Quality Indicators Compliance and Survival Outcomes in Breast Cancer according to Age in a Certified Center

Simple Summary In this study, we examined how age impacts the outcomes of breast cancer by comparing three age groups: patients 45 years old or younger, patients between 46 and 69 years old, and patients 70 years old or older. Despite similar cancer staging and tumor characteristics among the age groups, the study found that older patients were prone to suboptimal treatment. Older patients also had a lower overall survival rate, but this was not related to cancer itself. Instead, we found that undertreatment was a factor that negatively impacted survival for older women with breast cancer. This study suggests that tumor characteristics and treatment compliance are more important predictors of survival than chronological age. Age as a breast cancer (BC) prognostic factor remains debatable. Several studies have investigated clinicopathological features at different ages, but few make an age group direct comparison. The European Society of Breast Cancer Specialists quality indicators (EUSOMA-QIs) allow a standardized quality assurance of BC diagnosis, treatment, and follow-up. Our objective was to compare clinicopathological features, compliance to EUSOMA-QIs and BC outcomes in three age groups (= 70 years). Data from 1580 patients with staged 0-IV BC from 2015 to 2019 were analyzed. The minimum standard and desirable target on 19 mandatory and 7 recommended QIs were studied. The 5-year relapse rate, overall survival (OS), and BC-specific survival (BCSS) were also evaluated. No meaningful differences in TNM staging and molecular subtyping classification between age groups were found. On the contrary, disparities in QIs compliance were observed: 73.1% in = 70 years women. Despite a unique exception-more invasive G3 tumors in younger patients-no age-specific differences in BC biology impacting outcome were found. Although increased noncompliance in older women, no outcome correlation was observed with QIs noncompliance in any age group. Clinicopathological features and differences in multimodal treatment (not the chronological age) are predictors of lower BCSS.The article publication was supported by National Funds through FCT-Fundacao para a Ciencia e a Tecnologia, I.P., within CINTESIS, R & D Unit (reference UIDB/4255/2020) and within the scope of the project RISE, Associated Laboratory (reference LA/P/0053/2020). ASB, acknowledges FCT-supported funds from UnIC@RISE (UIDB/00051/2020 & UIDP/00051/2020)

Morphological features and mucin expression profile of breast carcinomas with signet-ring cell differentiation

Signet-ring cells are relatively common in breast cancers but are frequently overlooked. Although previously defined as a subtype of mucin producing carcinomas, breast carcinomas with signet-ring cell (SRC) differentiation nowadays are not considered a distinct entity.The objective of the present study was to characterize the morphological features and mucin expression profile of breast carcinomas with SRC differentiation. All breast carcinomas diagnosed at Centro Hospitalar S. Joao between 1996 and 2006 in which the pathology report mentioned the presence of SRCs (n= 11) and four mucinous carcinomas were included in the study. The frequency of SRCs and immunohistochemistry expression of MUC1/MUC2/MUC5AC/MUC6 were evaluated.We confirmed that SRC differentiation can occur in different histological types, including ductal, lobular, mucinous and metaplastic carcinomas. The proportion of SRCs was highly variable (range: 8-70%). Tumors encompassed SRCs of intracytoplasmic lumina and goblet-cell type. A higher percentage of SRCs was associated with lymphovascular invasion (p= 0.047). All tumors expressed cytoplasmic and membranous MUC1. Secretory mucins were more frequent in mucinous carcinomas and in carcinomas with extensive SRC differentiation.We conclude that besides the usefulness of mucin immunodetection for the differential diagnosis of carcinomas with SRC differentiation of breast origin, it is important to report SRC differentiation regardless of histological type because of its intrinsic prognostic value.We especially thank Professor Sobrinho-Simões for the careful review of the manuscript. IPATIMUP integrates the i3S Research Unit, which is partially supported by FCT, the Portuguese Foundation for Science and Technology. This work is funded by FEDER funds through the Operational Program for Competitiveness Factors-COMPETE and National Funds through the FCT-Foundation for Science and Technology , under the projects: PEst-C/SAU/LA0003/2013 and PTDC/BBB-EBI/0786/2012

Qualidade na Educação Superior: Uma estratégia para a Educação em Enfermagem

Poster apresentado no IX Foro Internacional sobre la Evaluación de la calidad de la Onvestigación y de la Educación Superior(FECIES. Santiago de Compostela. Junho 201

