEstudo longitudinal da qualidade da imagem mamográfica em sistemas digitais associado ao processo de otimização da dose glandular média(Universidade Federal de São Paulo (UNIFESP), 2014-06-11) Alves, Fatima Faloppa Rodrigues [UNIFESP]; Medeiros, Regina Bitelli Medeiros [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objective: Contribute to the development of practices that may assist AGD?s optimization process associated to image quality in digital systems (CR and DR). Method: Two pieces of mammographic equipment (Lorad and Performa) were tested regarding performance with CR Kodak system and with Digital mammographic equipment (DR) GE, and image viewing systems have been assessed in the period between January/ 2012 to January/2014. IPS uniformity was checked in outpatient routine until July/2013 and, after their replacement, in October/2013. AGDs were calculated using PMMA semicircular plates with 1 and 2 mm thickness, and physical properties of images were assessed through quality parameters: FTM, SNR, CNR and FOM. Regarding breast tissue, AGDs were estimated in MLOE projection according to mammographic density through a databank with information from 1071 patients including: age, biometry and operational technical data of the exams. An electronic spreadsheet made it possible to obtain mAs values so as to keep AGDs below European protocol limits, and, at the same time, to maximize CNR values. Simulated image quality and structure detection were performed with CIRS-11A phantom. Mammographic image quality was analyzed based on the quality criteria recommended by IAEA. Results: IPs uniformity ranged between 9,9% and 92,3% from January/ 2012 to July/2013, and after these IPs were changed, uniformity ranged less than 7%. AGD values were above Euref?s limits for both PMMA and breast tissue, for most of the period between March/2012 and July/2013, in Lorad and Performa equipment. In the Digital System, AGDs remained within Euref?s PMMA and breast tissue limits. However, regarding mammographic density, AGDs were inferior in the Digital System. FTM, SNR and CNR parameters remained above Euref?s reference limits in the same period in which nonconformity of IPs? uniformity was observed. After IPs were replaced, mAs was on average reduced in 30% and 10%, with average CNR gain of 13% and 7% in Lorad and Performa equipment. Detection simulator?s structure ranged between 0,165 and 0,275mm for microcalcification and between 1,19 and 2,38mm for tumor mass, but there was no variation in detection of fibers. In clinical image analysis, although 99% of the images were considered acceptable for diagnosis, in 62% of the cases it was not possible to view the pectoral muscle in left CC positioning, and in 44% the angle of inframammary fold in left MLO projection, which can be attributed to positioning error. Specific viewbox luminance values were out of the limits set by the norm 543/98. Monitors had luminance superior to 500cd/m2. Conclusion: It is suggested, as a practical method, monthly CNR and SNR analysis, and the use of an electronic spreadsheet is suggested, so as to reduce time and make AGDs optimization process easier. The deterioration of IPs caused increase in AGDs, loss in image quality and variation in uniformity, in SNR, in FTM and in FOM which points to the necessity of establishing an IP uniformity base line and other quality parameters. Monitoring quality of clinical images allowed the detection of failures in positioning, highlighting the need for training. AGDs that were calculated in Digital System were inferior to the CR system, showing differences between technological characteristics. The use of different target/filter combinations, as well as a superior output in Digital System, may have contributed to achieving lower doses. It stresses the necessity to establish specific quality tests and to establish a revision of norms for Digital Systems in Brazil.