PURPOSE: The purpose of this study was to determine if there is a risk difference in survival in the first event of locoregional recurrence and distant disease in women who underwent breast-conserving therapy (BCT) compared with women who underwent mastectomy. Premenopausal women with early-stage breast cancer and positive lymph node/s make up this group. METHODS: Retrospective cohort study was conducted to answer this study question by a chart review. RESULTS: The results of the study demonstrated that women with breast cancer who underwent mastectomy had higher risk of distant disease compared with breast-conserving therapy. Also women aged under 35 had an independent association with distant disease. In addition, the type of surgery did not have a significant result association with locoregional recurrence. CONCLUSIONS: These results support the fact that the breast-conserving therapy group had a low rate of distant disease compared with the mastectomy group. Also they endorse the necessity to conduct further descriptive studies to address the association between type of surgery and locoregional recurrence.

Les chiffres mondiaux estiment l’incidence du cancer du sein, cancer féminin le plus fréquent, à 1.3 millions de cas par an, dont près d’un tiers a une issue fatale.La polarité est indispensable à l’organisation cellulaire, ses défauts peuvent mener au cancer. Notre projet est focalisé sur une protéine de la polarité, Lano, et son influence sur le cancer du sein et les CSC. L’Institut Paoli-Calmettes dispose d’environ 10000 échantillons de cancer du sein dont l’analyse montre que la perte de Lano est corrélée à des cancers du sein plus graves et à une augmentation des CSC. Nos résultats in vitro, sur des cellules de cancer du sein humain et in vivo montrent aussi que Lano est un régulateur du nombre de CSC. Les CSC sont une ces causes principales de rechute des patients. La suite de nos travaux pourrait déterminer si Lano est un facteur pronostique de la maladie ou une cible thérapeutique possible. / Breast cancer is the most common cancer in women. Worldwide figures estimate the incidence of breast cancer at 1.3 million cases per year, nearly one third of them has a fatal outcome.Our project focuses on the study of Lano, a polarity protein, in breast cancer and stem cells. The hospital “Institute Paoli-Calmettes” gathered 10,000 breast cancer samples whose analysis shows that the loss of Lano has a role in breast cancer and stem cells. Our in vitro results on human breast cancer cells and in vivo also show that Lano is a regulator of the number of cancer stem cells. Cancer stem cells are one of the major causes of relapse in patients. The rest of our work could determine if Lano could be a prognostic factor of the disease or a possible therapeutic target.

Anti-estrogen drugs such as Tamoxifen and Raloxifene are widely prescribed for breast cancer patients. While they are effective, they also have serious side effects. Alternative drugs are therefore being developed. In the drug discovery process, the in vitro binding of estrogen receptors and lead compounds were studied. The binding strength was conventionally quantified in terms of equilibrium dissociation constants (K0 ). However, the binding kinetic rates and especially off-rates (k0 ff) were recently shown to be better indicators of drug potency. In this thesis, we identified a few dietary estrogens as candidate lead compounds. We studied the binding of full-length human recombinant ERa with these dietary estrogens. In particular, we measured for the first time their binding kinetics rate constants. We also measured the change in the receptor-ligand binding kinetics upon its recruitment of co-activators, as a means to gauge agonist/antagonist propensity ofthe ligand. Our results showed that the following dietary estrogens, a-Zearalenol, Zearalenone, and Coumestrol bind favorably to the estrogen receptor alpha.

Orientadores: Marcelo Alvarenga, Cesar Cabello dos Santos / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-10T14:34:16Z (GMT). No. of bitstreams: 1 Bianchessi_SusanaTrigo_M.pdf: 5977471 bytes, checksum: 691416790e0a9f01b1b82619e5b6e1f3 (MD5) Previous issue date: 2008 / Resumo: Introdução: A correta avaliação da extensão local do câncer de mama é necessária para a escolha do tratamento local entre cirurgia conservadora e mastectomia. Objetivo: Avaliar se a ressonância magnética (RM) é um bom preditor do tamanho tumoral, multifocalidade e multicentricidade. Sujeitos e Métodos: Vinte mulheres com carcinoma mamário unilateral e unifocal, agendadas para mastectomia, realizaram RM. As medidas dos três diâmetros tumorais foram realizadas em milímetros e outros focos de captação do contraste foram avaliados. O resultado anatomopatológico da peça de mastectomia incluiu os três diâmetros tumorais em milímetros (mm) e descrição de outros focos tumorais, quando presentes. Resultados: Os três diâmetros do tumor foram avaliados e os índices de concordância entre o AP e a RM foram de 95% para o diâmetro longitudinal e 85% para os diâmetros anteroposterior e transversal. A sensibilidade e a especificidade da RM no diagnóstico de doença multifocal foi de 78% e 82%, no diagnóstico de doença multicêntrica foi de 81% e 100% e sua acurácia foi de 80% e 85%. O Índice Kappa em relação a multifocalidade e a multicentricidade foi de 0,6 e 0,63, respectivamente. Conclusão: A RM pode ser usada como método complementar para auxiliar o planejamento cirúrgico / Abstract: Introduction: Predicting the extent of local breast cancer is essential for making the choice between breast-conservation treatment and mastectomy. Aim: To determine whether preoperative breast magnetic resonance (MR) could predict size of index tumor, multifocality and multicentricity. Patients and methods: Twenty women with unilateral end unifocal breast cancer scheduled for mastectomy underwent breast MR. Measurements in the three diameters were taken in millimeters (mm) and other foci of contrast uptake were evaluated. The anatomopathologic (AP) result of the mastectomy specimen included measurements in the three diameters of the index tumor, taken in millimeters, and other foci of tumor. Results: The concordance index was calculated for each diameter and was 95% for longitudinal diameter and 85% for antero-posterior and transversal diameters. The MR sensitivity and specificity for multifocal disease was 78% and 82% and for multicentric disease was 81% and 100%, respectively. The Kappa index was 0,6 for multifocality and 0.63 for multicentricity. Conclusion: MR can be used as a complementary method for surgical planning / Mestrado / Tocoginecologia / Mestre em Tocoginecologia

