Cheung Shu Yan. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2001. / Includes bibliographical references (leaves 124-137). / Abstracts in English and Chinese. / Abstract (English) --- p.i / Abstract (Chinese) --- p.iii / Acknowledgements --- p.iv / Contents --- p.v / Chapter Chapter 1 --- Introduction / Chapter 1.1 --- Epidemiology of Breast Cancer --- p.1 / Chapter 1.1.1 --- Epidemiology of Breast Cancer in Females --- p.1 / Chapter 1.1.2 --- Incidence and Morality of Female Breast Cancer in Hong Kong --- p.2 / Chapter 1.1.3 --- Epidemiology of Breast Cancer in Males --- p.3 / Chapter 1.2 --- Risk Factors for Female Breast Cancer --- p.4 / Chapter 1.2.1 --- Genetic Risk Factors --- p.4 / Chapter 1.2.2 --- Hormonal Risk Factors --- p.6 / Chapter 1.2.2.1 --- Endogenous Hormonal Risk Factors --- p.7 / Chapter 1.2.2.2 --- Exogenous Hormonal Risk Factors --- p.8 / Chapter 1.2.3 --- Other Environmental Risk Factors --- p.9 / Chapter 1.3 --- Oncogenetic Basis of Female Breast Cancer --- p.10 / Chapter 1.4 --- Hormonal Basis of Female Breast Cancer --- p.12 / Chapter 1.4.1 --- Mechanisms of Hormone Action --- p.12 / Chapter 1.4.1.1 --- Estrogen and Progesterone --- p.12 / Chapter 1.4.1.2 --- Prolactin --- p.14 / Chapter 1.4.2 --- Hormonal Regulation of Normal Breast Development --- p.15 / Chapter 1.4.3 --- Hormonal Regulation of Breast Carcinogensis and Its Subsequent Progression --- p.17 / Chapter 1.4.3.1 --- Androgen --- p.17 / Chapter 1.4.3.2 --- Estrogen --- p.18 / Chapter 1.4.3.3 --- Progesterone --- p.20 / Chapter 1.4.3.4 --- Prolactin --- p.22 / Chapter 1.5 --- Animal Models for Breast Cancer --- p.23 / Chapter 1.5.1 --- Mouse Models --- p.24 / Chapter 1.5.2 --- Rat Models --- p.25 / Chapter 1.5.2.1 --- Carcinogen Induced Rat Models --- p.26 / Chapter 1.5.2.2 --- Hormone Induced Rat Models --- p.28 / Chapter 1.5.2.3 --- Spontaneously Developed Rat Models --- p.31 / Chapter 1.6 --- Aims of Study --- p.34 / Tables and Figures --- p.35 / Chapter Chapter 2 --- Materials and Methods / Chapter 2.1 --- Origin and Supply of Noble Rats --- p.37 / Chapter 2.2 --- Supply of Materials --- p.37 / Chapter 2.3 --- Induction of Mammary Tumors by Singe Dose of Chemical Carcinogens in Female Rats --- p.38 / Chapter 2.3.1 --- Induction by 7，12-Dimethylbenz[a]anthracene in Female Noble Rats --- p.38 / Chapter 2.3.2 --- Induction by N-Methyl-N-Nitrosourea in Female Sprague- Dawley Rats --- p.38 / Chapter 2.4 --- Induction of Mammary Tumors by Long-Term Treatments with Steroid Hormone --- p.39 / Chapter 2.4.1 --- Preparation of Steroid Hormone-filled Silastic® Tubings --- p.39 / Chapter 2.4.2 --- Surgical Implantation of Silastic® Tubings --- p.40 / Chapter 2.4.3 --- Protocols of Hormonal Treatments --- p.40 / Chapter 2.5 --- Collection of Spontaneously Developed Mammary Tumors in Noble Rats --- p.41 / Chapter 2.6 --- Transplantation of Spontaneously Developed Mammary Tumors into Noble Rats --- p.41 / Chapter 2.7 --- Bilateral Ovariectomy of Female Noble Rats bearing Spontaneously Developed Mammary Tumors --- p.42 / Chapter 2.8 --- Measurement of Mammary Tumor Growth --- p.43 / Chapter 2.9 --- Whole Mount Preparation of the Hormone-Treated Mammary Glands in Noble Rats --- p.44 / Chapter 2.10 --- Histological Examination of Mammary Gland and Tumors in Noble Rats --- p.45 / Chapter 2.11 --- Detection of Protein Expression of Hormone Receptors in Normal Mammary Glands and Mammary Tumors of Noble Rats --- p.45 / Chapter 2.11.1 --- Antibodies --- p.45 / Chapter 2.11.2 --- Immunohistochemistry --- p.47 / Chapter 2.11.3 --- "Protein extraction, SDS-PAGE and western blotting analysis" --- p.48 / Chapter Chapter 3 --- Results / Chapter 3.1 --- Gross Appearance of Mammary Tumors --- p.51 / Chapter 3.2 --- Incidence Rate of Mammary Tumors --- p.53 / Chapter 3.2.1 --- Spontaneously Developed Mammary Tumors in Noble Rats --- p.53 / Chapter 3.2.2 --- Hormone Induced Mammary Tumors in Female Noble Rats --- p.53 / Chapter 3.2.3 --- DMBA Induced Mammary Tumors in Female Noble Rats --- p.54 / Chapter 3.2.4 --- NMU Induced Mammary Tumors in Female SD Rats --- p.54 / Chapter 3.3 --- Histology of Normal and Lactating Mammary Glands in Female Noble Rats --- p.54 / Chapter 3.4 --- Histopathology of Mammary Tumors --- p.55 / Chapter 3.4.1 --- Histopathology of Spontaneously Developed Mammary Tumors in Noble Rats --- p.55 / Chapter 3.4.2 --- Histopathology of Hormone Induced Mammary Tumors in Female Noble Rats --- p.59 / Chapter 3.4.3 --- Histopathology of DMBA Induced Mammary Tumors in Female Noble Rats --- p.60 / Chapter 3.4.4 --- Histopathology of NMU Induced Mammary Tumors in Female SD Rat --- p.60 / Chapter 3.5 --- Whole Mount Preparation of Mammary Glands under Hormonal Treatments --- p.61 / Chapter 3.6 --- Effects of Bilateral Ovariectomy on the Growth of Spontaneously Developed Mammary Tumors --- p.61 / Chapter 3.7 --- Transplanability of the Spontaneously Developed Mammary Tumors in Noble Rats --- p.62 / Chapter 3.8 --- Examination of the Malignancy of Mammary Tumors by Immunohistochemical analysis of Epithelial Keratin Expression --- p.62 / Chapter 3.9 --- Immunohistochemical Analysis of Expression and Localization of Hormone Receptor Protein in Normal and Neoplastic Mammary Tissues of Female Noble Rats --- p.63 / Chapter 3.9.1 --- Expression and Localization of Hormone Receptors in Control Tissue --- p.63 / Chapter 3.9.2 --- Expression and Localization of Estrogen Receptor α --- p.64 / Chapter 3.9.3 --- Expression and Localization of Estrogen Receptor β --- p.65 / Chapter 3.9.4 --- Expression and Localization of Progesterone Receptor --- p.65 / Chapter 3.9.5 --- Expression and Localization of Androgen Receptor --- p.66 / Chapter 3.9.6 --- Expression and Localization of Prolactin Receptor --- p.66 / Chapter 3.10 --- Western Blot Analysis of Expression of Hormone Receptor Proteins in Normal and Neoplastic Mammary Tissues of Female Noble Rats - --- p.67 / Chapter 3.10.1 --- Expression of Estrogen Receptor α --- p.67 / Chapter 3.10.2 --- Expression of Estrogen Receptorβ --- p.68 / Chapter 3.10.3 --- Expression of Progesterone Receptor --- p.68 / Chapter 3.10.4 --- Expression of Androgen Receptor --- p.69 / Chapter 3.10.5 --- Expression of Prolactin Receptor --- p.69 / Figures and Tables --- p.71 / Chapter Chapter 4 --- Discussions / Chapter 4.1 --- Comparison of the Incidence Rate of Spontaneously developed Mammary Tumors in Noble Rats with the Previously Reported Incidence Rate --- p.102 / Chapter 4.2 --- Comparison of the Incidence rate of Spontaneously Developed Mammary Tumors in Noble Rats with the Incidence Rate in Other Rat Strains --- p.103 / Chapter 4.3 --- Crucial Factors Influencing the Incidence Rate of Spontaneously Developed Mammary Tumors in Noble Rats --- p.104 / Chapter 4.4 --- Comparison of the T+E2 Induced Mammary Tumors with the T+DES Induced Mammary Tumors in Female Noble Rats --- p.105 / Chapter 4.5 --- Comparison of the Incidence Rate & Latency Period of the Hormone Induced Mammary Tumors in Noble Rats with the Previously Reported Data --- p.106 / Chapter 4.6 --- Comparison of the Phenotypic Behaviors in Spontaneously Developed Mammary Tumors with the Hormone Induced Mammary Tumors in Female Noble Rats --- p.107 / Chapter 4.7 --- Comparison of the Behaviors of Carcinogen Induced Mammary Tumors with Spontaneously Developed & Hormone Induced Mammary Tumors in Female Noble Rats --- p.109 / Chapter 4.8 --- "Comparison of Expression Patterns of Hormone Receptor Proteins in Spontaneously Developed, Hormone Induced & Carcinogen Induced Mammary Tumors in Female Noble Rats" --- p.111 / Chapter 4.9 --- "Expressions of ERα & ERβ Proteins in Spontaneously Developed, Hormone Induced and Carcinogen Induced Mammary Tumors in Female Noble Rats" --- p.112 / Chapter 4.10 --- "Expressions of PR Proteins in Spontaneously Developed, Hormone Induced and Carcinogen Induced Mammary Tumors in Female Noble Rats" --- p.115 / Chapter 4.11 --- "Expressions of AR Proteins in Spontaneously Developed, Hormone Induced and Carcinogen Induced Mammary Tumors in Female Noble Rats" --- p.116 / Chapter 4.12 --- "Expressions of PRLR Proteins in Spontaneously Developed, Hormone Induced and Carcinogen Induced Mammary Tumors in Female Noble Rats" --- p.120 / Chapter Chapter 5 --- Conclusions --- p.123 / References --- p.124

