bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of the endometrium of women who used tamoxifen: correlation between ultrasonographic, hysteroscopic, and histological findings
Authors: Neves Júnia Franco de Oliveira , Lopes Ana Paula Brum Miranda , Lucena Clécio Ênio Murta de
Published: November 2024

Objective: Tamoxifen (TAM) has been increasingly used for an extended period, longer than 5 years. Secondary endometrial thickening is a common finding, unrelated to disease. The main objective was to evaluate the correlation between abnormal echographic and hysteroscopic findings of endometrial study with clinical manifestations and histological diagnosis in women with a history of breast cancer and the use of TAM. Methodology: This is a retrospective study in which medical records of women who underwent hysteroscopy due to endometrial alterations at ultrasonography (US) or abnormal uterine bleeding (AUB), with a history of breast cancer and use of TAM, were reviewed. Patients on current or previous treatment for breast cancer and use of TAM, symptomatic or not, were also evaluated with US and referred to hysteroscopy if endometrial thickness ≥9 mm, intracavitary imaging, or AUB. For data analysis, only postmenopausal patients were included (n=50). A control group was formed by postmenopausal women without a history of breast cancer, with endometrial thickness ≥5 mm, intracavitary imaging, or AUB (n=47). It was approved by the ethics committee (CAAE=26397219.4.0000.5149). Results: US had good sensitivity in the case group (94.1%) and very unsatisfactory specificity (15.2%) in relation to the final histological result, with 63.6% of false-positives. Hysteroscopy had also high sensitivity (94.1%) and higher specificity than US (72.7%). The percentage of false-positives was 36.0%. Older age was related to altered anatomopathological findings (p=0.036). In the control group, US was also less effective compared with hysteroscopy, but with more cases with altered histopathology. Conclusion: The US correlation with the hysteroscopic image and histology in women using TAM is poor. Although hysteroscopy is more accurate, it should not be used as a screening method either. US and hysteroscopy showed similar results in the control group. Outpatient hysteroscopy was very tolerable, with or without biopsy.
Evaluation of pathological complete response in axilla in patients with triple-negative breast cancer and pathological complete response in breast: a systematic review
Authors: Pereira Deise Azevedo , Cristófalo Milena Martello , Nóbrega Gabriela Bezerra , Maesaka Jonathan Yugo , Filassi José Roberto
Published: November 2024

Objective: The role of neoadjuvant chemotherapy in breast cancer has been crucial in obtaining prognostic information through systemic treatment response. Thus, the aim was to evaluate the rate of pathological complete response in patients with triple-negative breast cancer who demonstrated pathological complete response in the breast and to determine if it is possible to predict pathological complete response in the axilla based on breast response. Methodology: This is a systematic review conducted following the PRISMA protocol and registered in the study registry PROSPERO ID: 498121. PubMed, Embase, and Web of Science databases were consulted with a selection of 180 studies. The Rayyan platform was used for article screening by two independent evaluators until the final selection. The final selected studies were subjected to the Newcastle-Ottawa Scale for methodological quality assessment. Results: Ten cohort studies evaluating breast and axilla pathological response after neoadjuvant treatment in breast cancer patients, including triple negatives, were included. In this population, the percentage of pathological complete response in the axilla was higher than the pathological complete response in the breast in almost all studies. Furthermore, in no study, a pathological response in the breast was greater than the response in the axilla. The overall rate of pathological response solely in the breast in the triple- -negative population was 33.4%, solely in the axilla was 49.3%, and considering complete pathological response (breast and axilla) was 26.9%. Conclusion: Despite triple-negative tumors presenting an excellent rate of complete pathological response, there is no directly proportional relationship between breast and axilla response rates. Thus, it is still not possible to affirm that pathological complete response in the breast can predict pathological complete response, even in a tumor subtype with high chemosensitivity. Other factors beyond the tumor subtype may interfere with this response pattern.
Capivasertib and fulvestrant, a new salvation for hormone receptor-positive breast cancer? A systematic review
Authors: Andrade Gustavo Moreira , Ferreira Rebeca da Silveira , Milki Marcos Vinícius , Crispim Sofia Reis de Oliveira
Published: November 2024

