Navegando por Palavras-chave "Breast"

Agora exibindo 1 - 20 de 46
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Ação dos esteroides ovarianos sobre a quantidade dos glicosaminoglicanos sulfatados e do ácido hialurônico nas mamas de ratas ovariectomizadas
    (Universidade Federal de São Paulo (UNIFESP), 2016-11-17) Torres, Sueli Maria Preda dos Santos [UNIFESP]; Simoes, Manuel de Jesus [UNIFESP]; http://lattes.cnpq.br/5987164343458678; http://lattes.cnpq.br/2539410198240163; Universidade Federal de São Paulo (UNIFESP)
    The extracellular matrix (ECM) act an essential role in the function of mammary epithelial cells and glycosaminoglycans have long been attracting clinical interest in all areas of medicine for their important role in cell recognition, migration, cell proliferation and differentiation. OBJECTIVE: Evaluate the morphology and the concentration of glycosaminoglycans in the breast of female rats treated with estrogen and/or progesterone. MATERIAL AND METHODS: Sixty female rats were divided into six groups with 10 animals each: G1 (5 months) and GII (18 months) in the proestrus phase were treated with vehicle; the other animals were ovariectomized, and immediately after were treated with vehicle (GC) or with hormones ? (GE) treated with oestradiol benzoate (37.6 mg/animal); (GP) ? treated with medroxyprogesterone acetate (11.28 mg/animal) and (GEP) ? treated with oestradiol benzoate (37.6 mg/animal), more medroxyprogesterone acetate (11.28 mg/animal). In the GE group, the oestradiol was administered subcutaneously for seven days; in the GP group, the progestogen was administered subcutaneously for 23 dats; in the GEP group, the oestradiol was administered once a day in the first seven days and the progestogen throughout the next 23 days, subcutaneously. Twenty four hours after the last administration of hormones, the animals were euthanized, and the first pairs of inguinal breasts were removed, part of them being fixated in formaldehyde at 10% (morphological evaluation) and the other part submerged in acetone (evaluation of the glycosaminoglycans). The material destined to the morphology was included in paraffin, and the cuts were stained by hematoxylin-eosin. The material destined to the biochemistry was processed to the electrophoresis in agarose gel to sulfated GAGs analysis, and the hyaluronic acid was analyzed with a Elisa-Like fluorimetric method. The statistical analysis was made by the analysis of variance (ANOVA) followed by the Bonferroni test (p<0.05). RESULTS: The breasts of the groups with ovaries (GI and GII) as well as the ovariectomized control group (GC) have shown to be atrophic, wherein we observed typical alveoli with secretion in the lumen in the groups (GE) and (GEP); yet in the animals treated with progestogen (GP), we noticed alveoli formed basically by cells that occupied almost all the alveolar light. In relation to the data of the sulfated glycosaminoglycans we noticed higher concentration in the oophorectomized group (GC) due to high concentration of dermatan sulfate (GC = GE > GP = GEP > GII = GI; p<0.05). And in relation to the hyaluronic acid we found higher concentration in the animals of five months (GI > GII, GC, GE, GEP > GP; p<0.005).CONCLUSION: Oestradiol and progesterone had a trophic effect in the breast parenchyma. However, the administration of oestradiol beforehand changes the action of progesterone in the rat?s mammary tissue.
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Acurácia diagnóstica da biópsia percutânea com agulha grossa orientada por estereotaxia nas lesões mamárias categoria BI-RADS® 4
    (Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2007-12-01) Moutinho, Maria Silvia Petty [UNIFESP]; Elias, Simone [UNIFESP]; Kemp, Claudio [UNIFESP]; Nazário, Afonso Celso Pinto [UNIFESP]; Baracat, Edmund Chada [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)
    PURPOSE: to assess the accuracy (rate of correct predictions) of stereotactic core needle biopsy (CNB) of risk category BI-RADS® 4 breast lesions. METHODS: a retrospective analysis of category BI-RADS® 4 breast lesions that had been submitted to a stereotactic core-needle biopsy from June 1998 to June 2003. Patients with histological benign results consistent with the radiographic image were referred to mammographic follow-up. Patients with malign diagnosis and papillary lesions were submitted to standard specific treatment. Excisional biopsies were performed when results were benign, but in disagreement with the mammographic image. It was considered as a gold-standard attendance: (1) the mammographic follow-up of low suspicion lesions with benign results at CNB, which stayed unchanged for, at least, three years, and (2) surgical resection when specimen results were malign or benign, but with a high suspicion on mammography. Sensitivity (S) specificity (E) and overall accuracy of stereotactic CNB were statistically analyzed. RESULTS: among the 118 non-palpable lesions of category BI-RADS® 4 submitted to CNB, the results obtained were: 27 malign cases, 81 benign, and ten lesions with atypical or papillary lesions. The statistical analysis comprised 108 patients (atypical and papillary lesions were excluded). CNB sensitivity was 87.1% and specificity 100%. The positive predictive value was 100% and the negative, 95.1%. False negatives occurred in 3.7% (4/108) of cases. The prevalence of malign diagnostics in the BI-RADS® 4 lesions of this sample was 29.7 (31/118).The accuracy of this method in this casuistic was 96.3%. CONCLUSIONS: these results support stereotactic CNB as an extremely reliable alternative to open biopsy, in the diagnosis and definition of breast lesions. In positive results, it is possible to indicate the appropriate therapy, and, in negative (when mammography shows low suspicion), it allows a follow up.
