bluuebunny/crossref_metadata_2025 huggingface dataset:
Application of MARS-5 and UltraWAVE microwave systems to the digestion of silicate rocks followed by ICP-MS analysis
Authors: Nikolaeva I. V. , Palesskiy S. V.
Published: April 2023

Two microwave systems MARS-5 and UltraWAVE are compared in the efficiency with regard to the digestion of silicate rocks with subsequent determination of 32 elements (Sc, V, Cr, Co, Ni, Cu, Zn, Rb, Sr, Y, Nb, Ta, Cs, Ba, 14 REE, Hf, Ta, Th, U) by inductively coupled plasma mass spectrometry (ICP-MS). The development of digestion methods and validation of the obtained results has been carried out using international reference materials — basalts BHVO-2 and BCR-2, serpentinite UB-N and peridotite JP-1. Microwave digestion included a two-stage treatment of samples with a mixture of concentrated acids HF, HNO3, HCl in MARS-5 (T = 190°C, P = 20 bar) and UltraWAVE (T = 240°C, P = 80 bar) with distillation of excess fluorides in the form of SiF4 between microwave digestion stages. The determination of concentrations in the obtained solutions was carried out on a high-resolution mass spectrometer ELEMENT in low and medium resolution according to external calibration with the internal standard (In), taking into account the acid composition of the analyzed solutions. The detection limits of the analytes after acid digestion in MARS-5 and UltraWAVE are comparable and provide the determination of all specified elements, except for Ta in JP-1. The use of the developed sample preparation procedure in MARS-5 ensures complete decomposition of BHVO-2, BCR-2, UB-N followed by ICP-MS determination of 32 specified elements in the obtained solutions without additional preconcentration steps. The relative standard deviations for the determined elements are 2 – 9% for the reference materials BHVO-2, BCR-2, 3 – 12% for UB-N with an increase to 16 – 25% (Nb, Ta) due to the approach to the detection limit. The more efficient microwave digestion in UltraWAVE compared to MARS-5 was proved by the complete decomposition of JP-1 with the transfer of all the elements, including Cr, to the solution.
Cyclic behavior of heat resistant nickel-base alloys EP741NP and EI698VD under strain-control loading
Authors: Khudiakova A. D. , Servetnik A. N. , Volkov M. E. , Polianskii S. B.
Published: April 2023

Low cycle fatigue behavior of nickel-base alloys EP741NP and EI698VD under strain-control loading with zero strain ratio was studied for a wide range of strain amplitudes and temperatures. Dependences of the stress amplitude, mean stress and plastic strain range on the number of cycles were analyzed. Three stages of the cyclic behavior were marked out: the first stage of non-steady behavior with hardening, or softening, or transition from hardening to softening; the second stage of steady hardening, softening or stability; and the third stage associated with a crack development. Qualitative and quantitative parameters are proposed that make it possible to determine a share of the first stage of cyclic instability in the total cyclic durability and the nature of the material behavior in the first and second stages proceeding from the analysis of the dependence of the range of plastic deformations on the cycle number. The absence of cyclic stability was demonstrated for both alloys almost in the whole range of testing. It was shown, that the contribution of the first stage to the fatigue life (total durability) can be up to 30% and the greater the strain range, the greater the contribution. The temperature dependence of the character of cyclic behavior of materials is revealed. Alloy EP741NP is softened at the first and second stages at room temperature and is liable to hardening at elevated temperatures 300, 450, and 600°C, whereas alloy EI698VD is hardened at the first stage at 20 and 400°C, but inclines to softening at 650°C. At the second stage alloy EI698VD inclines to softening at 20 and 650°C and is liable to hardening at 400°C. With strain ranges 0.6 and 0.7%, both alloys can be considered cyclic stable at the second stage over the entire temperature range
Study of changes in the mechanical and acoustic properties of epoxy resins under long-time polymerization
Authors: Drachev K. A. , Kazarbin A. V. , Rimlyand V. I.
Published: April 2023

Changes in the mechanical stress-strain curves and sound velocity of longitudinal waves for epoxy resin ED-20 with different content of polyethylene polyamine (PPA) hardener and diethylene glycol (DEG) plasticizer were studied for cure time from one to 30 days. The obtained dependences of the applied force on the absolute value of stretching for samples with different PPA content and different curing time make it possible to divide the sample state into three types: highly elastic; not fully cured; vitreous fully cured. The parameters characterizing each state are determined. The polymerization process continues with a curing time of 24 – 720 h for all samples. Acoustic measurements were carried out by the pulse method using an automated measuring system. The dependences of the longitudinal sound velocity on the curing time for samples with different contents of PPA and DEG plasticizer are presented. The sound velocity changed much less than the static Young’s modulus within the considered interval of the curing time. The presence of a «kink» in the interval from about 20 to 180 h is a feature of the dependences of the sound velocity on the curing time. The data obtained revealed that the section of rapid growth of the sound velocity corresponds to the transition from the highly elastic state to the glassy solid one. Experimental study of the physical properties of compositions based on ED20 resin with a concentration of the curing agent less than standard provides the possibility of detailed study of the dynamics of polymerization process after the transition from the gel state to the solid state at a long curing time. It is shown that the curing process continues for a rather long time in the solid state. The observed features on the dependences of the sound velocity on the curing time are attributed to the formation of the 3D structure during the transition from the highly elastic state to the solid glassy state. In this case, the value of the longitudinal sound velocity can be an indicator of the degree of completion of the polymerization process of finished products from composite materials based on epoxy resin, for which it may be difficult to measure the mechanical properties.
Epidemic intelligence data of Crimean-Congo haemorrhagic fever, European Region, 2012 to 2022: a new opportunity for risk mapping of neglected diseases
Authors: Fanelli Angela , Schnitzler Johannes Christof , De Nardi Marco , Donachie Alastair , Capua Ilaria , Lanave Gianvito , Buonavoglia Domenico , Caceres-Soto Paula , Tizzani Paolo
Published: April 2023

