Estudo exploratório, descritivo, com abordagem qualitativa, que teve como objetivo analisar a influência de um núcleo de reabilitação para mastectomizadas na vida das mulheres que o frequentam e identificar quais tipos de mudanças ocorreram em suas vidas. Participaram 13 mulheres com idade entre 49 e 82 anos, que frequentavam o grupo de reabilitação há no mínimo três meses. Os dados foram obtidos por meio de entrevistas, com perguntas abertas. Procurou-se identificar unidades temáticas pela Análise de Conteúdo, nas seguintes categorias: 1. Deparando-se com uma nova realidade; 2. Encontrando uma forma de enfrentamento da nova realidade; 3. Mudando comportamentos e maneiras de pensar. Os resultados mostraram que após terem sido encaminhadas ao serviço de reabilitação, as mulheres começaram a entender que havia uma forma de enfrentar, com um pouco menos de sofrimento, a dura realidade de ter câncer de mama, uma doença estigmatizante, que lhes gerava dúvidas e medos em relação ao presente e ao futuro. A frequência ao serviço de reabilitação fez com que elas se descobrissem como membros do grupo e acolhidas, tanto pelas outras mulheres como pelos profissionais; sentiram nestes últimos uma verdadeira preocupação em atender todas as suas necessidades físicas, emocionais e psicossociais. Compartilharam experiências, compreenderam a importância de dividir seus problemas com o grupo, conseguiram pedir e oferecer ajuda. Encontraram um grupo de \"iguais\", e sentiram-se à vontade para compartilhar experiências, criar novas amizades e até mesmo uma \"nova família\". Conseguiram ressocializar-se. Reconheceram-se mais fortes para enfrentar o câncer, sentiram que podiam melhorar e que podiam e deviam participar de sua reabilitação, chegando a modificar comportamentos e maneiras de pensar sobre a doença e suas consequências, sobre as pessoas e sobre si mesmas. Reconheceram o serviço de reabilitação, ou seja, o grupo de mulheres e profissionais, como o grande responsável pelas mudanças positivas que ocorreram em suas vidas; conseguiram lidar melhor até mesmo com as questões da própria finitude e manifestaram a apropriação do senso crítico, quando propuseram, ainda que de forma discreta, algumas sugestões para aprimoramentos na assistência oferecida pelo serviço. O serviço de reabilitação é o lugar onde encontram ânimo para seguir a vida, com segurança para rir e chorar, falar e calar, ouvir e ser ouvida, sem reprimendas. Consideram um privilégio poder desfrutar de tudo o que serviço oferece, inclusive atividades de lazer e sem gastos financeiros. Fazer parte desse grupo significou para as participantes deste estudo um presente de Deus, a chance de vislumbrar uma nova vida. / Exploratory, descriptive, qualitative approach, which aimed to examine the influence of a full mastectomy rehabilitation group in women who lives attend it and identify what kinds of changes in their lives. Participants included 13 women aged between 49 and 82 years who attended the rehabilitation group for at least three months. Data were obtained through interviews with open questions. We sought to identify thematic units through content analysis, the following categories: 1. finding a new reality, 2. finding a way to face the new reality; 3. changing behavior and way of thinking.The results showed that after being sent to rehabilitation services, women began to understand that there was a way to deal with a little less suffering, the harsh reality of having breast cancer, a stigmatizing disease, they generated questions and fears about the present and the future. Attendance at the rehabilitation service meant that they were discovered as members of the group and accepted by both other women and professionals, experienced in the last a genuine concern to meet all their physical, emotional and psychosocial factors. Shared experiences, understood the importance of sharing their problems with the group, could ask for and offer help. They found a group of \"equal\" and felt free to share experiences, new friendships and even a \"new family\". They managed to re-socialize. Acknowledged to be stronger to cope with cancer, they felt they could improve and that could and should participate in them rehabilitation, getting to change behaviors and ways of thinking about disease and its consequences, about people and about themselves. Acknowledged the service of rehabilitation, the group of women and professionals, as largely responsible for the positive changes occurring in their lives got better even with the issues of their own finitude and expressed the appropriation of critical sense, when they proposed , albeit discreetly, some suggestions for improvements on the care offered. The rehabilitation service is the place where they find the courage to follow the life safely to laugh and cry, talk, listen and be heard without reprimand. They consider it a privilege to enjoy all that service offers, including leisure activities and no financial expenditure. Being part of this group has meant to the participants in this study a godsend chance to glimpse a new life.

