bluuebunny/crossref_metadata_2025 huggingface dataset:
IMPROVEMENT OF PUBLIC SPACES IN SMALL CITIES OF TVER REGION: TERRITORIAL AND INSTITUTIONAL ASPECTS
Authors: Смирнов Илья Петрович , Смирнова Александра Андреевна
Published: January 2022

Статья посвящена проблеме благоустройства малых городов. На примере семи малых городов Тверской области рассмотрены количественные итоги их участия в различных программах благоустройства (институциональный аспект), а также проведен анализ микрогеографии реализованных проектов (территориальный аспект). В качестве инструментов благоустройства выбраны региональная программа Тверской области по формированию комфортной городской среды, Программа поддержки местных инициатив, Всероссийский конкурс лучших проектов создания комфортной городской среды. Города различаются в активности использования названных программ. Отмечена также дифференциация разных зон города - центра, полупериферии, периферии - по числу реализованных проектов. Предложены три территориальные модели благоустройства в зависимости от того, в какой части города сконцентрирована большая часть проектов.

The article is devoted to the problem of the improvement of public spaces in small cities. On the example of seven small cities of the Tver region, the quantitative results of their participation in various improvement programs (institutional aspect) are considered, as well as an analysis of the microgeography of the implemented projects (territorial aspect). The regional program of the Tver region on the formation of a comfortable urban environment, the Program to Support Local Initiatives, the All-Russian Competition of the Best Projects for Creating a Comfortable Urban Environment were selected as the improvement tools. Cities differ in the activity of using the named programs. Differentiation of different zones of the city - center, semi-periphery, periphery - according to the number of implemented projects was also noted. Three territorial improvement models have been proposed, depending on which part of the city is where most of the projects are concentrated.
The Classification of Children’s Songs with the Classification Model CMCS / Klasifikacija otroških pesmi po klasifikacijskem modelu CMCS
Authors: Mihelač Lorena , Panić Grazio Jelena
Published: January 2022

The paper presents a manual classification model, the Classification Model for the categorization of Children’s Songs (Model CMCS) for the selection of children’s songs based on the proposed criteria found in studies about the selection of children’s songs, on music theoretical background, and on findings from cross-cultural studies about (dis)similarities in children’s songs. A step-by-step procedure comprising four levels for the classification of songs is explained and applied in the first testing, employing two musical experts for the evaluation of three different songs. The results have shown that the Model CMCS is transparent (understandable), applicable, and useful and will be tested in the next stage on a larger number of songs and involving more musical experts. An improved version of the Model CMCS could be used in the future as a framework for an automatic classification model for the selection of children’s songs.
Educational Administration and Management
Authors: M Balasubramaniam
Published: January 2022

Every unit in this book has been explained in details and supported by sufficient examples. The present book has been designed to equip student teachers with as much knowledge on educational management, administration, educational planning and Education supervision. Efforts have been made to make Educational Management and Administration more interesting for the learners.
EXTENDED EUCLIDEAN ALGORITHM OF AUNU BINARY POLYNOMIALS OF CARDINALITY ELEVEN
Authors: Abubakar S.I.
Published: January 2022

Binary polynomials representation of Aunu permutation patterns has been used to perform arithmetic operations on words and sub-words of the polynomials using addition, multiplication, and division modulo two. The polynomials were also found to form some mathematical structures such as group, ring, and field. This paper presents the extension of our earlier work as it reports the Aunu binary polynomials of cardinality eleven and how to find their greatest common divisor (gcd) using the extended Euclidean algorithm. The polynomials are pairly permuted and the results found showed that one polynomial is a factor of the other polynomial or one polynomial is relatively prime to the other and some gave different results. This important feature is of combinatorial significance and can be investigated further to formulate some theoretic axioms for this class of Aunu permutation pattern. Binary polynomials have important applications in coding theory, circuit design, and the construction of cryptographic primitives.
ALL-OPTICAL N-BIT BINARY TO TWO’S COMPLEMENT CONVERTER WITH THE HELP OF SEMICONDUCTOR OPTICAL AMPLIFIER-ASSISTED SAGNAC SWITCH
Authors: Bhattachryya Arunava
Published: January 2022

All-optical n-bit paired to 2’s complement converter has been planned with the assistance of Terahertz optical unbalanced demultiplexer (TOAD) switches. The paper depicts all-optical transformation conspire to utilize a bunch of every single optical switch. PC framework ordinarily utilizes 2’s complement for paired deduction and intelligent control. By embracing a definite mathematical reproduction the impact of these critical boundaries on the measurements that decide the nature of exchange is completely examined and diverse plan rules are extricated for their legitimate determination to guarantee ideal activity.
A Química “mal dita” em Fake Science
Authors: Cunha Marcia Borin
Published: January 2022

A presença de notícias e informações falsas ou de conteúdo duvidoso tem sido um dos problemas do mundo conectado. Seja nas telas dos computadores, celulares, nos aplicativos de mensagens ou nas redes sociais e, até mesmo, nas rodas de conversa é comum a presença de Fake News. Neste contexto, é pouco provável que uma pessoa nunca tenha recebido uma mensagem de conteúdo falso ou distorcido. Essas informações versam sobre diversos temas e assuntos, sendo um deles as informações com conteúdo relativo à Ciência. Para esse tipo de notícia falsa denominamos de Fake Science, que, dentre os assuntos que podem conter, estão informações relativas ao conhecimento químico. Neste artigo trazemos algumas mensagens recebidas, que contém informações que podem ser discutidas em aulas de Química. Ao apresentá-las, o faremos apontando que conhecimentos são estes e que estão “mal ditos”. A ideia é oferecer, aos professores, material para problematizar e discutir o conhecimento químico presente em Fake Science.
Literacia estatística, probabilística e financeira: caminhos que se cruzam
Authors: Giordano Cassio Cristiano , Lima Reinaldo Feio , Silva Ady Wallace Jaques
Published: January 2022