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Adenomyoepithelioma with malignant transformation diagnosed by immunohistochemical analysis: case report
    (Sociedade Brasileira de Patologia ClínicaSociedade Brasileira de PatologiaSociedade Brasileira de Citopatologia, 2011-10-01) Rossetti, Claudia; Azzalis, Ligia Ajaime [UNIFESP]; Junqueira, Virginia Berlanga Campos [UNIFESP]; Guidoni, Regina Maria; Gomes, Mara Regina Alcalá; Fonseca, Fernando Luiz Affonso [UNIFESP]; Faculdade de Medicina do ABC Serviço de Patologia da Mama; Universidade Federal de São Paulo (UNIFESP); FMABC; Hospital Heliópolis
    Adenomyoepitheliomas (AMEs) are rare breast lesions, which are characterized by the proliferation of epithelial and myoepithelial cells. They are circumscribed lesions, which can be clinically and mammographically detected. However, when they are indistinctly limited, differential diagnosis with malignant lesions becomes difficult. In this paper, we report a case of adenomyoepithelioma with malignant transformation of the myoepithelial component, a rare histological type that arises from the malignant transformation of epithelial, myoepithelial, or both elements. Its course and prognosis are uncertain. Mastectomy with sentinel lymph node biopsy followed by radiotherapy are the most effective treatment approaches.
  • Nenhuma Miniatura disponível
    Item
    Somente Metadadados
    Anthropometry of the Breast Region: How to Measure?
    (Springer, 2014-04-01) Espírito Santo, Paulo Rogério Quieregatto do [UNIFESP]; Hochman, Bernardo [UNIFESP]; Ferrara, Soraia F. [UNIFESP]; Furtado, Fabianne [UNIFESP]; Liebano, Richard E. [UNIFESP]; Sabino Neto, Miguel [UNIFESP]; Ferreira, Lydia M. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Breast region measurements are important for research, but they may also become significant in the legal field as a quantitative tool for preoperative and postoperative evaluation. Direct anthropometric measurements can be taken in clinical practice. the aim of this study was to compare direct breast anthropometric measurements taken with a tape measure and a compass.Forty women, aged 18-60 years, were evaluated. They had 14 anatomical landmarks marked on the breast region and arms. the union of these points formed eight linear segments and one angle for each side of the body. the volunteers were evaluated by direct anthropometry in a standardized way, using a tape measure and a compass.Differences were found between the tape measure and the compass measurements for all segments analyzed (p > 0.05).Measurements obtained by tape measure and compass are not identical. Therefore, once the measurement tool is chosen, it should be used for the pre- and postoperative measurements in a standardized way.This journal requires that authors assign a level of evidence to each article. for a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Application time for postoperative wound dressing following breast augmentation with implants: study protocol for a randomized controlled trial
    (Biomed Central Ltd, 2015-01-27) Mendes, Denise de Almeida [UNIFESP]; Veiga, Daniela Francescato [UNIFESP]; Veiga-Filho, Joel [UNIFESP]; Fonseca, Fernando Elias Martins; Paiva, Luiz Francisley de; Novo, Neil Ferreira; Loyola, Ana Beatriz Alkmin Teixeira; Ferreira, Lydia Masako [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Univ Vale Sapucai
    Background: Breast augmentation with silicone implants is one of the most frequently performed cosmetic surgeries worldwide. Surgical site infection (SSI) remains an important complication of this procedure. One of the most important risk factors for SSI is the presence of microorganisms on the skin surrounding the wound. Guidelines by the Centers for Disease Control (CDC) recommend that surgical wounds be covered with a sterile dressing for 24 to 48 hours. However, a recent study showed that the application of a dressing for six days after breast reduction reduced wound colonization by coagulase-negative staphylococci.Methods/Design: A randomized clinical trial was designed to assess two protocols of postoperative wound care to determine how the application duration of the postoperative dressing influences wound colonization in patients undergoing breast augmentation with silicone implants. Women aged between 18 and 60 years who are candidates for breast augmentation with silicone implants will be randomly allocated to group I (n = 48), in which the dressing will be removed on the first postoperative day, or group II (n = 48), in which the dressing will be removed on the sixth postoperative day. Cutaneous colonization will be assessed by cultures of samples of skin flora taken from the wound region. the incidence of SSI, using standardized CDC criteria, and the perceptions of patients towards the dressing will be secondary outcomes.Discussion: An important component of SSI prevention is to minimize all possible risk factors, and the application of postoperative dressing plays a key role in this endeavor. the results of this clinical trial may help to standardize postoperative wound care after breast augmentation with silicone implants.