Objetivo: compreender o significado da vivência do câncer de mama para mulheres jovens, com relação ao Trabalho, Maternidade e Imagem corporal. Método: estudo qualitativo; referencial metodológico: Discurso do Sujeito Coletivo; teórico: Interacionismo Simbólico. Desenvolvido em um Ambulatório de Mastologia e Núcleo de Reabilitação de Mastectomizadas. A coleta ocorreu de fevereiro/2014 a janeiro/2015. Participaram 12 mulheres selecionadas por prontuários, entre 18 e 40 anos, com até um ano do diagnóstico do câncer, sendo excluídas aquelas que não se expressavam individualmente e com metástase; responderam às questões norteadoras: \"Como é para você ser uma mulher jovem que teve diagnóstico do câncer de mama com relação ao trabalho? À maternidade? À sua imagem corporal?\". Resultados: emergiram as categorias: \"Fato de você ser jovem e ter que parar de trabalhar, às vezes eu me sinto meio inválida, sabe? E o fato de me tirar daquilo que eu mais gosto de fazer que era trabalhar, que é trabalhar, me apavorou um pouco\"; A importância do trabalho pelo fato de ser mulher e jovem: \"O Trabalho é a edificação da alma! Não tem frase melhor que defina trabalho, e como mulher jovem: Liberdade!\"; O afastamento da mulher jovem de sua atividade de trabalho e as relações sociais; A maternidade e o fato de ser mulher jovem com câncer de mama: \"A maternidade me mostrou um amor grande demais, mas abala (o câncer) porque nessa idade que eu estou a gente tem muitos sonhos ainda, entendeu\"; Dilema materno: ter ou não filhos após o câncer de mama?; A amamentação para a mulher jovem com câncer de mama; Dilema materno: a possível ausência para os filhos; Dilema materno como mulher jovem: a proteção com os filhos diante do diagnóstico do câncer de mama; Para a mulher jovem com câncer de mama a maternidade é o ponto de equilíbrio para o enfrentamento do câncer; Perda de cabelos, pelos e mudança na coloração da pele e unhas: \"Me fez sentir feia. Fica sem expressão. Me sinto debilitada como mulher\"; O fato de ser jovem e a falta da mama: \"Não quero ser mutilada. Perder um seio é muito difícil\"; Sentimento da mulher relacionado ao ganho de peso durante o tratamento: \"está me incomodando e fico com a autoestima lá embaixo\'\"; A mulher jovem se incomoda com os olhares curiosos por apresentar mudança corporal causada pelo câncer de mama: \"Quero passar despercebida, não quero que sintam pena \'coitada, tão nova\'\"; \"O pessoal jovem sofre demais. Você se olha no espelho e diz: \'puts eu não sou igual a todo mundo\'.\" A vivência do câncer de mama para as mulheres jovens, relacionado ao trabalho, maternidade e imagem corporal, significou viver com a dualidade de \"ter de se tratar\" e ter de \"passar pelas adversidades impostas pelo câncer de mama\"; lidar com dificuldades, quando necessitaram \"camuflar sofrimentos\" para que filhos/companheiros/familiares e amigos não sofressem \"pelas suas dores (das mulheres)\", e \"apoio\", quando conseguiram \"compartilhar o câncer de mama\" com eles. Conclusão: profissionais de saúde devem atuar diante dos comprometimentos causados pela doença / Objective: to understand the meaning of breast cancer experience for young women in relation to Work, Maternity and Body Image. Method: qualitative study; Methodological approach: Discourse of the Collective Subject; Theory: Symbolic Interactionism. Developed in a Mastology Ambulatory and Mastectomized Rehabilitation Nucleus. The data collect occurred from February / 2014 to January / 2015. Twelve women between 18 and 40 years were selected by medical records, with up to one year of diagnosis of cancer participated, and those with metastasis and who could not express themselves individually were excluded; they answered the guiding questions: \"How is for you to be a young woman diagnosed with breast cancer in relation to work? Motherhood? And body image?\" Results: The categories emerged: \"The fact that you are young and have to stop working, sometimes I feel kind invalid, you know?\"; The importance of work for being a woman and a young person: \"Work is the building up of the soul! There\'s no better phrase that defines work, and as a young woman: Freedom!\"; The removal of the young woman of his work activity and the social relations; Motherhood and the fact of being a young woman with breast cancer: \"Motherhood has shown me a great love, but it shakes (cancer) because at this age that I am we have many dreams yet, do you understand?\"; Maternal dilemma: have or not have children after breast cancer?; Breastfeeding for the young woman with breast cancer; Maternal dilemma: possible absence for the children; For the young woman with breast cancer, motherhood is the point of balance for coping with cancer; Loss of hair and change in the color of the skin and nails: \"It made me feel ugly. Without expression. I feel weak as a woman\"; The fact of being young and the breast\'s loss: \"I do not want to be mutilated. Losing a breast is very difficult\"; Woman\'s feeling associated to weight gain during treatment: \"it\'s bothering me and my self-esteem falls\"; The young woman is bothered by the curious looks due to the corporal change caused by breast cancer: \"I want to go unnoticed, I do not want them to feel \"poor, so young\'\"; \"Young people suffer a lot. You look at yourself in the mirror and say, \'Oh, I\'m not like everyone else.\' The experience of breast cancer for young women, in relation to work, maternity and body image, it meant living with the duality of \"having to treat\" and to have to \"go through the adversities imposed by breast cancer\"; deal with difficulties, especial when they needed to \"camouflage their suffering\", so their children / partner / relatives and friends would not suffer \"with their pains (of women)\", and \"support\" when they were able to \"share the experience of breast cancer\" with them. Conclusion: health professionals must act on the deficits caused by the disease