Made available in DSpace on 2016-01-26T12:51:47Z (GMT). No. of bitstreams: 1 divaneiaparecidabottarocriado_tese.pdf: 2464607 bytes, checksum: aea6796d266c29667edf552adc7a26bb (MD5) Previous issue date: 2014-02-14 / Introduction: Currently, breast cancer is the most common malignancy in women, being a public health issue. Objective: To assess the early diagnosis of breast cancer in mammography campaigns in São Paulo State by considering demographical and radiological data, as well as the association between age and BI-RADS classification. Patients and Method: A total of 1,015,508 mammography campaign examinations that were performed by women between May 2005 and November 2009 in municipalities of the 17 Regional Health Divisions (DRS) of Sao Paulo State were assessed. The mammogram results were analyzed according to the BI-RADS radiological classification. Chi-square tests with Yates or Fisher corrections were used to verify a possible association between age and BI-RADS classification. The relative likelihood of associations between lesions classified as categories 1 and 2 (benign), 4 (suspicious for malignancy) and 5 (highly suggestive of malignancy) and the patient age group (up to 39 and above 40 years, up to 49 years and above 50 years, and between 40-49 and 50-59 years of age) was assessed according to the Odds Ratio (OR). Results: In Sao Paulo State, with respect to age, there was a predominance of the fifth and sixth decades of life, totaling 379,561 and 311,020 mammograms, respectively (71.7%). Radiological findings obtained in the campaigns showed that the category 0 was found in 122 332 (12.0%) examinations; in category 1, 412,020 (40.6%) examinations showed no radiographic alterations; category 2 was the most common, being found in 436,099 (42.9%) examinations; the total mammograms in category 3 were 39,871 (3.9%); category 4 was observed in 4435 (0.4%) examinations, and category 5 was obtained in 751 mammograms (0, 1%). The frequency of occurrence of categories 4 + 5 (suspicious for malignancy) increased in parallel to increasing age. By analyzing the possible association between age and BI-RADS classification using a cutoff of up to 39 years against 40 years or more, there was a significant difference between the groups, both with respect to category 5 (P <0.0001) and the categories 4+5 (P <0.0001), as compared to categories 1 +2. The Odds Ratio of categories 4 and 5 appear in mammogram results of patients aged 40 or more was 56% higher than among those with up to 39 years (OR, 1.56; 95% Confidence Interval (CI), 1.36 to 1.79). Conclusions: Mammography campaigns performed in the São Paulo State contributed to the early diagnosis of breast cancer. There was a gradual increase in population participation in these campaigns over the studied period. Predominant age groups were the fifth and sixth decades of life. Radiological findings showed that the most frequent categories were 1 and 2, being 4 and 5 the least frequent. The increase in the frequency of BI-RADS categories 4 and 5 coincided with increasing age. The Odds Ratio of mammograms with categories 4 and 5 appear in patients aged 40 or more is 56% higher than among those with up to 39 years, indicating that the recommended age for mammogram evaluation should be for women aged 40 or more. / Introdução: Atualmente, o câncer de mama é a neoplasia maligna mais frequente na população feminina, sendo problema de saúde pública. Objetivo: Avaliar diagnóstico precoce do câncer de mama em mutirões de mamografia no Estado de São Paulo, considerando-se dados demográficos, radiológicos e associação entre faixa etária e classificação BI-RADS. Casuística e Método: Foram estudados 1.015.508 exames dos mutirões de mamografia realizadas por mulheres no período de maio/2005 a novembro/2009 em municípios pertencentes aos 17 Departamentos Regionais de Saúde (DRS) do Estado de São Paulo. Os resultados das mamografias foram analisados conforme classificação radiológica do sistema BI-RADS. Para verificar possível associação entre faixa etária e classificação BI-RADS foram usados testes Qui-quadrado com correção de Yates ou de Fisher. A possibilidade relativa das categorias 1 e 2 (benignas), 4 (suspeita de malignidade) e 5 (altamente sugestiva de malignidade) estar associada às faixas etárias (até 39 e acima de 40 anos, até 49 anos e acima de 50 anos e, entre 40-49 e 50-59 anos) foi obtida com cálculo de Odds Ratio (OR). Resultados: No Estado de São Paulo, com relação à idade, houve predomínio da quinta e sexta décadas de vida, totalizando 379.561 e 311.020 mamografias, respectivamente (71,5%). Achados radiológicos obtidos nos mutirões revelaram que a categoria 0 foi encontrada em 122.332 (12,0%) exames; na categoria 1, 412.020 (40,6%) exames não apresentaram alterações radiológicas; a categoria 2 foi a mais frequente, sendo encontrada em 436.099 (42,9%) exames; o total de mamografias na categoria 3 foi 39.871 (3,9%); a categoria 4 foi verificada em 4.435 (0,4%) exames, e a categoria 5 obtida em 751 mamografias (0,1%). A frequência de ocorrência das categorias 4 + 5 (suspeitas de malignidade) foi crescente em relação ao aumento da idade. Na análise da possível associação entre faixa etária e classificação BI-RADS, utilizando-se a faixa de corte até 39 anos contra 40 anos ou mais, houve diferença significante entre os grupos, tanto com relação à categoria 5 (P < 0,0001) como às categorias 4+5 (P < 0,0001), comparada às categorias 1+2. A chance relativa de mamografias com categorias 4 e 5 aparecer em pacientes com 40 anos ou mais é 56% maior em relação aquelas com até 39 anos (OR 1,56; IC 95% 1,36 a 1,79). Conclusões: Os mutirões de mamografia realizados no Estado de São Paulo contribuíram para o diagnóstico precoce do câncer de mama. Houve aumento gradativo na participação da população nos mutirões de mamografia ao longo do período estudado. As faixas etárias predominantes foram quinta e sexta décadas de vida. Os achados radiológicos mostraram que as categorias mais frequentes foram 1 e 2, sendo 4 e 5 as menos frequentes. O aumento na frequência das categorias 4 e 5 do sistema BIRADS coincidiu com o aumento da idade. A chance relativa de mamografias com categorias 4 e 5 aparecer em pacientes com 40 anos ou mais é 56% maior em relação aquelas com até 39 anos, indicando que a idade recomendada para realização de mamografia deva ser a partir dos 40 anos.