Objective: The treatment of estrogen receptor-positive (ER+) cancer has advanced significantly with the use of targeted therapies, but there are still cases in which therapy fails, therefore, carrying out a systematic review to address a treatment option for these cancers and visualize the importance of approval in Brazil. Methodology: We comprehensively searched the PubMed database for trials and phases I, II, and III that included treatment with capivasertib and fulvestrant in their papers. Our systematic review followed the PRISMA statement guidelines. Results: Cabivasertib in conjunction with fulvestrant is a new therapeutic modality for hormone-positive breast carcinomas refractory to conventional treatment because the mutability rate of these tumors is high and generates resistance to the various hormonal drugs already established on the market, such as tamoxifen and anastrozole. From the phase 2 FAKTION study, 140 patients were eligible for the study, in which 69 achieved dual treatment with a survival of 10.3 months compared with a placebo survival of 4.8 months. In the phase 3 CAPItello-291 study, 708 patients were eligible, and the overall survival was higher in the dual treatment group. Changes in AKT1 were found in 289, and the treatment resulted in a survival of 7.3 months compared with a survival of 3.1 months with a placebo. The adverse effects of the drugs were rash, diarrhea, hyperglycemia, kidney injury, vomiting, and atypical pneumonia due to indirect alteration of the immune system. Conclusion: It was evident that dual therapy capivasertib with fulvestrant is quite effective in the proposed treatment, even more so in patients with altered PI3K/AKT1/PTEN pathways, with efficacy and improvement in survival twice that of conventional treatment, and with less adverse effects comparable with the classic therapy. With this, it is safe to affirm the need for ANVISA to take the lead in this advancement in treatment and approve the treatment.
Impact of surgical treatment on the quality of life of female public employees in the state of São Paulo after breast cancer treatment: a single institution cross-sectional observational study
Authors: Antonini Marcelo , Becale Mylena Scheneider , Peixoto Arthur Gaia Duarte , Mattar Andre , Ferraro Odair , Lopes Reginaldo Guedes Coelho
Published: November 2024

Objective: This study aimed to assess the quality of life (QoL) of breast cancer patients after surgical treatment, compare groups undergoing conservative, radical, and oncoplastic surgeries, and identify symptoms and treatment-related factors that worsen QoL. Methodology: This is an observational, cross-sectional, descriptive, and single-institution study that evaluated QoL in state public servants with breast cancer undergoing surgical treatment at the Hospital do Servidor Público Estadual de São Paulo (HSPE) from October 2021 to December 2022. The study included patients with in situ or non-metastatic invasive breast cancer who completed the assessment questionnaire. The European Organization for Research and Treatment of Cancer 30-Item Quality of Life Questionnaire instruments were used for QoL assessment. The study was submitted through Plataforma Brasil to the Research Ethics Committee of the Hospital do Servidor Público Estadual de São Paulo – Francisco Morato de Oliveira and filed on Platform Brasil with approval numbers (CAAE 68337823.4.0000.5463). All patients included in the study signed the TCLE. Results: A total of 300 patients with a mean age of 56.6 years were included in the study. The majority had a partner (55.69%) and completed higher education (72.15%). The most prevalent histological type was invasive breast carcinoma (79.74%), and 69.62% of tumors had a positive hormone receptor subtype. The most common surgical treatment was conservative surgery (77.21%). According to the questionnaire, the population’s global QoL level (70.6) was satisfactory and the most affected function was emotional (65.1). The majority were satisfied with their appearance after treatment (74.9), but sexual satisfaction was impaired (57.4). Conclusion: Patients surviving BC evaluated in this study showed significant changes in QoL. The symptoms most reported by them were insomnia, pain, and fatigue. Advanced clinical staging and triple-negative molecular subtypes were associated with worse QoL scores. Conservative surgical treatment interfered less with QoL and oncoplastic surgery was associated with lower scores. Adjuvant radiotherapy did not impair QoL. Adjuvant chemotherapy was the systemic treatment that most interfered with the QoL of the patients evaluated.
Body composition, metabolic status, and level of physical activity in women with breast cancer under adjuvant hormonal therapy
Authors: Custodio Amanda Guimarães Castro , Sousa Romualdo Barroso , Santos Daniele Laperche dos , Moura Fernanda Cesar , Zapalowski Anna Luiza , Florence Kelly Farina da Silva , Souza Bruno Santos Wance de , Suzuki Daniele Assad
Published: November 2024