Background

The Epidemic Intelligence from Open Sources (EIOS) system, jointly developed by the World Health Organisation (WHO), the Joint Research Centre (JRC) of the European Commission and various partners, is a web-based platform that facilitate the monitoring of information on public health threats in near real-time from thousands of online sources.

Aims

To assess the capacity of the EIOS system to strengthen data collection for neglected diseases of public health importance, and to evaluate the use of EIOS data for improving the understanding of the geographic extents of diseases and their level of risk.

Methods

A Bayesian additive regression trees (BART) model was implemented to map the risk of Crimean-Congo haemorrhagic fever (CCHF) occurrence in 52 countries and territories within the European Region between January 2012 and March 2022 using data on CCHF occurrence retrieved from the EIOS system.

Results

The model found a positive association between all temperature-related variables and the probability of CCHF occurrence, with an increased risk in warmer and drier areas. The highest risk of CCHF was found in the Mediterranean basin and in areas bordering the Black Sea. There was a general decreasing risk trend from south to north across the entire European Region.

Conclusion

The study highlights that the information gathered by public health intelligence can be used to build a disease risk map. Internet-based sources could aid in the assessment of new or changing risks and planning effective actions in target areas.
Cryptic SARS-CoV-2 lineage identified on two mink farms as a possible result of long-term undetected circulation in an unknown animal reservoir, Poland, November 2022 to January 2023
Authors: Domańska-Blicharz Katarzyna , Oude Munnink Bas B , Orłowska Anna , Smreczak Marcin , Opolska Justyna , Lisowska Anna , Trębas Paweł , Socha Wojciech , Giza Aleksandra , Bomba Arkadiusz , Iwan Ewelina , Rola Jerzy , Koopmans Marion
Published: April 2023

In late 2022 and early 2023, SARS-CoV-2 infections were detected on three mink farms in Poland situated within a few km from each other. Whole-genome sequencing of the viruses on two of the farms showed that they were related to a virus identified in humans in the same region 2 years before (B.1.1.307 lineage). Many mutations were found, including in the S protein typical of adaptations to the mink host. The origin of the virus remains to be determined.
Gestão de projetos esportivos em período de pandemia da covid-19
Authors: Silva Junior Vagner Pereira da , Tavares Giselle Helena
Published: April 2023

Gestão de projetos esportivos em período de pandemia da covid-19 
ResumoO estudo teve como objetivo descrever a proposta adaptada, planejada e implementada para atendimentos do Programa Segundo Tempo Universitário (PSTU) durante a pandemia da covid-19 e a gestão empreendida na Universidade Federal do Mato Grosso do Sul. A ação foi gerenciada a partir do ciclo de projetos e subsidiada por cinco grupos de processos (iniciação, planejamento, execução, monitoramento e controle, e encerramento). Evidenciou-se que o fomento de práticas corporais por meio de equipe virtual no período de pandemia da covid-19 consistiu em alternativa viável ao atendimento de universitários e que a aplicação dos conhecimentos e ferramentas da gestão, em específico a gestão de projetos, corroborou com a funcionalidade da implantação do projeto adaptado, gerenciamento das etapas desenvolvidas e qualidade do mesmo.Palavras-chave: Gestão. Projetos Esportivos. Ferramentas. PMBOK.
Management of sports projects in period of covid-19 pandemic 
AbstractThe study aimed to describe the adapted, planned, and implemented proposal for the Segundo Tempo Universitário Program (PSTU) services during the covid-19 pandemic, and the management undertaken at the Federal University of Mato Grosso do Sul. The action was managed through the project cycle and supported by five process groups (initiation, planning, execution, monitoring and control, and closing). It was evidenced that the promotion of physical practices through a virtual team during the covid-19 pandemic period proved to be a viable alternative for serving university students, and the application of management knowledge and tools, specifically project management, contributed to the functionality of the implementation of the adapted project, management of the developed stages, and quality of the project.Keywords: Management. Sports Projects. Tools. PMBOK.
Gestión de proyectos deportivos en periodo de Pandemia de covid-19
ResumenEl estudio tuvo como objetivo describir la propuesta adaptada, planificada e implementada para los servicios del Programa Segundo Tempo Universitário (PSTU) durante la pandemia covid-19, y la gestión realizada en la Universidad Federal de Mato Grosso do Sul. La acción fue gestionada a través del ciclo de proyectos y subsidiada por cinco grupos de procesos (inicio, planificación, ejecución, monitoreo y control, y cierre). Se evidenció que la promoción de prácticas corporales a través de un equipo virtual durante el período de pandemia covid-19 resultó ser una alternativa viable para la atención de estudiantes universitarios, y que la aplicación de conocimientos y herramientas de gestión, específicamente la gestión de proyectos, contribuyó a la funcionalidad de la implementación del proyecto adaptado, la gestión de las etapas desarrolladas y la calidad del mismo.Palabras clave: Gestión. Proyectos Deportivos. Herramientas. PMBOK.
Ativismo no futebol e estudos críticos: um ensaio sobre coletivos de torcedores
Authors: Lopes Felipe Tavares Paes
Published: April 2023