Submitted by Fabíola Silva (fabiola.silva@famerp.br) on 2017-03-16T11:48:07Z No. of bitstreams: 1 anamarciasdealmeidavianna_dissert.pdf: 923997 bytes, checksum: 91cfee711fbecdf2ade7a86724cc75a5 (MD5) / Made available in DSpace on 2017-03-16T11:48:07Z (GMT). No. of bitstreams: 1 anamarciasdealmeidavianna_dissert.pdf: 923997 bytes, checksum: 91cfee711fbecdf2ade7a86724cc75a5 (MD5) Previous issue date: 2015-06-29 / Breast cancer is the second most frequent type of cancer, only preceded by skin cancer. Although considered of good prognosis, it is still a stigmatizing condition. Objective: To characterize demographic aspects and quality of life (QoL) of women with breast cancer before and after treatment with neo-adjuvant chemotherapy at a teaching hospital in the state of São Paulo. Methodology: descriptive, cross-sectional study. Patients: participants were 60 adult women starting neo-adjuvant chemotherapy AC (Adriamycin + Cyclophosphamide). For data collection the following instruments were used: Identification Card, Interview Guide and Functional Assessment of Cancer Therapy (FACT-B). Data were qualitative and quantitatively analyzed with descriptive statistics. For comparative analysis between variables the Wilcoxon test was used with significance level of p<0.05. Results: Participants ages ranged from 27 to 83 years old (M = 52.42 years, SD = 12.66 years), married (61.7%), with children and attending primary school (75%). For the physical, and functional domain, TOI (Trial Outcome Index), FACT-G (Functional Assessment of Cancer Therapy – General) and FACT-B there was a significant difference in the assessment of QoL pre and post-QT. Feeling unattractive (58.3%), sexual dissatisfaction (56.6%), insomnia (53.3%), alopecia (52.3%), fatigue (43.3%), inability to experience pleasure in life (40%) and feelings of sadness (41.6%) and inability to work (35%) were the most frequent symptoms post-QT. Conclusion: QT has an important impact on physical and functional QoL, impairing several roles played by the patient and affecting sexual and affective relationships. / Câncer de mama é o segundo tipo de neoplasia mais frequente, apenas precedido do câncer de pele. Apesar de ser considerado com bom prognóstico, ainda assim é uma condição estigmatizante. Objetivo: caracterizar aspectos sócios demográficos e avaliar a qualidade de vida (QV) de mulheres com câncer de mama pré e pós-quimioterapia neoadjuvante (QT), atendidas no Hospital de Base de São José do Rio Preto-SP. Metodologia: estudo descritivo, transversal. Casuística: participaram 60 mulheres adultas que iniciaram a QT neoadjuvante AC (Adriamicina + Ciclofosfamida). Para a coleta dos dados foram utilizados: Ficha de Identificação, Roteiro de Entrevista e Functional Assessment of Cancer Therapy - Breast (FACT-B). Os questionários foram aplicados em dois momentos: antes do início e após o término da QT. Os dados foram analisados de forma quali e quantitativa, por meio de estatística descritiva e para análise de comparação entre as variáveis o Teste de Wilcoxon com nível de significância p<0,05. Resultados: A idade das participantes variou entre 27 e 83 anos (M=52,42 anos; DP = 12,66 anos), casadas (61,7%), com filhos e cursando ensino fundamental (75%). Nos domínio físico, funcional, TOI (Trial Outcome Index), FACT-G (Functional Assessment of Cancer Therapy – General) e FACT-B houve diferença significante na avaliação da QV pré e pós-QT. Não sentir-se atraente (58,3%), insatisfação sexual (56,6%), insônia (53,3%), alopécia (52,3%), fadiga (43,3%), incapacidade de sentir prazer na vida (40%) e sentimentos de tristeza (41,6%) e incapacidade para trabalhar (35%), foram sintomas mais freqüentes pós-QT. Conclusão: A QT é um tratamento de grande impacto e sofrimento físico-funcional na QV, com prejuízo no desempenho de papéis e relações afetivo-sexuais.