Nessa pesquisa qualitativa, de natureza bibliográfico-documental, nós abordamos diferentes concepções a respeito de três modalidades de literacia que temos investigado nos últimos anos: a Literacia Estatística, a Literacia Probabilística e a Literacia Financeira, em busca de possíveis intersecções entre essas três áreas da experiência humana. Consideramos esse tema de grande relevância para a educação brasileira, em tempos de reforma curricular, impulsionada pela publicação da Base Nacional Comum Curricular – BNCC, documento esse que confere grande importância ao multiletramento. A Probabilidade e a Estatística ganharam muito espaço a partir da publicação da BNCC, pois constituem uma unidade temática que deve ser explorada em sala de aula, desde a Educação Infantil até o término do Ensino Médio. Vale destacar, ainda, que a Educação Financeira, ausente nos documentos norteadores da educação nacional até então, os Parâmetros Curriculares Nacionais – PCN, agora aparece nos novos currículos com grande destaque, uma vez que adquiriu o status de tema transversal. Ao final, propomos um modelo de literacia financeira compatível com modelos de literacia estatística e probabilística amplamente utilizados na Educação Estatística.
Transição do modelo de ensino presencial para o remoto no contexto de isolamento social: a experiência do TECPUC
Authors: Arantes Valente Solan
Published: January 2022

O presente artigo compartilha a experiência do Colégio Irmão Mário Cristóvão (TECPUC) no processo de transição abrupta do modelo de aulas presenciais para remotas, no contexto do isolamento social decorrente da pandemia de covid-19, iniciada em março de 2020, para atendimento às recomendações do Governo do Estado e das entidades de saúde, sem, contudo, interromper as atividades acadêmicas nos cursos técnicos. Além de abordar as principais estratégias utilizadas para capacitar os docentes nos recursos do ambiente virtual de aprendizagem (AVA), garantir o acesso dos estudantes à plataforma digital e motivá-los a continuar estudando, o artigo apresenta pesquisas quantitativas e qualitativas, com coleta de dados primários e secundários que retratam tanto as percepções e dificuldades dos alunos e docentes neste processo de transição quanto informações derivadas de massa de dados estatísticos referentes a adesão e participação do corpo discente nas aulas remotas e nas avaliações on-line, retroalimentando assim as estratégias de engajamento e permanência dos alunos.
Programas de aprendizagem profissional: um estudo de indicadores de permanência e êxito
Authors: Ribeiro Mendonça Marcel , da Silva Neta Maria de Lourdes
Published: January 2022

Os programas de aprendizagem profissional (Programa Jovem Aprendiz), no âmbito da Rede Federal de Educação Profissional, Científica e Tecnológica, têm sido implementados com cada vez mais frequência. Segundo Villar e Mourão (2018), esses programas costumam aumentar a empregabilidade e a percepção de autoeficácia dos adolescentes e jovens participantes. Além disso, a possibilidade de formação omnilateral proporcionada pelos institutos federais, apontada por Mota, Araújo e Santos (2018), e a dificuldade de inserção do jovem no mundo do trabalho, estudada por Pfaffenseller (2014), tornam essas instituições estratégicas no fortalecimento da política pública. No âmbito do Instituto Federal de Educação, Ciência e Tecnologia do Ceará (IFCE), o programa foi implantado a partir de 2017 nos campi de Pecém e Caucaia. Contudo, a literatura apresenta referenciais como os de Silva, Dias e Póvoas (2017) e Santos, Tavares e Silva (2018) com considerações sobre a implantação desse programa em períodos anteriores. Como forma de contribuir para a investigação do impacto da implantação do programa, o presente trabalho apresenta um estudo de indicadores de permanência e êxito de estudantes do IFCE, com ênfase naqueles que participaram do programa Jovem Aprendiz. Os indicadores de permanência e êxito foram avaliados por meio de um formulário eletrônico aplicado a estudantes de dois cursos técnicos do campus. Os resultados demonstram que a implementação desse tipo de prospecto se apresenta como um instrumento relevante para a melhoria dos indicadores de permanência e êxito em cursos técnicos, especialmente quando a própriainstituição se posiciona como a entidade formadora do programa de aprendizagem.
La importancia de las habilidades blandas en el Home office y su impacto en la productividad de una empresa
Authors: Laines Alamina Cristina Isabel , Hernández García Alejandra Paola , Zamayoa Urbina Diana Alejandra
Published: January 2022

La reconfiguración de los esquemas laborales y lo trascendental de comprender y analizar la relevancia e importancia del impacto de las habilidades blandas en la productividad de una empresa en el contexto del home office, derivan en este documento donde se analizan con detalle las diversas habilidades blandas , tanto personales como interpersonales, necesarias para afrontar los escenarios Post pandemia y que impactan directamente en la productividad dentro de las organizaciones, vinculando el aspecto fundamental del talento humano y el desarrollo de sus competencias personales y profesionales.
Extensão popular em educação ambiental e a formação de educadores/as ambientais
Authors: Souza Tiago Zanquêta de
Published: January 2022