Breast cancer is the most common cancer among females and it is the leading cause of death in mid-age women. Epidemiological studies indicate that Asian women have a lower incidence of breast cancer compared with their counterparts in the West, which soy consumption has been suggested as a contributory factor. Soy and soy-based food contain a rich amount of phytoestrogens, which are suggested to be protective against cancer. Cyclooxygenase (COX) is the rate-limiting enzyme for the conversion of arachidonic acid to prostaglandins. Recent studies have revealed that up-regulation of cyclooxygenase-2 (COX-2), an isoform of COX, plays an important role in tumorigenesis and metastasis. COX-2 may facilitate carcinogenesis in a number of means, may include altering cell proliferation and apoptosis, enhancing angiogenesis and suppressing immune surveillance. Clinical examinations of breast cancer specimens indicated that COX-2 is overexpressed. In the present study, we investigated the effect of flavonoids on COX-2 expression in human breast cells. / Our results showed that daidzein and its metabolite eqoul, genistein, butein, isoliquiritigenin (ILN) and apigenin could inhibit phorbol 12-myristate 13-acetate (PMA)-induced COX-2 expression in breast cells MCF-7 and MCF-10A. The inhibitory effects were in concentration-dependent manners. Real-time PCR and western blot analysis showed that the flavonoids suppressed the induced mRNA and protein expression. Suppression could be observed in concentration as low as 0.1 muM. Luciferase reporter assay indicated that the inhibition was at the gene transactivation level. Further investigation using truncated hCOX-2 promoter plasmids revealed that the AP-1 site (-67/-61) and cyclic AMP response element (CRE) site (-59/-53) on hCOX-2 promoter were responsible for the suppression. Electrophoretic mobility shift assay results further confirmed that the flavonoids acted through inhibiting AP-1/CREB DNA binding to suppress the expression. / To examine the possible upstream signal transduction pathways involved, inhibitors of protein kinase A (PKA), protein kinase (PKC) and mitogen activated protein kinase (MAPK) were employed. Reporter gene assay revealed a possible involvement of ERK1/2 MAP kinase in AP-1 and/or CRE activation of hCOX-2 promoter. Taken together, these results suggested that the phytochemicals down-regulated PMA-induced COX-2 expression by counteracting AP-1 and CRE sites via the modulation of MAPK pathway. The findings might have significant implications in the chemopreventive and chemotherapeutic applications of flavonoids in breast cancer. / Lau, Tak Yi. / "December 2007." / Adviser: Lai Kwok Leung. / Source: Dissertation Abstracts International, Volume: 69-08, Section: B, page: 4734. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2007. / Includes bibliographical references (p. 142-164). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

by Tsui Hong Teng. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1999. / Includes bibliographical references (leaves 174-181). / Abstracts in English and Chinese. / A CKNO WLED GMENTS --- p.7 / ABSTRACT --- p.8-10 / Chapter Chapter 1: --- Introduction: --- p.11-44 / Chapter 1.1) --- Glucose transporters / Chapter 1.2) --- Glucose transporters and cancers / Chapter 1.3) --- Antisense strategies / Chapter 1.4) --- Cellular uptake of oligonucleotides / Chapter 1.5) --- Hyperthermia and combined treatments / Chapter Chapter 2: --- Materials and methods --- p.45-60 / Chapter 2.1) --- Materials: / Chapter 2.1a) --- Cell lines and culture media / Chapter 2.1b) --- Oligonucleotides synthesis / Chapter 2.1c) --- Chemicals / Chapter 2.2) --- Methods: / Chapter 2.2a) --- Oligonucleotide design / Chapter 2.2b) --- Oligonucleotide treatment / Chapter 2.2c) --- Flow cytometry / Chapter 2.2d) --- Confocal microscopy / Chapter 2.2e) --- MTT assay for cytotoxicity or cell proliferation / Chapter Chapter 3: --- Cellular uptake of oligonucleotide spontaneously and Lipofectin-aided: --- p.61-85 / Chapter 3.1) --- Introduction / Chapter 3.2) --- Flow cytometric studies / Chapter 3.3) --- Confocal microscopic studies / Chapter 3.4) --- Cytotoxic effect of Lipofectin alone on MCF-7 cells / Chapter 3.5) --- Discussion / Chapter Chapter 4: --- Hyperthermia can enhance oligonucleotide uptake: --- p.86-118 / Chapter 4.1) --- Introduction / Chapter 4.2) --- Flow cytometric studies / Chapter 4.3) --- Confocal microscopic studies / Chapter 4.4) --- Cytotoxic effect of hyperthermia on MCF-7 cells / Chapter 4.5) --- FITC-ODN uptake in survival cells by propidium iodide (PI) exclusion method for hyperthermia / Chapter 4.6) --- Discussion / Chapter Chapter 5: --- The antiproliferative effects of antisense molecules against Glut-1 and 5 on MCF- 7 cells transfected by Lipofectin: --- p.119-146 / Chapter 5.1) --- Introduction / Chapter 5.2) --- The growth curve of MCF-7 cells / Chapter 5.3) --- The calibration of MTT assay / Chapter 5.4) --- The effect of antisense Glut-1 concentration without Lipofectin on MCF-7 cells / Chapter 5.5) --- The effect of antisense Glut-1 concentration with Lipofectin on MCF-7 cells / Chapter 5.6) --- The effect of antisense Glut-5 concentration without Lipofectin on MCF-7 cells / Chapter 5.7) --- The effect of antisense Glut-5 concentration with Lipofectin on MCF-7cells / Chapter 5.8) --- The effect of transfection time of antisense Glut-1 on MCF-7 cells / Chapter 5.9) --- The effect of transfection time of antisense Glut-5 on MCF-7 cells / Chapter 5.10) --- The effect of transfection time of antisense Glut-5 for higher concentration on MCF-7 cells / Chapter 5.11) --- The effect of antisense Glut-1 to Lipofectin (w/w) ratio on MCF-7 cells / Chapter 5.12) --- The effect of antisense Glut-1 to Lipofection (w/w) ratio for higher transfection time on MCF-7 cells / Chapter 5.13) --- The effect of antisense Glut-5 to Lipofectin (w/w) ratio on MCF-7 cells / Chapter 5.14) --- Discussion / Chapter Chapter 6: --- Combined treatments: --- p.147-162 / Chapter 6.1) --- Introduction / Chapter 6.2) --- The effect of combined treatment of antisense Glut-1 combined with antisense Glut-5 on MCF-7 cells / Chapter 6.3) --- The chronic effect of hyperthermia for 5 hours on MCF-7 cells / Chapter 6.4) --- The effect of combined treatment between antisense Glut-1 and hyperthermia on MCF-7 cells / Chapter 6.5) --- The net effect of antisense Glut-1 in combined treatment between hyperthermia and antisense Glut-1 on MCF-7 cells / Chapter 6.6) --- The effect of combined treatment between antisense Glut-5 and hyperthermia on MCF-7 cells / Chapter 6.7) --- The net effect of antisense Glut-5 in combined treatment between hyperthermia and antisense Glut-5 on MCF-7 cells / Chapter 6.8) --- Discussion / Chapter Chapter 7: --- Discussion: --- p.163-173 / Chapter Chapter 8: --- References: --- p.174-181