Submitted by Fabíola Silva (fabiola.silva@famerp.br) on 2017-05-26T12:52:18Z No. of bitstreams: 1 edivandrabuzato_dissert.pdf: 917604 bytes, checksum: b9e88e30b29c674ac928aaff474acc7e (MD5) / Made available in DSpace on 2017-05-26T12:52:18Z (GMT). No. of bitstreams: 1 edivandrabuzato_dissert.pdf: 917604 bytes, checksum: b9e88e30b29c674ac928aaff474acc7e (MD5) Previous issue date: 2014-11-13 / Introduction: Breast cancer is currently the most common cancer of women worldwide. Historically, one of the most feared complications after the treatment of breast cancer is lymphedema. However, one problem often observed in patients is obesity with abdominal fat being a cardiovascular risk factor. Objective: The aim of this study was to evaluate the distribution of abdominal fat in patients with clinical diagnosis of breast cancer treatment-related lymphedema. Patients and Method: Forty-five female patients with clinical diagnosis of lymphedema after breast cancer treatment were evaluated in a randomized controlled case study in the Clinica Godoy in 2012. A control group of 38womenwithout breast cancer, who attended the clinic for other reasons, were matched for age and body mass index (BMI). Both groups were evaluated by bioimpedance using the InBody®S10 device; age, abdominal fat and BMI were the main variables considered. The unpaired t-test, and Mann-Whitney and Fisher's exact tests were used for statistical analysis with an alpha error of 5% being considered acceptable. Results: There was no significant difference in the BMI between groups (unpaired t-test: p-value=0.23; 95% CI=-2.68-0.66: Standard deviation of study and control groups were 4.03 and 3.53, respectively). However there was a significant difference between the two groups in respect to abdominal fat (unpaired t-test: p-value<0.0001; 95% CI=86.71-116.77 and Mann-Whitney test: mean =100.75; 95% CI =83.7-112.5). Conclusions: Using bioimpedance, this study found that women with arm lymphedema after breast cancer treatment have higher levels of abdominal fat compared to women who had not suffered from breast cancer. Bioimpedance is efficient to evaluate abdominal fat as a low cost option in these patients and not invisibility. / Introdução: O câncer de mama atualmente é o mais comum dos cânceres em mulheres no mundo. Uma das complicações mais temida no pós-tratamento do câncer de mama relatado historicamente é o linfedema. Entretanto, um dos problemas observados nestas mulheres é a obesidade, sendo que a gordura abdominal constitui risco cardiovascular. Objetivo: O objetivo do presente estudo foi avaliar o aumenta na distribuição da gordura abdominal em mulheres pós-tratamento de câncer de mama com linfedema de membros superiores. Casuística e Método: Foram avaliadas, em estudo caso controle randomizado, 45 pacientes do sexo feminino com linfedema, diagnóstico clínico pós-tratamento de câncer de mama, acompanhadas na Clínica Godoy, em 2012; e comparadas com 38 mulheres sem câncer de mama, do grupo controle, que frequentam a clínica por outras causas, as quais foram pareadas por idade e Índice de Massa Corpórea (IMC). Ambos os grupos foram submetidos à avaliação pela bioimpedância, aparelho InBody® S 10, sendo enfatizada a idade, gordura abdominal e Índice de Massa Corpórea (IMC). Para a análise estatística foram utilizados Teste t não pareado, Teste de Mann-Whitney e Teste exato de Fisher, considerando erro alfa de 5%. Resultados: Relação do IMC do grupo controle com o grupo de estudo apresentado no Teste t não pareado: P = 0,23; IC 95% = -2,68 - 0,66. Desvio padrão do grupo de estudo (4,03) e desvio padrão do grupo controle (3,53). Em relação à gordura abdominal do grupo controle com o grupo de estudo apresentado no teste t não pareado: P < 0,0001; IC 95% = 86,71- 116,77. Teste Mann-whitney para análise da gordura abdominal entre o grupo de estudo e o grupo controle: média= 100,75; IC = 83,7 - 112,5. Conclusões: 1- O presente estudo concluiu que mulheres no pós-tratamento de câncer de mama com linfedema de membros superiores, apresentaram aumento no valor da gordura abdominal em relação a mulheres que não tiveram câncer de mama, avaliadas pela Bioimpedância. 2- A bioimpedância pode ser indicada para rastreamento da gordura abdominal nessas pacientes como uma opção de exame de baixo custo e viável.

Submitted by Suzana Dias (suzana.dias@famerp.br) on 2018-10-19T18:22:34Z No. of bitstreams: 1 StephaniePiacentidosSantos_dissert.pdf: 499357 bytes, checksum: e7f6872448bfb8c9bb786b4bd30f9c94 (MD5) / Made available in DSpace on 2018-10-19T18:22:34Z (GMT). No. of bitstreams: 1 StephaniePiacentidosSantos_dissert.pdf: 499357 bytes, checksum: e7f6872448bfb8c9bb786b4bd30f9c94 (MD5) Previous issue date: 2016-11-08 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Breast cancer is a leading cause of death in women worldwide. The etiology of this disease is multifactorial, including factors such as habits and lifestyle, hormonal, environmental and genetic. The xenobiotic metabolism contribute to the development of breast carcinoma and polymorphisms in genes encoding enzymes in this pathway, such as GST (GSTM1 and GSTT1) and CYPs (CYP1A1*2A and CYP1A1*2C) have been associated to breast cancer. Objectives: To investigate the influence of the GSTM1, GSTT1, CYP1A1*2A and CYP1A1*2C polymorphisms at the risk for developing breast cancer; to evaluate the association of polymorphisms and risk factors (age, smoking, alcohol, clinical features), tumor clinical and histopathologic features in breast cancer. Methods: This case-control study included 752 women, 219 patients and 533 controls. Molecular analysis were performed by PCR-multiplex (GSTM1 null and GSTT1 null), PCR-RFLP (CYP1A1*2A) and real-time PCR (CYP1A1*2C). For the statistical analysis, the MINITAB 16.0 (Multiple Logistic Regression Test), SNPstats (Inheritance Model tests) and BioEstat 5.0 (Hardy-Weinberg test) tests were used. Results: Women with old age and the alcohol consumption had increased risk for developing breast cancer. Women with breast cancer had slightly higher frequency (51%) of the GSTM1 null genotype than women without cancer (49%), however this difference was not significant statistically. GSTT1 null genotype was also not associated with breast cancer. CYP1A1*2A polymorphism was associated with the risk for breast cancer and CYP1A1*2C polymorphism was more frequent in tumors with no distant metastases. Conclusions: Women with age advanced and who drink alcohol present increased risk for developing breast cancer. CYP1A1*2A polymorphism is associated with breast cancer and CYP1A1*2C polymorphism is related to women with no distant metastases. The polymorphisms of the GSTM1 and GSTT1 genes are not associated with the development of breast cancer. / O câncer de mama é uma das principais causas de morte em mulheres no mundo. A etiologia desta doença é multifatorial e inclui fatores como hábitos, estilo de vida, hormonais, ambientais e genéticos. O metabolismo de xenobióticos contribui para o desenvolvimento do carcinoma mamário, e polimorfismos nos genes que codificam enzimas desta via, tais como GSTs (GSTM1 e GSTT1) e CYPs (CYP1A1*2A e CYP1A1*2C) têm sido associados ao câncer de mama. Objetivos: Investigar a influência dos polimorfismos GSTM1, GSTT1, CYP1A1*2A e CYP1A1*2C no risco de desenvolvimento de câncer de mama; avaliar a associação dos polimorfismos e fatores de risco (idade, fumo, álcool, características clínicas) no câncer de mama, assim como características clínicas e histopatológicas do tumor. Casuística e Métodos: O presente estudo caso-controle incluiu 752 mulheres, 219 pacientes e 533 controles. Para análise molecular foram realizadas as técnicas de PCR-Multiplex (GSTM1 e GSTT1), PCR-RFLP (CYP1A1*2A) e PCR em tempo real (CYP1A1*2C). Para a análise estatística foram utilizados os programas MINITAB 16.0 (teste de Regressão Logística Múltipla), SNPstats (testes de Modelos de Herança) e BioEstat 5.0 (teste de Equílibrio de Hardy-Weinberg). Resultados: Mulheres com idade avançada e com o hábito etilista apresentaram risco aumentado para o desenvolvimento de câncer de mama. Mulheres com carcinoma mamário apresentaram frequência discretamente maior (51%) do genótipo nulo GSTM1 em relação a mulheres sem câncer (49%), no entanto essa diferença não foi estatisticamente significante. O genótipo nulo de GSTT1 também não foi associado ao câncer de mama. O polimorfismo CYP1A1*2A foi associado ao risco para câncer de mama e o polimorfismo CYP1A1*2C foi mais frequente em tumores com ausência de metástase à distância. Conclusões: Mulheres com idade avançada e que ingerem bebida alcoólica apresentam risco aumentado para desenvolver câncer de mama. O polimorfismo CYP1A1*2A está associado ao câncer de mama e o polimorfismo CYP1A1*2C está relacionado às mulheres com ausência de metástase à distância. Os polimorfismos dos genes GSTM1 e GSTT1 não apresentam associação com o desenvolvimento do câncer de mama.