Ativismo no futebol e estudos críticos: um ensaio sobre coletivos de torcedores
ResumoEste ensaio aborda as práticas ativistas de três coletivos de torcedores da cidade de São Paulo e discute de que maneira essas práticas desafiam algumas interpretações oferecidas pelas teorias críticas do futebol. Ao realizar essa discussão, argumento que, embora as referidas intepretações permaneçam, sob certos aspectos, úteis para a análise do futebol, este não deve ser interpretado como uma espécie de “cimento simbólico”. Também argumento que as relações de dominação de classe não são o principal eixo organizador do conflito político no universo do futebol e que, ao consumir as mensagens da indústria futebolística, as pessoas não são, necessariamente, impelidas a agir de forma imitativa e conformista.Palavras-chave: Futebol. Ativismo Esportivo. Estudos Críticos. Coletivos de Torcedores.
Activism in football and critical studies: an essay on football fans' collectives
AbstractThis essay addresses the activist practices of three collectives of football fans in the city of São Paulo and discusses how these practices challenge some interpretations offered by critical theories of football. In doing so, I argue that while these interpretations remain, in some aspects, useful for the analysis of soccer, this sport should not be interpreted as a kind of “symbolic cement”. I also argue that class relations of domination are not the main organizing axis of political conflict in the football universe and that, by consuming the messages of the football industry, people are not necessarily impelled to act in an imitative and conformist way.Keywords: Football. Sports Activism. Critical Studies. Football Fans' Collectives.
Activismo en el fútbol y estudios críticos: un ensayo sobre colectivos de hinchas
ResumenEste ensayo aborda las prácticas activistas de tres colectivos de hinchas de la ciudad de São Paulo y discute cómo estas prácticas desafían algunas interpretaciones ofrecidas por las teorías críticas del fútbol. Al desarrollar esta discusión, sostengo que, si bien esas interpretaciones siguen siendo, bajo ciertos aspectos, útiles para el análisis del fútbol, él no debe ser interpretado como una especie de “cemento simbólico”. También argumento que las relaciones de dominación de clase no son el principal eje organizador del conflicto político en el mundo del fútbol y que, al consumir los mensajes de la industria del fútbol, las personas no necesariamente se ven impulsadas a actuar de manera imitativa y conformista.Palabras clave: Fútbol. Activismo Deportivo. Estudios Críticos. Colectivos de Hinchas.
CLINICOPATHOLOGICAL FEATURES ASSOCIATED WITH THE PROGNOSIS OF YOUNG WOMEN WITH BREAST CANCER IN BRAZIL
Authors: Santos Igor Lopes dos , Nogueira Nathalia Amaral , Amador Luciana Corrêa , Abreu Pedro Paulo Batista de , Abreu Deidimar Cássia Batista , Ayres Flavio Monteiro , Saddi Vera Aparecida
Published: April 2023

Objective: The aim of this study was to investigate the clinical-pathological features and the prognosis of premenopausal breast cancer patients, stratified by three age groups (below 33 years, 34–36 years, and 37–49 years). Methods: This is a retrospective study including 206 patients with breast carcinomas diagnosed before the age of 50 years, selected from the records of the Laboratory of Immunohistochemistry, Department of Pathology, Hospital Araújo Jorge, in Goiânia (GO). Results: Patients’ age at diagnosis ranged from 21 to 49 years, and the mean age was 34 years (±4.3). The 5-year overall survival for the group was 61.8%. Younger patients, diagnosed before 32 years, presented a worse prognosis (52.3%), compared to other age groups (p=0.049). Younger patients also presented a higher percentage of T4 tumors (33.3%) (p=0.045) and advanced stages of the disease (III–IV) (79.1%) (p=0.007). Conclusion: The clinicopathological and immunohistochemical characteristics of patients diagnosed with breast cancer before the age of 50 years were associated with low overall survival. In addition, patients diagnosed before 32 years of age presented with more aggressive tumor characteristics and worse prognosis when compared to other age groups.
CONDUCTING BREAST CANCER RESEARCH DURING A PANDEMIC ISOLATION TIME
Authors: Carvalho Junia Costa , Pires Natália Tomaz , Santos Silvana Soares dos , Tarabay Christina Haas , Sanches Solange Moraes , Gondim Guilherme Rocha Melo , Makdissi Fabiana Baroni Alves
Published: April 2023