  • Nenhuma Miniatura disponível
    Item
    Somente Metadadados
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Aumento mamário por meio da incisão da abdominoplastia: estudo prospectivo de 100 casos
    (Sociedade Brasileira de Cirurgia Plástica, 2013-03-01) Dini, Gal Moreira [UNIFESP]; Milani, Jean [UNIFESP]; Albuquerque, Luciana Gianini; Oliveira, Mario Farinazzo de [UNIFESP]; Santos Filho, Ivan Dunshee de Abranches Oliveira [UNIFESP]; Iurk, Lauren Klas [UNIFESP]; Ferreira, Lydia Masako [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Cidade de São Paulo
    INTRODUCTION: Pregnancy and obesity cause distension of the abdominal wall and produce changes in the shape and size of the breasts. Thus, the need of aesthetic improvement of the abdominal area is not uncommon, coinciding with the desire for breast augmentation. Performing mammoplasty via the abdominoplasty incision approach was first described in 1976. Because of the lack of prospective studies using this approach, we performed a series of dermolipectomy procedures using the abdominal incision to insert a pair of silicone gel breast implants. METHODS: In total, 100 consecutive patients were selected, with a mean age of 33 ± 2 years. Classic abdominoplasty was performed, and 2 tunnels were then made in the right and left hypochondria. After implant placement, the mammary fold was reconstructed using simple sutures with absorbable threads to attach the subcutaneous tissue to the aponeurosis. RESULTS: None of the following complications were observed: deep-vein thrombosis, cardiorespiratory or anesthetic complications, skin necrosis, visible bleeding, hematoma, or clinically detectable infection. The volume of the implants ranged from 280 to 450 mL (median, 350 mL). The mean operation time was 116 minutes. Reoperation was not necessary in any of the cases. The monitoring period ranged from 9 to 84 months (mean, 36 months). CONCLUSIONS: Breast augmentation via the abdominoplasty incision approach was demonstrated to be a reliable and simple technique, providing a new, scar-free alternative to mammary surgical procedures.
  • Nenhuma Miniatura disponível
    Item
    Somente Metadadados
    Avaliação da imunoexpressão do anticorpo monoclonal MIB-1 no epitélio mamário adjacente ao fibroadenoma de mulheres no menacme tratados com tamoxifeno
    (Universidade Federal de São Paulo (UNIFESP), 1999) Sousa, Juarez Antônio de [UNIFESP]; Gebrim, Luiz Henrique [UNIFESP]
    A quimioprofilaxia do cancer mamario com tamoxifeno tem reduzido em 45 por cento a incidencia de cancer em mulheres de alto risco, segundo dados do National Cancer Institute (l998). Seus efeitos sobre o tecido mamario normal sao pouco conhecidos, bem como sua interacao com os receptores esteroides e a dose-efeito. Estudou-se por tecnica imunohistoquimica, atraves da imunoexpressao do anticorpo monoclonal MIB-1 (IMUNOTECH, catalogo n. 0505, lote OO1), a atividade proliferativa no epitello mamario adjacente ao fibroadenoma de 44 pacientes, de forma aleatoria em duplo-cego, divididas em 3 grupos: A =l6; placebo), B (N=15; tamoxifeno, 10mg) e C (N=13; tamoxifeno, 2Omg). O medicamento foi utilizado por 22 dias, a partir do 20 dia do ciclo menstrual, sendo a cirurgia realizada no 23º dia. O perfil hormonal foi analisado pela dosagem serica de estradiol, progesterona, SHBG (globulina transportadora de horrnonlos esteroides), FSH (horrnonio foliculo-estimulante), LH (honnonlo luteinizante) e prolactina, entre os dias 21 e 24 do ciclo menstrual previo, e no dia da cirurgia. Os grupos B e C apresentaram aumento significante nos niveis de progesterona (p=O,O38), estradiol (p
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Avaliação postural em mulheres submetidas à mamoplastia de aumento
    (Universidade Federal de São Paulo (UNIFESP), 2018) Barrera, Mayara Roberta [UNIFESP]; Aveiro, Mariana Chaves [UNIFESP]; http://lattes.cnpq.br/8912160623559438; http://lattes.cnpq.br/0251633865730137; Universidade Federal de São Paulo (UNIFESP)
    Introdução: Foi observado em mulheres com macromastia que há mudança do centro de gravidade, as curvaturas da cifose torácica e lordose lombar são maiores e também as lombalgias tem alta prevalência ocasionando a diminuição da funcionalidade. Entretanto, aspectos psicológicos podem também influenciar nas alterações posturais, como já foi identificado em estudos que mulheres com hipomastia adotam postura cifótica na intenção de esconder as mamas. O presente estudo adota a hipótese de que a cirurgia de mamoplastia não aumenta o grau da cifose torácica, já que aspectos psicossociais e autoestima também são fatores importantes para determinar a postura corporal. Objetivo: Comparar as curvaturas da coluna vertebral, dor e autoestima de mulheres jovens que realizaram a mamoplastia de aumento, com mulheres que desejam realizar a cirurgia. Métodos: Foram avaliadas 24 participantes, divididas em dois grupos: com implante mamário e sem implante mamário. As voluntárias responderam ao IPAQ versão curta, à Escala de autoestima de Rosenberg e ao Questionário de dor de McGill. Para a avaliação postural foi utilizado o Software para avaliação postural (SAPO). As medidas das lordoses cervical e lombar e também cifose torácica foram obtidas pela ferramenta de ângulos livres. Resultados: Foi observada diferença significativa intergrupo apenas para a curvatura de lordose lombar, sendo que as voluntárias com implante mamário possuem maior lordose lombar (p=0,02). Não houve diferença significativa intergrupo para as variáveis: dor - McGill e Autoestima de Rosenberg. Não foi observada correlação significativa entre as variáveis. Conclusão: A partir dos resultados apresentados no estudo, concluímos que não há diferença entre a cifose torácica dos grupos estudados, este dado demonstra que a hipótese tem fundamento, porém a lordose lombar se apresentou aumentada no grupo com silicone, o que sugere que os implantes podem induzir alterações na coluna vertebral para compensação funcional.