Submitted by Suzana Dias (suzana.dias@famerp.br) on 2018-10-29T17:50:59Z No. of bitstreams: 1 RubensdePaulaJunior_tese.pdf: 3756902 bytes, checksum: 62626523c38921fce4f785793a29be0e (MD5) / Made available in DSpace on 2018-10-29T17:50:59Z (GMT). No. of bitstreams: 1 RubensdePaulaJunior_tese.pdf: 3756902 bytes, checksum: 62626523c38921fce4f785793a29be0e (MD5) Previous issue date: 2018-02-27 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Breast cancer is the most prevalent neoplasm in women and the subtype Triple Negative (TNBC) is one of the most serious because of its aggressive metabolic phenotype. Hepatocellular carcinoma (HCC) is the most common primary neoplasm in liver tissue and, together with breast neoplasms, leads to the causes of death associated with cancer worldwide. It is known that tumor behavior is influenced by the host local intrinsic inflammation in the tumor microenvironment, as well as, by the metabolism reprogramming. Immunological cells in the tumor microenvironment are modulate by cytokines and transcription factors such as NF-kB. In addition to inflammation, host metabolism is under the diurnal control, which can control circulating levels of amino acids thus making it an important target for cancer analysis. OBJECTIVES: To evaluate the effect of melatonin on the transcript profile, on the modulation of NF-kB in breast and hepatic cancer models as well as on the metabolic profile in plasma during a diurnal variation in breast cancer. MATERIALS AND METHODS: In vitro was used HepG2 and MDA-MB-231. In vivo the tumor was developed by implantation of MDA-MB-231 tumor cells in nude athymic female mice. Plasma samples were collected under strict conditions at eight times during a full day and the tumors were removed for gene expression, RNA sequencing and Mass Spectrometry. RESULTS: It was observed a reduction in tumor volume and the expression of NF-kB in the animals with breast cancer and treated with melatonin. On the other hand, melatonin increased the expression of NF-kB in hepatocarcinoma cells. In the mammary tumor, microenvironment melatonin increased the expression of the Tnfaip8l2 and Il1f6 genes, which are important in the local immune response. In plasma, among the 20 amino acids detected, 10 had similar behavior during the day. At most times of the day, animals with tumor had reduced plasma levels of these amino acids. In addition, there was an inversion in the profile of these amino acids between the groups observed in the first hours of the morning. CONCLUSIONS: The effect of melatonin on NF-kB in breast cancer appears to be better defined, but in liver cancer its role remains controversial. In the same way the anti-tumor action of melatonin was proven by the high expression of the Tnfaip8l2 and Il1f6 genes in the tumor microenvironment. In the plasma samples, the changes in metabolites are a reflex of the altered metabolism, determined by mammary tumor cells in the mice background. While this inversion of the amino acid profile in animals suggests that one cyclic event of host metabolism at these times appears to influence circulating amino acid levels. Thus, our results have pointed out that during carcinogenesis there is a strong association between the immune response and the chronobiology of the host that requires further investigations. / O câncer de mama é a neoplasia mais prevalente em mulheres e o subtipo Triplo Negativo (TNBC) é considerado o mais grave por possuir um fenótipo metabólico agressivo. O Carcinoma Hepatocelular (HCC) é a neoplasia primária mais frequente no tecido hepático e junto com as neoplasias mamárias lidera as causas de óbito associadas ao câncer no mundo. Sabe-se que o comportamento tumoral é influenciado pela inflamação local no microambiente intrínseco do hospedeiro, bem como pela reprogramação do metabolismo. Células imunológicas no microambiente tumoral são moduladas por citocinas e fatores de transcrição como o NF-kB. Além da inflamação, o metabolismo do hospedeiro está sobre o controle cíclico diurno, o qual pode controlar os níveis circulantes de aminoácidos, tornando assim um alvo importante para análises do câncer. OBJETIVOS: Avaliar o efeito da melatonina no perfil de transcritos e na modulação do NF-kB em modelos de câncer de mama e hepático, e também o perfil metabólico no plasma durante uma variação diurna em modelos de câncer de mama. MATERIAL E MÉTODOS: In vitro, foram utilizadas células HepG2 e MDA-MB-231. In vivo, o tumor foi desenvolvido pela implantação de células tumorais MDA-MB-231 em camundongos fêmeas nude atímicos. Amostras de plasma foram coletadas sob rigorosas condições em oito tempos durante um dia completo e os tumores foram retirados para análises de expressão gênica, sequenciamento de RNA e Espectrometria de Massas. RESULTADOS: Foi observada redução do volume tumoral e também da expressão de NF-kB nos animais com câncer de mama e tratados com melatonina; por outro lado em células de hepatocarcinoma, a melatonina aumentou a expressão do NF-kB. No microambiente tumoral mamário, a melatonina aumentou a expressão dos genes Tnfaip8l2 and Il1f6, que são importantes na resposta imune local. No plasma, dentre os 20 aminoácidos detectados, 10 tiveram comportamento similar durante o dia. Na maioria dos horários do dia, os animais com tumor apresentaram níveis plasmáticos reduzidos desses aminoácidos. Além disso, houve uma inversão no perfil desses aminoácidos entre os grupos, observado nos primeiros horários da manhã. CONCLUSÕES: O efeito da melatonina sobre o NF-kB no câncer de mama parece estar melhor definido, porém o seu papel permanece controverso no câncer hepático. Da mesma forma a ação anti-tumoral desse hormônio foi comprovada pela alta expressão dos genes Tnfaip8l2 e Il1f6 no microambiente tumoral. No plasma, as alterações dos metabólitos são um reflexo do metabolismo alterado, determinado pelas células tumorais mamárias na matriz dos camundongos. Enquanto que, essa inversão do perfil dos aminoácidos sugere que um evento cíclico do metabolismo do hospedeiro nesses horários aparece influenciando os níveis de aminoácidos circulantes. Desse modo, os nossos resultados apontam que durante a carcinogênese existe uma forte associação entre a resposta imune e a cronobiologia do hospedeiro que exige futuras investigações.