Objective: Aiming at the assistance of women with breast cancer, quality of life indicators can help in clinical practice, guide therapeutic intervention strategies, and evaluate the success of intervention after surgery and cancer treatment, in addition to defining parameters for actions. This perspective study is about the quality of life of patients treated for breast cancer at the Institution. However, as soon as the pandemic started, the need to readapt the way of filling out the questionnaires to an online model emerged. Our objective is to share the facilities and difficulties of online model research. Methods: Through the selection of patients for research that aimed to analyze the quality of life of patients with breast cancer, they were contacted by their registered e-mails in the institution system. Each patient received an explanation of the project through e-mail and the Free and Informed Consent Term (TCLE). After agreement, the survey link of the REDCap system directing the selected instrument to be filled in was sent. The analysis included a general questionnaire composed of demographic and clinical aspects (collected by electronic medical record data) and specific questionnaires. Results: In all, 477 e-mails were sent, 52 patients signed the TCLE (but 2 did not answer the research), 36 answered the questionnaires completely, and 14 incompletely. A total of 12 e-mails were returned (wrong e-mail address). Conclusion: During the pandemic period, new tools were incorporated in order to obtain data and maintain research. Moving to an online way brought the chance to keep studies, giving new possibilities to answer research remotely, but difficulties were added to this new kind of research. E-mail data, lack of explanation face-to-face, and the number of complete responses mainly in long questionnaires were some of the most tricky parts of this new way of study. Online strategy is a real option, but the success of the process depends on many variables.
ACCESS TO BREAST CANCER TREATMENT ASSOCIATED WITH MALIGNANT TUMOR CLASSIFICATION AND HISTOPATHOLOGICAL CHARACTERISTICS
Authors: Gomes Filho José Euderaldo Costa , Fernandes Gisele Aparecida , López Rossana Verónica Mendoza , Curado Maria Paula
Published: April 2023

Objective: There are differences between patients from the public system and those from Supplementary Health Care seeking treatment for breast cancer. An investigation of the association of the form of access to treatment for invasive breast cancer with the classification of malignant tumors and histopathological characteristics becomes important in view of the scarcity of research in mixed populations such as the Brazilian. Methods: This cross-sectional study examined the association of the form of access to treatment for invasive breast cancer with the classification of malignant tumors and histopathological characteristics in 583 patients seen in a cancer center in southeastern Brazil. The Pearson’s chi- -square test or Fisher’s exact test was used for statistical analysis. Results: This analysis found an association between the form of access to treatment and morphology, in which invasive ductal carcinoma was more frequent in the public system (p=0.024). We found no association with the variables clinical stage (p=0.880), pathological stage (p=0.585), histological grade (p=0.948), nuclear grade (p=0.395), estrogen (p=0.749), progesterone (p=0.943), HER2 (p=0.266), Ki-67 (p=0.550), and molecular subtype (p=0.686). Conclusion: In this research, access to treatment showed no association when crossed with clinical and histopathological characteristics of breast câncer.
LOCOREGIONAL TREATMENT FOR EARLY-STAGE TRIPLE-NEGATIVE BREAST CANCER: A RECOMMENDATION FROM AN EXPERT PANEL OF THE BRAZILIAN SOCIETY OF MASTOLOGY
Authors: Soares Leonardo Ribeiro , Oliveira Vilmar Marques de , Frasson Antonio Luiz , Cavalcante Francisco Pimentel , Mansani Fabio Postiglione , Mattar André , Zerwes Felipe Pereira , Freitas-Junior Ruffo
Published: April 2023

Objective: The aim of this study was to evaluate the knowledge and attitudes of the members of the Brazilian Society of Mastology (SBM) about the locoregional treatment of triple-negative breast cancer (TNBC). Methods: All 1,400 SBM members were invited to answer a survey of 44 objective questions. An expert meeting was held in December 2021, with the participation of 27 experts and 3 ad hoc consultants. Panelists responded to the survey before and after the meeting (brainstorm). Responses that reached 70% agreement were considered consensual. Results: In a patient undergoing conservative surgery after neoadjuvant therapy, with a compromised sentinel lymph node (SLNB), there was a double consensus on the indication of lymphadenectomy (ALND). In patients undergoing upfront surgery, with compromised SLNB, there was a double consensus on the indication of radiotherapy for locoregional control. However, 22% of breast specialists still indicate ALND in patients eligible for the ACOSOG Z0011 study. In women with TNBC who tested negative for pathogenic mutations, 100% of the panelists disagreed with the unrestricted indication of bilateral mastectomy. In women with a positive test, almost 100% of the respondents stated that the possibility of bilateral mastectomy should be considered. The panel reaffirmed the concept of “no ink on tumor” as adequate margins, regardless of initial treatment. Conclusion: Consensus among experts was reached on more than 70% of the questions, and agreement between panelists and associates was moderate. In view of the differences observed in some points already consolidated in the literature, it is suggested that the locoregional treatment of TNBC be explored, in an intense and systematic way, in continuing education actions aimed at the mastologist.
BREAST RECONSTRUCTION WITH AND WITHOUT ADJUVANT RADIOTHERAPY: A CRITICAL REVIEW
Authors: Bax Maria Luiza de Oliveira Almeida , Lucena Clécio Ênio Murta de , Alves Calliny Cristina Pimentel , Oliveira Matheus Assis dos Anjos Bastos
Published: April 2023