Objective: This study aimed to evaluate body composition, level of physical activity, and the presence of metabolic syndrome in women with breast cancer undergoing adjuvant hormone therapy. Methodology: Recruitment was carried out in two tertiary hospitals: one public and one private, with women under adjuvant hormone therapy for at least 6 months or more. Analyses included sociodemographics, body composition by bioelectrical impedance analysis, and biochemical and physical activity level questionnaires. Selected data were used to determine the presence of metabolic syndrome according to the classification of the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III). Results: A total of 107 women were included, with a mean age of 56.9 years, a mean hormone therapy use of 3.4 years, and 81.3% postmenopausal. A total of 71.9% were overweight and 87.8% had high body fat percentage (mean 37.2%) and a mean skeletal muscle index of 6.7 kg/m². Metabolic syndrome was identified in 41.1% of the sample, and 50% of the patients were sedentary or with a low level of physical activity. Patients who have undergone prior chemotherapy had, on average, a 3.7% higher fat percentage (p=0.0107). For each increase of one unit in BMI, the chance of developing metabolic syndrome increases by 30% (p=0.0003). Patients with aromatase inhibitors had a 4.52 times greater chance of developing metabolic syndrome when compared with tamoxifen (p=0.0074). Patients in stages II and III had a 2.58 times greater chance of being in a lower category of physical activity instead of being in a higher category of physical activity than those with grade I (p=0.0178). Sedentary patients were more associated with a treatment interval of 2–5 years and patients with high physical activity were more associated with a treatment interval ≤2 years of hormonal treatment. Conclusion: Patients on adjuvant hormone therapy often had metabolic syndrome and high levels of body fat, even though they were physically active.
Prediction of recurrence after neoadjuvant chemotherapy in early triple-negative breast cancer
Authors: Polho Gabriel Berlingieri , Testa Laura , Sousa Romualdo Barroso de , Batista Daniel Negrini , Bonadio Renata Colombo
Published: November 2024

Objective: This study aimed to explore the clinical and pathological biomarkers to predict recurrence after neoadjuvant chemotherapy (NACT) in triple-negative breast cancer (TNBC). Methodology: We retrospectively reviewed our institutional database to identify patients with TNBC who underwent NACT with anthracyclines and taxanes. Medical charts were analyzed to extract data. Log-rank was used to compare survival estimates and Cox proportional hazard to determine effects on survival. Approval from the Ethics Committee was obtained before the study procedures. Results: We identified 110 TNBC patients receiving NACT. The median age was 48 years, 60% had stage III tumors, and 30.9% achieved pathologic complete response (pCR). One-year disease-free survival (1y-DFS) was 74.6% (95% confidence interval [CI] 65.3–85.3). A higher risk of recurrence was observed in patients with residual disease (RD) (hazard ratio [HR] 5.0, 95%CI 1.17–21.52), stage III disease (HR 2.7, 95%CI 1.02–7.48), and neutrophil-to-lymphocyte ratio (NLR) >2 (HR 2.66, 95%CI 1.03– 6.87). In a subgroup analysis, the percentage of tumor-infiltrating lymphocytes (TILs) ≥30% was a favorable prognostic factor in stage II disease (no patients recurred after a median follow-up of 13.2 months) but did not impact prognosis in stage III. Among patients with pCR, those who had NLR >2 had a significantly worse prognosis (1y-DFS: 100% vs. 75%, p=0.039), while TIL levels did not predict the risk of recurrence. The prognosis of patients who had RD after NACT was not related to TILs ≤30% (p=0.56) or NLR >2 (p=0.34). Conclusion: After NACT, patients with RD and those with high NLR despite pCR have a significant risk of recurrence. TIL levels did not discriminate recurrence risk within the subgroups of pCR or RD. As a readily available biomarker, NLR should be further explored to tailor treatment decisions.
Histopathological findings of patients undergoing vacuum breast biopsy
Authors: Souza Maryana Neves de , Anjos Renata Grigorio dos , Torres Adriana de Freitas , Amorim Heverton Leal Ernesto
Published: November 2024

