Navegando por Palavras-chave "Neoplasias Da Mama"

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    Breast-Q©: expectativas de pacientes com câncer de mama quanto à reconstrução mamária
    (Universidade Federal de São Paulo (UNIFESP), 2020-11-10) Amaro, Luciana Chamone [UNIFESP]; Veiga, Daniela Francescato [UNIFESP]; Universidade Federal de São Paulo
    Introduction: Breast reconstruction is currently part of the comprehensive treatment of breast cancer, and many studies have demonstrated its beneficial effects on the quality of life and body image of patients. Patients’ expectations regarding breast appearance, pain and recovery are important factors related to breast reconstruction. Objective: To evaluate Brazilian patients’ expectations regarding breast reconstruction. Method: Clinical, observational, cross-sectional, descriptive, uncontrolled, multicenter study. The sample calculation resulted in 123 patients. Women diagnosed with breast cancer, candidates for immediate or delayed breast reconstruction after mastectomy, with surgery already scheduled were included. To assess expectations, an instrument validated for use in Brazil, the BREAST-Q © module “Expectations with breast reconstruction”, was used, which was preoperatively applied. Results: 123 patients were included, with an average age of 48.1 years. The majority (65%) underwent delayed breast reconstruction, and the most prevalent type of reconstruction was with implants (65.9%). The highest expectations were related to Coping (mean ± standard deviation: 95 ± 14.9) and Appearance (mean ± standard deviation: 90.7 ± 18.5). Associations were found between some aspects of expectations and chemotherapy, reconstruction technique, education level, skin color and age. Conclusion: The expectations with breast reconstruction of the studied population are high, especially in relation to Coping and Appearance. Adjuvant treatments and different reconstruction techniques can influence expectations.
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    Início precoce versus tardio de movimentação livre de membros superiores no pós-operatório de câncer de mama e reconstrução imediata: impacto na recuperação cinético-funcional e nas complicações cicatriciais
    (Universidade Federal de São Paulo (UNIFESP), 2019-11-26) Rizzi, Samantha Karlla Lopes De Almeida [UNIFESP]; Facina, Gil [UNIFESP]; Haddad, Cinira Assad Simão [UNIFESP]; http://lattes.cnpq.br/5999034606911576; http://lattes.cnpq.br/1029334251705417; http://lattes.cnpq.br/5651190805842271; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Physical therapy is important for prevention of motor and functional complications after breast cancer surgery, especially when started early, with restoration of motor function and improvement of patients' quality of life. However, there is no prospective randomized study on different physiotherapeutic treatments in patients undergoing mastectomy and immediate alloplastic reconstruction. Objectives: To evaluate the impact of upper limb free exercise released 15 or 30 days after surgery on shoulder range of motion (ROM), pain and limb function; on the incidence of dehiscence, seroma, infection and necrosis; and in need of reoperations of patients after mastectomy and immediate reconstruction with alloplastic material. Methods: Sixty women after mastectomy for breast cancer surgery were included in a randomized controlled trial. They underwent preoperative evaluations and 07, 15, 30, 60 and 90 days after surgery. They started exercises, with shoulder range of motion limited to 90º, the day after surgery and were instructed to perform at home. After two weeks, they were randomized into two groups of 30 patients: “Free Amplitude Group” - release of shoulder joint amplitude at the pain limit or until the surgical edges were detached, and “Limited Amplitude Group” - maintenance of shoulder movement restriction at 90º until 30 days after the surgery, at which time they were also released to free range exercises. Results: Patients with free upper limb exercise release after 15 days of surgery had less pain, greater shoulder amplitude and better upper limb function, compared to those who had restricted movement at 90º for 30 days, with no increased incidence or prevalence of postoperative scarring complications, and without interference with the need for reoperations . Conclusion: Postoperative protocol with free shoulder ROM released after 15 days of surgery is safe and beneficial for kinetic-functional recovery and pain control of patients after mastectomy and immediate reconstruction with alloplastic material for breast cancer.