Orientador: Jacks Jorge Junior / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-24T16:42:54Z (GMT). No. of bitstreams: 1 SouzaLima_NathaliaCarolinede_M.pdf: 622004 bytes, checksum: 0c706eecc1567182559d2fa1ba1d3900 (MD5) Previous issue date: 2014 / Resumo: Exposição a hormônios sexuais no início da vida pode influenciar a susceptibilidade às doenças relacionadas às diferenças de sexo. A proporção 2D:4D tem sido considerada um marcador putativo de exposição e sensibilidade pré-natal a hormônios sexuais, assim como à expressão de genes relacionados ao câncer. Dessa maneira, essa dissertação propôs-se a investigar a proporção 2D:4D de mulheres com câncer de mama, mulheres com lesão benigna de mama e mulheres controle; e associar 2D:4D com diagnóstico histológico, receptores hormonais, expressão de HER-2 e estadiamento clínico tumoral. No total, 810 mulheres foram recrutadas e classificadas em três grupos: câncer de mama (CM); lesões benignas de mama (LBM); e controle (CON). Mulheres com histórico de injúria nos dedos indicador ou anelar foram excluídas. Todas as mulheres tiveram as palmas das mãos fotografadas utilizando câmera digital acoplada a uma estativa. As imagens foram transferidas para computador e analisadas utilizando o software Adobe Photoshop®, e a distância entre a depressão primária da superfície ventral e a ponta dos dedos indicador (2D) e anelar (4D) das mãos foram medidas duas vezes e registradas. Aos dados foram aplicados os testes de Coeficiente de Correlação Intraclasse, ANOVA, Teste t de Student e teste X². Os resultados mostraram que CM relatou amamentar mais (p=0,0043) e apresentou maior diferença entre as proporções digitais das mão direita e esquerda ( ?D-E ) em comparação ao CON (p=0,0320). Os grupos CM e CON relataram maior paridade em comparação ao grupo LBM (p=0,0157 e p=0,0439, respectivamente). Não houve relação entre 2D:4D e diagnóstico histológico, receptores hormonais, expressão de HER-2 ou estadiamento clínico tumoral. A análise da diferença entre 2D:4D das mãos direita e esquerda (?D-E) sugere que a exposição aos hormônios sexuais intra útero possa influenciar o desenvolvimento de câncer de mama em mulheres adultas / Abstract: Exposure to sex hormones in early life may influence susceptibility to diseases related to sex differences. The ratio 2D:4D has been considered a putative marker of prenatal exposure and sensitivity to sex hormones, as well as the expression of genes related to cancer. Thus, this dissertation aimed to investigate the ratio 2D:4D in breast cancer women, benign breast lesion women and healthy women, and to associate 2D:4D with histological diagnosis, hormone receptor status, HER- 2 expression and tumor clinical staging. Overall, 810 women were recruited and classified into three groups: breast cancer (BC), benign breast lesion (LBM) and control (CON). Subjects with history of injury in the index or ring finger were excluded. All women had their palms of the hands photographed, using a digital camera attached to a stand. The images were transferred to a computer and analyzed using Adobe Photoshop® software, and the distance between primary depression of the ventral surface and the tip of the index finger (2D) and ring finger (4D) were measured twice and recorded. Intraclass correlation coefficient, ANOVA, Student's t test, and X ² test were applied to the data. The results showed that CM reported more breastfeeding habits (p=0.0043) and showed higher ?R-L (p=0.0320) compared to CON. The CM and CON groups reported higher parity compared to LBM group (p=0.0157 and p=0.0439, respectively). Histological diagnosis, hormone receptor status, HER-2 expression, and tumor clinical staging were not associated to 2D:4D. The results of the difference between 2D:4D of the right and left hands (?R-L) suggests that exposure to prenatal sex hormones may influence the development of breast cancer in adult women / Mestrado / Estomatologia / Mestra em Estomatopatologia