ResumoEste artigo tem por objetivo apresentar, a partir de nossas compreensões em torno da convivência em diálogo, na comunidade de trabalho, o quem somos e a construção colaborativa no fazer dessa prática social, com a finalidade de compreender melhor nossos traços identitários e os processos educativos que emergem desse contexto. Além disso, tem a finalidade de discutir como, considerando-se os processos educativos, pode-se pensar na extensão enquanto tripé de sustentação da universidade. Ao fazer extensão popular, nutrimos uma perspectiva teórica e epistemológica para a extensão universitária que seja capaz de sugerir caminhos possíveis para outras realizações entre a universidade e a sociedade, e entre a sociedade e a universidade, ou seja, em ambos os sentidos, na busca pelo enfrentamento da desumanização em curso.Palavras-chave: Processos Educativos. Extensão Popular. Educação Ambiental.
Popular extension in environmental education and the training of environmental educators
AbstractThis article aims to present, based on our understanding of living in dialogue, in the work community, who we are and the collaborative construction in making this social practice, with the specialization of better our identity traits and the educational processes that emerge from this context. In addition, it has to discuss how, through educational processes, one can think of extension as a tripod supporting the university. When doing popular extension, we nurture a theoretical and epistemological perspective for university extension that is capable of suggesting possible paths for other achievements between a university and a society, and between a society and a university, that is, in both senses, in the search for the confrontation of the dehumanization in progress.Keywords: Educational Processes. Popular Extension. Environmental Education.
Extensión popular en educación ambiental y formación de educadores/as ambientales
ResumenEste artículo tiene como objetivo presentar, a partir de nuestra comprensión del vivir en diálogo, en la comunidad de trabajo, quiénes somos y la construcción colaborativa en la realización de esta práctica social, con el fin de comprender mejor nuestros rasgos identitarios y procesos educativos que emergen de este contexto. Además, tiene como objetivo discutir cómo, a través de procesos educativos, se puede pensar en la extensión como un trípode de apoyo para la universidad. Al hacer extensión popular, alimentamos una perspectiva teórica y epistemológica para la extensión universitaria que sea capaz de sugerir posibles caminos para otros logros entre la universidad y la sociedad, y entre la sociedad y la universidad, es decir, en ambos sentidos, en la búsqueda de confrontación de la deshumanización en curso.Palabras clave: Procesos Educativos. Extensión Popular. Educación Ambiental.
Do Capoeira para a Capoeira: reflexões etimológicas e existenciais
Authors: Oliveira André Luis
Published: January 2022

ResumoA prática social capoeira é permeada por diferentes histórias e interpretações de seu surgimento, incluindo a própria etimologia da palavra capoeira, que pode ter sua origem na língua portuguesa, bem como na língua indígena tupi. Outra comum recorrência é da capoeira ser tratada como algo que tem existência em si, separada de seu sujeito, o capoeirista ou o Capoeira. Esse ensaio tem como objetivo recuperar na literatura a origem do nome capoeira, possíveis significados e sua relação com o jogador-lutador-dançador do que denominamos jogo-de-luta-dançada, assim destacar o/a praticante, professor/a, mestre/a, ou seja, o Capoeira, ser que dá existência a capoeira.Palavras-chave: Capoeira. Capoeirista. Etimologia.
From Capoeira player to Capoeira fight: etymological and existential reflections 
AbstractCapoeira social practice is permeated by different histories and interpretations of its emergence, including the etymology of the word capoeira, which can have its origins in the Portuguese language, as well as in the Tupi indigenous language. Another common recurrence is that capoeira is treated as something that has an existence in itself, separate from its subject, the capoeira player or the Capoeira. This essay aims to recover in the literature the origin of the name capoeira, possible meanings and its relationship with the player-fighter-dancer of what we call game-of-fight-dance, thus highlighting the practitioner, teacher, master, that is, the Capoeira, being that gives existence to capoeira.Keywords: Capoeira. Capoeira Player. Etymology.
Del Capoeira para la Capoeira: reflexiones etimológicas e existenciales 
ResumenLa práctica social de la capoeira está impregnada de diferentes historias e interpretaciones de su surgimiento, incluida la etimología de la palabra capoeira, que puede tener sus orígenes en la lengua portuguesa, así como en la lengua indígena tupí. Otra recurrencia común es que la capoeira es tratada como algo que tiene una existencia en sí misma, separada de su sujeto, el jugador de capoeira el Capoeira. Este ensayo tiene como objetivo recuperar en la literatura el origen del nombre capoeira, los posibles significados y su relación con el jugador-luchador-danzador de lo que llamamos juego-de-lucha-danzada, destacando así al practicante, profesor, maestro, es decir, el Capoeira, ser que da existencia a la capoeira.Palabras clave: Capoeira. Jugador de Capoeira. Etimología.
ESTROGEN RECEPTOR β AND AS A POSSIBLE BIOMARKER OF TAMOXIFEN RESISTANCE
Authors: Lichtenfels Martina , Schwartsmann Gilberto , Wiemann Stefan
Published: January 2022