Objective: This study aimed to categorize the histopathological findings of breast lesions investigated through vacuum- -assisted biopsy, in a reference service, using the National Health Service Screening Program (NHSBSP) classification. Methodology: This was a cross-sectional observational study. Information was collected from a database available in a private clinic in the city of João Pessoa/PB – UD Diagnóstico por Imagem from June 2021 to June 2023. A total of 416 female patients who underwent the procedure were included in this study, and 13 patients who did not have data on anatomopathological results were excluded, totaling a final sample of 403 patients. Associations between categorical variables were verified using the chi-square test or Fisher’s exact test. The significance level will be 5%. Results: Patients were divided according to the classification of the anatomopathological results of the lesions by the NHSBSP category. Of the 403 patients, 2 were selected as B1 (0.5%), 224 (55.6%) were selected as B2, 123 (30.5%) as B3, only 1 (0.2%) as B4, and 53 (13.2%) as B5. Of the B3 lesions, 66.67% corresponded to histopathological findings of radiating scar. Of the malignant lesions (B5), the highest percentage was histopathological results of ductal carcinoma in situ, representing 58.49% of the lesions. Of these cases, 30 (96.7%) were diagnosed using aspiration biopsy guided by mammography and with the indication of the procedure due to grouped Bi-RADS® 4 microcalcifications. The microcalcifications for B5 lesions compared with B3 lesions were significant p<0.0001. Conclusion: The prevalence of “in situ” lesions favors the early diagnosis of breast neoplasms. Mammotomy has proven to be a safe and effective method for diagnosing suspicious non-palpable lesions, and benign cases can be considered treated.
Cancer health disparities among patients with estrogen-receptor-positive invasive breast carcinoma undergoing adjuvant endocrine therapy: impact of insurance coverage
Authors: Laperche-Santos Danielle , Assad-Suzuki Daniele , Resende Heloisa , Arakelian Netto Renata , Signorini Poliana Albuquerque , Nogueira-Rodrigues Angélica , Rosa Daniela Dornelles , Barroso-Sousa Romualdo
Published: November 2024

Objective: Challenges in social dynamics and disparities in healthcare persist within the context of cancer care in Brazil, and there is a gap regarding access to optimal care between patients in the public and private health systems. The objective of this study was to describe patients’ characteristics at diagnosis and patterns of treatment received and to evaluate diagnosis-to-treatment interval and their association with health insurance coverage. Methodology: We performed a real-world data analysis among women with a history of early-stage ER+ invasive carcinoma of the breast on adjuvant endocrine therapy for at least 6 months in 15 centers of five different Brazilian regions. Data collection was done with the RedCap software. Analyses were performed in SAS 9.4. Results: From June 2021 to March 2024, 774 patients were included. The mean age was 56.8 years; 52.2% were publicly insured. Treatment at public institutions was significantly associated with more premenopausal patients (47.6% vs. 29.2%, p<0.0001), living without a partner (46.8% vs. 34.7%, p=0.001), lower educational level (46.1% vs. 6.8%, p<0.0001), stage III tumors (29.1% vs. 13.5%, p<0.0001), mastectomy (35.0% vs. 29.8%, p=0.001), axillary dissection (40.6% vs. 18.1%, p<0.0001), chemotherapy (72.7% vs. 58.5%, p<0.0001), radiotherapy (87.2% vs. 78.7%, p=0.003), lower use of ovarian function suppression plus ET (4.2% vs. 18.8%, p<0.0001), ower use of CDK4/6 inhibitors (0.6% vs. 2.7%, p=0.02), and higher use of tamoxifen (53.8% vs. 29.4%, p<0.0001). The diagnosis-to-treatment interval was double for women treated in the public vs the private system (94 vs. 42 days, p<0.0001). Conclusion: Patients with public health coverage were diagnosed with later stages and received more local treatment and less intense and optimal endocrine therapy when compared with privately insured patients. Treatment initiation intervals exceeding the recommended 60-day limit were observed for patients receiving treatment in the public service, despite legal restrictions.
Regional disparities in breast cancer histopathological examination turnaround time: a 5-year comparative analysis in Brazil
Authors: Vieira Natália Barros Salgado , Bittar Mariana Valadares , Lavor Bianca Santos Arrais de , Marra Gabriel de Assis , Esteves Paulo Lisbão de Carvalho
Published: November 2024