by Wong Che-cheuk, Dobe. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1998. / Includes bibliographical references (leaves 98-112). / Abstract also in Chinese. / Acknowledgements --- p.i / Abstracts --- p.ii / List of Abbreviation --- p.vi / Table of Contents --- p.vii / Chapter 1. --- Introduction / Chapter 1.1 --- Stages of Cancer Development --- p.1 / Chapter 1.2 --- Comparison of Breast Cancer in Hong Kong & the United States --- p.2 / Chapter 1.2.1 --- Statistics of Breast Cancer in the United States --- p.2 / Chapter 1.2.2 --- Statistics of Breast Cancer in Hong Kong --- p.2 / Chapter 1.3 --- Factors for Breast Cancer --- p.6 / Chapter 1.3.1 --- Genetic Factor --- p.6 / Chapter 1.3.2 --- Hormonal Factor --- p.7 / Chapter 1.3.3 --- Genetic Bias --- p.9 / Chapter 1.3.4 --- Influence of Diet --- p.10 / Chapter 1.3.5 --- Obesity --- p.14 / Chapter 1.3.6 --- Xenoestrogen --- p.14 / Chapter 1.4 --- Hormonal Therapy in Breast Cancer --- p.15 / Chapter 1.4.1 --- Antiestrogen --- p.15 / Chapter 1.4.2 --- Progestin Antagonist --- p.19 / Chapter 1.4.3 --- Aromatase Inhibitor --- p.20 / Chapter 1.4.4 --- Gonadotropin Releasing Hormone (GnRH) Analogue --- p.23 / Chapter 1.5 --- Metabolism of Estrogen --- p.25 / Chapter 1.6 --- Substance with Chemopreventive Properties towards Breast Cancer --- p.29 / Chapter 1.7 --- Aryl Hydrocarbon Receptor --- p.33 / Chapter 1.8 --- Cytochrome P450s --- p.34 / Chapter 1.9 --- Yuehchukene --- p.36 / Chapter 1.10 --- Objectives of the Present Study --- p.38 / Chapter 2. --- Materials and Methods / Chapter 2.1 --- Animals --- p.40 / Chapter 2.2 --- Animal Treatment --- p.40 / Chapter 2.3 --- Preparation of Crude Microsomal Fraction --- p.41 / Chapter 2.4 --- Protein Assay --- p.41 / Chapter 2.5 --- Ethoxyresorufm-O-deethylase Assay --- p.41 / Chapter 2.6 --- Methoxyresorufin-O-deethylase Assay --- p.42 / Chapter 2.7 --- Estradiol-2-hydroxylase Assay --- p.42 / Chapter 2.8 --- Progesterone Hydroxylase Assay --- p.43 / Chapter 2.9 --- Hepatic Aromatase Activity Assay --- p.43 / Chapter 2.10 --- Inhibition of Ethoxyresorufm-O-deethylase and Estradiol-2-hydroxylase --- p.44 / Chapter 2.11 --- Free Radicals Scavenging Assay --- p.44 / Chapter 2.12 --- Chemicals --- p.45 / Chapter 3. --- Result / Chapter 3.1 --- Optimization of Condition --- p.47 / Chapter 3.1.1 --- Dosage --- p.47 / Chapter 3.1.2 --- Time for Sacrifice --- p.47 / Chapter 3.2 --- "Effect of Isoprenyl Compounds on the Body Weight, Liver Weight and Hepatic Microsomal Protein Content" --- p.50 / Chapter 3.3 --- Hepatic Enzyme Activities --- p.54 / Chapter 3.3.1 --- Ethoxyresorufm-O-deethylase --- p.54 / Chapter 3.3.2 --- Methoxyresorufm-O-deethylase --- p.57 / Chapter 3.3.3 --- Estradiol-2-hydroxylase --- p.60 / Chapter 3.3.4 --- Progesterone Hydroxylase --- p.62 / Chapter 3.3.5 --- Aromatase --- p.65 / Chapter 3.4 --- Effect of Inhibitors in Ethoxyresorufin-O-deethylase and Estradiol-2-hydroxylase Activity --- p.65 / Chapter 3.5 --- Free Radical Scavenging Activity --- p.72 / Chapter 4. --- Discussion --- p.77 / Chapter 5. --- Conclusion --- p.95 / Chapter 6. --- References --- p.98 / Chapter 7. --- Appendix --- p.113

Background: Breast cancer is the most common form of cancer in women. It is considered anappalling disease with its high mortality, demanding treatment and major impact on selfimageand body perception. Aim: The aim of this study is to describe women's experiences of being diagnosed and treatedfor breast cancer and how the breast cancer affects their life situation. Method: The method used was a literature study based on qualitative research. Eleven studieswere analysed according to the five-step model by Friberg. Results: The analysis resulted in three main themes and sex subthemes. The main themeswere: The life is threatened, Suffer from disease and Life continues. Conclusion: Suffering from breast cancer imposes changes on all aspects of the women's life,both physically, mentally and socially and evokes various individual coping strategies. In thisprocess it is vital that the nurse, which is closest to the patient, has a good understanding ofthe various patterns of crisis reaction to be able to deliver a good professional care andindividual support to the women.

Lee Mei-sze. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2003. / Includes bibliographical references (leaves 123-133). / Abstracts in English and Chinese. / ACKOWLEDGEMENT --- p.i / ABSTRACT --- p.ii / ABSTRACT in Chinese (摘要） --- p.iv / LIST OF FIGURES AND TABLES --- p.vi / LIST OF ABBREVIATIONS --- p.viii / Chapter CHAPTER 1: --- INTRODUCTION / Chapter 1.1 --- Discovery of polyphyllin D in pharmaceutical study --- p.1 / Chapter 1.2 --- Structure of Polyphyllin D --- p.4 / Chapter 1.3 --- Origin of Polyphyllin D --- p.4 / Chapter 1.4 --- Polyphyllin D in antitumor activities analysis --- p.6 / Chapter 1.5 --- Characteristic of Polyphyllin D --- p.9 / Chapter 1.6 --- General properties of Saponin --- p.9 / Chapter 1.6.1 --- Membrane-disrupting property --- p.10 / Chapter 1.6.2 --- Hemolytic Property --- p.10 / Chapter 1.7 --- Antitumor properties of saponins --- p.11 / Chapter 1.7.1 --- Induction of apoptosis by saponins --- p.11 / Chapter 1.7.2 --- Induction of cell cycle arrest by saponins --- p.12 / Chapter 1.7.3 --- Saponins with structure similar to polyphyllin D are found with antitumor activity --- p.13 / Chapter 1.8 --- Human breast cancer --- p.14 / Chapter 1.8.1 --- Incidence of Breast Cancer --- p.14 / Chapter 1.8.2 --- Classification of Breast Cancer --- p.16 / Chapter 1.8.3 --- Role of estrogen and estrogen receptor in breast cancer --- p.16 / Chapter 1.8.4 --- Today treatment in Breast Cancer --- p.18 / Chapter 1.8.4.1 --- Hormonal Therapy --- p.18 / Chapter 1.8.4.1.1 --- Tamoxifen --- p.19 / Chapter 1.8.4.2 --- Chemotherapy --- p.20 / Chapter 1.8.4.2.1 --- Doxorubicin (Adriamycin) --- p.20 / Chapter 1.9 --- The