Metastatic Breast Cancer to the Gastrointestinal Tract: Report of Five Cases and Review of the Literature

Luminal gastrointestinal (GI) metastases from breast cancer are rare, reports are fragmentary and poor. The purposes of this study are to assess the gastrointestinal involvement from breast cancer in a retrospective study at a single institution and reviewing the related literature. Between January 2007 and December 2011 a total of 980 patients with breast cancer were treated at our institution, patients' records and report database were analysed. Institutional Review Board approval was obtained for this study. A search of the literature using PubMed, CancerLit, Embase, was performed. Selected for the present review were papers published in English before June 2012. Five of 980 patients (0.5%) showed gastrointestinal metastases from breast cancer, 3 patients had gastric involvement, 1 jejunum, and 1 rectum. Reviewing the literature, 206 patients affected by gastrointestinal metastasis from breast cancer were identified: the most frequent site of metastasis was the stomach (60%). The majority of the patients underwent chemotherapy and endocrine therapy, someone surgery and radiotherapy. GI metastases from breast cancer are rare, but possible, and a very late recurrence can also occur. Cyto-histological diagnosis is mandatory, to differentiate GI metastases from breast cancer to other diseases and to allow an adequate treatment

COVID-19 in patients with thoracic malignancies (TERAVOLT): first results of an international, registry-based, cohort study

Background: Early reports on patients with cancer and COVID-19 have suggested a high mortality rate compared with the general population. Patients with thoracic malignancies are thought to be particularly susceptible to COVID-19 given their older age, smoking habits, and pre-existing cardiopulmonary comorbidities, in addition to cancer treatments. We aimed to study the effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on patients with thoracic malignancies. Methods: The Thoracic Cancers International COVID-19 Collaboration (TERAVOLT) registry is a multicentre observational study composed of a cross-sectional component and a longitudinal cohort component. Eligibility criteria were the presence of any thoracic cancer (non-small-cell lung cancer [NSCLC], small-cell lung cancer, mesothelioma, thymic epithelial tumours, and other pulmonary neuroendocrine neoplasms) and a COVID-19 diagnosis, either laboratory confirmed with RT-PCR, suspected with symptoms and contacts, or radiologically suspected cases with lung imaging features consistent with COVID-19 pneumonia and symptoms. Patients of any age, sex, histology, or stage were considered eligible, including those in active treatment and clinical follow-up. Clinical data were extracted from medical records of consecutive patients from Jan 1, 2020, and will be collected until the end of pandemic declared by WHO. Data on demographics, oncological history and comorbidities, COVID-19 diagnosis, and course of illness and clinical outcomes were collected. Associations between demographic or clinical characteristics and outcomes were measured with odds ratios (ORs) with 95% CIs using univariable and multivariable logistic regression, with sex, age, smoking status, hypertension, and chronic obstructive pulmonary disease included in multivariable analysis. This is a preliminary analysis of the first 200 patients. The registry continues to accept new sites and patient data. Findings: Between March 26 and April 12, 2020, 200 patients with COVID-19 and thoracic cancers from eight countries were identified and included in the TERAVOLT registry; median age was 68·0 years (61·8-75·0) and the majority had an Eastern Cooperative Oncology Group performance status of 0-1 (142 [72%] of 196 patients), were current or former smokers (159 [81%] of 196), had non-small-cell lung cancer (151 [76%] of 200), and were on therapy at the time of COVID-19 diagnosis (147 [74%] of 199), with 112 (57%) of 197 on first-line treatment. 152 (76%) patients were hospitalised and 66 (33%) died. 13 (10%) of 134 patients who met criteria for ICU admission were admitted to ICU; the remaining 121 were hospitalised, but were not admitted to ICU. Univariable analyses revealed that being older than 65 years (OR 1·88, 95% 1·00-3·62), being a current or former smoker (4·24, 1·70-12·95), receiving treatment with chemotherapy alone (2·54, 1·09-6·11), and the presence of any comorbidities (2·65, 1·09-7·46) were associated with increased risk of death. However, in multivariable analysis, only smoking history (OR 3·18, 95% CI 1·11-9·06) was associated with increased risk of death. Interpretation: With an ongoing global pandemic of COVID-19, our data suggest high mortality and low admission to intensive care in patients with thoracic cancer. Whether mortality could be reduced with treatment in intensive care remains to be determined. With improved cancer therapeutic options, access to intensive care should be discussed in a multidisciplinary setting based on cancer specific mortality and patients' preference

Electromyographic activity of upper trapezius muscle in mastectomized women with depressive symtoms