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    Lobulite linfocítica esclerosante - proposta de algoritmo baseado na análise retrospectiva de 53 casos com correlação clínica, laboratorial e por imagem
    (Universidade Federal de São Paulo (UNIFESP), 2019-05-16) Watanabe, Lucy Tiemi Sato [UNIFESP]; Lederman, Henrique Manoel [UNIFESP]; Mello, Giselle GuedesNetto de [UNIFESP]; http://lattes.cnpq.br/4561063545030677; http://lattes.cnpq.br/6102707812313296; http://lattes.cnpq.br/2601942442874740; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Sclerosing lymphocytic lobulitis (SLL) is a benign breast condition which, despite rare, has as main differential diagnosis the breast cancer and, therefore the importance of being both clinically and radiologically recognized. Objective: To feature the most common mammary findings on mammography, ultrasonography and Magnetic Resonance Imaging in patients with SLL histological diagnosis based on a review of 53 cases; to evaluate the association between this condition with changes in glucose metabolism or autoimmune diseases; and to suggest an interpretation and management algorithm for clinical practice. Methods: an analytic longitudinal observational study based on the database of the pathology sector of a private clinic was carried out. Diagnoses for diabetic mastopathy or SLL in the results of anatomapathological exams of percutaneous or excisional breast biopsies were searched and identified in 54 patients with a total of 60 lesions. Gender, age, clinical complaint, laboratory tests and imaging exams in the electronic record of the patients were studied. A case/ lesion where it was not possible to obtain neither the outcome of laboratory clinical data nor image, was excluded. Results: All the patients were females between 26 to 78 years old and a mean age of 43.7 years. Clinically 50.9% (29/57) of the patients were asymptomatic and the diagnosis was made in screening test, 47.4 % (25/57) had palpable complaints and 1.7% (1/57) had bloody nipple discharge complaint. Patterns of dense or extremely mammary density were shown by mammography in 60% of the cases detecting 41.6% (15/36) with predominance of non-calcified (nodules, asymmetries and distortion) lesions classified as BI-RADS® 4 or 5 in 53.3% (8/15). 91.1% (51/56) of the lesions were found by ultrasonography being 94.1% (48/51) of them classified as BI-RADS®4 with predominance of non circumscribed nodule in 94.1% (48/51), with posterior acoustic shadowing in 62.7% (32/51) and/or indistinct margin in 52.9% (27/51). The size of the lesion on ultrasonography varied from 0.5 to 6.1 cm. Seven patients were submitted to Magnetic Resonance Imaging with positive outcomes in five of them and BI-RADS®4 classification in three. Prevalence of nodular enhancement was significant in 60.0% (3/5). 85% (40/47) of the lesions were seen in patients with some kind of laboratory abnormality: 44.6% (21/47) showed Diabetes Mellitus, being 62.0% (13/21) type 1 (DM1) and 38.0% (8/21) type 2 (DM2), and among the patients 36.1% (17/47) had antithyroid antibodies with two of them with DM (one DM1 and other DM2) while 6.3% (3/47) showed other auto immune diseases. Laboratory abnormality was not shown in seven patients (14.8%). The follow-up of 45% (13/29) of the patients showed remission of the lesion within 2 years and contralateral breast cancer was developed in one of the patients (3%) about 2 years later. Conclusion: In the studied group the most found imaging patterns on mammography were non-calcified lesions, on ultrasonography was non circumscribed nodule with posterior acoustic shadowing and/or indistinct margin and, on Magnetic Resonance Imaging was nodular enhancement. There was a greater association between SLL and DM followed by auto immune thyroid disease. Based on this revision, female diabetic patients less than 40 years old who present clinical palpable lesion and whose ultrasonography evaluation identifies a non circumscribed indistinct nodule, may be submitted to core biopsy and, being the histopathologic findings suggestive of SLL, considered in concordance and the patient might be undergone to conservative treatment.