Introduction: Approximately two-thirds of all breast cancer patients overexpress hormonal receptors and are treated with endocrine therapy, being tamoxifen (TAM) the standard treatment. However, many of the initial responders to TAM as first-line experience relapse. Several mechanisms have been proposed to explain the occurrence of acquired TAM resistance. Previous studies showed that estrogen receptor β (ERβ) expression is associated with better response to tamoxifen treatment, as the co-expression of ERα and ERβ is associated with TAM antiproliferative effects. Moreover, there is a growing interest about the cross talk between ERs and ErbB family in response to endocrine therapy. Objectives: The aim of the present study was to evaluate the expression of ERβ and the relation of ERβ with ERα and ErbB family in response to TAM treatment and in TAM resistant cells. Methods: ERβ expression was analyzed in two different databases of breast cancer patients. The mRNA levels of ER, HER receptors and PTEN and MAPK signal pathways were measured after TAM treatment, in TAM resistance cells and in cells silenced for ER genes. The cellular viability was also measured after TAM treatment, in TAM resistance cells and in cells silenced for ER genes. Results: Breast cancer patients presented reduced ERβ expression, and the ERα-positive breast cancer subtypes presented lower ERβ levels when compared to ERα-negative breast cancer subtypes. Cells expressing moderate levels of ERβ presented a better response to TAM treatment. Downregulation of ERs induced by TAM treatment was accompanied by an increase in ErbB2 and ErbB3, MAPK3 mRNA levels and increased PTEN levels. TAM–resistant cells expressed decreased ERs, PTEN and MAPK3 mRNA levels and increased EGFR, ErbB3 and ErbB4 levels. In accordance to the resistance finding, cells silenced for ERβ presented decreased MAPK3 and cells silenced for ERα showed an increased EGFR. Conclusions: These results provide additional data indicating the importance of ERβ as a possible biomarker of endocrine resistance and highlighted the interaction between ERα and EGFR as a mechanism of TAM resistance.
TLNC-UC.147, A NOVEL LONG RNA (lncRNA) FROM AN ULTRACONSERVED REGION AS POTENTIAL BIOMARKER IN LUMINAL A BREAST CANCER
Authors: Zambalde Erika Pereira , Rodrigues Ana Carolina , Lima Rubens Silveira , Ribeiro Enilze Maria Souza Fonseca , Oliveira Jaqueline Carvalho
Published: January 2022

Introduction: Long RNAs are non-coding RNAs with more than 200 nucleotides in length, with essential regulatory roles in several biological processes, including in breast cancer (BC). The human genome contains 481 ultraconserved regions, which are genomic stretches of over 200 base pairs conserved among humans, rats, and mice. Most of these regions are transcriptionally active (T-UCRs), and several are differentially expressed in tumors. Some T-UCRs have been functionally characterized, but few have been associated with BC. Objectives: In this study, we aimed to expand the knowledge of T-UCRs in BC and characterize the lnc-uc.147, a long RNA transcribed from an ultraconserved region. Methods: We evaluated the expression level of 481 T-UCRs and their association with clinical parameters from TCGA data. For confirmation, 102 Brazilian BC samples were analyzed by RT-qPCR. Cytosolic and nuclear cell fractions and RT-qPCRs were done to determine the cell compartment of the transcript. Northern blotting and RACE were performed to determine the sequence and precise size of lnc-uc.147. Using two luminal cell lines (CAMA and BT474), a siRNA-based approach was applied to investigate the effects of lnc-uc.147 knockdown in cell viability, colony formation, and apoptosis level. To understand the interactions of lnc-uc.147 and proteins, we performed a pull-down assay. Results: Using TCGA (The Cancer Genome Atlas) data, we found 302 T-UCRs related to clinical features in BC: 43% were associated with molecular subtypes, 36% with estrogen-receptor positivity, 17% with HER2 expression, 12% with stage, and 10% with overall survival. We found that uc.147 is highly expressed in luminal A and B patients, which was also confirmed in Brazilian samples. For luminal A, a subtype usually associated with better prognosis, high uc.147 expression was associated with a poor prognosis and suggested as an independent prognostic factor. The lncRNA from uc.147 (lnc-uc.147) is in the nucleus. Northern blotting results show that uc.147 is a 2,8 kb monoexonic transcript. The silencing of uc.147 increases apoptosis, arrests the cell cycle and reduces cell viability and colony formation in luminal BC cell lines. Additionally, we identified 19 proteins that interact with uc.147 through mass spectrometry. These proteins are mainly involved in cytoskeletal and centrosome organization as well as in epithelial-mesenchymal transition. Conclusions: We show herein evidence that neoplastic BC cells exhibit a unique expression profile of T-UCRs. This study characterized the lnc-uc.147, a transcript that has never been described before. Indeed, lnc-uc.147 has an oncogenic effect in the luminal BC cell line and can interact with proteins. Furthermore, uc.147 has the potential as a BC prognostic marker in luminal patients.
ANALYSIS OF CD80 AND CD86-EXPRESSING B LYMPHOCYTE LEVELS IN THE BLOOD OF WOMEN WITH LOCALLY ADVANCED TRIPLE NEGATIVE BREAST CANCER
Authors: Salgado Amanda Forte Mendes Tejo
Published: January 2022