Objective: This study aimed to compare the turnaround time for histopathological examination in cases of breast cancer among the regions of Brazil over the last 5 years. Methodology: A retrospective study of descriptive and quantitative nature was conducted using secondary data obtained from the Cancer Information System (SISCAN), available on the DATASUS electronic platform. It evaluated Brazil’s turnaround time for breast cancer histopathological examinations, covering the collection, laboratory arrival, and result release intervals over the past 5 years (2019–2023), comparing data across the nation’s five regions. Results: The Central-West region demonstrated slightly the best percentage of examination completion within 30 days (65.8%), with 16.3% finalized after 60 days. The South region followed, with 65.3% of histopathological examinations completed within 30 days, and only 13.5% conducted after 60 days. Maintaining good performance, the Southeast region presented 65.1% of examinations reported within 30 days, with 14.1% released after 60 days. Meanwhile, the North and Northeast regions showed lower percentages of process completion within 30 days, with 47.3% and 50.1% of examinations, respectively. The percentage of analyses released only after 60 days is also higher, corresponding to 23.8% in the North region and 25.5% in the Northeast. In light of the foregoing, national data indicate an average of 58.5% of examinations reported within the first 30 days, with 18.9% of these released after 60 days. Conclusion: The results reveal significant variations in the turnaround time for histopathological examination of breast cancer cases among the regions of Brazil. These disparities underscore the importance of health policies aimed at optimizing diagnostic procedures in the country, especially in the context of breast cancer, where early detection plays a crucial role in the treatment and prognosis of patients.
Return to work after breast cancer treatment in state public employees in Brazil: a cross-sectional observational study
Authors: Antonini Marcelo , Peixoto Arthur Gaia Duarte , Becale Mylena Scheneider , Mattar Andre , Ferraro Odair , Lopes Reginaldo Guedes Coelho
Published: November 2024

Objective: The aim of the study was to evaluate the return-to-work (RTW) rate in public employee patients in the State of São Paulo with breast cancer who underwent surgical treatment in a single institution. Methodology: This is an observational, descriptive, cross-sectional, and single-institution study involving public employees, with non-metastatic breast cancer who underwent surgical treatment at the State Public Servant Hospital of São Paulo from October 2021 to December 2022. To assess the quality of life, the following instruments were used: the EORTC QLQ-30 and QLQ-BR-22 questionnaires. The study was submitted through Plataforma Brazil and approved (CAAE 68337823.4.0000.5463). Results: Of the 339 eligible patients, 300 (88.2%) were still working at the time of diagnosis. The RTW rate in this study was 74.41%. A significant majority of patients (80.6%) resumed employment within 6 months, whereas 15.1% returned between 6 and 12 months, and 12.8% between 12 and 18 months, respectively. The predominant reason cited for RTW was personal satisfaction with financial necessity prompting. In the EORTC BR-23 sub-questionnaire, referring to functional scales, patients who returned to work had a higher score in the body image assessment, an average of 76.0 vs. 52.3, when compared with patients who did not RTW (p=0.032). It was shown that the type of surgical treatment impacts the RTW rate (p<0.001). Among patients who RTW, 87.5% underwent BCS compared with 9.1% of those who did not RTW. In this same group, it was observed that 45.5% underwent radical and oncoplastic surgery. Adjuvant treatment also correlated with RTW; patients undergoing adjuvant chemotherapy have a 6.25-fold increased risk of not returning to work when compared with patients who did not undergo adjuvant chemotherapy. Conclusion: The RTW rate among state public employees in the state of São Paulo was 74.41%. It was observed that oncological treatment (surgical, chemotherapy, and radiotherapy) has a statistically significant association with the RTW rate. Socially, the offer of adjustment by the employer influences the RT decision, in addition to the patient’s personal and work satisfaction. Returning to work is associated with the quality of life of women surviving BC.
Intrinsic chemoresistance in luminal breast neoplasms: efficacy from an innovative in vitro chemoresistance platform
Authors: Lichtenfels Martina , Fontana Vivian , Barbosa Isis Mendes , Nyland Francine Hickmann , Silva Camila Alves da , Marcolin Júlia Caroline , Farias Caroline Brunetto de , Pedrini José Luiz
Published: November 2024