Proteomics Reveals mRNA Regulation and the Action of Annexins in Thyroid Cancer

Differentiated thyroid cancer is the most common malignancy of the endocrine system. Although most thyroid nodules are benign, given the high incidence of thyroid nodules in the population, it is important to understand the differences between benign and malignant thyroid cancer and the molecular alterations associated with malignancy to improve detection and signal potential diagnostic, prognostic, and therapeutic targets. Proteomics analysis of benign and malignant human thyroid tissue largely revealed changes indicating modifications in RNA regulation, a common cancer characteristic. In addition, changes in the immune system and cell membrane/endocytic processes were also suggested to be involved. Annexin A1 was considered a potential malignancy biomarker and, similarly to other annexins, it was found to increase in the malignant group. Furthermore, a bioinformatics approach points to the transcription factor Sp1 as being potentially involved in most of the alterations seen in the malignant thyroid nodules

31. Biopsia aspirativa transtorácica por agulha fina para o diagnóstico de lesões pulmonares

Transthoracic Fine-Needle Aspiration contributes for the diagnosis of pulmonary malignant and benign lesions through cytologic analysis of the obtained material.The purpose of this study was to determine indications, accuracy and safety of transthoracic fine-needle aspiration (TNA) in the evaluation of patients with pulmonary lesions.The authors made a retrospective chart review of seven hundred and forty patients submitted to TNA in our hospital, between September 1, 1998 and June 30, 2003. Three hundred and seventy four (50,5%) were outpatients. TNA procedure was performed using an ultrathin needle, guided by fluoroscopy and cytopathologic evaluation of samples was immediate in all patients. TNA was diagnostic in 72.0% patients: a diagnosis of malignancy was achieved in 81.8% of those and benign pathology was identified in 18.2%. Complications occurred in 7.8%: pneumothorax in 5,9% patients (chest tube placement required in 2,1%); haemoptysis occurred in 2.5%.We concluded that TNA has an excellent diagnostic accuracy for malignant pulmonary lesions at a low complication rate, therefore it can be safely done in outpatients

Sentinel Node Total Tumour Load As a Predictive Factor for Non-Sentinel Node Status in Early Breast Cancer Patients – The porttle study

OSNA is a molecular assay for the detection of sentinel node metastasis. TTL emerged as a concept that seems to accurately predict the status of the NSN. Authors tried to confirm this motion. This is a retrospective and multicentric study that analyzed 2164 patients, 579 of whom had positive SN and completion AD. Logistic regression models were performed in order to identify a suitable cutoff to identify patients who benefit from AD. Univariate and multivariate regression analysis showed a relationship between TTL>30000 and the presence of NSN metastasis (OR 2.84, CI 1.99-4.08, p < 0.001). Logistic regression indicated that the cutoff of 30000 copies/μL better discriminates patients with NSN positivity and allows wide use of these criteria. This cutoff value may safely assist clinicians and patients to decide to proceed or not with an AD.info:eu-repo/semantics/publishedVersio

Pre-operative management of Pleomorphic and florid lobular carcinoma in situ of the breast: Report of a large multi-institutional series and review of the literature

Background: Pleomorphic and Florid Lobular carcinoma in situ (P/F LCIS) are rare variants of LCIS, the exact nature of which is still debated. Aim: To collect a large series of P/F LCIS diagnosed on preoperative biopsies and evaluate their association with invasive carcinoma and high grade duct carcinoma in situ (DCIS). Data obtained were compared with those reported in the literature. Methods: A multi-institutional series of P/F LCIS was retrieved. All cases were diagnosed on pre-operative biopsies, which was followed by an open surgical excision. Data on post-operative histopathology were available. A literature review was performed. Results: A total of 117 cases were collected; invasive carcinoma and/or DCIS was present in 78/117 cases (66.7%). Seventy cases of P/F LCIS were pure on biopsy and 31 of these showed pathological upgrade in post-surgical specimens. Pre-operative biopsy accuracy was 47/78 (60.3%); pre-operative biopsy underestimation of cancer was 31/78 (39,7.%). In the literature review papers, invasive carcinoma or DCIS was associated with 274 of 418 (65.5%) cases of P/F LCIS. Pre-operative biopsy accuracy was 66% (181/274) whereas pre-operative biopsy underestimation of cancer was 33.9% (93/274). Conclusions: The data presented here indicate that P/F LCIS is frequently associated with invasive carcinoma or high grade DCIS and that pre-operative biopsy is associated with an underestimation of malignancy. Open surgery is indicated when P/F LCIS is diagnosed pre-operatively