Introduction: Breast Cancer was the second most common malignant neoplasm and the leading cause of cancer-related deaths in women worldwide in 2018; it can be classified according to the immunohistochemical pattern in four main tumor subtypes, with triple negative breast cancer (TNBC) being the most aggressive subtype with the worst prognosis, representing a public health problem. With the advancement of knowledge about the biology of tumors, the importance of understanding the interactions between the tumor, the tumor microenvironment and immune system cells has come to light, especially the role of CD80 and CD86 co-stimulator molecules in the activation of TCD4+ lymphocytes, cytokine production and proliferation of these cells against tumor antigens. Objectives: To assess the levels of CD80 and CD86-expressing B lymphocytes in the blood of women with locally advanced triple negative breast cancer. Methods: This is a prospective and exploratory cohort study of 30 women with triple negative breast cancer and 30 healthy controls, conducted in 2018– 2019. Peripheral blood collection was performed prior to chemotherapy. Immunophenotyping of B lymphocytes and CD80 and CD86 molecules was performed by flow cytometry. Women were evaluated for the degree of pathological response to chemotherapy, and were divided into groups with full (RC) or partial (RP) pathological response. Nonparametric MannWhitney tests were used for comparison between the two groups. Values of p <0.05 were considered significant. Analyzes were performed using Graphpad v7.0 software. Results: We analyzed 30 patients with locally advanced triple-negative breast cancer. The age of the patients ranged from 27 to 59 years, median age was 44.5 years (35.5–51.7), most patients were in the age group ≤50 years (43.3%). Regarding menopausal status, 62.1% were premenopausal and 37.9% postmenopausal. Regarding the nuclear grade, 63% of the tumors were grade 3, followed by 27% grade 2. In relation to clinical stage, 30% were in stage IIIA, 63.4% stage IIIB and 6.6% stage IIIC. In the evaluation of response to neoadjuvant treatment, 56.7% of patients had complete pathological response, and 43.3% partial response. TNBC patients had high levels of CD86 + B lymphocytes when compared to controls (p <0.0001). Regarding total B and CD80 + B levels - no significant differences were observed between the groups. In the analysis of CD86 and CD80 expression and total B cell levels, no significant differences were observed between the RC and RP groups. Conclusions: This study showed that the immune system of patients with triple negative breast cancer is able to regulate costimulatory molecules in circulating B.
PREDICTIVE VARIABLES OF PATHOLOGIC COMPLETE RESPONSE (PCR) IN INVASIVE DUCTAL CARCINOMA
Authors: Rabinovich Iris , Soares Isabela Chaves Monteiro , Jakobson Julia Mizrahi , Kac Eduardo Milleo , Zonta Bruno Luiz
Published: January 2022

Introduction: Achieving a pCR after neoadjuvant chemotherapy is generally associated with better outcomes. Identifying modifiable and non-modifiable variables that correlate with a complete response is important to treatment. Objectives: The aim of this study was to identify clinical and immunohistochemical variables that correlate with pCR, in a public and a private breast cancer unit in the city of Curitiba, state of Paraná, Brazil. Methods: A retrospective analysis was carried out through medical records at Hospital de Clínicas- UFPR and Centro de Doenças da Mama- Hospital Nossa Senhora das Graças. Patients who underwent surgical treatment after neoadjuvant chemotherapy, in the period from January 1, 2017 to December 31, 2020, due to an invasive ductal carcinoma were selected. Clinical and immunohistochemical variables were correlated to the presence of pCR. Ethical committee approval n. 4,295,049. Results: In 240 cases included, 66 (27.5%) reached pCR. There was a significant correlation between pCR and the negativity of the hormonal receptors (p=0.002), HER2 positivity (p=0.002), Ki67 expression (p=0.012) and molecular subtypes (p=0.001). A ROC (receiver operating characteristic) curve analysis identified a 50% percentage as the best cut-off value to predict complete response. On the other hand, it was not observed a significant correlation between pCR and body mass index, or physical activity. Conclusions: There is a strong correlation between immunohistochemical parameters and pCR. Further studies are needed to determine the correlation between modifiable variables.
CORRELATION BETWEEN THE PRESENCE OF ANDROGENIC RECEPTORS AND MOLECULAR AND HISTOPATHOLOGICAL VARIABLES IN BREAST CANCER
Authors: Geronymo Beatriz Baaklini , Carvalho Filomena Marino , Yoshimura Adriana Akemi , Andrade Juliana Zabukas de , Andrade Danúbia Ariana de , Barros Alfredo Carlos Simões Dornellas de
Published: January 2022

Introduction: The expression of androgenic receptors (AR) is a new predictive marker of response and prognosis in invasive breast carcinoma (BC). It emerges as a potential therapeutic target. Objectives: To evaluate the frequency of AR positivity and its correlation with molecular and histopathological parameters in infiltrative BC. Methods: Retrospective cohort study, analyzing 119 cases of non-metastatic invasive BC, seen at a private clinic. Hormonal receptors were screened by immunohistochemical reaction, and AR were considered positive when present in at least 10% of cells, ER and PR from 1%. This finding was correlated with pathological staging, histological grade (HG), vascular-lymphatic invasion (VLI), estrogen receptors (ER), progesterone receptors (PR), HER2 and Ki 67. Results: AR were positive in 96 cases (80.6%). The correlation with the surveyed parameters can be seen in the table. Conclusions: AR positivity is associated with more differentiated hormone-dependent tumors and with a lower proliferation rate.
TYPES OF SURGERY AND BREAST RECONSTRUCTIONS PERFORMED ON PATIENTS TREATED BY THE BRAZILIAN UNIFIED HEALTH SYSTEM AT PÉROLA BYINGTON HOSPITAL
Authors: Aquino Renata Borges , Gebrim Luiz Henrique , Mattar Andre , Shida Jorge Yoshinori
Published: January 2022