Objective: The aim of this study was to validate an in vitro chemoresistance platform, BioversoÒ, to predict the responsiveness of luminal tumors to cytotoxic and target therapy drugs. Methodology: Patients with estrogen receptor (ER)-positive HER2-negative breast cancer (BC) who underwent upfront surgery were included. Fresh tumor samples were collected during surgery and dissociated to obtain the tumor cells. The tumor cells were cultured in the BioversoÒ with the drugs, and after 72h, cell viability was evaluated. The test result is defined as low, medium, and high resistance. Results: Samples from 31 patients diagnosed with ER+/HER- undergoing upfront surgery were tested in the BioversoÒ. A total of 18 (58%) patients presented luminal A tumors and 13 (42%) luminal B. A majority (83.8%) underwent breast-conserving surgery and sentinel lymph node biopsy (80%). The tumor staging revealed 61.2% T1, followed by 35.5% T2 and 3.3% T3 categories. Invasive ductal carcinoma was predominant (90%), with histologic grading of 23.4% grade 1, 63.3% grade 2, and 13.3% grade 3. Adjuvant chemotherapy, predominantly ACT regimen, was administered to 38.7% of the cohort. Over a median follow-up of 13 months, no recurrence was observed. The chemoresistance platform demonstrated higher rates of high resistance to taxanes (63.3% docetaxel and 70.9% paclitaxel), platin-based drugs (60% carboplatin and 46.4% cisplatin), and mTOR inhibitors (60% everolimus) compared with anthracyclines (22.6% doxorubicin and 25.8% epirubicin), cyclophosphamide (14.8%), and PARP inhibitors (36.8% Olaparib). The high resistance to taxanes, platin drugs, and everolimus corroborates existing literature, and the data regarding olaparib invite consideration for personalized treatment based on tumor biomarker profiling. Conclusion: The preliminary finding highlighted the capability of BioversoÒ to delineate distinct resistance patterns to both cytotoxic drugs and target therapies in luminal BC and suggest the potential influence of intrinsic tumor resistance in the differential response to BC treatments.
Cosmetic perception after breast-conserving surgery and quality of life: is there a correlation?
Authors: Oliveira Junior Idam de , Silva Fabíola Cristina Brandini da , Sarri Almir José , Vieira René Aloísio da Costa
Published: November 2024

Objective: Breast-conserving surgery (BCS), compared with mastectomy, guarantees equivalent local control and survival, with lower morbidity and higher quality of life (QOL). However, the cosmetic result (CR) of this surgery can be unsatisfactory and influence the survivor’s QOL. This issue exacerbates when the patient reports dissatisfaction despite good results determined by healthcare professionals and/or objective methods. Thus, it is necessary to understand the impact of CR on QOL, as well as potential influencing factors. Methodology: A cross-sectional, prospective study (ethical approval and FAPESP) was conducted, including patients undergoing BCS. Patients completed the EORTC-C30, QLQ-BR23, and BCTOS questionnaires, performed self-assessment of breast cosmetics, and had photographs taken. The photographs were analyzed using BCCT.core software. For categorical variables, frequencies were calculated, and for numerical variables, mean and standard deviation were determined. The results of BCCT.core were compared with patient self-assessment, analyzing four groups: satisfied, very satisfied, true-dissatisfied, and false-dissatisfied. Kappa was used to assess agreement between categorical variables, and Student t and Mann-Whitney tests were employed to evaluate the relationship between QOL and CR. ANOVA and Bonferroni adjustment was used to compare groups. Results: A total of 300 patients were evaluated, 298 completed self-assessment of their breasts (76.8% satisfactory result and 23.2% unsatisfactory) and 297 had BCCT.core evaluation (29.9% satisfactory result and 79.1% unsatisfactory), with a kappa of 0.095 (p=0.01). In self- -assessment, patients with unsatisfactory CR showed worse QOL scores in 17 items. Under software analysis, this relationship did not have the same proportion, with unsatisfied patients showing worse scores in only four items. In falsely dissatisfied patients (satisfactory result by software and unsatisfactory self-assessment), higher scores of pain and worse functionality were found on the treated side. Conclusion: Unsatisfactory CRs were associated with worse QOL scores, a fact that may be linked to other aspects such as breast pain and functionality.
Impact of surgical treatment on shoulder joint complex and muscle strength of women undergoing breast cancer treatment
Authors: Noleto Flávia Batista Gomes , Rodarte Tatiane Nunes da Silva , Marques Vitor Alves , Oliveira Ellen Gomes de , Silva Anderson Garcia , Alves Rafael Ribeiro , Ferreira Júnior João Batista , Vieira Carlos Alexandre
Published: November 2024

