Navegando por Palavras-chave "Neoplasias de mama"

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    Avaliação da resposta imune celular de mulheres com câncer de mama localmente avançado
    (Universidade Federal de São Paulo (UNIFESP), 2018-09-27) Moura, Jose Fernando do Prado [UNIFESP]; Melo, Analy Salles de Azevedo [UNIFESP]; Torres, Leuridan Cavalcante [UNIFESP]; http://lattes.cnpq.br/4973562538598237; http://lattes.cnpq.br/8922840487452492; http://lattes.cnpq.br/1354495849607971; Universidade Federal de São Paulo (UNIFESP)
    Breast cancer (BC) is the most frequent and the second leading cause of cancer death among women. The immune response in cancer in the development and prognosis of the cancer patient is the focus of current studies due to the new possibilities of treatment (immunotherapy). T lymphocytes contribute to tumor immunosurveillance indicating that the immune system influences the prognosis and response to chemotherapy. However, its clinical relevance is not fully established in breast cancer. Based in immunohistochemistry there are four BC subtypes: Luminal (A and B), HER2+ and Triple negative (TN).This study aimed to characterize the profile of circulating T, NKT cells and their subpopulations, in patients with locally advanced breast cancer. Two prospective cohorts of women with locally advanced breast cancer (n=82) and healthy controls (CTRL) (n=25) were analysed. Tumor subtype distribution was as follow: 31 Luminal, 20 HER2+ and 31 Triple-Negative. The peripheral blood was collected from the pacients before neoadjuvant chemotherapy. Immunophenotyping of the cell populations by flow cytometry was performed for analysis of the cellular immune response. Pathological complete response (pCR) was defined as the absence of invasive neoplasia in the surgical specimen (breast and axilla). The Mann Whitney test was used for analysis between the two groups and Kruskall-Wallys for analysis between three or more groups, using the program GraphPad Prism, v6.0. Patients with pCR showed lower % of lymphocytes TCD3+ (p=0.007), TCD4+ (p=0,02), CD4+/CD8+ ratio (p=0.02) and higher % of TCD8+ (p=0.01). The TCD8+naive/memory ratio was lower in TN than Luminal and CTRL. Regarding naïve T lymphocytes and memory, the TCD8+ naive / memory ratio was decreased in TN compared to Luminal and CTRL. Patients with pCR had reduced levels of TCD8 + memory and high CD4+ naive / memory and CD8+ naive / memory ratios (respectivally, p=0,003, p=0,01, p=0,02). Patients with BC (all subtypes) and TN subtype show reduced levels of CD161 + NKT cells compared to CTRL (p = 0.006 and p = 0.004, respectively). The NKT CD94 + were reduced in luminals when compared to HER2+ (p = 0.04), TN (p = 0.02) and CTRL (p = 0.005). There was an increase in % of total iNKT cells compared to CTRL (p <0.05). The % of CD4+CD8 + iNKT were reduced in the luminal (p = 0.01), HER2+ (p = 0.02) and TN (p = 0.001) subtypes compared to the CTRL. The iNKT CD4+/ CD8+ ratio were lower in Luminal compared to HER2+ (p = 0.02). There was an increase in % of iNKT CD8+ in Luminal compared to HER2+ (p = 0.003) and CTRL (p = 0.002) and higher in TN compared to HER2+ (p = 0.02) and CTRL (p = 0.01). No difference was observed when the iNKT subpopulations according to pCR. There is an association of the cellular immune response with the type of response to the treatment, and the analysis of the subpopulations of T lymphocytes in the peripheral blood is a good tool to predict response to neoadjuvant chemotherapy in patients with breast cancer.