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Avaliação semanal dos receptores de estrogênio α e progesterona no epitéllio mamário de mulheres após o uso de anticoncepcional hormonal combinado oral por um mês
    (Universidade Federal de São Paulo (UNIFESP), 2020-07-30) Araujo Neto, Joaquim Teodoro De [UNIFESP]; Nazario, Afonso Celso Pinto [UNIFESP]; Universidade Federal de São Paulo
    Introduction: Oral combined contraceptives (OCC) have been used since 1957 and currently estimates that approximately one billion women worldwide use OCC to treat some gynecological disorders and primarily as a contraceptive method. Due to their systemic actions, OCC have benefits and harms. However it is the increased risk of breast cancer its most controversial adverse effect and the most feared by women. The mechanisms by which contraceptives would act on the breast parenchyma leading to its increased incidence, are not yet well known. Objectives: To calculate and compare α estrogen receptor (ERα) and progesterone receptor (PR) expression in the mammary epithelium in the first, second, third and fourth weeks of patients who do not use OCC (natural cycle) and those who use one cycle of OCC composed of 30 μg ethinyl estradiol (EE) and 150 μg levonorgestrel (L). Casuistic and Methods: A retrospective study with paraffin blocks of 118 women from February 2001 to February 2004. At the time, women were included in the menacme who had a breast lump with the triple diagnosis of positive benignity and eumenorrheic during the last six months. The study project was analyzed and approved by the Research Ethics Committee of UNIFESP-EPM. The patients underwent excision of the breast lumps and adjacent normal breast tissue fragments which were fixed in 10% buffered formalin. 31 patients were excluded and 87 patients were analyzed. The patients were divided into two groups: group A (with OCC) consisted of 42 women who used an OCC cycle composed of 30 μg of EE and 150 μg of L, group B (without OCC) consisted of 45 women with natural cycles. The immunohistochemical reaction was performed in an automation device and the following antibodies were used: ERα antibody clone SP1 titer 1:500 and PR antibody clone PgR636 titer 1:400. The histological slides were read using conventional optical microscopy. After identifying the epithelial areas, 7 fields with 40X magnification were evaluated. Statistical analysis for parity was performed using Fisher's exact test. At age the Students t-Test was applied. ERα and PR counts were evaluated in the Generalized Estimation Equation (EEG) model. In order to compare the total ERα and PR counts by evaluation and group moments, we used the Analysis of Variance (ANOVA) and the Kolmogorov-Smirnov test. Statistical analyzes were performed using the programs SPSS 20.0 and STATA 12. For all statistical tests the significance level of 5% (p ≤ 0.05) was adopted. Results: The control group (without OCC) had a higher mean age of 23.7 ± 5.9 years compared to the study group (with OCC) with a mean age of 20.5 ± 5.1 years. Regarding parity, the study group (with COC) had 83.9% of nulligesta versus 73.3% in the control group (without OCC). From the EEG model a statistically significant mean difference in ERα expression was observed in the fourth week in the study group (with COC) compared to the control group (without OCC) with p <0.001. The comparison of PR expressions in the control group (without OCC) in the fourth week or in the late luteal phase (LLP) with the ERα expressions, also in the fourth week (LLP) of the control group (without OCC) the mean PR expression was higher and statistically significant than ERα expression with p <0.001. The group of women using OCC showed higher average percentages of ERα (p <0.001) and PR (p <0.001) when compared to women in the control group (without OCC). Conclusions: The expressions of ERα and PR in users of an OCC cycle composed of 30 μg EE and 150 μg L higher percentages of ERα (p <0.001) and PR (p <0.001) media when compared to women from the control group (without OCC). The ERα expression in the study group (with OCC) in the fourth week (pause) was higher than the ERα expression in the fourth week (LLP) of the control group (without OCC), a statistically significant difference (p <0.001). The expression PR in the fourth week of the control group (without OCC) or LLP was higher than the ERα and this difference was statistically 5 significant (p <0.001). This difference was not observed at another three weeks in the control group (without OCC) and in the four weeks of the study group (with OCC).