Objective: Breast cancer is the most common malignancy in women worldwide. After mastectomy, many women wish to reconstruct the affected breast, and immediate breast reconstruction has proven to be oncologically safe in relation to just mastectomy. In addition, indications for post-mastectomy radiotherapy (PMRT) sessions are becoming more frequent, due to their relationship with reduced mortality and locoregional recurrence. For this reason, many women who opted for immediate reconstruction underwent radiotherapy with implants or expanders. This study aims to compare the outcomes of patients with breast cancer undergoing adjuvant radiotherapy after breast reconstruction surgery with an implant or expander with patients who did not need irradiation. Methods: A literature review was carried out on the CAPES Journal Portal. Results: The studies are unanimous when it comes to the increased risk of complications between the control groups and patients who have undergone PMRT. The reconstructive failure rates are lower, and the aesthetic results are better in surgeries with implants when compared with tissue expanders. Autologous surgeries are apparently safe and should be considered in the context of the PMRT. Conclusion: This review did not find sufficient scientific evidence to determine the best technique and the best period for radiotherapy in PMRT indications. It is concluded that the choice of the operative technique and the time of radiotherapy must be at the discretion of the surgeon and the multidisciplinary team of each service, always in a shared decision with the patient.
IMMUNOPHENOTYPING OF BREAST CANCER ASSOCIATED WITH SOCIODEMOGRAPHIC AND LIFESTYLE CHARACTERISTICS
Authors: Gomes Filho José Euderaldo Costa , Fernandes Gisele Aparecida , López Rossana Verónica Mendoza , Curado Maria Paula
Published: April 2023

Objective: The immunohistochemical profile of breast cancer is based on the evaluation of estrogen and progesterone receptors, HER2 expression, and cell proliferation index. An investigation of the association of immunophenotyping of invasive breast cancer with sociodemographic characteristics and lifestyle becomes important in view of the scarcity of research in mixed populations such as the Brazilian. Methods: This cross-sectional study investigated the association of immunophenotyping of invasive breast cancer with sociodemographic characteristics and lifestyle in 583 patients seen in a cancer center in southeastern Brazil. The Pearson’s chi-square test or Fisher’s exact test was used for statistical analysis. Results: There was a higher frequency of women with the luminal B HER2-negative subtype (33.9%). The analysis of immunophenotyping with sociodemographic characteristics found a higher frequency of women aged 50 years or older in luminal A, 65.5% (p≤0.040) and medical suspicion of breast cancer at a clinical examination in HER2-positive subtype, 89.7% (p=0.015). In this research, we found no association of immunophenotyping with marital cohabitation (p=0.856), education (p=0.723), ethnicity (p=0.129), access to hospital (p=0.686), tobacco (p=0.099) and alcohol consumption (p=0.270), body mass index (p=0.584), performance of the first mammogram (p=0.477), family cancer history (p=0.254), and parity (p=0.676). Conclusion: Younger women had tumors with a worse prognosis when compared to those aged 50 years or older. Ethnicity showed no association, contrary to the wide discussion in the literature about the high frequency of the triple-negative subtype. There was no association with alcohol consumption, a factor recognized in the literature as a risk factor for the development of breast cancer.
ANALYSIS OF WOMEN WITH BREAST CANCER SUBMITTED TO IMMEDIATE OR DELAYED BREAST RECONSTRUCTION
Authors: Ferreira Filho Darley de Lima , Ferreira Nancy Cristina Ferraz de Lucena , Ferreira Thais
Published: April 2023

Objective: Breast reconstruction is a right guaranteed by the public health system to patients undergoing mastectomy. However, there are factors that delay the performance of this procedure, mainly in the single health system. This study aims to analyze the characteristics of immediate or delayed reconstructions in women with breast cancer in a referral hospital in the state of Pernambuco (Barao Lucena Hospital). Methods: This is an observational, retrospective, analytical research with a descriptive approach of 400 cases of breast reconstruction from 2010 to 2020. Data were collected through a clinical-surgical questionnaire from patients with breast carcinoma who underwent reconstruction mammary, being later analyzed by the SPSS software version 18 with the percentages of the categories evaluated by the chi-square test, considering the level of significance of 5%. The comparison of analyses was significant (p <0.005), demonstrating that the profile described is the most frequent in the group of patients evaluated. CAAE: 42457420.1.0000.5193. Results: Most patients were with a mean age between 46 and 59 years (45.3%), mixed race (61.1%), married (79.1%), with schooling up to high school (60.7%), housewives (45 %), non-smokers (84.9%), and do not consume alcohol (94.9%). Using the TNM system, 84% of the patients were in the initial stages, underwent immediate reconstruction after mastectomy or sectorectomy (70.3%), and the reconstruction surgeries with regional flaps such as inferior, superior, or mediolateral and implants were performed in 70% of the patients. According to the molecular subtype, luminal A represented 60% of the patients, followed by luminal B with 16%, triple-negative with 15%, and HER2 with 9%. Conclusion: The findings support the fact that patients with high educational levels are able to immediately undergo breast reconstruction. We conclude that the number of immediate breast reconstructions in patients with breast cancer has a significant increase.
EPIDEMIOLOGICAL ANALYSIS OF WOMEN WITH BREAST CANCER SUBMITTED TO BREAST RECONSTRUCTION IN A TERTIARY HOSPITAL IN PERNAMBUCO
Authors: Lima Filho Darley Ferreira de , Ferreira Nancy Cristina Ferraz de Lucena , Ferreira Thais de Lucena
Published: April 2023