Orientador: Evanisi Teresa PalomariDissertação (mestrado) - Universidade Estadual de Campinas, Instituto de BiologiaResumo: A mastectomia radical é uma técnica cirúrgica muito agressiva, que causam sensações de estresse, gerando ansiedade e depressão. Esses fatores são responsáveis por desequilíbrios no organismo, como mialgias, retardo motor e fadiga. O objetivo deste trabalho foi investigar variações na atividade eletromiográfica da porção superior do músculo trapézio em mulheres mastectomizadas comparando com a interferência da sintomatologia depressiva e dominância dos MMSS. O estudo foi realizado em 23 mulheres com mastectomia radical do tipo Patey e Madden ou total simples e em 9 mulheres saudáveis portadoras ou não de sintomatologia de depressão, quantificada pelo Inventário de Depressão de Beck. Para a aquisição dos dados utilizou-se um eletromiógrafo, composto de 4 canais, com canais compostos por filtros com banda de freqüência entre 20 (FPA) e 500 Hz (FPB), placa de conversão AIO, de 12 bits de resolução e freqüência de amostragem de 1000 Hz, eletrodos bipolares ativos de Ag-Ag CI, conectados a eletrodos auto adesivos e eletrodo terra. Para análise estatística foram utilizados modelos de regressão linear. Os resultados não foram estatisticamente significantes, entretanto, houve tendências à diminuição nos valores de mediana da amplitude do sinal em RMS para o grupo mastectomizado (GM), quando comparado ao grupo controle (GC), ambos depressivo, o que sugere que a dor no local da cirurgia reduz a atividade; notou-se também, aumento desta amplitude, para o (GM) lado com cirurgia, quando comparado ao lado sem cirurgia, exceto para o (GM) sem sintomatologia depressiva, sugerindo que a postura antálgica aumente a atividade mioelétrica; para o fator psicológico e a dominância dos membros não se observou nem mesmo tendênciasAbstract: The radical mastectomy is one very agrgressive technique surgical, that they cause sensations de stress, generating anxiety and depression. These factors cause some disorders in the organism, like a muscle pain, slow motor response and fatigue. This study was carried out with women who have undergone mastectomies in order to investigate possible changes in electromyographic activity of the upper trapezius muscle and compare the influence on symptoms of depression. The present study assessed bilaterally in 23 women underwent to Simple or Patey and Madden's radical mastectomies and in 9 healthy women with or without depression's symptoms, quantified by Beck Depression Inventory. The clinical records were picked up by a four-channel electromyographer. The channels were composed of filters with a frequency range between 20 (FPA) and 500 Hz (FPB), A/O conversion plate with 12 bits resolution and sampling frequency of 1000 Hz and active bipolar electrodos de Ag-Ag CI connected the adhesive electrodes and reference electrode. For statistical analysis a model of linear regression was used. Was noted tendencies in the depressive group~ thought the data were not statistically significant. It was observed the CDG had the higher median, which suggested that the pain on the site of the surgery reduces the EMG activity. On the other hand, in the MDG side with surgery, it was observed an increase in the EMG activity in comparison with the si de without surgery, which suggests that antalgic posture increases the myoelectric activity. For non-depression group, the data did not permit any conclusive data, and, in none of the cases, the dominance interfered in the myoelectric activity. Nevertheless, the data obtained was not statiscally sígnificantMestradoAnatomiaMestre em Biologia Celular e Estrutura

Metastatic Breast Cancer to the Gastrointestinal Tract: Report of Five Cases and Review of the Literature

Luminal gastrointestinal (GI) metastases from breast cancer are rare, reports are fragmentary and poor. The purposes of this study are to assess the gastrointestinal involvement from breast cancer in a retrospective study at a single institution and reviewing the related literature. Between January 2007 and December 2011 a total of 980 patients with breast cancer were treated at our institution, patients’ records and report database were analysed. Institutional Review Board approval was obtained for this study. A search of the literature using PubMed, CancerLit, Embase, was performed. Selected for the present review were papers published in English before June 2012. Five of 980 patients (0.5%) showed gastrointestinal metastases from breast cancer, 3 patients had gastric involvement, 1 jejunum, and 1 rectum. Reviewing the literature, 206 patients affected by gastrointestinal metastasis from breast cancer were identified: the most frequent site of metastasis was the stomach (60%). The majority of the patients underwent chemotherapy and endocrine therapy, someone surgery and radiotherapy. GI metastases from breast cancer are rare, but possible, and a very late recurrence can also occur. Cyto-histological diagnosis is mandatory, to differentiate GI metastases from breast cancer to other diseases and to allow an adequate treatment