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Carcinoma da mama com diferenciação coriocarcinomatosa
    (Sociedade Brasileira de Patologia ClínicaSociedade Brasileira de PatologiaSociedade Brasileira de Citopatologia, 2009-12-01) Rossetti, Claudia; Sacchi, Renata Silvia; Junqueira, Virginia Berlanga Campos [UNIFESP]; Fonseca, Fernando Luiz Affonso [UNIFESP]; Faculdade de Medicina do ABC Serviço de Patologia da Mama; FMABC; Universidade Federal de São Paulo (UNIFESP); FMABC Laboratório de Análises Clínicas
    This report describes the case of a 45 year-old patient with breast carcinoma characterized by choriocarcinomatous features, presence of bizarre anaplastic cells with areas of necrosis and multinucleated giant cells. The immuno-histochemical analysis showed positivity for chromogranin and β-HCG. The tumor size was 5.7 cm at the largest axis and it was refractory to initial neo-adjuvant treatment. Mastectomy was performed and after microscopic and immuno-histochemical examination it was diagnosed as carcinoma with choriocarcinomatous features. These lesions are rare and liable to synthesize hormonal substances not specific to breast tissue. Its diagnosis is highly significant to the therapeutic and prognostic approach insofar as these lesions are potentially aggressive.
  • Nenhuma Miniatura disponível
    Item
    Somente Metadadados
    Carcinoma Mamário Invasivo Her2-Superexpresso E Triplo-Negativo: Correlação Entre Achados De Imagem E Subtipos Imunohistoquímicos
    (Universidade Federal de São Paulo (UNIFESP), 2017-11-30) Santiago, Isaac Bispo [UNIFESP]; Fernandes, Artur Da Rocha Correa [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objective: To evaluate the epidemiological, anatomopathological and imaging characteristics of the different modalities of invasive mammary tumors of HER2-superexpressed and triple-negative molecular subtypes from a database of biopsies performed at two breast imaging centers. Methods: Retrospective study descriptive study with 26 patients submitted to percutaneous breast biopsy in two mammary imaging centers, with histopathological result of invasive mammary carcinoma and immunohistochemical pattern compatible with HER2-superexpressed and triple-negative subtypes, from 2010 to 2015, correlating the immunohistochemical pattern with the occurrence of imaging findings, epidemiological and histopathological. RESULTS: Twenty-six cases were found: 18 triple-negative tumors and 8 HER-2 superexpressed tumors. The mean age for TN tumors was 48.8 years and for HER-2 it was 50 years. Ductal carcinoma was the most common histological subtype in TN tumors (94.5%) and HER2 (87.5%), presenting nuclear grade III in 94.5% of TN tumors and 75% in HER2-superexpressed tumors. At mammography, 81.6% of TN tumors and 66.6% of HER2 presented as nodules / mass. In the sonographic study, the non-circumscribed masses predominated (86.6% in TN, 100% in HER2). Two cases (13.4%) of circumscribed nodules were found in the NT group. At MRI, there was predominance of nodular enhancement in 70% of NT, with a more common pattern of heterogeneous enhancement (58%). CONCLUSION: Tumor tumors TN present greater manifestation as non-calcified, non-circumscribed mass, with heterogeneous enhancement, while HER-2 tumors present a larger manifestation as irregular and non-circumscribed mass, with significantly larger tumor dimensions in relation to TN tumors.