Objective: Breast reconstruction is a right assured by the public health system to patients submitted to mastectomy. However, there are factors that delay the performance of this procedure. This study aims to understand the epidemiological profile of women with breast cancer who underwent breast reconstruction in a reference hospital in the state of Pernambuco. Methods: This is an observational, retrospective research with an analytical character and descriptive approach. The data were collected through a questionnaire sociodemographic and clinical-surgical history of patients with breast carcinoma and then analyzed by the SPSS software version 18 with the percentages of the categories evaluated by the chi-square test, considering the significance level of 5%. The comparison of analyses was significant (p <0.005), showing that the profile described is the most frequent in the group of patients evaluated. CAAE: 42457420.1.0000.5193. Results: A non-probabilistic sample of 400 records was obtained in 10 years at a tertiary hospital in Recife (PE), most of them with a mean age between 46 and 59 years (45.3%), brown (61.1%), married (79.1%), with education until high school (60.7%), household professionals (45%), non-smokers (84.9%), who did not consume alcohol (94.9%), and had immediate reconstruction after mastectomy (70.3%). Conclusion: The findings support that patients with high educational levels are likely to undergo immediate breast reconstruction, pointing out that the socioeconomic level significantly influences the rates of breast reconstruction after mastectomy.
DELETERIOUS VARIANTS IN RAD51C GENE AND BREAST CANCER – REPORT OF THREE PATIENTS WITH TRIPLE-NEGATIVE BREAST CANCER
Authors: Lisboa Elis Nogara , Lima Rita de Cassia , Taniwaki Leticia , Guendelmann Rafael Aliosha Kaliks , Callegaro Filho Donato , Maluf Fernando Cotait , Lima Fernanda Teresa de
Published: April 2023

RAD51C is a gene associated with hereditary predisposition to ovarian cancer, and its association with hereditary breast cancer was controversial for a while. Current evidence demonstrates that RAD51C deleterious variants increase the risk of estrogen receptor-negative breast cancer. This study presents three unrelated patients with triple-negative breast tumors with heterozygous deleterious RAD51C variants. The first patient was diagnosed with post-menopausal breast cancer at 55 years of age and treated with conservative surgery and adjuvant chemotherapy. Her sister had breast cancer at 49 years of age. Multigene panel showed a heterozygous pathogenic variant in RAD51C:c.93del; p.(Phe32Serfs*8). The second patient was diagnosed at 48 years of age and treated with neoadjuvant chemotherapy, followed by a conservative surgery with lymph node dissection and radiotherapy. Her sister had triple-negative breast cancer at 64 years of age; her maternal cousin had breast cancer at 58 years of age. Multigene panel disclosed a heterozygous pathogenic variant in RAD51C:c.404G>A; p.(Cys135Tyr). The third patient, detected with the same mutation, was diagnosed with triple-negative breast cancer at 39 years of age and treated with neoadjuvant chemotherapy, bilateral mastectomy, and adjuvant radiotherapy. Her paternal aunt had ovarian cancer, her paternal grandfather had prostate cancer, and her sister had breast cancer at 40 years of age. Genetic counseling was provided for all patients, along with the recommendation of risk-reducing salpingo-oophorectomy, due to ovarian cancer risk. This study adds evidence for the inclusion of the RAD51C gene in multigene panels as a relevant gene to be screened in patients with triple-negative breast cancer.
NEUROENDOCRINE CARCINOMA OF THE BREAST AND ILEUM IN A PATIENT WITH BRCA2 PATHOGENIC VARIANT – ONCOLOGIC AND GENETIC CONSIDERATIONS DERIVED FROM A CASE REPORT
Authors: Souto Andreza Karine de Barros Almeida , Blasi Poliana Bergamaschine Giovani , Taboada Brenda Fabiola Delgado , Lima Fernanda Teresa , Garicochea Bernardo , Resende Cristiano Augusto Andrade de
Published: April 2023

Background: Neuroendocrine neoplasms (NENs) are a heterogeneous group of neoplasms. Most frequently, they occur in the digestive system, and breast neuroendocrine tumors constitute less than 1% of all of them. Germline mutations can increase the risk of developing tumors and predispose to hereditary cancer syndromes. Some NENs are well-established components of common hereditary syndromes. Recently, whole genomic sequencing revealed that 17% of apparently sporadic pancreatic NENs carried germline mutations, including DNA repair genes, such as BRCAs. It is well known that this gene plays a role in hereditary breast cancer, but variations in these genes were not described in patients with breast/ ileum neuroendocrine tumors. We present a patient with a neuroendocrine tumor and a germline pathogenic variant in BRCA2. Case report: A 44-year-old female patient presented with a palpable lesion at the right breast, with 1.1×1.4 cm, and a biopsy confirmed an invasive ductal carcinoma, grade 2. Immunohistochemistry revealed a neuroendocrine breast carcinoma (ER10% PR5%, HER2 negative, Ki-67=8%). The regular staging examinations did not show any abnormalities, but a 68Ga PET/CT demonstrated an ileum wall thickening with a marked expression of somatostatin receptors compatible with primary disease, with mesenteric lymph nodes and hepatic lesions suggestive of metastasis, in addition to the right breast lesion that could be either a secondary implant or a primary synchronic tumor. A detailed family history did not reveal any important cancer cases in the family except for the father and a paternal uncle, both with prostate cancer at 72 and 85 years old, respectively. Germline genetic analysis confirmed the presence of a heterozygous pathogenic variant in BRCA2 (c.2167delA;p.Ser723Alafs*7). The patient is currently being treated with octreotide LAR with good tolerance and stable disease. Final comments: This case shows the importance of molecular germline investigation in patients with NENs. This patient adds knowledge to the association of the BRCA2 gene and neuroendocrine tumors.
MALE BREAST CANCER ASSOCIATED WITH A LARGE DELETION IN BLM GENE – REPORT OF A CASE
Authors: Lima Fernanda Teresa de , Cardenas Madeleyne Beatriz Boado Quiroga , Costa Gabriela de Almeida Vasconcelos , Simomoto Mary Miyazawa , Nazario Afonso Celso Pinto , Araujo Neto Joaquim Teodoro , Baratela Wagner Antonio da Rosa , Facina Gil
Published: April 2023