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    Nível de atividade física e risco de câncer de mama: estudo de caso e controle em usuárias de serviços de saúde pública
    (Universidade Federal de São Paulo (UNIFESP), 2019-12-18) Bonilha, Elias Campos Martins [UNIFESP]; Nazario, Afonso Celso Pinto [UNIFESP]; http://lattes.cnpq.br/7745925386381770; http://lattes.cnpq.br/6852851908187815; Universidade Federal de São Paulo (UNIFESP)
    Objective: A case-control of outpatient clinic discipline of Mastology (EPM-UNIFESP) study was conducted to examine the association between lifetime physical activity and breast cancer risk. Methods: Sociodemographic, clinical and anthropometric data were collected of the case group (80 women with breast cancer survivors) and of the control group (161 women with benign breast diseases). Two models of physical activity evaluation were applied: “The Lifetime total physical activity questionnaire” (LTPAQ) and the other self-applied questionnaire “Physical activity in the last 12 months” (BAECKE). Descriptive statistics were prepared to characterize the study population and to examine case-control differences. Student t-test and chi-square test were used in addition to multiple logistic regression with (95% CI) evaluated the analysis of the relationship between physical activity and breast cancer, adjusted for age, ethnicity and family history of the disease, which were the significant variables to analyze the relationship between physical activity and breast cancer. Results: The cases and controls had similar sociodemographic, anthropometric and reproductive histories. The differences were higher age, white ethnicity and family history of breast cancer. Both groups were overweight or obesity (body mass index was 28.5 in cases and 28.4 in controls) and had a high waist-hip ratio (0.86 and 0.85, respectively). The exposure of physical activities showed an association with the reduction of the chance of breast cancer (P=0.05 and OR=0.97). The lifetime physical occupational activity evaluated by metabolic equivalent task (MET) conferred a smaller risk of breast cancer for postmenopausal women only (P=0.03 and OR=0.99). Conclusion: An increased cardiovascular risk and overweight were observed in these women. The occupational physical activity reduced breast cancer risk after menopause.
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    Prevalência de xerostomia em mulheres durante a quimioterapia por câncer de mama
    (Universidade Federal de São Paulo (UNIFESP), 2020-01-30) Pinto, Vania Lopes [UNIFESP]; Elias, Simone [UNIFESP]; http://lattes.cnpq.br/7745925386381770; http://lattes.cnpq.br/8078552208250536; Universidade Federal de São Paulo
    Objective: to identify the prevalence of xerostomia in women diagnosed with breast cancer and undergoing chemotherapy treatment in a public reference service in the city of São Paulo. Method: prospective cohort with women diagnosed with any malignant breast cancer, with or without previous surgical procedure and / or previous chemotherapy, in outpatient care. Women who discontinued or abandoned treatment during the data collection period, those who changed their treatment to non-chemotherapy, and those who needed a regimen with more than 16 sessions were excluded only the surpluses. The sample calculation predicted an expected error of 17% at an expected prevalence of 50% and with a significance level of 95% therefore considered a sample of 27 women followed up at the end of treatment. The research respected all stages of study with human beings, including obtaining the signature of the Informed Consent Form and submitting it to the Research Ethics Committee. Data collection was performed using two instruments built by the researchers to identify the sample characterization data and anamnesis of the oral cavity. The identification of dry mouth was assessed by means of a validated xerostomia evaluation questionnaire cross-culturally adapted to the Portuguese language, which was applied before the beginning of treatment and after each administration of chemotherapy. Results: All women in the study were from the State of São Paulo aged 35 to 77 years and with an average of nine years of schooling. Dry mouth complaints were present in 48.1% of women before chemotherapy and they were 28 times more likely to develop xerostomia during treatment. It was observed that the use of antiemetics contributed to the increased occurrence of xerostomia and the antiulcerants presented as a protective factor. Conclusion: the present study identified the prevalence of xerostomia in the studied population of 75.4%.