Submitted by Suzana Dias (suzana.dias@famerp.br) on 2018-11-09T18:31:25Z No. of bitstreams: 1 JessicaHelenaPires_dissert.pdf: 3617808 bytes, checksum: 1df14ad1ee40275580d520f969311d14 (MD5) / Made available in DSpace on 2018-11-09T18:31:25Z (GMT). No. of bitstreams: 1 JessicaHelenaPires_dissert.pdf: 3617808 bytes, checksum: 1df14ad1ee40275580d520f969311d14 (MD5) Previous issue date: 2018-03-06 / Fundação de Amparo à Pesquisa do Estado de São Paulo - FAPESP / Breast cancer represents the second type of tumor that has the highest mortality rates, being the most common among women. The causes of these high mortality rates are related to high proliferation and metastasis, and for tumor progression, the growth of new blood vessels, angiogenesis is required. This event can be stimulated by several factors, such as insulin-like growth factor 1 receptor (IGF-1R), hypoxia-inducible factor 1-alpha (HIF-1α) and vascular endothelial growth factor (VEGF). Several molecules are involved in the control of angiogenesis such as melatonin and microRNAs (miRNAs). The miRNAs can induce the gene silencing of genes related to angiogenesis by pairing with certain specific messenger RNA (mRNA), resulting in the degradation of this molecule. Melatonin (N-acetyl-5-methoxytryptamine), the main hormone produced and secreted by the pineal gland, has several physiological functions and a proven antiangiogenesis action. This hormone can regulate miRNAs and genes related to this process. Objective: To evaluate the ability of melatonin to modulate miR-152-3p and its targets in triple-negative breast cancer cells. Material and Method: After the determination of the melatonin concentration to be used, the differential expression of the miRNAs in the MDA-MB-468 strain after the melatonin treatment was evaluated using the plate RT² Profiler™ PCR Array Human Breast Cancer containing 84 miRNAs related to breast cancer. An in-silico analysis was performed to select a miRNA involved in angiogenesis and its potential target genes. Overexpression of miR-152-3p was performed on MDA-MB-468 and MDA-MB-231 cells by transient transfection and after relative quantification of their expression and their target genes IGF-1R, VEGF and HIF-1α was evaluated by real-time PCR. Quantification of the protein expression of the genes was verified by immunocytochemistry. Results: The cell viability assay in the MDA-MB-468 cell line demonstrated that cells treated with 1 mM melatonin had the lowest viability (p <0.05). Analysis of the miRNAs by PCR Array in the MDA-MB-468 cell line showed six positively regulated miRNAs and seven negatively regulated miRNAs after treatment with melatonin. Evaluation of gene expression demonstrated that miR-152-3p overexpression was influenced by melatonin, leading to increased expression of the genes IGF-1R, HIF-1α and VEGF in MDA-MB-468 cells. In the MDA-MB-231 cell line, melatonin did not influence the expression of miR-152-3p and decreased the expression of the target genes. Finally, immunocytochemistry revealed that melatonin and overexpression of miR-152-3p were able to decrease the protein expression of IGF-1R, HIF-1α and VEGF in the MDA-MB-468 and MDA-MB-231 cells. Conclusions: Melatonin was able to modulate the expression of miR-152-3p and its target genes involved in angiogenesis in triple-negative breast cancer. Therefore, this study confirms the action of melatonin on the important cellular event of angiogenesis, a determinant process for the progression of the disease and also indicates it as a potential therapeutic protocol for triple-negative breast cancer. / O câncer de mama representa o segundo tipo tumoral que possui os maiores índices de mortalidade, sendo o mais comum entre as mulheres. As causas desses altos índices de mortalidade têm relação com a alta proliferação e formação de metástases, e para a progressão tumoral, é necessário o crescimento de novos vasos sanguíneos, a angiogênese. Este evento pode ser estimulado por diversos fatores, como o receptor tipo 1 do fator de crescimento semelhante à insulina (IGF-1R), o fator induzido por hipóxia 1 alfa (HIF-1α) e o fator de crescimento endotelial vascular (VEGF). Os miRNAs podem induzir o silenciamento de genes relacionados com a angiogênese pelo pareamento com determinado RNA mensageiro (RNAm) específico, resultando na degradação desta molécula. A melatonina (N-acetil-5-metoxitriptamina), principal hormônio produzido e secretado pela glândula pineal, possui diversas funções fisiológicas e comprovada ação antitumoral, inclusive ação antiangiogênica. Esse hormônio pode regular miRNAs e genes relacionados a esse processo. Objetivo: Avaliar a capacidade da melatonina em modular o miR-152-3p e seus alvos, em células de câncer de mama triplo-negativo. Material e Método: Após a definição da concentração de melatonina a ser utilizada pelo ensaio de viabilidade celular, foi avaliada a expressão diferencial dos miRNAs na linhagem MDA-MB-468, após o tratamento com melatonina, utilizando-se a placa RT² Profiler™ PCR Array Human Breast Cancer que contêm 84 miRNAs relacionados ao câncer de mama. Uma análise in silico foi realizada para seleção de um miRNA envolvido na angiogênese e seus potenciais genes-alvo. A superexpressão do miR-152-3p foi realizada nas células MDA-MB-468 e MDA-MB-231 por transfecção transiente e após, a quantificação relativa de sua expressão e de seus genes-alvo IGF-1R, VEGF e HIF-1α foram avaliadas por PCR em tempo real. A quantificação da expressão proteica dos genes foi verificada por imunocitoquímica. Resultados: O ensaio de viabilidade celular na linhagem MDA-MB-468, demonstrou que as células tratadas com 1 mM de melatonina tiveram os menores valores de viabilidade (p<0,05). A análise dos miRNAs por PCR Array na linhagem MDA-MB-468 apontou seis miRNAs regulados positivamente e sete miRNAs regulados negativamente, após o tratamento com a melatonina. A avaliação da expressão gênica demonstrou que a superexpressão do miR-152-3p foi influenciada pela melatonina, levando ao aumento da expressão dos genes IGF-1R, HIF-1α e VEGF na linhagem MDA-MB-468. Já na linhagem MDA-MB-231 a melatonina não influenciou a expressão do miR-152-3p e diminuiu a expressão dos genes-alvo. Por fim, a imunocitoquímica revelou que a melatonina e a superexpressão do miR-152-3p foram capazes de diminuir a expressão proteica de IGF-1R, HIF-1α e VEGF nas linhagens MDA-MB-468 e MDA-MB-231. Conclusões: A melatonina foi capaz de modular a expressão do miR-152-3p e de seus genes-alvo envolvidos com a angiogênese no câncer de mama triplo-negativo. Portanto, este estudo confirma a ação da melatonina no importante evento celular de angiogênese, processo determinante para a progressão da doença e ainda indicá-la como potencial protocolo terapêutico para o câncer de mama triplo-negativo.