Introduction: Breast cancer is the most frequent cause of cancer death in women, also haunting them because surgical treatment can vary from expanded resection to mastectomy, causing aesthetic, functional, psychological and social damage. In Brazil, where 70% of the population is treated through the Unified Health System (SUS) and about 55% of cases are treated in advanced stages, most patients undergo mastectomy without immediate reconstruction. However, occasional mammographic screening carried out in some large cities has led to an increase in the number of diagnoses in the initial stages and, thus, a decrease in mortality from breast cancer, in addition to the possibility of less radical surgical treatments. Due to the scarcity of data in this population, we decided to perform an observational study at our institution. Objectives: This work aims at characterizing the types of surgical treatment that patients with breast cancer were submitted to at the Women’s Health Reference Center (CRSM) at Hospital Pérola Byington in São Paulo, SP, from 2015 to 2019 and the breast reconstructions carried out from January 2015 to December 2019. Methods: This is a retrospective, descriptive, observational study performed through the review of medical records of patients followed up at our service. Inclusion criteria were female patients diagnosed with malignant breast cancer treated with conservative and radical surgery, with or without immediate and late reconstruction in this 5-year period. Results: At CRSM, from 2015 to 2019, 9,097 surgical procedures were performed for the treatment of breast cancer. Radical surgeries represented 53.5%, with 2% of adenectomies. Regarding conservative surgeries, there were 4,222 procedures, 43.4% of which were quadrantectomies. From January 2015 to December 2019, 4,902 breast reconstructions were performed, 17.8% of which were immediate. Conclusions: Our data also showed 51.5% of patients underwent mastectomy due to the predominance of tumors in stages II and III. However, about 47% of patients were treated conservatively for their efforts to reduce the time to diagnosis, palpable lesions and the occasional screening performed in the city of São Paulo, resulting in a proportion of 46.5% of the patients who underwent conservative surgery. Breast reconstruction was performed in 46.8% of mastectomies, with only 82.4% being in a late stage.
RECONSTRUCTION OF THE THORACIC WALL WITH EPIPLOON AND DERMO-CUT ABDOMINAL LOWER NEO FLAP IN BREAST ANGIOSARCOMA - CASE REPORT
Authors: Melo Maria Eduarda Bernardino Martins , Ferreira Darley de Lima , Oliveira Irnanda Layanna Gomes , Carneiro Julia Cavalcanti dos Santos , Lopes Gabriela Prado
Published: January 2022

Introduction: Breast angiosarcoma is very rare and highly aggressive. It has an incidence of 0.5% to 1% of cases and its presentation is typically in women between 14 and 82 years of age with an average age that revolves around 35 years. Breast angiosarcoma presents clinically as a unilateral, softened tumor with ill-defined borders and skin thickening, with a variable growth rate. However, if compared to epithelial breast cancer, angiosarcoma has a faster growth rate. The second is known as stromal sarcoma, fibrosarcoma, leiomyosarcoma, histiocytoma, and giant cell sarcoma. Regarding adjuvant therapy, chemotherapy and radiotherapy, they present an ineffective response. The effective treatment to offer a chance of healing is a broad surgical approach. Case report: Female patient U..S., 35, from Paulo Afonso, state of Pernambuco, complaining of a left breast nodule. She had a tumorectomy in her city, due to fibroadenoma and phyloid tumors with atypia and mitosis. In our service, she underwent a series of tests, where mammogram/ultrasonography confirmed the presence of a 1.5 cm nodule in the left breast.She underwent a new segmental resection surgery, whose histopathology confirmed a low-grade malignant cystosarcoma phyllodes and exiguous margins.A new surgical proposal was discussed with the patient – a simple mastectomy with immediate reconstruction with silicone breast implant and latissimus dorsi flap. The surgery was performed and the histopathological result was the absence of residual neoplastic tissue, with an area of scar fibrosis and usual ductal hyperplasia. After her recovery, the patient was referred to clinical oncology and radiotherapy, but both had no indication for adjuvant therapy. After one year, the patient returned to undergo symmetrization of the opposite breast and reconstruction of the nipple-areolar complex. After two years, the patient returned with a breast US, which demonstrated a nodular image of 1.5 cm adjacent to the breast prosthesis and an MRI suggested the same image. A core biopsy was performed, which confirmed a malignant variant recurrent tumor. The tumor evolved very quickly and the surgery was performed with an enlarged resection of the entire pectoralis large and small and skin inclusion. To correct the deformity, we used the rotation of the great epiploon with the lower abdominal dermocutaneous flap.
3D TATTOO OF THE NIPPLE-AREOLA COMPLEX AS A COMPLETION OF BREAST RECONSTRUCTION: CASE REPORT
Authors: Clarke Paula , Pires Douglas de Miranda , Cavalcante Jéssica Moreira
Published: January 2022

