Diferencias entre los cánceres de mama diagnosticados clínicamente y los detectados en un programa de cribado

OBJETIVOS: El objetivo principal fue determinar si los cánceres de mamadiagnosticados clínicamente tenían características histológicas y biológicasdiferentes a los que se diagnostican en un programa de cribado. Los objetivossecundarios fueron comparar los factores de riesgo y el tratamiento recibido porlas pacientes diagnosticadas a partir de un programa de cribado y lasdiagnosticadas clínicamente.METODOLOGÍA: Estudio de casos y controles. Se incluyeron 311 pacientescon diagnóstico histológico de cáncer de mama y edad entre 45 y 65 años que setrataron en el Servicio de Oncología Médica del Hospital Universitario La Fe deValencia entre 1999 y 2003. En función del método de diagnóstico (cribado oclínico) se establecieron 2 grupos: grupo de diagnóstico precoz donde seincluyeron 158 pacientes (DP) y grupo de diagnóstico clínico (DC) donde seincluyeron 153 pacientes.RESULTADOS: Las pacientes diagnosticadas en el grupo de cribado teníanmayor porcentaje de carcinomas in situ (DP 9.5%, DC 2.62), tumores invasivosmenores de 10 mm (DP 25.9%, DC 8.1%), menor porcentaje de afectaciónganglionar axilar (DP 75.9%, DC 55.6%) y tumores más diferenciados (DP38%, DC 24.8%). Las pacientes del grupo de diagnóstico precoz tenían mayorporcentaje de receptores de estrógeno (DP 87.3%, DC 79.1%), progesterona (DP84.3%, DC 76.7%) y de expresión de bcl2 (DP 75.3%, DC 62.9%). Laspacientes procedentes del cribado se trataron más con cirugía conservadora (DP83.2%, 62.5%) y hormonoterapia (DP 92.3%, DC 82.9%) y menosquimioterapia (DP 44.3%, DC 78.4%).CONCLUSIONES: Las pacientes de DP tienen mayor porcentaje de carcinomasno invasores Los carcinomas invasores en este grupo son de menor tamaño ytienen menos afectación de los ganglios axilares. Los tumores diagnosticados enel grupo de DP tienen menor agresividad que los tumores diagnosticados en elde DC (grado histológico, receptor de estrógeno y progesterona, expresión debcl2). El cribado mamográfico permite utilizar tratamientos quirúrgicos menosagresivos y menos tratamiento adyuvante con quimioterapia sistémica, no asícon hormonoterapia.OBJECTIVES: The aim of the study was to compare the histological andbiological features of breast cancers diagnosed with screening and clinically.METHODS: The study considers 311 patients with breast cancers between 45and 65 treated in the Oncology Department of Hospital Universitario La Fe inValencia (Spain) between 1999 and 2003. They were divided in two groups onthe basis of the diagnosis method: screening group (DP) with 158 patients andclinical group (DC) with 153 patients.RESULTS: The patients in group of DP had many carcinomas in situ (DP 9.5%,DC 2.62), invasive tumours less than 10 mm (DP 25.9%, DC 8.1%), lesspositive nodes (DP 75.9%, DC 55.6%) and lower histological grades (DP 38%,DC 24.8%). The patients in group of DP had higher percentaje of estrogenreceptors (DP 87.3%, DC 79.1%), progesteron receptors (DP 84.3%, DC 76.7%)and bcl2 expresion (DP 75.3%, DC 62.9%). The patients in group of DP weretreated with conservative surgery in many cases (DP 83.2%, 62.5%) andadjuvant hormonal treatment (DP 92.3%, DC 82.9%) but they received lesschemotherapy (DP 44.3%, DC 78.4%).CONCLUSIONS: patients with breast cancer in the DP goup have morecarcinoma in situ, smaller invasive tumours and less positive nodes.Screeningtumours have higher expression of estrogen and progesteron receptors and bcl 2.Patients in the DP group have been treated with more conservative surgery andadjuvant hormonal therapy but less chemotherapy

Randomized phase II study of fulvestrant plus palbociclib or placebo in endocrine-sensitive, hormone receptor-positive/HER2-advanced breast cancer: GEICAM/2014-12 (FLIPPER).

Este artículo ha sido publicado en la revista European Journal of Cancer. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).Background: The potential benefit of adding palbociclib to fulvestrant as first-line treatment in hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative endocrine-sensitive advanced breast cancer (ABC) patients remains uncharacterized. Patients and methods: In this randomized (1:1), double-blind, phase II study, postmenopausal women with HR-positive, HER2-negative ABC with de novo metastatic disease or those who relapsed after >12 months of adjuvant endocrine therapy received palbociclib/fulvestrant or placebo/fulvestrant. Stratification was based on recurrent versus de novo metastatic disease and visceral involvement. The primary objective was one-year progression-free survival (PFS-1y) rate. The sample size was 190 patients. The two-sided alpha of 0.2, 80% of power to detect a difference between the arms, assuming PFS rates of 0.695 and 0.545 for palbociclib/fulvestrant and placebo/fulvestrant, respectively. Results: In total, 189 patients were randomized to palbociclib/fulvestrant ([n = 94] or placebo/fulvestrant [n = 95]). 45.5% and 60.3% of patients had de novo metastatic disease and visceral involvement, respectively. PFS-1y rates were 83.5% and 71.9% in the palbociclib/fulvestrant and placebo/fulvestrant arms, (HR 0.55, 80% CI 0.36-0.83, P = 0.064). The median PFS were 31.8 and 22.0 months for the palbociclib/fulvestrant and placebo/fulvestrant arms (aHR 0.48, 80% CI 0.37-0.64, P = 0.001). The most frequent grade 3-4 adverse events were neutropenia (68.1% vs. 0%), leucopenia (26.6% vs. 0%), anemia (3.2% vs. 0%), and lymphopenia (14.9% vs. 2.1%) for the palbociclib/fulvestrant and placebo/fulvestrant, respectively. The most frequent non-hematologic grade 3-4 adverse event was fatigue (4.3% vs. 0%). Conclusions: Palbociclib/fulvestrant demonstrated better PFS-1y rates and median PFS than placebo/fulvestrant in HR-positive/HER2-negative endocrine-sensitive ABC patients