Malignant breast neoplasm in men is rare, corresponding to less than 1% of all breast neoplasms, and 100 times less frequent than in women. It is molecularly different from female breast cancer, and germline pathogenic mutations in genes aside from BRCAs have been recently associated with an increased risk of male breast cancer. Here, we report an elderly male, 71 years old, with a malignant neoplasm in the left breast, with positive hormone receptors, HER2-negative, and Ki-67 of 25%. A modified radical mastectomy was performed, and the surgical specimen showed a micropapillary invasive mammary carcinoma, 1.9 cm, 2 of 11 lymph nodes positive, pT1cpN1acM0. He was treated with adjuvant chemotherapy and radiotherapy, followed by endocrine therapy. His mother had breast cancer at 50 years, and his smoking father died of lung cancer. During his treatment, a multigene panel was done and a heterozygous likely pathogenic large deletion involving exons 20–22 of the BLM gene was found, associated with a variant of unknown significance in the same gene; c.3427G>A; p.(Glu1143Lys). All his three daughters harbor the same mutation. The risk of breast cancer in association with a heterozygous pathogenic variant in the BLM gene is still controversial because of its ability to cause tumors when not associated with polymorphisms in other homologous recombination genes, which poses a challenge for genetic counseling, surveillance, and management. This report aims to add data and clinical evidence to the attempts to elucidate the role of BLM germline variants in breast cancer predisposition.
BREAST PLASMACYTOMA: A CASE TREATED WITH IRRADIATION THAT EVOLVED TO FURTHER BILATERAL BREAST INVOLVEMENT AND SYSTEMIC DISEASE REFRACTORY TO CHEMOTHERAPY
Authors: Esteban Jorge Illarramendi , Quispe Ivan , Rodriguez Mercedes , Ormazabal Irati , Cordoba Alicia , Azua Geranie Ruiz de , Pons María José , Manterola Ana
Published: April 2023

Introduction: Plasmacytomas are uncommon malignant lesions in the breast. Further knowledge is needed about the presentation, diagnosis, and therapy of this disease. Case report: A 78-year-old woman had a previous diagnosis of sacral bone plasmacytoma in March 2005 that was treated with radiotherapy. A new lesion involved in the cervical spine in 2008 was also irradiated. A mammogram and ultrasound found two well-defined nodules in January 2012 in the upper outer quadrant of the right breast, with a total diameter of 38 mm. Biopsy showed a proliferation of cells with Ki-67 staining in more than 90% and positivity for CD38, CD138, CD45, and CD79A, an exclusive expression of lambda light chains. The pathological diagnosis was anaplastic plasmacytoma. She received radiotherapy with remission of the breast lesions. After further appearance of bone lesions, she started chemotherapy with bortezomib, melphalan, and prednisone in January 2016. A PET study in July 2016 showed, among other findings, the presence of a 4-cm lesion in the upper-outer quadrant of the left breast (SUVmax: 3.9). Biopsy gave a diagnosis of plasmacytoma, with cells staining strongly positive for CD138, MUN1, and CD38, with the expression of lambda light chain. Chemotherapy was changed to lenalidomide plus dexamethasone. A further PET in January 2017 displayed, among other findings, the persistence of the lesion in the left breast (SUVmax: 5.4) with two new lesions in the right breast (SUVmax: 5.3 and 13). There was also a sacral progression, and chemotherapy was changed to pomalidomide, dexamethasone plus cyclophosphamide. The evolution of the patient was unfavorable, and she died in June 2017. Criteria for multiple myeloma were not present along the course of the disease. Conclusion: Evolution to bilateral involvement, relapse in the same breast, and refractoriness to chemotherapy are remarkable aspects of this case report and give further information about this presentation of the disease.
METASTATIC BREAST CANCER TO THE UTERINE CERVIX: A CASE REPORT
Authors: Barros Jordana Joab Alencar , Moreira Alexandre Bravin , Sousa Paulo Roberto Moreira , Borges Tatiane Oliveira , Santos Luciana Carla Belém dos , Blum Catharina Maria Facciolli
Published: April 2023