Hypothesis and the aim my project --- p.22 / Chapter CHAPTER 2: --- Materials and methods / Chapter 2.1 --- Materials --- p.24 / Chapter 2.1.1 --- Cell Lines --- p.24 / Chapter 2.1.1.1 --- MCF-7 --- p.24 / Chapter 2.1.1.2 --- MDA-MB-231 --- p.25 / Chapter 2.1.1.3 --- HS68 --- p.25 / Chapter 2.1.1.4 --- WRL-68 --- p.25 / Chapter 2.1.2 --- Culture Medium --- p.26 / Chapter 2.1.2.1 --- RPMI 1640 (Phenol Red Medium) --- p.26 / Chapter 2.1.2.2 --- RPMI 1640 (Phenol Red-free Medium) --- p.27 / Chapter 2.1.2.3 --- Dulbecco's modified Eagle's medium --- p.27 / Chapter 2.2 --- Reagent and Buffers --- p.28 / Chapter 2.2.1 --- Regents for DNA fragmentation Assay --- p.28 / Chapter 2.2.2 --- Regents for Western Blot Analysis --- p.29 / Chapter 2.2.3 --- Reagent for Two Dimensional Electrophoresis Analysis --- p.31 / Chapter 2.2.3.1 --- Protein Preparation --- p.31 / Chapter 2.2.3.2 --- First dimension Electrophoresis --- p.31 / Chapter 2.2.3.3 --- Second dimension Electrophoresis --- p.32 / Chapter 2.2.3.4 --- Silver staining --- p.32 / Chapter 2.2.4 --- Reagent for ln-gel digestion --- p.33 / Chapter 2.2.4.1 --- Destaining --- p.33 / Chapter 2.2.4.2 --- Digestion --- p.33 / Chapter 2.2.4.3 --- Desalting of the peptide mixture for MS analysis --- p.33 / Chapter 2.2.5 --- Reagent for flow cytomertry analysis --- p.34 / Chapter 2.2.6 --- Reagent for immunofluorescent staining --- p.34 / Chapter 2.2.7 --- Reagent for Primary mouse speenocytes and macrophages preparation --- p.34 / Chapter 2.2.8 --- Reagent for Cell Cytotoxicity Assay --- p.35 / Chapter 2.2.9 --- Reagent for in vivo study --- p.35 / Chapter 2.2.10 --- Reagent for Estrogen Receptor Competitive Assay --- p.35 / Chapter 2.3 --- Chemicals --- p.36 / Chapter 2.4 --- Methods --- p.38 / Chapter 2.4.1 --- Polyphyllin D preparation --- p.38 / Chapter 2.4.1.1 --- in vitro application --- p.38 / Chapter 2.4.1.2 --- in vivo application --- p.39 / Chapter 2.4.2 --- Treatment of polyphyllin in vitro --- p.39 / Chapter 2.4.3 --- MTT assay --- p.39 / Chapter 2.4.4 --- Trypan Blue Exclusion Assay --- p.40 / Chapter 2.4.5 --- Analysis of Cell-Cycle Phase Distribution by Flow cytometry with PI staining --- p.41 / Chapter 2.4.6 --- Estrogen Receptor competitive Assay --- p.41 / Chapter 2.4.7 --- Nucleosome Detection Assay --- p.42 / Chapter 2.4.8 --- Quantification of Apoptosis by Flow Cytometry with Annexin V ´ؤ PI Staining --- p.42 / Chapter 2.4.9 --- Assessment of the Change in Mitochondrial Membrane Potential (Δφ m) --- p.43 / Chapter 2.4.10 --- Western Blotting Analysis --- p.44 / Chapter 2.4.10.1 --- Protein Extraction --- p.45 / Chapter 2.4.10.2 --- Protein concentration Determination --- p.47 / Chapter 2.4.10.3 --- SDS acrylamide gel electrohphoresis --- p.47 / Chapter 2.4.10.4 --- Electroblotting of Protein --- p.47 / Chapter 2.4.10.5 --- Probing of Proteins with Antibodies --- p.48 / Chapter 2.4.10.6 --- Enhanced Chemiluminescence (ECL) Assay --- p.48 / Chapter 2.4.11 --- Two Dimensional Electrophoretic Analysis --- p.49 / Chapter 2.4.11.1 --- Protein preparation --- p.50 / Chapter 2.4.11.2 --- First dimensional electrophoresis --- p.51 / Chapter 2.4.11.2.1 --- Rehydration of IPG strips --- p.51 / Chapter 2.4.11.2.2 --- IEF with IPGphor --- p.51 / Chapter 2.4.11.2.3 --- Running IPG strips --- p.52 / Chapter 2.4.11.2.4 --- Eauilibration of the IPG strip --- p.52 / Chapter 2.4.11.3 --- Second dimensional electrophoresis Equilibration of the IPG strip --- p.52 / Chapter 2.4.11.4 --- Visualization of the 2D gel by Silver staining --- p.53 / Chapter 2.4.11.5 --- Computer analysis of the 2d gel image --- p.54 / Chapter 2.4.12 --- Protein identification with Matrix assisted laser desorption- ionization Time-of-flight mass spectrometry (MALDI-TOF) --- p.54 / Chapter 2.4.12.1 --- In gel tryptic digestion --- p.54 / Chapter 2.4.12.2 --- Desalting of the peptide mixtures --- p.55 / Chapter 2.4.12.3 --- Database Searching --- p.55 / Chapter 2.5 --- Statisitc Analysis --- p.55 / Chapter CHAPTER 3: --- Cytotoxic effects of polyphyllin D / Chapter 3.1 --- Introduction --- p.57 / Chapter 3.2 --- Cytotoxic activities on human breast cancer cell lines --- p.58 / Chapter 3.2.1 --- In MCF-7 cells --- p.53 / Chapter 3.2.2 --- In MDA-MB-231 cells --- p.58 / Chapter 3.3 --- Cytotoxic activities on human normal cell lines --- p.63 / Chapter 3.3.1 --- "Human normal liver cell line, WRL-68" --- p.63 / Chapter 3.3.2 --- "Human skin fibroblast cell line, HS-68" --- p.63 / Chapter 3.4 --- Cytotoxic activities on primary culture --- p.65 / Chapter 3.4.1 --- Primary mouse spleenocytes --- p.65 / Chapter 3.5 --- Conclusion --- p.59 / Chapter CHAPTER 4: --- Induction of apoptosis / Chapter 4.1 --- Introduction --- p.70 / Chapter 4.2 --- Induction of apoptosis on MCF-7 cells --- p.71 / Chapter 4.2.1 --- Nucleosome formation by ELISA assay --- p.71 / Chapter 4.2.2 --- Phosphatidylserine Extemalization by flow cytometrial study --- p.73 / Chapter 4.3 --- Induction of apoptosis on MDA-MB-231 cells --- p.75 / Chapter 4.3.1 --- Apoptotic peak by flow cytometrial study --- p.75 / Chapter 4.3.2 --- Phosphatidylserine Extemalization by flow cytometrial study --- p.78 / Chapter 4.4 --- Conclusion --- p.80 / Chapter CHAPTER 5 --- : Induction of apoptosis via mitochondrial pathway / Chapter 5.1 --- Introduction --- p.81 / Chapter 5.2 --- Mitochondrial Membrane Depolarization by flow cytometrial study --- p.82 / Chapter 5.2.1 --- In MCF-7 cells --- p.84 / Chapter 5.2.2 --- In MDA-MB-231 cells --- p.84 / Chapter 5.3 --- Alternation of mitochondrial protein expression by western blot analysis on MCF-7 and MDA-MB-231 cells --- p.87 / Chapter 5.4 --- Activation of caspase9 --- p.90 / Chapter 5.5 --- Conclusion --- p.92 / Chapter CHAPTER 6 --- : Antitumor activities independent of estrogen receptor / Chapter 6.1 --- Introduction --- p.93 / Chapter 6.2 --- Completion assay on Estrogen Receptor binding --- p.95 / Chapter 6.3 --- Expression level of Estrogen receptor --- p.97 / Chapter 6.4 --- Conclusion --- p.99 / Chapter CHAPTER 7 --- : Proteomic detection of intracellular changes / Chapter 7.1 --- Introduction --- p.100 / Chapter 7.2 --- Differential Protein expression profile of MCF-7 cells --- p.101 / Chapter 7.3 --- Elevated HLA-A antigen expression --- p.104 / Chapter 7.3.1 --- Mass fingerprinting with MALDI-TOF-MS --- p.104 / Chapter 7.3.2 --- Flow cytometrial analysis with immunofluoresent staining --- p.107 / Chapter 7.4 --- Conclusion --- p.109 / Chapter CHAPTER 8 --- : Discussion / Chapter 8.1 --- Polyphyllin D is Invaluable for further Investigation --- p.110 / Chapter 8.2 --- Induction of common mitochondrial pathway --- p.111 / Chapter 8.3 --- Induction of Fas receptor apoptotic pathway is unknown --- p.112 / Chapter 8.4 --- Polyphyllin D is Caspase-3 independent --- p.113 / Chapter 8.5 --- MDA-MB-231 is more sensitive to polyphyllin D --- p.113 / Chapter 8.6 --- Antitumor effects regardless of induction of apoptosis --- p.114 / Chapter 8.7 --- Advances in antitumor effect by MHC-1 antigen up-regulation --- p.114 / Chapter 8.8 --- Implication of polyphyllin D in up-regulating MHC-1 antigen --- p.115 / Chapter 8.9 --- Future aspect --- p.117 / Chapter 8.10 --- Conclusion --- p.121 / Chapter CHAPTER 9 : --- References --- p.122

Submitted by Fabíola Silva (fabiola.silva@famerp.br) on 2016-06-22T18:42:10Z No. of bitstreams: 1 josealtino_dissert.pdf: 1203044 bytes, checksum: 98a2323333c4e318b345940a3837aec3 (MD5) / Made available in DSpace on 2016-06-22T18:42:10Z (GMT). No. of bitstreams: 1 josealtino_dissert.pdf: 1203044 bytes, checksum: 98a2323333c4e318b345940a3837aec3 (MD5) Previous issue date: 2012-11-01 / Introduction: Breast cancer has a high prevalence and mortality in women. The family history in first-degree relatives is the main risk factor for the disease, accounting for 20-25% of cases. The remaining cases are caused by multiple factors, such as obesity, dyslipidemia, use of hormone therapy (HT). However it is unclear the effect of the combination of these factors in breast cancer. Objective: To evaluate the relationship between hormone levels and lipid profile and its influence on the immunohistochemical expression of receptors in breast tumors in postmenopausal women with or without HT, and to assess some risk factors and prognosis of breast cancer. Casuistic and Method: We studied 50 post-menopausal women with breast cancer, divided into two groups: G1 without, and G2 - with HT, at least 5 years, with HT suspended for cancer diagnosis. We analyzed lipid profile including total cholesterol (TC) and fractions (LDLc, HDLc, VLDLc) and triglycerides (TG), and the hormonal profile (estradiol, follicle stimulating hormone (FSH) and luteinizing hormone (LH). The analysis of immunohistochemical expression comprised estrogen receptors (ER), progesterone (PR) and human epidermal factor type 2 (HER-2). We also evaluated the value prognosis of these receptors and the body mass index (BMI). Higher significance level of P <0.05 was considered. Results: Values of serum TC, LDLc, and HDLc were according to recommended limits in both groups (P> 0.05), while increased median values were observed for VLDLc and TG in G1 (36, 180 mg / dL, respectively ) versus G2 (28; 142 mg / dL, respectively, P = 0.048 for both). The presence of ER, PR, and HER-2 and itsrelationship with lipid profile and hormonal profile were similar between the groups (P> 005). The median values for hormone profile were similar in both groups (P> 005), except in the group analysis for LH values in pre-and postmenopausal women, especially the HT group, with 28% of patients with levels LH corresponding to premenopausal women (P = 0.010). A positive correlation was observed between levels of LDLc with CT. VLDLc, and TG for G1 (P ≤ 0.001) and G2 (P <0.05) positive correlation between TG and VLDLc in G1 (P <0.001) and G2 (P <0.001) negative correlation between the level of HDL-C and LH in G1 (P = 0.023); positive correlation between FSH and LDLc in G2 (P = 0.041), positive correlation between FSH and LH in G2 (P = 0.048); negative correlation between FSH and estradiol in G1 (P = 0.001). Risk factors (lipid profile and lipid BMI) and prognostic factors (absence of ER and PR, and presence or absence of HER-2) were similar in G1 and G2 for disease-free survival and overall (P> 0.05). Conclusion: Changes in hormonal and lipid profile did not influence the immunohistochemical expression of tumor tissue, prognostic factor in breast cancer, therefore, does not interfere with overall survival and free- tumor recurrence. / Introdução - O câncer de mama apresenta alta taxa de prevalência e mortalidade nas mulheres. A história familiar em parentes em primeiro grau é o principal fator de risco para a doença, sendo responsável por 20-25% dos casos. Os demais casos são decorrentes de múltiplos fatores, como obesidade, dislipidemia, uso de terapia hormonal (TH). No entanto, ainda é obscuro o efeito da associação dos referidos fatores no câncer de mama. Objetivos - Avaliar a relação entre perfil lipídico e níveis hormonais, e sua influência na expressão de receptores imunohistoquímico nos tumores de mama, em mulheres na pós-menopausa, com ou sem TH, e avaliar fatores de risco e prognóstico do câncer de mama. Casuística e Métodos - Foram estudadas 50 mulheres com câncer de mama na pós-menopausa, distribuídas em dois grupos: G1 – sem, e G2 – com uso de TH, no mínimo por 5 anos, TH suspenso ao diagnóstico do câncer. Analisou-se perfil lipídico incluindo níveis séricos de colesterol total (CT) e frações (LDLc, HDLc, VLDLc) e triglicérides (TG), além do perfil hormonal [estradiol, hormônio folículo estimulante (FSH) e hormônio luteinizante (LH)]. A análise da expressão imunohistoquímica compreendeu receptores de estrógeno (RE), progesterona (RP) e fator epidermal humano do tipo 2 (HER-2). Avaliou-se também o valor prognóstico dos referidos receptores e o índice de massa corporal (IMC). Admitiu-se nível de significância para P<0,05. Resultados - Valores séricos de CT, LDLc, e HDLc mostraram-se nos limites recomendados em ambos os grupos (P>0,05), enquanto valores aumentados de mediana foram observados para VLDLc e TG no G1 (36; 180 mg/dL, respectivamente), versus G2 (28; 142 mg/dL, respectivamente; P=0,048, para ambos) A presença de RE, RP, e HER-2, e sua relação com perfil lipídico, e perfil hormonal foram semelhantes entre os grupos (P>0,05). Os valores de mediana para perfil hormonal foram semelhantes em ambos grupos (P>0,05), exceto na análise dos grupos para valores de LH na pré e pós-menopausa, destacando-se o grupo com TH, com 28% das pacientes com níveis de LH correspondente a pré-menopausa (P=0,010). Observou-se correlação positiva entre níveis de CT com LDLc, VLDLc, e TG para G1 (P≤0,001) e G2 (P<0,05); correlação positiva entre TG e VLDLc em G1 (P<0,001) e G2 (P<0,001); correlação negativa entre HDLc e LH em G1(P=0,023); correlação positiva entre LDLc e FSH em G2 (P=0,041); correlação positiva entre FSH e LH em G2 (P=0,048); correlação negativa entre FSH e estradiol em G1 (P=0,001). Fatores de risco (perfil lipídico e IMC) e fatores prognósticos (ausência de RE e RP, e presença ou ausência do HER-2) foram semelhantes em G1 e G2 para sobrevida livre de doença e global (P> 0,05). Conclusão – As mudanças no perfil lipídico e hormonal não tem relação com a expressão imunohistoquímica do tecido tumoral, dados imunohistoquímicos são fatores prognóstico no câncer de mama e, portanto, estas mudanças não apresentam interferência na sobrevida global e livre de recidiva tumoral.

Uma das principais complicações do tratamento cirúrgico do câncer de mama é o linfedema do membro superior homolateral à linfonodectomia, que pode levar a sérias conseqüências físicas e emocionais às mulheres que o apresentam. O objetivo deste estudo foi avaliar a eficácia de um protocolo que inclui a utilização da estimulação elétrica de alta voltagem, no tratamento do linfedema, em um grupo de mulheres submetidas à cirurgia para o câncer de mama. O protocolo de tratamento constituiu-se de aplicações da estimulação elétrica de altavoltagem, duas vezes por semana, num total de catorze sessões, em dias de atendimento de um núcleo de reabilitação, complementadas por orientações quanto ao autocuidado, automassagem e exercícios físicos, no domicílio. Os instrumentos de avaliação foram: a perimetria em sete pontos; o cálculo da diferença de volume (DV) entre os membros e do percentual de aumento do volume (PAV) do membro com linfedema, em relação ao contralateral; um formulário com dados sociodemográficos e pessoais, acerca do tratamento do câncer de mama, e outro acerca dos sinais e sintomas do linfedema. Participaram 17 voluntárias, com uma diferença de perimetria de 2 a 5 centímetros entre os membros superiores. Os resultados analisados por meio do método estatístico T pareado para variáveis dependentes revelaram redução significativa de 14,13% (p = 0,0067) do PAV e de 13,8% (p = 0,0089) da DV. A perimetria apresentou redução significativa em 3 pontos: sete cm acima do cotovelo (p = 0,0138), sete cm abaixo do cotovelo (p = 0,0282) e no punho (p = 0,0476). A análise das variáveis subjetivas, sobre a avaliação do aspecto do membro com linfedema, por meio do teste de McNemar para dois grupos emparelhados, também revelou melhora significativa de alguns sinais e sintomas. Houve melhora na sensação de membro volumoso (p = 0,0265), na sensação de aumento de temperatura (p = 0,0003), melhora da dor (p = 0,0442), da ADM (p = 0,0098), da consistência do linfedema (p = 0,0002) e do sinal de cacifo (p = 0,0023). Pôde-se concluir que a utilização da estimulação elétrica de alta-voltagem associada a exercícios e orientações foi eficaz na redução do linfedema. / One of the main complications of surgical breast cancer treatment is the lymphedema in the upper limb on the same side where the lymphadenectomy was performed, which can cause severe physical and emotional consequences for women with this complication. This study aimed to assess the efficacy of a lymphedema treatment protocol that includes the use of high voltage electrical stimulation in a group of women submitted to breast cancer surgery. The treatment protocol consisted of high-voltage electrical stimulation applications, twice a week, totaling fourteen sessions, held during meetings of a rehabilitation group, in addition to selfcare, self-massage and physical exercise orientations at home. The assessment instruments were: anthropometrics in seven points; calculation of the volume difference (VD) between the limbs and the volume increase percentage (VIP) of the limb with lymphedema as opposed to the other side; a form with sociodemographic and personal data about the breast cancer treatment, and another about the signs and symptoms of the lymphedema. Participants were 17 volunteers, with a perimeter difference ranging from 2 to 5 centimeters between the upper limbs. The results, analyzed through the statistical paired T method for dependent variables, revealed a significant reduction by 14.13% (p = 0.0067) in VIP and 13.8% (p = 0.0089) in VD. The anthropometrics presented a significant three-point reduction: seven cm above the elbow (p = 0.0138), seven cm below the elbow (p = 0.0282) and at the wrist (p = 0.0476). The analysis of the subjective variables, about the aspect evaluation of the limb with lymphedema, using McNemars test for two paired groups, also revealed a significant improvement in some signs and symptoms. Improvements were found in the feeling of a bulky limb (p = 0.0265), in the feeling of increased temperature (p = 0.0003), pain (p = 0.0442), movement range (p = 0.0098), consistency of the lymphedema (p = 0.0002) and the Godet sign (p = 0.0023). It was concluded that the use of high voltage electrical stimulation in combination with exercises and orientations, was effective to reduce the lymphedema.