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Coexistence of benign phyllodes tumor and invasive ductal carcinoma in distinct breasts: case report
    (Biomed Central Ltd, 2012-04-25) Barbalaco Neto, Guerino; Rossetti, Claudia; Souza, Natalia A.; Fonseca, Fernando L. A.; Azzalis, Ligia Ajaime [UNIFESP]; Junqueira, Virginia Berlanga Campos [UNIFESP]; Valenti, Vitor Engrácia; Abreu, Luiz Carlos de; Faculdade de Medicina do ABC; Universidade Federal de São Paulo (UNIFESP); Universidade Estadual Paulista "Júlio de Mesquita Filho"
    This report describes a rare case of coexistence of benign phyllodes tumor, which measured 9 cm in the right breast, and invasive ductal carcinoma of 6 cm in the left breast, synchronous and independent, in a 66-year-old patient. the patient underwent a bilateral mastectomy due to the size of both lesions. Such situations are rare and usually refer to the occurrence of ductal or lobular carcinoma in situ when associated with malignant phyllodes tumors, and more often in ipsilateral breast or intra-lesional.
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Dispositivo de simetrização de cicatriz mamária em mamoplastias
    (Universidade Federal de São Paulo (UNIFESP), 2017-06-30) Giometti, Maria Claudia Sanchez [UNIFESP]; Ferreira, Lydia Masako [UNIFESP]; Sobral, Christiane Steponavicius [UNIFESP]; http://lattes.cnpq.br/7996290670653478; http://lattes.cnpq.br/1619822351741819; http://lattes.cnpq.br/9274257878506103; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Dissatisfaction with the symmetrization of scars after mammoplasty is one of the main causes of postoperative complaints. Purpose: To develop a device to symmetrize breast scars. Methods: Search of anteriority of devices described for symmetrization of mammary scars post mammoplasties and comparison with the design of the new device. Description of the main features and functions of the developed instrument. Results: The search of anteriority in the bases of the INPI, EPO, USPTO, WIPO, SIPO and JPO, Google Patents and Scholar resulted in the 11 patents described in the international patent classification. But none with the bilateral symmetrization characteristics of the breasts. In the analysis of the device under study the patents of the existing devices were compared with the following criteria: design and applicability. The composition, function, measurements and mode of use of the device have been described. Conclusion: A device to symmetrize mammary scars has been developed.
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Dores na coluna: avaliação em pacientes com hipertrofia mamária
    (Sociedade Brasileira de Ortopedia e Traumatologia, 2007-01-01) Fernandes, Paulo Magalhães; Sabino Neto, Miguel [UNIFESP]; Veiga, Daniela Francescato; Abla, Luiz Eduardo Felipe [UNIFESP]; Araújo, Carlos Delano Mundim; Juliano, Yara; Ferreira, Lydia Masako [UNIFESP]; Universidade do Vale do Sapucaí Hospital das Clínicas Samuel Libânio Departamento de Ortopedia Traumatologia; Universidade Federal de São Paulo (UNIFESP); Universidade do Vale do Sapucaí Hospital Clínicas Samuel Libânio Divisão de Cirurgia Plástica; UNIVÁS Departamento de Bioestatística
    OBJECTIVE: To evaluate the influence of breast hypertrophy on the incidence of back pain and how much they can interfere in patients' daily activities. METHODS: This was a cross-sectional analytic study in patients examined at the Outpatient Orthopedics and Plastic Surgery Departments at Samuel Libânio University Hospital in Pouso Alegre, MG. 100 women were examined, 50 presenting breast hypertrophy (study group) and 50 with normal breast size (control group). Breasts were classified according to Sacchini's criteria. The Numerical Rating Scale (NRS) and the Roland-Morris questionnaire were used in order to evaluate the magnitude of back pain and the limitations arising from these symptoms. RESULTS: The mean age of the patients in the study group was 32.2 years and 32.7 for the control group. The scores in the NRS scale and Roland- Morris Questionnaire were higher in the study group when compared to the control group. CONCLUSION: The results achieved showed that back pain is more severe and determined more extensive limitations in the daily activities for patients presenting breast hypertrophy.
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Efeitos de diferentes doses de tamoxifeno sobre a proliferação celular do epitélio mamário
    (Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2003-04-01) Facina, Gil [UNIFESP]; Baracat, Edmund Chada [UNIFESP]; Lima, Geraldo Rodrigues De [UNIFESP]; Gebrim, Luiz Henrique [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    PURPOSE: to quantitatively analyze the immunoreaction of monoclonal antibody Ki-67 in the mammary epithelium adjacent to fibroadenoma of premenopausal women treated with tamoxifen, for 50 days, at doses of 5, 10 and 20 mg/day. METHODS: we studied, prospectively, the effects of tamoxifen administered for 50 days, at doses of 5, 10 e 20 mg/day, by the immunoreaction of the Ki-67 (clone Ki-S5) monoclonal antibody on mammary epithelium adjacent to fibroadenoma in premenopausal women. We studied 58 patients in a double-blind trial who were divided into four groups: Group A (n=13; placebo), Group B (n=16; 5 mg/day tamoxifen), Group C (n=14; 10 mg/day) and Group D (n=15; 20 mg/day). All patients received the medication from the first day on of the menstrual cycle and biopsy was performed on the last day of the treatment. Cells stained and not stained by the immunoreagent were counted by optical microscopy (400X) with a digital image capturing system and image analysis. RESULTS: the average percentage of stained nuclei was calculated for all groups: Group A was 2.0 with a standard error (SE) of 0.3. In Group B it was 0.7 (SE=0.2); in Group C it was 0.4 (SE=0,2) and in Group D it was 0.1 (SE=0). Statistical analysis showed significant reductions between the groups (p<0.001), and Tukey's pairwise comparison test confirmed that there was a significant increase in the immunoreaction of the monoclonal Ki-67 antibody in groups B, C and D. CONCLUSIONS: tamoxifen, administered at doses of 5, 10 and 20 mg/day for 50 days, significantly reduced the immunoreaction of monoclonal Ki-67 in the mammary epithelium of premenopausal patients and there was no significant difference between the groups that received 5, 10 and 20 mg/day tamoxifen.