Breast cancer has a high propensity to metastasize to bone. While the genetic and epigenetic changes associated with metastatic breast cancer progression are being identified, the changes that drive metastatic progression are poorly understood. Proteases, and in particular matrix metalloproteinases (MMPs), have been shown to play a pivotal role in certain aspects of tumor metastasis by modifying the affected microenvironment. Bone matrix-depositing mouse MC3T3 osteoblasts were co-cultured with metastatic human MDA-MB-23 1 (MDA23 1) cells or the bone-homing MDA-MB 231-1 833/TR (1 833/TR) variant in an effort to identify novel, osteoclast-independent, changes to the tumor/bone microenvironment. Co-culture-induced changes in the complete “protease and inhibitor” expression profile in the osteoblasts and the tumor cells were then determined using targeted murine and human specific microarray chips (CLIP-CHIP TM ). This analysis revealed an increase in the RNA expression of collagenase-3 (MMP 13) in the co-cultured osteoblasts that was confirmed by qPCR. Further, Western blotting indicated increased MIvIP13 protein secretion into the bone matrixltumor microenvironment by the co-cultured MC3T3 cells. The elevation in osteoblast-produced MMP13 was observed when the co- cultured tumor cells were in direct contact or separated by filters. Additionally, the elevation was also induced by conditioned medium derived from separate MDA23 1 or 1 833/TR cultures, which indicates that a soluble factor produced by the tumor cells is capable of inducing MMP 13. One soluble factor that appears to be produced by 1 833iTR cultures is oncostatin M. Oncostatin M is an interleukin-6 family cytokine that is known to upregulate MMP13 synthesis and secretion during chondrogenesis. Genome-wide Affymetrix® analysis revealed, and qPCR analysis confirmed, that oncostatin M receptor-specific subunit RNA was also significantly upregulated in co-cultured osteoblasts. Therefore, breast tumor cells may be capable of initiating protein degradative changes in the bone microenvironment that are independent of the much studied osteolytic degradation initiated by osteoclast activation. / Medicine, Faculty of / Graduate

This is the first systematic large-scale study of lesbian health that has been conducted in the U.K. Its purpose is to provide data about lesbians' breast and cervical screening behaviour and experiences of health care. Comparable studies in the U.S.A. suggest that lesbians do not attend for routine screening tests and are less likely, than heterosexual women, to practise breast self examination. A questionnaire (the Lesbians and Health Care Survey) was distributed to 1066 lesbians in the UK. Four follow-up focus groups (n = 30) were used to explore some of the issues arising from the survey. The major quantitative survey findings include: 12 per cent of lesbians have never attended for a cervical smear; 20 per cent have never practised BSE, and only 11 per cent attend for a mammogram every three years. The qualitative survey data were content analysed in order to identify the reasons given by lesbians for their healthcare behaviour. In the follow-up focus groups, breast health is taken as a case study. This thesis contributes to defining a lesbian feminist health agenda by its valuing of lesbians' own perspectives; by providing alternative conceptions of lesbians' health that do not rely on biomedical, disease models; and it locates lesbians' health experiences within a socio-political framework. By providing a range of data about-lesbians' health, the findings may help to inform the understanding of health providers about lesbians' health needs, improve the practice of health care delivery for lesbians and be of value to lesbians in making decisions about their health care behaviour.

No description available.

Breastfeeding is widely considered the healthiest way to feed an infant. Promoting breastfeeding and increasing breastfeeding rates has become a global strategy to improve children’s health. However the latest rate of exclusive breastfeeding at six months in 2014 in China was 30% in rural areas and 16% in urban areas. Support from skilled practitioners can positively influence breastfeeding initiation rates, duration and women’s breastfeeding experience. This research aims to develop and evaluate a new breastfeeding training programme for professionals to improve support for breastfeeding mothers in China. Mixed research methods were used in the research which included qualitative and quantitative studies. Two qualitative studies provided the evidence for the importance of training professionals in two essential skills of positioning and attachment (P & A) and hand expression (HE). This study further applied a 15-minute breastfeeding DVD training intervention to train Chinese professionals in P & A and HE. At the meantime, the research developed two valid breastfeeding assessment tools, including knowledge assessment tool and confidence assessment tool. Two quantitative studies of the pilot study and RCT study evaluated the effectiveness of DVD training intervention on improving professionals’ knowledge and confidence before and after DVD training by the two breastfeeding assessment tools. The findings in both studies indicated that the DVD training intervention significantly improve the professionals’ knowledge and confidence in P & A and HE with a big effect size. The semi-structured interviews conducted after the RCT study showed the feasibility and applicability of DVD training for professionals in China. This first evidence-based new training programme is likely to be widely implemented in China due to its effectiveness, convenience and ease of access. However, the long-term effectiveness of the DVD training at improving professionals’ knowledge, confidence and breastfeeding outcome needs to be further examined in the future.

No description available.