Breast cancer is a public health problem in the world, it is estimated that more than 1 million women are diagnosed with the disease each year. It is most frequent in all regions of the country except in the north. With this, the mastectomy woman experiences a moment of emotional and sexual weakness, as the breast, symbol of femininity, plays an important role in the exercise of sexuality. The objectives of this study were to assess female sexual dysfunction in a group of women who underwent mastectomy and not mastectomy from the application of the Female Sexual Function Index; determine the incidence of female sexual dysfunction among women with mastectomies mastectomy and not women; and the correlation between the scores of the FSFI and personal history, clinical signs, symptoms and complaints related to sexuality in both groups. Developed a cross-sectional comparative study conducted in the Integrated Regional Oncology Center (CRYO), Association of Women in Cearà Mastectomized - Touch of Life and the Center for Family Development (CEDEFAM). . Data collection occurred in the period January-February 2014 As the sample consisted of two groups: 73 women who underwent mastectomy and 62 women without a diagnosis of breast cancer. The Female Sexual Function Index (FSFI), and a socioeconomic questionnaire and gynecological obstetric was applied. Descriptive statistics (absolute and relative frequencies, mean and standard deviation) was performed and the means to test the F Snedecor test (ANOVA) was applied. Most women with mastectomies investigated concentrated in the age group above 42 years (75.3%), while non-mastectomy women concentrated in the age group 18-36 years (66.1%). When analyzing the prevalence of sexual dysfunction in this study it was observed that was 55.6%. It was observed that the group of women with breast CA only field lubrication statistically significant when compared with age. Regarding monthly sex in the group of women who underwent mastectomy, it can be noticed that there was a statistically significant correlation in all domains of FSFI scale, except the pain domain (p> 0.05). Introducing the positive test r, this shows that the more sex these women have greater desire, arousal, lubrication, orgasm and satisfaction. The Cronbach alpha of the FSFI was 0.95 indicating high internal consistency and construct validity was assessed by the coefficient of linear correlation (p = 0.0001), demonstrating correlation between domains of scale. Therefore, we conclude that the nurse who assists women in general should provide quality care for all the obstacles are minimized to promote quality of life and sexual. / O cÃncer de mama à um problema de saÃde pÃblica no mundo, pois se estima que mais de 1 milhÃo de mulheres sejam diagnosticadas com a doenÃa a cada ano. à o mais frequente em todas as regiÃes do paÃs, exceto na RegiÃo Norte. Com isso, a mulher mastectomizada vivencia um momento de fragilidade emocional e sexual, jà que a mama, sÃmbolo de feminilidade, exerce importante papel no exercÃcio da sexualidade. Os objetivos deste estudo foram avaliar a disfunÃÃo sexual feminina em um grupo de mulheres mastectomizadas e nÃo mastectomizadas a partir da aplicaÃÃo do Female Sexual Function Index; verificar a incidÃncia da disfunÃÃo sexual feminina entre as mulheres mastectomizadas e das mulheres nÃo mastectomizadas; e verificar a correlaÃÃo entre os escores da FSFI e os antecedentes pessoais, clÃnicos, queixas e sintomas relacionados à sexualidade nos dois grupos avaliados. Desenvolveu-se um estudo transversal, comparativo realizado no Centro Regional Integrado de Oncologia (CRIO), na AssociaÃÃo Cearense das Mulheres Mastectomizadas - Toque de Vida e no Centro de Desenvolvimento Familiar (CEDEFAM). A coleta de dados ocorreu no perÃodo de janeiro a fevereiro de 2014. Sendo a amostra composta por dois grupos: 73 mulheres mastectomizadas e 62 mulheres sem diagnÃstico de cÃncer de mama. Foi aplicado a Female Sexual Function Index (FSFI), e um questionÃrio socioeconÃmico e gineco-obstÃtrico. Foi realizada anÃlise estatÃstica descritiva (frequÃncias absoluta e relativa, mÃdia e desvio padrÃo) e para se testar as mÃdias foi aplicado o teste F de Snedecor (ANOVA). A maioria das mulheres mastectomizadas investigadas concentrou-se na faixa etÃria acima de 42 anos (75,3%), enquanto as mulheres nÃo mastectomizadas concentrou-se na faixa etÃria de 18 a 36 anos (66,1%). Ao analisarmos a prevalÃncia de disfunÃÃo sexual neste estudo observa-se que foi de 55,6%. Foi possÃvel observar que no grupo de mulheres com CA de mama somente o domÃnio lubrificaÃÃo apresentou significÃncia estatÃstica quando comparado com a idade. Quanto Ãs relaÃÃes sexuais mensais no grupo das mulheres mastectomizadas, percebe-se que houve correlaÃÃo estatisticamente significante em todos os domÃnios da escala FSFI, exceto no domÃnio dor (p>0,05). Apresentando o teste r positivo, isso demonstra que quanto mais relaÃÃes sexuais essas mulheres tiverem maior serà o desejo, a excitaÃÃo, a lubrificaÃÃo, o orgasmo e a satisfaÃÃo. O alfa de Cronbach da FSFI foi de 0,95 indicando alta consistÃncia interna e a validade de construto foi analisada por meio do coeficiente de correlaÃÃo linear de Pearson (p=0,0001), demonstrando correlaÃÃo entre os domÃnios da escala. Logo, podemos concluir que o enfermeiro que assiste a mulher de um modo geral deve prestar assistÃncia qualificada para que todos os obstÃculos sejam minimizados para favorecer a qualidade de vida e sexual.

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / Reconhecendo a magnitude do problema de saÃde pÃblica que o cÃncer de mama se tornou ao longo dos anos e considerando a mamografia como procedimento especÃfico para detecÃÃo precoce, elegeu-se a realizaÃÃo da mamografia como comportamento desejado para esta investigaÃÃo. O objetivo geral foi avaliar a intenÃÃo comportamental de realizar mamografia e seus determinantes, entre mulheres de uma comunidade rural, submetidas ou nÃo a uma mensagem persuasiva. Trata-se de estudo experimental, do tipo apenas-posterior, tendo a Theory of Planned Behavior como referencial teÃrico-metodolÃgico. O estudo foi realizado em municÃpio da ParaÃba, com amostra composta por 148 mulheres divididas nos grupos Experimental 70(47,3%) e Controle 78(52,7%). As participantes eram, em sua maioria, casadas, com ensino fundamental incompleto, do lar, catÃlicas, com rendimentos mensais atà 2 salÃrios mÃnimos e idades entre 35 e 78 anos. A Coleta de dados foi realizada em duas etapas, sendo o levantamento das crenÃas (n= 33) em outubro/2009 e a avaliaÃÃo da intenÃÃo e seus determinantes em novembro/2009. As crenÃas compuseram as questÃes, formuladas em escalas de diferencial semÃntico de adjetivos bipolares tipo Likert. Os dados foram analisados comparativamente entre os grupos, sendo aplicados os testes de Fisher-Freeman-Halton, Mann-Whitney e o coeficiente de correlaÃÃo de Sperman. Utilizou-se o procedimento Forward para regressÃo logÃstica, com testes de Wald, Hosmer-Lemeshow e Omnibus, alÃm do R2 de Nagelkerke para poder de prediÃÃo. As anÃlises utilizaram os softwares PASW 18.0 e R versÃo 2.8.1, com nÃvel de significÃncia de 5%. As crenÃas comportamentais modais salientes positivas foram prevenÃÃo do cÃncer de mama, diagnÃstico precoce e se cuidar, e as negativas foram dor e medo. As crenÃas normativas mais frequentes foram o mÃdico, a televisÃo, vizinha e amiga. Quanto aos fatores facilitadores, foram mais citados: encaminhamentos, dinheiro, disponibilidade do exame pelo SUS e facilidade na marcaÃÃo. Entre os fatores impeditivos estiveram a demora para marcar/realizar o exame e a falta de dinheiro. Atitude foi considerada positiva em ambos os grupos, contudo o grupo controle apresentou melhor desempenho. Os escores maiores da norma subjetiva foram apresentados pelo grupo experimental, com predominÃncia do item que avaliava se a maioria das pessoas achava que a participante deveria realizar a mamografia nos prÃximos trÃs meses (p= 0,000). Os referentes com significÃncia estatÃstica foram: mÃdico, mÃe, irmÃ, enfermeira e agentes comunitÃrios. No tocante à percepÃÃo de controle comportamental, o grupo experimental(79,34) teve melhor desempenho em relaÃÃo ao grupo controle(70,15). A medida da intenÃÃo comportamental obteve tendÃncia positiva em ambos os grupos, sendo a mÃdia do grupo experimental (81,92) relativamente superior ao grupo controle (67,84). As variÃveis preditoras que melhor explicaram a intenÃÃo foram a atitude e a norma subjetiva, com coeficiente de determinaÃÃo de aproximadamente 50% (R2=0,503). O conhecimento das intenÃÃes comportamentais favorece o desenvolvimento de estratÃgias de trabalho para a enfermagem e demais profissionais de saÃde, a exemplo de aÃÃes de educaÃÃo em saÃde, que desperte a mulher para a importÃncia do rastreamento, bem como possibilite busca ativa de mulheres em idades apropriadas para a realizaÃÃo dos exames de detecÃÃo precoce. / Recognizing the magnitude of the public health problem that breast cancer has become over the years and considering mammography as specific procedure for early detection, mammography screening was elected as desired behavior for this investigation. The aim was to assess the behavioral intention and its determinants to perform mammography screening among women in a rural community, with or without a persuasive message. This is an experimental study, only-posterior type, and the Theory of Planned Behavior was a theoretical and methodological framework. The study was conducted in a city of Paraiba, with a sample of 148 women divided into experimental groups 70 (47.3%) and Control 78 (52.7%). The participants were, mostly, married women with incomplete primary education, work at home, catholic, with monthly incomes up to 2 minimum wages, aged 35 to 78 years. The data collect was performed in two steps: a survey of beliefs (n = 33) in October/2009 and assessment of intention and its determinants in November/2009. Beliefs composed the questions formulated in semantic differential scales of bipolar adjectives Likert type. The data were analyzed comparing the two groups, being tested by Fisher-Freeman-Halton, Mann-Whitney test and correlation coefficient of Spearman. It was used the procedure for Forward logistic regression, Wald test, Hosmer-Lemeshow and Omnibus, in addition to R2 Nagelkerke for predictive power. The analysis used the software PASW 18.0 and R version 2.8.1, with a significance level of 5%. The modal salient behavioral beliefs positive were breast cancer prevention, early diagnosis and itself care, and the negatives were pain and fear. Most frequent normative beliefs were physician, television, neighbor and friend. As facilitating factors, were most often cited: referent, money, availability of the examination in SUS and ease of marking. Among the impediments were taking so long to check / perform the examination and lack of money. Attitude was positive in both groups, however the control group showed better performance. The higher scores of subjective norm were presented by the experimental group, with predominance of the item that assessed whether most people thought that the participant should perform the mammogram in the next three months (p = 0.000). The referent with significant statistically were: physician, mother, sister, nurse and community agents. Regarding the behavioral control perception, the experimental group (79.34) had better performance comparing to the control group (70.15). The measure of behavioral intention received positive trend in both groups, with the mean of the experimental group (81.92) bigger than the control group (67.84). The predictor variables that best explained the intention were the attitude and subjective norm, with coefficient of determination of approximately 50% (R2 = 0.503). Knowledge of behavioral intentions should improve the strategies development of nursing work and other health professionals, like shares of health education to awaken women to the importance of mammography screening and make possible active search for women of appropriate ages to perform exams for early detection.

