The prognostic impact of local recurrence on early breast cancer patients treated with breast conserving therapy

OBJETIVO: investigar o impacto da recorrência local no prognóstico de pacientes com câncer de mama em estágio inicial tratado com cirurgia conservadora. MÉTODO: foi realizado estudo de coorte retrospectivo incluindo 192 pacientes com câncer de mama em estágio inicial submetidas a tratamento conservador. Utilizando critérios clínicos e patológicos (tempo para recorrência, local da recorrência e tipo histológico) classificamos as pacientes em três grupos. O grupo de recorrência local verdadeira (RLV), o grupo de novo tumor primário (NP) e o grupo livre de recorrência local (LRL). Foi comparada a evolução entre os diferentes grupos. RESULTADOS: menor idade e uma maior proporção de pacientes na pré-menopausa foram observas no grupo NP. A presença de RLV foi o mais importante fator prognóstico sendo que 40% das pacientes deste grupo desenvolveram doença metastática sincrônica à recorrência local. Doença metastática ocorreu em 28,5% e 4,7% nos grupos NP e LRL, respectivamente (p< 0,0001). A taxa de sobrevida global em cinco anos foi de 75% no grupo RLV, 100% no grupo NP e 98,2% no grupo LRL (p< 0,0001). Tipo histológico, margens cirúrgicas, metástase em linfonodos axilares e expressão de receptores hormonais não foram preditores de recorrência local. Pacientes que não foram submetidas a hormonioterapia adjuvante e a idade foram os mais importantes fatores preditores de recorrência local. CONCLUSÃO: recorrência local verdadeira é um fator prognóstico em pacientes com câncer de mama inicial tratado com cirurgia conservadora. A idade é o mais importante fator na recorrência local neste grupo de pacientes. O alto risco recorrência local nestas pacientes é um fator limitante da cirurgia conservadora.BACKGROUND: In order to investigate the impact of local recurrence on breast cancer patient prognosis, we developed this study. METHOD: A retrospective cohort study including 192 patients with early stage breast cancer subjected to breast conserving surgery (BCT) was performed to evaluate the local recurrence pattern and its role on disease progression. Using clinical and pathological criteria (time for recurrence, site of local recurrence and histological type) we classified patients as true local recurrence (TR group), new primary tumor (NP group), and patients free of local recurrence (FLR group). We compared the clinical course among these groups. RESULTS: Patients classified as NP are associated with young age and pre-menopausal status. The presence of TR is the most important predictive factor of prognosis and 40% of patients presented synchronic metastatic disease. The metastatic disease occurred in 28.5% and 4.7% of patients in the NP and FLR groups, respectively (p< 0.0001). Five-year overall survival rate was 75% in the TR group, 100% in the NP group and 98.2% in the FLR group (p< 0.0001). The Histological type and grade, margins status, lymph node metastasis and hormonal receptors were not predictive factors of local recurrence. Patients who were not submitted to hormonal therapy and young age are the most important predictive factors of local recurrence. CONCLUSION: True local recurrence had an influence on overall survival in patients with early breast cancer and the main risk factor for local recurrence was young age. The high-risk incidence for recurrence after BCT in such patients is a limiting factor of therapy

Preliminary Assessment of Radiolysis for the Cooling Water System in the Rotating Target of {SORGENTINA}-{RF}

The SORGENTINA-RF project aims at developing a 14 MeV fusion neutron source featuring an emission rate in the order of 5-7 x 10(13) s(-1). The plant relies on a metallic water-cooled rotating target and a deuterium (50%) and tritium (50%) ion beam. Beyond the main focus of medical radioisotope production, the source may represent a multi-purpose neutron facility by implementing a series of neutron-based techniques. Among the different engineering and technological issues to be addressed, the production of incondensable gases and corrosion product into the rotating target deserves a dedicated investigation. In this study, a preliminary analysis is carried out, considering the general layout of the target and the present choice of the target material

Photon momentum change of quasi-smooth solar sails

The solar photon sail (SPS) allows space missions without propellant that would otherwise not be feasible. Thrust models frequently used in the literature for the calculation of trajectories often underestimate the effect that the surface roughness has on SPS dynamics. A small variation of the thrust vector can induce a large modification of sail flight. In this work, the variation of the photon momentum vector (PMV) is computed as resulting from the incident Sun radiation, taking into account the absorbed and reflected photons. The momentum resulting from diffuse light has been modeled by using vectorial scattering theories in the limit of a quasi-smooth sail where the first-order of Rayleigh–Rice can be applied. In particular, the momentum change resulting from diffuse radiation causes a PMV reduction as well as a deviation of its direction from what is foreseen in the case of an ideally smooth sail

Crystal structures, magnetic and superconducting properties of the RuSr2NdCu2Ox and RuSr2GdCu2Oy compounds

We report the magnetization and the susceptibility measurements of the RuSr2GdCu2Oy and RuSr2NdCu2Ox perovskite materials. We find that RuSr2GdCu2Oy compound exhibits a magnetic transition at Tn = 135 K followed by a superconducting one with an onset Tc = 35 K. Samples of RuSr2NdCu2Ox material have shown neither a superconductivity nor a magnetic transition. XRD measurements show that in RuSr2NdCu2Ox the Nd ions tend to be substituted by Sr ions in very high percentages. The relevance of this phenomenon on the absence of superconductivity in RuSr2NdCu2Ox is discussed. © 2002 Elsevier Science B.V. All rights reserved

Analysis of coupling losses in multifilamentary untwisted BSCCO/Ag tapes through a.c. susceptibility measurements

Losses as a function of the a.c. magnetic field amplitude (B/sub 0/) have been evaluated at 77 K in untwisted BSCCO(2223)/Ag tapes, at different frequencies, by measuring the imaginary part of a.c. magnetic susceptibility. In particular, the measurements were performed on different portions of the same tape, obtained by cutting it in pieces with different length, starting from around 120/spl ap/mm down to 10/spl ap/mm. The experimental results show that the losses depend on the sample length, but this observed behavior can not be always ascribed to the coupling mechanism among filaments. In this work we discuss the observed experimental behavior for different typologies of tapes. The data are analyzed by comparing them with the results obtained by means of analytical models allowing us to characterize the tapes with respect to the coupling mechanisms