A 49-year-old woman was diagnosed with invasive ductal carcinoma in the left breast with positive estrogen and progesterone receptors (ER, PR) and negative HER2, and Ki-67 10%. Computed tomography of the abdomen, chest, and bone scintigraphy did not show metastasis. Treatment was established with neoadjuvant chemotherapy, followed by sectorectomy, sentinel lymph node biopsy, and oncoplasty. Freezing was negative, but in the anatomopathological result, metastasis in the axillary lymph node was observed. Then, axillary lymphadenectomy was performed, and she underwent radiotherapy and hormone therapy. Around 6 months later, she remained asymptomatic and underwent oncotic colpocytology. It detected atypical squamous cells but was not able to rule out intraepithelial lesions (ASCH). The investigation was continued by means of colposcopy and conization that showed poorly differentiated carcinoma and alterations suggestive of metastatic mammary carcinoma to the uterine cervix. This diagnosis was confirmed with immunohistochemistry: HER2 negative, ER and PR 95%, and Ki 67 30%. Magnetic resonance imaging of the chest, pelvis, and abdomen, and transvaginal ultrasound showed no suspicious lesions. She is currently being diagnosed with breast nodule ultrasound with a Bi-RADS 4 and is still under anatomopathological investigation. Discussion: Metastasis to the female genital organ originating from a primary extragenital tumor is uncommon. The most common sites of invasive breast metastasis are the lung, liver, bone, and brain. Its occurrence in the uterine cervix is rare, probably due to a small blood supply and an afferent lymphatic system. Its prevalence is uncertain in the literature. Only strict gynecological surveillance of these asymptomatic women permits early detection of these secondary lesions. This case report shows the importance of considering rare sites of metastasis on follow-up given the different treatment protocols related to primary cancer and the clinical impact on prognosis. Besides, it is pertinent to know the exact nature of cervical cancer, mainly in women with a personal history of breast cancer.
PRIMARY BREAST TUBERCULOSIS MASTITIS MANIFESTED AS NON-HEALING ABSCESS
Authors: El-Helou Etienne , Hoang Huu , Pop Catalin-Florin , Shall Ammar , Zaiter Manar , Naccour Jessica , Ho Xuan Dung , Nguyen Van Cau
Published: April 2023

Primary breast tuberculosis is a rare extrapulmonary tuberculosis mainly affecting young women of childbearing age in endemic countries. Its incidence is increasing in immunocompromized and HIV-infected people and with the emergence of drug-resistant strains of Mycobacterium tuberculosis. There are no specific clinical signs suggestive of this disease, and it often presents as a hard mass or breast abscess. There is an overlap of features with other inflammatory, infectious, benign lesions, fat necrosis, and malignant neoplasms of the breast. The detection of Mycobacterium tuberculosis remains the gold standard for diagnosis. Several diagnostic modalities are used, with varying degrees of lack of sensitivity and specificity, and with a range of false negatives. A quarter of cases were treated solely on the basis of clinical, imaging, or histological suspicion, without confirmation of the diagnosis. Therefore, we report the case of a young Vietnamese woman who presented with a non-healing breast abscess and was diagnosed with breast tuberculosis based on the patient’s ethnicity, histological findings, lack of clinical response to conventional antibiotic therapy, and a good clinical response to antituberculosis treatment.
INCIDENTAL FINDING OF SOLITARY FIBROUS TUMOR OF MALE BREAST
Authors: El-Helou Etienne , Zaiter Manar , Delrue Pauline , Awada Ahmad , Veys Isabelle , Pop Catalin-Florin
Published: April 2023

Myofibroblastoma (MFB), also known as a solitary fibrous tumor of the breast, is a rare sporadic benign tumor composed of spindle-shaped tumor cells with myoblast differentiation. The most typical presentation is a painless unilateral mass that is not connected to any surrounding structure and seldom surpasses 3 cm in size and should be evaluated by using the triple-assessment approach. They have several subtypes, and a definite diagnosis can only be confirmed safely after surgery using immunohistochemistry. Surgical excision serves an essential diagnostic and therapeutic purpose; MFB has a favorable prognosis even when excision margins are positive, and local recurrence is extremely rare. The following is the case of a 73-year-old man who presented with a dry cough. An MFB was discovered by chance during the investigative workup and referred to our department. The patient’s presentation, imaging, and histological samples all supported the diagnosis, and he had surgical resection without incident. We present the second case of an incidental finding of breast MFB and urge clinicians to consider this differential diagnosis.
EXTREME ONCOPLASTIC SURGERY IN A PATIENT WITH BREAST CANCER AND MACROMASTIA
Authors: Bononato José Manuel Lagos , Berrios Jaime Letzkus , Galte Jorge Gamboa , Vigil María José Del Río , Soto Guillermo Belmar , Hales Andrea Sepúlveda
Published: April 2023

Until the 1970s–1980s, the only treatment recommended for breast cancer was mastectomy. During those years, prospective randomized trials confirmed the survival equivalency for breast conservation (when compared to patients with tumors 5 cm or smaller). During the past decades, there has been significant progress in breast cancer diagnosis and treatment. This progress has led to improved overall and breast cancer-specific survival. Extreme oncoplasty is a breast- -conserving surgery that uses oncoplastic techniques in a patient who, in most cases, would require a mastectomy. This is particularly useful in patients with breast cancer and macromastia, with an oncoplastic reduction approach in the affected breast and reduction mammoplasty in the contralateral breast. We present the case of a 32-year-old woman with a multifocal tumor located in the inner lower quadrant of the right breast. The core biopsy revealed an invasive ductal carcinoma of 2.5 cm (cT2 N1 HER2+). After neoadjuvant chemotherapy with trastuzumab, there was a complete clinical response. The surgical treatment was an extreme oncoplastic surgery in the affected breast with a reduction mammoplasty to the left breast. The surgical biopsy revealed a complete pathological response both in the breast and the axilla. After a 7-month follow-up, there is no locoregional recurrence and the aesthetic result is excellent for both the patient and the surgical team. We selected this case to prove that despite the COVID-19 pandemic, it is possible to offer the best surgical treatment according to each patient, giving the option of personalized medicine.