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / O controle do cÃncer de mama fundamenta-se no mapeamento do risco, no planejamento e na implementaÃÃo de aÃÃes que visam à detecÃÃo de tumores cada vez menores, proporcionando melhorar a assistÃncia à saÃde, diminuindo os gastos desnecessÃrios e estimulando o desenvolvimento de estratÃgias educativas. Objetivou-se avaliar os efeitos da aplicaÃÃo de um manual educativo relacionado aos exames de detecÃÃo precoce do cÃncer de mama para mulheres. Trata-se de um estudo quase-experimental, realizado no municÃpio de Fortaleza-Ce em uma Unidade BÃsica de SaÃde. A populaÃÃo do estudo foi composta por mulheres cadastradas na referida unidade que realizaram o exame de prevenÃÃo ginecolÃgica, nos meses de abril e maio de 2011, destinados para a primeira etapa da coleta de dados, sendo baseada no nÃmero de atendimentos ginecolÃgicos mensais, totalizando uma amostra de 294 mulheres, distribuÃdas equitativamente em grupo intervenÃÃo-GI e grupo controle-GC. A coleta de dados foi feita atravÃs de uma entrevista por meio de um formulÃrio do tipo inquÃrito CAP (conhecimento, atitude e prÃtica), elaborado baseado no conhecimento dos exames de detecÃÃo precoce e na realizaÃÃo correta dos mesmos, alÃm de caracterÃsticas sÃcio-demogrÃficas das participantes e informaÃÃes sobre fatores de risco para cÃncer de mama nestas mulheres. O estudo foi desenvolvido em duas fases para o GI (inquÃrito CAP prÃ-intervenÃÃo acompanhado de uma sessÃo educativa do manual com leitura posterior dos mesmos pelas participantes e consulta de retorno com preenchimento do inquÃrito CAP pÃs-intervenÃÃo) e, uma fase para GC (inquÃrito CAP). O material educativo aplicado trata-se de um manual de orientaÃÃes a mulheres mastectomizadas onde foram utilizados os dois primeiros capÃtulos que correspondem a explicaÃÃes voltadas para os exames de detecÃÃo precoce. Para a anÃlise estatÃstica, utilizou-se o programa SPSS versÃo 16.0 e os dados foram tabulados, processados e analisados, em tabelas. Os testes estatÃsticos foram selecionados de acordo com a necessidade da anÃlise dos dados, a fim de alcanÃar os objetivos propostos, com confiabilidade e validade do instrumento. ApÃs anÃlise dos dados observou-se a homogeneidade dos dois grupos, mostrando a associaÃÃo das variÃveis sociodemogrÃficas e das variÃveis relacionadas aos fatores de risco para o desenvolvimento de cÃncer de mama. Contudo, puderam-se observar diferenÃas significativas nos escores, no que se refere ao grau de conhecimento, atitude e a prÃtica em relaÃÃo à realizaÃÃo dos exames de detecÃÃo precoce do cÃncer de mama, quando comparados apÃs aplicaÃÃo da intervenÃÃo educativa, notando-se que o grupo intervenÃÃo pÃs-manual mostrou a maioria das variÃveis comparativas superiores Ãs do grupo controle e Ãs do grupo intervenÃÃo antes do manual, isto Ã, apÃs a aplicaÃÃo do manual educativo, houve mudanÃas significantes voltadas para o diagnÃstico precoce do cÃncer de mama. O estudo tornou-se relevante à medida que propÃs avaliar uma estratÃgia de educaÃÃo em saÃde, a fim minimizar as lacunas do conhecimento e a realizaÃÃo dos exames de detecÃÃo precoce do cÃncer de mama e, dessa forma, melhorar a assistÃncia à saÃde mamÃria. Nesse sentido, comprova-se a tese de que a intervenÃÃo educativa, com a utilizaÃÃo de um manual educativo sobre detecÃÃo precoce do cÃncer de mama para mulheres, possibilitou importantes resultados na promoÃÃo da saÃde mamÃria, atravÃs da prevenÃÃo secundÃria. / The control of breast cancer is based on risk mapping, planning and implementation of actions aimed to detect increasingly smaller tumors, providing better health care, reducing unnecessary spending and stimulating the development of educational strategies. The objective was to assess the effects of the application of an educational handbook related to early detection tests of breast cancer for women. This is a quasi-experimental study carried out in Fortaleza-CE, Brazil, in a Basic Health Unit. The study population consisted of women registered in this unit who underwent preventive gynecological examination in April and May 2011, intended for the first stage of data collection, being based on the number of gynecologic examination per month, totaling a sample of 294 women, equally distributed in intervention group and control group. Data collection happened through an interview by a KAP (knowledge, attitude and practice) survey, developed based on knowledge of early detection tests and the correct performance of them, as well as socio-demographic characteristics of participants and information about risk factors for breast cancer in these women. The study was developed in two phases for the intervention group (pre-intervention KAP survey followed by an educational session of the manual and later reading by the same participants and a return visit to post-intervention KAP), and a phase for the control group (KAP survey). The educational material used is a manual of guidelines for mastectomized women where we used the first two chapters that correspond to explanations focused on early detection tests. For statistical analysis we used SPSS program version 16.0 and data was tabulated, processed and analyzed in tables. Statistical tests were selected according to the need for data analysis, in order to achieve the proposed objectives, with reliability and validity of the instrument. After data analysis we observed the homogeneity of both groups, showing the association of socio-demographic variables and variables related to risk factors for developing breast cancer. However, we could verify significant differences in scores, regarding the degree of knowledge, attitude and practice on the performance of examinations for early detection of breast cancer, when compared after application of the educational intervention, noticing that the post-manual intervention group presented most of the comparative variables higher than the control group and the intervention group before the handbook, which means, after the implementation of an educational handbook, there were significant changes addressed at early diagnosis of breast cancer. The study became relevant once it proposed to assess a health education strategy, in order to minimize the gaps in knowledge and performance of the examinations for early detection of breast cancer, thus improving breast health care. In this sense, we prove the thesis that the educational intervention using an educational handbook on early detection of breast cancer for women, allowed significant results in promoting breast health through secondary prevention.