Effectiveness of group therapy in women with localized breast cancer

Abstract Background/Objective: Breast cancer causes high levels of anxiety and depression, deteriorating quality of life of patients. Several studies have found that group therapy reduces depression and anxiety also improves the quality of life. The aim of this study is to analyze group therapy effectiveness in emotional state and quality of life in women with breast cancer after finalized medical treatments. Method: Participants in this study were 100 adult women diagnosed of breast cancer nonmestastasic and were divided into two types of intervention groups (Self-esteem-Social Skills and Cognitive-Behavioral Therapy). Evaluation instruments were questionnaire Functional Assessment of Breast-cancer Therapy (FACT-B) and Hospital Anxiety and Depression Scale (HADS). Results: A statistically significant effect of group therapy in reducing anxiety and depression were observed. Quality of life and emotional well-being significantly improved. These effects remain three months after intervention. Conclusions: The results show that the psychological intervention group is efficient to improve emotional state and quality of life of women with breast cance

Estudio de la efectividad de la intervención psicológica en pacientes con cáncer de mama localizado

Resumen: Objetivo: valorar la efectividad de la intervención psicológica individual sobre ansiedad, depresión y las estrategias de afrontamiento en tres grupos: Grupo 1 (G1) que utiliza la Terapia Cognitivo Conductual (TCC); Grupo 2 (G2) basado en counselling y psicoeducación; y el Grupo Control (GC) que no realiza intervención psicológica. Método: estudio cuasi experimental con una muestra de 180 pacientes y 51,9 años de edad media. Los instrumentos de evaluación fueron el MINI-MAC y el HADS; se administraron después de la operación quirúrgica a G1 (n= 50) y G2 (n=98), y al finalizar el tratamiento quimioterápico a G1, G2 y GC (n=32). Resultados: después de 7 meses de intervención psicológica, G1 redujo significativamente las medias de ansiedad, depresión, preocupación ansiosa y desesperanza; en G2 disminuyeron los niveles de ansiedad, depresión; y se mantuvo el espíritu de lucha al mismo nivel. El GC demostró niveles de depresión, ansiedad y preocupación ansiosa mayores que G1 y G2. Conclusión: la intervención psicológica (independientemente del tipo de terapia) ayuda a reducir las medias de depresión y ansiedad e incrementar las estrategias de afrontamiento adecuadas como el espíritu de lucha. La TCC es más efectiva en la reducción de sintomatología clínica depresiva y ansiosa. El counselling y la psicoeducación contribuyen a mantener y mejorar las medias de ansiedad, depresión en parámetros no clínicos y fomenta el espíritu de lucha en mujeres que no poseían inicialmente sintomatología depresiva o ansiosa grave. Palabras Clave: Cáncer de mama localizado; ansiedad; depresión; intervención psicológica; terapia cognitivo conductual (tcc); counselling; psicoeducación

Current status of cardio-oncology in Spain: A national multidisciplinary survey

Carta científica. Comisión de Trabajo Nacional de Cardio-Oncología.Peer reviewe

Tumor to Tumor: Metastatic Lobular Breast Carcinoma into Primary Clear Cell Renal Cell Carcinoma

Tumor to tumor condition is a rare phenomenon described in up to 15% of tumor in patients that present more than one primary tumor simultaneously. The most common metastatic donor primary tumor is lung carcinoma, followed by invasive ductal carcinoma of the breast, prostatic acinar adenocarcinoma, and papillary thyroid carcinoma. Herein, we present a case regarding a 61 year-old tumor patient who developed a metastasis of lobular carcinoma of the breast over a primary clear cell renal cell carcinoma diagnosed incidentally

Multidisciplinary consensus on the criteria for fertility preservation in cancer patients

Infertility is one of the main sequelae of cancer and its treatment in both children and adults of reproductive age. It is, therefore, essential that oncologists and haematologists provide adequate information about the risk of infertility and the possibilities for its preservation before starting treatment. Although many international clinical guidelines address this issue, this document is the frst Spanish multidisciplinary guideline in paediatric and adult oncological patients. Experts from the Spanish Society of Medical Oncology, the Spanish Fertility Society, the Spanish Society of Haematology and Haemotherapy, the Spanish Society of Paediatric Haematology and Oncology and the Spanish Society of Radiation Oncology have col‑ laborated to develop a multidisciplinary consensus

Overall survival in the OlympiA phase III trial of adjuvant olaparib in patients with germline pathogenic variants in BRCA1/2 and high-risk, early breast cancer

International audienc