Objective: This study aimed to evaluate the range of motion (ROM), muscle strength, and functional performance of the shoulder joint complex (SJC) of women with breast cancer undergoing surgical treatment, in two moments, before and after surgery. Methodology: The study included 11 volunteers (age 53.7±10.8 years; body mass 73.1±17.1 kg; height 1.55±0.06 m; BMI 30.4±6.3 kg/m2 ) recruited at the Advanced Breast Diagnostic Center (CORA)/Universidade Federal de Goiás. The volunteers were evaluated in the preoperative moment (0–8 days before) and in the postoperative moment (30–43 days after). ROM was assessed using the Clinometer application, muscle strength was assessed using the handgrip strength (HGS) test, and functional performance was assessed using the arm, shoulder, and hand dysfunction questionnaire (DASH). Results: There was no interaction between the side and time factors and the effect of the side factor for HGS (p=0.80 and p=0.41, respectively) and ROM on abduction shoulder movements (p=0.45 in both), flexion (p=0.92 and p=0.54, respectively), 0° abduction lateral rotation (p=0.28 and p=0.14, respectively), 90° abduction lateral rotation (p=0.39 and p=0.15, respectively), and 90° medial rotation of abduction (p=0.06 and p=0.81, respectively). There was also no effect of the time factor for HGS (p=56) and ROM on shoulder movements of lateral rotation 0° abduction (p=0.29), lateral rotation 90° abduction (p=0.09), and medial rotation 90° abduction (p=0.94). However, there was a reduction in abduction ROM (p=0.002) and shoulder flexion ROM (p=0.002) after surgery on both sides. In addition, there was a reduction in the scores on shoulder functional performance after surgery (p=0.005). Conclusion: Abduction and flexion of the shoulder were affected after surgery, in addition to a reduction in the scores on the functional performance of the shoulder.
Muscle strength related to quality of life in breast cancer patients and survivors
Authors: Diniz Júlia Kalida , Amorim Fabline Ribeiro , Santos Débora Emanuelle Gonçalves Leal , Galli Isabelle Cadore , Benevides Giovana Pereira , Oliveira Arthur Guilherme Dias , Oliveira Neto José Aldo de Almeida , Oliveira Rodrigo Franco de
Published: November 2024

Objective: The objective of this study was to evaluate the relationship between muscle strength and quality of life in breast cancer patients and survivors who practice physical exercise vs those who do not. Methodology: We conducted searches using the terms “Muscle Strength,” “Breast Cancer,” and “Resistance” in the following databases: MEDLINE (by PubMed), Embase (by OvidSP), and Karger. We also searched ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform. This systematic review of the literature was performed using PRISMA and Cochrane Handbook for the Scopus, and six articles were selected for qualitative analysis. Results: The majority of studies found the effectiveness of resistance training (RT) in breast cancer survivors during anticancer treatment, with a positive impact on reducing fatigue levels, less loss of muscle strength, and a lower incidence of joint dysfunction, especially when associated with kinesiotaping (KT). Some of the studies listed showed a higher quality of life post-treatment in the group that practiced physical activity, suggesting that RT is superior in post-therapeutic anti-cancer rehabilitation, compared with sedentary patients. However, none of the studies found consistent correlations between strength exercise and reduced BMD in breast cancer survivors. Another study suggests that RT can reduce chronic inflammation, with the potential to prevent cancer recurrence, but more robust evidence is still lacking. Conclusion: Breast cancer patients face significant challenges related to muscle strength loss and fatigue during and after treatment. The implementation of an exercise protocol emphasizing resistance training has proven beneficial. The inclusion of KT therapy also shows the potential to improve functional performance. When developing treatment strategies for breast cancer patients, it is essential to consider resistance training and possibly KT therapy as integral parts of the care plan to optimize physical outcomes and quality of life for these patients.
Valvulopathy due to mediastinal radiation: a diagnosis little thought of in radiotherapy for breast cancer, a systematic review
Authors: Andrade Gustavo Moreira , Castro Marina Ribeiro , Santos Gabriela Muniz Ferreira dos , Ramos Cynara louany da Silva , Milki Marcos Vinícius , Ferreira Rebeca da Silveira
Published: November 2024