Pathological non-response to chemotherapy in a neoadjuvant setting of breast cancer: an inter-institutional study

To identify markers of non-response to neoadjuvant chemotherapy (NAC) that could be used in the adjuvant setting. Sixteen pathologists of the European Working Group for Breast Screening Pathology reviewed the core biopsies of breast cancers treated with NAC and recorded the clinico-pathological findings (histological type and grade; estrogen, progesterone receptors, and HER2 status; Ki67; mitotic count; tumor-infiltrating lymphocytes; necrosis) and data regarding the pathological response in corresponding surgical resection specimens. Analyses were carried out in a cohort of 490 cases by comparing the groups of patients showing pathological complete response (pCR) and partial response (pPR) with the group of non-responders (pathological non-response: pNR). Among other parameters, the lobular histotype and the absence of inflammation were significantly more common in pNR (p < 0.001). By ROC curve analyses, cut-off values of 9 mitosis/2 mm(2) and 18 % of Ki67-positive cells best discriminated the pNR and pCR + pPR categories (p = 0.018 and < 0.001, respectively). By multivariable analysis, only the cut-off value of 9 mitosis discriminated the different response categories (p = 0.036) in the entire cohort. In the Luminal B/HER2- subgroup, a mitotic count < 9, although not statistically significant, showed an OR of 2.7 of pNR. A lobular histotype and the absence of inflammation were independent predictors of pNR (p = 0.024 and < 0.001, respectively). Classical morphological parameters, such as lobular histotype and inflammation, confirmed their predictive value in response to NAC, particularly in the Luminal B/HER2- subgroup, which is a challenging breast cancer subtype from a therapeutic point of view. Mitotic count could represent an additional marker but has a poor positive predictive value

Ocorrência de anticorpos para toxoplasmose em ovinos e equinos da região do Pantanal Sul Mato-Grossense, Brasil.

A toxoplasmose é uma zoonose de distribuição mundial que acomete vertebrados homeotérmicos, incluindo o ser humano e animais de produção. É causada pelo protozoário Toxoplasma gondii (T. gondii) e pode ser transmitida pela ingestão de cistos teciduais, presente na carne crua ou mal-cozida, pela ingestão de oocistos esporulados, presentes na água e alimentos contaminados, ou até mesmo ingestão de taquizoítos presentes no leite. Dentre estes, a contaminação ambiental com oocistos esporulados apresenta-se como um importante fator de risco para a infecção toxoplásmica em animais herbívoros, como equinos e ovinos. O presente estudo teve como objetivo pesquisar a presença de anticorpos para T. gondii em equinos e ovinos criados na Fazenda Experimental Nhumirim, propriedade da Embrapa Pantanal, Mato Grosso do Sul, Brasil, em amostras de soro de 101 equinos e 99 ovinos coletadas entre março de 2011 e maio de 2015. Os soros foram submetidos à reação de imunofluorescência indireta (RIFI), sendo consideradas positivas a partir da diluição 1:64. Anticorpos para T. gondii foram detectados em 15,2% (15/99) dos ovinos e 9,9% (10/101) dos equinos. A ocorrência observada aponta contaminação ambiental da propriedade, onde, possivelmente, felídeos silvestres estariam atuando como dispersores do parasita. A exposição dos animais estudados ao parasita deve ser considerada ao avaliar resultados dos estudos de desempenho nos quais estes animais são utilizados, em especial os ovinos, devido à sua alta sensibilidade à infecção toxoplásmica. O presente estudo corrobora outros estudos sobre o risco de infecção de animais domésticos e a presença de T. gondii no ambiente do Pantanal brasileiro. Diante das dificuldades de se aplicarem medidas de prevenção e controle nos sistemas produtivos agropecuários praticados, sugere-se aplicá-las com foco na saúde humana