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / Objetivos. Desenvolver um modelo experimental para identificaÃÃo de linfonodo sentinela (LS) da mama da cadela com uso de corante azul de metileno e comparÃ-lo com o azul patente, controlados por tecnÃcio. MÃtodos. O trabalho foi realizado em 23 cadelas, tendo-se observado a marcaÃÃo dos LS do primeiro par superior de mamas ao se injetarem 0,2 ml de TecnÃcio 99m ligado ao fitato (Tc 99m) e 0,5 ml de azul patente Guerbet V 2,5 % nos espaÃos subpapilares das mamas direitas e 0,2 ml de Tc-99m e 0,5 ml do azul de metileno 1 % nos mesmos espaÃos das mamas esquerdas. Resultados. Na mama direita, as tÃcnicas de biopsia de LS quando utilizados o Tc-99m e azul patente foram concordantes. Dos 23 LS estudados, somente um nÃo corou nem foi captante. O azul patente foi eficaz em 100 % quando comparado com os dois mÃtodos associados. Na mama esquerda, dos 23 LS estudados, somente dois nÃo coraram e um nÃo foi captante, sendo esta diferenÃa estatisticamente nÃo significante. A tÃcnica de biopsia do LS utilizando-se o azul de metileno apresentou-se com eficÃcia de 91,3 % quando utilizado isoladamente e de 100 % quando associado ao Tc-99m. ConclusÃo. O uso do azul de metileno associado ao radiofÃrmaco pode ser considerado como tÃcnica potencial na pesquisa transoperatÃria do LS das mamas, sendo uma opÃÃo menos onerosa e com menores efeitos alergÃnicos do que o azul patente / Objetivos. Desenvolver um modelo experimental para identificaÃÃo de linfonodo sentinela (LS) da mama da cadela com uso de corante azul de metileno e comparÃ-lo com o azul patente, controlados por tecnÃcio. MÃtodos. O trabalho foi realizado em 23 cadelas, tendo-se observado a marcaÃÃo dos LS do primeiro par superior de mamas ao se injetarem 0,2 ml de TecnÃcio 99m ligado ao fitato (Tc 99m) e 0,5 ml de azul patente Guerbet V 2,5 % nos espaÃos subpapilares das mamas direitas e 0,2 ml de Tc-99m e 0,5 ml do azul de metileno 1 % nos mesmos espaÃos das mamas esquerdas. Resultados. Na mama direita, as tÃcnicas de biopsia de LS quando utilizados o Tc-99m e azul patente foram concordantes. Dos 23 LS estudados, somente um nÃo corou nem foi captante. O azul patente foi eficaz em 100 % quando comparado com os dois mÃtodos associados. Na mama esquerda, dos 23 LS estudados, somente dois nÃo coraram e um nÃo foi captante, sendo esta diferenÃa estatisticamente nÃo significante. A tÃcnica de biopsia do LS utilizando-se o azul de metileno apresentou-se com eficÃcia de 91,3 % quando utilizado isoladamente e de 100 % quando associado ao Tc-99m. ConclusÃo. O uso do azul de metileno associado ao radiofÃrmaco pode ser considerado como tÃcnica potencial na pesquisa transoperatÃria do LS das mamas, sendo uma opÃÃo menos onerosa e com menores efeitos alergÃnicos do que o azul patente / Objectives. To develop an experimental model for identification of sentinel lymph node (SLN) of breast bitch with the use of methylene blue and compares it with the patent blue, both associated with technetium. Methods. 23 dogs, there was the marking of the SLN of the first upper pair of breasts to inject 0.2 ml of Tc-99m phytate bound to (99m) and 0.5 ml of patent blue Guerbet V 2,5 % in subpapilar spaces right breast and 0.2 ml of 99mTc and 0.5 ml of 1% methylene blue in the same spaces left breast. Results. In the right breast biopsy techniques using 99mTc SLN and blue dye are in agreement. Of the 23 SLN studied, only one was not flushed nor uptake. The patent blue was effective in 100% when compared with the two methods together. The left breast of 23 SLN studied, only two non-stained and one was not uptake, this difference was not statistically significant. The SLN biopsy technique using methylene blue appeared with a 91.3% effectiveness when used alone and 100% when associated with 99mTc. Conclusion: The use of methylene blue associated with the radiotracer technique can be considered as potential research intraoperative SLN of breast, suggesting a less costly and less allergenic effects that blue patent. / Objectives. To develop an experimental model for identification of sentinel lymph node (SLN) of breast bitch with the use of methylene blue and compares it with the patent blue, both associated with technetium. Methods. 23 dogs, there was the marking of the SLN of the first upper pair of breasts to inject 0.2 ml of Tc-99m phytate bound to (99m) and 0.5 ml of patent blue Guerbet V 2,5 % in subpapilar spaces right breast and 0.2 ml of 99mTc and 0.5 ml of 1% methylene blue in the same spaces left breast. Results. In the right breast biopsy techniques using 99mTc SLN and blue dye are in agreement. Of the 23 SLN studied, only one was not flushed nor uptake. The patent blue was effective in 100% when compared with the two methods together. The left breast of 23 SLN studied, only two non-stained and one was not uptake, this difference was not statistically significant. The SLN biopsy technique using methylene blue appeared with a 91.3% effectiveness when used alone and 100% when associated with 99mTc. Conclusion: The use of methylene blue associated with the radiotracer technique can be considered as potential research intraoperative SLN of breast, suggesting a less costly and less allergenic effects that blue patent.