Introduction: Reconstruction of the nipple-areola complex (NAC) is the last step in breast reconstruction after a radical mastectomy. There are several techniques to perform NAC reconstruction and the most common described involve local flaps and skin grafts. However, they depend on good vascularization at the receptor site, which is often impaired in mastectomies with prosthetic reconstruction, often associated with an irradiated tissue, increasing risk of ischemia and necrosis of the new NAC. Tattooing of the NAC is an alternative to the surgical procedures and has gained space over the years, due to its ease, rapid recovery, and low rate of complications. A tattoo consists in placing pigments in the dermis, through perforations in the skin by different combinations of needles, called cartridges. Such pigments are currently synthetic, based on iron oxides and titanium dioxides dispersed in a suspended gel, offering safety with rare adverse events. Case report: Female, 62 years old, who had a modified radical mastectomy in 2008 for treatment of invasive breast cancer in another institution. In 2012, she started her follow-up at Santa Casa de Misericórida de Belo Horizonte and had a reconstruction using a latissimus dorsi myocutaneous flap with a prosthesis, associated with skin grafting for reconstruction of the areola and papilla and a reduction mammaplasty on the left. After discussing options and understanding patients’ expectations, an oval areola on the right was planned, similar to the left one. Lidocaine based topical anesthetics was applied, followed by a complete tattoo of the right NAC, using a 3D technique for the papilla. The machine used was TH PRO NeonPEN Slim® and needle cartridges 1RL, 3RL, 5RS and 7RM from the same brand. Dressing was performed with La Roche Cicaplast® ointment, covered with a plastic film, which was changed daily by the patient for 15 days, according to medical advice. After 40 days the bilateral oval shape. However, the patient was not satisfied, so we planned to transform it into a round areola. Tattooing of the round areola and retouching of details for the right papilla were performed, in addition to the left areola pigmentation, to symmetrize color and shape. Figure 3 illustrates the results 15 days after the second and last session, with similarity between color and areolar shape, as well as an effect of depth and projection on the right papilla. A subjective evaluation of outcome was carried out, with the patient claiming satisfaction with the procedure and feeling better about her breasts.
USE OF LATERAL INTERCOSTAL PERFURATED FLAPS (LICAP) IN TUMORS OF THE UPPER EXTERNAL QUADRANT OF THE BREAST
Authors: Pérez María Laura Ramos , Chagas Carlos Ricardo , Carvalho Fernando de , Jimenez Martín Falla
Published: January 2022

Introduction: In the surgical treatment of breast cancer we have two great options: mastectomy and conservation surgery. The second one has been increasing over the last 30 years, since the safety of tumor resection with margins added to radiation therapy was demonstrated. Currently with the use of neoadjuvant therapy in advanced and early stages, the challenge for surgeons is not only to offer to preserve breast tissue, but also to ensure oncological safety with increasingly better aesthetic results. Most of the breast volume is concentrated in the upper external quadrant, therefore the removal of tumors in this location represents a significant loss in breast volume, causing asymmetries, affecting the contour of the breast and causing visible scars in most cases. On the other hand, in many patients with small breasts, the breast and tumor ratio is often unfavorable, leading to mastectomies. However, by using flaps for immediate reconstruction, this could change favorably for this group of patients. The use of techniques that involve lateral flaps, such as the lateral intercostal artery perforator flap (LICAP), could solve these problems, allowing for an adequate replacement of the resected volume. In this series of cases, considerable volumes have been removed, which have been replaced by LICAP, successfully achieving the treatment of tumors of the upper external quadrant of the breast. The use of this technique through a lateral incision guarantees, in addition to a wide resection in the breast, a practical and simple axillary approach, minimizing visible scars and optimizing the cosmetic result in these patients. Case report: Three cases were reported from two institutions (Casa da Saúde Nossa Senhora de Fátima, in Rio de Janeiro, and Oncosalud -Auna, in Peru). The patients were middle-aged women, all of them with tumors located in the upper external quadrant of the breast, one of the patients having received neoadjuvant therapy. In one of the cases, the breast volume was small, having an unfavorable breast / tumor ratio. By using LICAP, a favorable immediate reconstruction was achieved and a mastectomy was avoided. In one of the cases, an axillary dissection was performed and the other two underwent sentinel node biopsy; the three cases had a single lateral approach, by which a tumor resection of the breast and axillary surgery were performed. During the evolution of the patients, there were no complications, initiating treatment with radiotherapy in due time. The cosmetic result was optimal in terms of volume replacement, minimal scarring and breast symmetry.
MALE BILATERAL BREAST CANCER: CASE REPORT
Authors: Melo Maria Eduarda Bernardino Martins , Lopes Gabriela Prado , Ferreira Filho Darley Lima , Oliveira Irnanda Layanna Gomes , Cavalcanti Maria Eduarda Vasconcelos Florêncio
Published: January 2022

Introduction: Breast cancer occurring bilaterally in men is extremely rare. Breast cancer represents 1% of all cancers, while bilateral cancer represents 5% of a total number of patients with breast cancer, which may be synchronic or metachronic. Many cases of breast cancer in men are detected between 60 and 70 years, with an average of 67 years of age. In men there is a tendency for late diagnosis at a more advanced stage than in women. Case report: A male patient, JSS, 68 years old, from Afogados da Ingazeira, state of Pernambuco, was seen with breast tumoration in June 2016. He arrived at the service with an existing diagnosis of breast cancer through core-biopsy examination. The physical exam presented bulging in the left retroareolar region and a hardened tumoration in palpation. Radical mastectomy was performed. The histopathological results confirmed an invasive mucinous carcinoma with histological grade I, nuclear grade II and mitotic grade I. Free margins. The most frequent histological type in men is ductal (85%–90%), followed by papillary in 4.5% and mucinous in 2.8% of the cases. Nineteen free axillary lymph nodes were dissected, with Estrogen and Progesterone + receptors, Her-2, negative and with Ki-67 of 5%. Breast cancers in men present with more positivity for hormone receptors and low expression for Her-2. The pathological staging was classified as II a. The patient was being followed by the clinical oncology department, where he was chosen not to do chemotherapy and only hormone therapy, with Tamoxifen 20 mg. However, over a period of six months he noticed the presence of a tumoration in the right breast. An image examination was performed with MG/USG, which confirmed the presence of a tumor in the right retro-areolar region (Birads IV). A core-biopsy of the lesion was requested, which confirmed an invasive breast cancer. The patient underwent right radical mastectomy, whose result confirmed an invasive ductal carcinoma with pathological staging II a. Conclusion: This pathology is extremely rare in men and the evaluation of the contralateral breast is of fundamental importance. Early diagnosis and compliance with treatment will reduce tumor recurrence and provide a better prognosis for these patients.
PLASMOBLASTIC LYMPHOMA WITH MAMMARY MANIFESTATION: A CASE REPORT
Authors: Lima Rodrigo Quevedo de , Pacheco Eimi Nascimento , Araujo Luiz Henrique Santana de , Paganini Cassio Fernando , Tiscoski Katsuki Arima
Published: January 2022