  • Nenhuma Miniatura disponível
    Item
    Somente Metadadados
    Efeitos dos esteróides sexuais endógenos e exógenos sobre a cinética celular do lóbulo mamário humano normal e do fibroadenoma
    (Universidade Federal de São Paulo (UNIFESP), 2002) Nazário, Afonso Celso Pinto [UNIFESP]
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Efeitos imediato e tardio das isoflavonas da soja e do estradiol na glândula mamária de ratas ovariectomizadas
    (Universidade Federal de São Paulo (UNIFESP), 2015-12-16) Santos, Miriam Aparecida dos [UNIFESP]; Simões, Manuel de Jesus [UNIFESP]; Carbonel, Adriana Aparecida Ferraz [UNIFESP]; http://lattes.cnpq.br/9174521191304809; http://lattes.cnpq.br/5987164343458678; http://lattes.cnpq.br/7415497496003016; Universidade Federal de São Paulo (UNIFESP)
    A importância do estrogênio na etiologia do câncer de mama é largamente reconhecida. Estudos indicam que mulheres que nunca receberam qualquer tipo de terapia hormonal (TH) na menopausa e que passaram a utilizá-la mais tardiamente, apresentam um aumento da resposta proliferativa em células da mama. Nesse contexto, as isoflavonas da soja têm sido investigadas como alternativa à TH. Objetivo: Nosso estudo objetiva investigar os efeitos do tratamento imediato e tardio das isoflavonas da soja ou do estradiol na glândula mamária de ratas ovariectomizadas. Metodologia: Utilizaram-se 30 ratas adultas ovariectomizadas (OVX) divididas em seis grupos (contendo 5 ratas em cada), sendo 3 grupos imediatos (tratados 3 dias após OVX) e 3 grupos tardios (tratados 30 dias após OVX). As ratas foram tratadas por 30 dias consecutivos, a saber: GI- Controle Imediato (Cont-Im) e GII- Controle Tardio (Cont-Tar) receberam 0,1 mL de solução veículo propilenoglicol por gavagem; GIII- Isoflavona Imediato (Iso-Im) e GIV- Isoflavona Tardio (Iso-Tar) receberam por gavagem 150 mg/Kg/dia de extrato de isoflavonas da soja; GVEstradiol Imediato (Est-Im) e GVI- Estradiol Tardio (Est-Tar) receberam 10?m/Kg/dia de 17?-estradiol por via subcutânea. Ao final dos tratamentos os animais foram eutanasiados e o 6o par de mamas inguinal foi retirado. Fragmentos do orgão foram mergulhados em formol a 10%, processados para estudo morfométrico; imunohistoquímico para o antígeno de proliferação celular Ki-67, antígeno de crescimento endotélio-vascular (VEGF-A) e ácido hialurônico (AH); e análise da birrefringência das fibras colágenas. Outros fragmentos foram mergulhados em acetona para determinação dos glicosaminoglicanos (GAGs). Resultados: Ambos os tratamentos com estradiol promoveram aumento das frações epitelial, ductal e lobular em comparação aos demais grupos estudados; e não observamos diferenças nestes parâmetros entre os grupos controle e isoflavonas. Na imunomarcação para o Ki-67 e VEGF-A os grupos tratados com estradiol apresentaram evidente aumento da imunopositividade a estes marcadores tanto no epitélio quanto no estroma mamário, em comparação aos controles e tratados com isoflavonas; que por sua vez apresentaram-se semelhantes entre si. Observamos também um aumento da imunoexpressão do AH nos ductos e estroma mamário de todas as ratas tratadas com estradiol em relação aos demais grupos, notando-se ainda uma semelhança entre os controles e isoflavonas, exceto no tratamento tardio com isoflavonas em que houve uma diminuição do AH em comparação ao controle. No estudo da matriz extracelular mamária observamos que ambos os tratamentos com estradiol promoveram aumento da concentração dos GAGs heparam sulfato, dermatam sulfato e ácido hialurônico em comparação aos demais grupos; não havendo diferenças nas concentrações destes GAGs entre os controles e isoflavonas, exceto no grupo isoflavonas tardio em que houve um aumento do heparam sulfato em relação ao controle. Além disso, notamos predominância de fibras colágenas com birrefringência avermelhada nos grupos tratados com estradiol, em relação aos grupos controles e isoflavonas, que apresentaram semelhantemente predominância de fibras colágenas esverdeadas. Conclusões: O estradiol administrado tanto imediatamente quanto tardiamente promoveu evidente proliferação do tecido mamário, enquanto as isoflavonas da soja não apresentaram este efeito.