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    Breast-Q® em reconstrução mamária com implante
    (Universidade Federal de São Paulo (UNIFESP), 2016-07-29) Aguiar, Isabella de Carvalho [UNIFESP]; Veiga, Daniela Francescato [UNIFESP]; http://lattes.cnpq.br/3380300231532979; http://lattes.cnpq.br/3380300231532979; Universidade Federal de São Paulo (UNIFESP)
    Background: Breast cancer is the second most common cancer worldwide and the most prevalent among women. Breast reconstruction plays an important role in the quality of life of patients with breast cancer. Purpose: To assess health-related quality of life and patient satisfaction after breast reconstruction with implants, using the BREAST-Q® in the late postoperative period. Methods: One hundred and fourteen women, aged 30 to 55 years, in the late postoperative period (range, 6-24 months) were selected to participate in this cross-sectional study, and were allocated to either the mastectomy group (n = 57) or reconstruction group (n = 57). The Brazilian version of the BREAST-Q®, a patient-reported outcome measure, was completed by all participants. Results: The mean age of patients was 46.6 and 44.3 years (P = 0.4080) in the mastectomy and reconstruction groups, respectively. All patients underwent chemotherapy and 6% and 11% of patients underwent radiotherapy (P = 0.2929) in the mastectomy and reconstruction groups, respectively. Patients in the reconstruction group reported higher satisfaction with breasts (P ? 0.0001) than those in the mastectomy group. However, no significant between-group differences were found in physical (P = 0.1616) and sexual (P = 0.5128) well-being, and satisfaction with the surgeon (P = 0.7147), medical team (P = 0.7488), and office staff (P = 0.8733). Conclusion: Breast reconstruction with implants increased patient satisfaction with breasts, but had no effect on patients? physical and sexual well-being, and satisfaction with the treatment received.
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    Female Sexual Function Index, Inventário de Depressão de Beck, Body Dysmorphic Disorder após reconstrução mamária 
    (Universidade Federal de São Paulo (UNIFESP), 2010-08-25) Archangelo, Silvania de Cassia Vieira [UNIFESP]; Sabino Neto, Miguel [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Breast cancer is the second most frequent one worldwide, the most prevalent one among women and the one that most causes death. Its treatment has improved in the last decades although it still presents an impact over global life quality and its specific aspects as depression and body image, which can be minimized through a reconstructing procedure of the breast that surgically removed. Goal: To evaluate sexual function, depression and body image after breast reconstruction. Methods: In order to evaluate the sexual function, it was applied a sexual function specific questionnaire, The Female Sexual Function Index (FSFI), which was used to 90 women divided into three groups: control ( n=30), mastectomy (n=30) and breast reconstruction (n=30). It was also applied the Beck Depression Inventory (BDI) and the Body Dysmorphic Disorder Examination (BDDE) in order to evaluate depression and body image, respectively. Results: It was observed a significant difference among the groups regarding the average scores of FSFI (p=0,007), the scores of BDI (p=0, 02) and the BDDE (p=0, 01). It was observed a correlation of sexual function decreasing with age, no steady relationship and high scholar formation. Young patients in the mastectomy group also presented significantly higher scores of BDI and BDDE, what means more depressive symptoms and worst body image, respectively. Conclusion: Sexual function and body image were better in the group of patients who underwent breast reconstruction which allowed observing fewer depressive symptoms.
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    Qualidade de vida, capacidade funcional e atividade física após o câncer mamário
    (Universidade Federal de São Paulo (UNIFESP), 2016-11-30) Fontes, Karina Prado [UNIFESP]; Veiga, Daniela Francescato [UNIFESP]; http://lattes.cnpq.br/1695706360514926; http://lattes.cnpq.br/7725591155052613; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Surgical treatment of breast cancer can cause functional limitations, harming the daily activities of the patients. Objective: To assess quality of life, functional capacity and level of physical activity in patients who had undergone different types of surgical treatment of breast cancer. Methods: 180 women between 30 and 60 years of age were selected and allocated into four groups: Control (without breast cancer, n=45), Conservative Surgery (n=45), Mastectomy (n=45) and Breast Reconstruction (n=45). In order to assess quality of life, functional capacity and physical activity, the Brazilian versions of validated instruments were self-applied: the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36), the Stanford Health Assessment Questionnaire (HAQ-20) and the International Physical Activity (IPAQ), respectively. Results: Groups were homogeneous in regard to age (overall average 48.5 years, p=0.5361) and body mass index (overall average 24,6kg/m2, p=0.5361). Mastectomy group significantly differedfrom Control group in the SF-36 domains "functional capacity" (p=0.004), ?physical aspects" (p<0.001), ?health perception? (p=0.036) and "emotional aspects" (p=0.001). Significant difference was observed between the Conservative and the Mastectomy groups regarding ?functional capacity? (p=0.022), ?physical aspects? (p=0.008) and ?health perception? (p=0.008). Regarding HAQ-20 scores, there was a statistically significant difference between the Control and the Mastectomy groups (p=0.006). In IPAQ there was a statistically significant difference between Reconstruction and Mastectomy groups (p=0.049) Conclusion: Patients who underwent breast reconstruction have a higher level of physical activity and quality of life, when compared to patients who underwent mastectomy alone or conservative treatment for breast cancer.