Introduction: Plasmoblastic lymphoma (PBL) is a rare entity of non-Hodking lymphoma that usually occurs in the oral cavity in immunosuppressed patients. The involvement of other organs has rarely been reported. The breast can be the site of the initial manifestation of many diseases and in cases like this report, lymphomas should be considered as differential diagnoses. Case report: D.S., female, 28 years old, quality reviewer, married, two children. Carrier of human immunodeficiency virus (HIV) with recent treatment. Intern for investigation of liver, duodenal and breast abnormalities. She had nodules in both breasts, with progressive growth for about two months, in addition she presente nausea, vomiting, episodes of diarrhea and weight loss. On physical examination of the breasts, presence of apparent vascularization and asymmetric breast – right breast about two times the size of the contralateral. On palpation, the right breast presented with multiple hard and mobile nodules in a single left nodulation in an inferolateral quadrant measuring about 4 cm, with the same characteristics as the previous ones. No axillary lymph node enlargement, supraclavicular or infraclavicular fossae were noticed. Core biopsy was performed on both breasts with the result of undifferentiated malignancy, with a diffuse standard and numerous foci of apoptosis (compatible with high-grade non-Hodgkin’s lymphoma). In the immunohistochemical study, there was positivity for LCA, MUM 1, CD10, EMA, CMYC, CD30, CD3 and Ki-67 with a proliferative índex of 95% in neoplasia. Histopathological aspects and immunohistochemical profile were compatible with plasmoblastic lymphoma. During hospitalization, the patient underwent a myelogram that showed slightly hypercellular bone marrow, hematopoiesis was present and was megaloblastic. There was moderate diffuse and a focal irregular infiltration by pleomorphic and dysmorphic plasma cells, suggesting spinal cord involvement by plasmoblastic lymphoma. In addition, oncological PET/CT was performed which showed a metabolic increase in nodular formations in the right breast and thickening of gastroduodenal transition compatible with the clinical information of lymphoproliferative disease. The patient underwent six cycles of the EPOCH polychemotherapy scheme (etoposide, prednisone, oncovinm, cyclophosphamide and ydroxideunorubicin), associated with four cycles of methotrexate at high doses, with remission of breast lesions and is currently being followed up.
NEOAJUVANT ENDOCRINE THERAPY IN BREAST CANCER: THE FIRST RESULTS OF 59 PATIENTS
Authors: Freitas Paola Ferreira , Souza Juliana Costa , Mattar Andre , Shida Jorge Yoshinori , Gebrim Luiz Henrique
Published: January 2022

Introduction: Luminal breast cancer cases, those with positive hormone receptors and human epidermal growth factor (HER 2) negative range around 70% of cases and it is known to be more frequent in older patients. Out of the neoadjuvant therapies, neoadjuvant endocrine therapy (NET) has been gaining more ground due to fewer side effects and tumor downstaging, making it possible for advanced breast cancer tumor patients to undergo breast conservation surgery (BCS). Objectives: To evaluate clinical and pathological response in women that underwent NET with Anastrozole (ANAS) at Pérola Byington Hospital (CRSM), a breast cancer reference center in São Paulo, Brazil. To determine the BCS (breastconserving surgery) rate after NET and the rate of disease progression during treatment. Methods: CRSM patients from 2018 to 2019 that underwent NET for luminal breast cancer with HER 2 negative were identified and data were reviewed. Results: 59 patients were identified, among which only 34 patients underwent breast surgery. All patients were treated with ANAS 1mg/daily. The median age was 63.5 years and average time on treatment was 203.5 days (approximately 6.78 months). Clinical stage at presentation was 3% Stage I, 6% Stage IIA, 32% stage IIB, 43% stage IIIA and 18% stage IIIB. After NET we found pathologic complete response (pCR) in 3% of the cases. and pathological downstage in different stages: Stage I 15%, Stage IIA 24%, Stage IIB 26%, stage IIB 26%, Stage IIIA 29% and stage IIIB 3%. During treatment 6.78% patients progressed, and all of them received chemotherapy. After NET 71% were submitted to adjuvant chemotherapy. The change for BCS was 19.35%. During surgical treatment patients 74% were submitted to axillary dissection and 26% had sentinel node biopsy (SNB). The average number of SNB removed was 5.33. No patients had to stop the medication due to toxicity. Conclusions: NET is still underutilized, having its optimal period of drug administration range around 8 to 12 months. It has been very important in aiding patients obtain better outcomes allowing for BCS while having fewer side effects when compared to neoadjuvant chemotherapy.