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Equipamento brasileiro de detecção gama intra-operatória para biópsia de linfonodo sentinela
    (Colégio Brasileiro de Cirurgiões, 2010-02-01) Oliveira Filho, Renato Santos de [UNIFESP]; Farah, Andréia Bufoni; Costa, Fábio Eduardo da; Nahas, Fabio Xerfan [UNIFESP]; Oliveira, Daniel Arcuschin de; Oliveira, Renan Gianotto de; Hospital Israelita Albert Einstein; IPEN; Universidade Federal de São Paulo (UNIFESP); Faculdade de Medicina Anhembi-Morumbi
    OBJECTIVE: To test the effectiveness of an intra-operative gamma detection Brazilian device (IPEN) on sentinel lymph node biopsy (SLNB) procedures. METHODS: Forty melanoma or breast cancer patients with indication for undergoing SLNB were studied. Lymphoscintigraphy was done 2 to 24 hours prior to surgery. Lymphatic mapping with vital dye and gamma detection were performed intraoperatively. For gamma detection Neoprobe ® 1500 was used followed by IPEN (equipment under test) in the first 20 patients and for the remaining half IPEN was used first to verify its ability to locate the sentinel node (SN). Measurements were taken from the radiopharmaceutical product injection site, from SN (in vivo and ex vivo) and from background. It was recorded if the SN was stained or not and if it was found easily by surgeon. RESULTS: There were 33 (82.5%) breast cancer and 7 (17.5%) melanoma patients. Ages varied from 21 to 68 year-old (median age of 46). Sex distribution was 35 (87.5%) women and 5 (12.5%) men. Sentinel node was found in all but one patient. There was no statistical difference between the reasons ex vivo/ background obtained with the measures of both equipments (p=0, 2583-ns). The SN was easily found by the surgeon with both devices. CONCLUSION: The SLNB was successfully performed using either equipment. It was possible to do SLNB with the Brazilian device developed by IPEN without prejudice for the patient.
  • Nenhuma Miniatura disponível
    Item
    Somente Metadadados
    Estudo da apoptose no epitélio do lóbulo mamário em mulheres no menacme tratadas com tamoxifeno
    (Universidade Federal de São Paulo (UNIFESP), 1999) Gebrim, Luiz Henrique [UNIFESP]
    Nosso objetivo foi avaliar, em mulheres no menacme, os efeitos do tamoxifeno administrado durante 22 dias, nas doses de 10 e 20 mg/dia, sobre a morte celular programada (apoptose), no epitelio lobular normal, em tecido adjacente fibroadenomas de mama. Estudaram-se de forma aleatoria em duplo-cego, 40 mulheres com fibroadenoma, eumenorreicas e que nao receberam hormonios nem estiveram gravidas nos ultimos 12 meses. As pacientes foram divididas em tres grupos: Grupo I (n = 14; placebo), Grupo II (n = 13;10 mg/dia) e Grupo III (n =13; 20 mg/dia). Iniciou-se o tratamento no 1§ dia do ciclo menstrual, e as cirurgias for feitas no 22§. Dosaram-se duas vezes o estradiol, progesterona, prolactina, FSH, L e SHBG, sendo a primeira no 22§ dia do ciclo anterior e a segunda no dia da cirurgia O tecido mamario foi fixado em formol a 1O por cento e corado pela HE. Contaram-se o corpusculos apoptoticos utilizando-se microscopio da marca Olympus BX-40, e duplo-cego num total de 10 campos com aumento de 4OOX. O numero medio de corpusculos apoptoticos no Grupo I (controle) foi de 34,8; no Grupo III (1O mg) 12,9 e no Grupo III (20 mg), 12,0. A analise de variancia revelou diferenca estatistica entre os grupos, e o teste de comparacoes multiplas de Fisher confirmou reducao significativa dos corpusculos nos Grupos II e III p < O,OO1. Nao houve diferenca entre os achados dos Grupos II e III. O tamoxifeno, nas doses de 10 e 20 mg/dia, reduziu apos 22 dias de tratamento numero de corpusculos apoptoticos no epitelio do lobulo mamario