Objective: This study aimed to review the possibility of diagnosing valvular heart disease due to mediastinal radiation, in radiotherapy for breast cancer, as it is little considered and an insidious diagnosis. Due to the reason that radiotherapy is an important way of treatment in patients with not only breast cancer but also lymphomas. Methodology: We comprehensively searched the PubMed database for studies and trials that included mediastinum radiotherapy for breast cancer and valvulopathy in their papers. Our systematic review followed the PRISMA statement guidelines. Results: Cardiac complications include coronary artery stenosis, pericardial disease, cardiomyopathy, conduction abnormalities, and, mainly, valve disease, with significant prevalence in survivors of Hodgkin’s lymphoma and breast cancer. Asymptomatic radiation-associated valve disease is usually diagnosed more than 10 years after mediastinal irradiation. Understanding the pathophysiological mechanisms underlying radiation-induced cardiovascular damage is crucial for early diagnosis and effective treatment of subclinical cardiac abnormalities, as valve disease begins with mild asymptomatic valve thickening and progresses to severe valve fibrosis with hemodynamic compromise that requires surgical intervention. Although evidence-based specific cardiac screening approaches are lacking, prevention remains the best way to treat radiation-induced cardiotoxicity. Modern radiotherapy techniques, such as three-dimensional planning and the use of subcarinal blocks, are essential to minimize the volume of the irradiated heart and reduce the risk of cardiovascular complications. Conclusion: It is clear that radiotherapy plays an indisputable role in the treatment of breast cancer; however, its application may be associated with serious cardiovascular complications, especially when the heart is directly exposed to radiation. Dose prediction models are being developed to predict the risk of future heart valve disease and new radiation techniques are being developed to reduce radiation dose to the heart, but continued surveillance and long-term cardiac follow-up will still be necessary to ensure quality. life expectancy of patients undergoing radiotherapy for breast cancer.
Implementation of Jarimatika Method to Improve Multiplication Calculation Ability in Grade III Elementary School Students
Authors: Akrom Muhamad , Zihab Zihab , Jalaluddin Jalaluddin , Imam Muslim Rachmat
Published: November 2024

This study aims to describe the use of the jarimatika method to improve multiplication calculation skills in grade III students at SD Negeri 2 Surabaya Utara in the 2023/2024 Academic Year. This research approach is a classroom action research with four stages, namely planning, implementation, observation, and reflection. Data collection techniques in this study used observation, tests and documentation. The data obtained from the research results were then analyzed using data analysis consisting of three stages, namely (1) data reduction, (2) data presentation, (3) drawing conclusions. Based on the initial conditions, the first data obtained were only 11 students (60.4%) whose scores were able to reach the KKTP while 14 students (39.6%) whose scores were below the KKTP. After conducting the research, the results obtained showed that in cycle I there were 19 students (72.48) who were able to achieve the KKTP score and 6 (27.52%) students whose scores were below the KKTP. Meanwhile, in cycle II, there were 2 students (19.28) who were below the KKTP and 23 (80.72%) students who were able to achieve the KKTP score. This shows that learning activities using the jarimatika method can improve student learning outcomes in multiplication material.
Analysis Study Of Paulo Freire's Thoughts And Its Application In Elementary Education
Authors: Rahayu Hendra , Ndona Yakobus , Gultom Ibrahim
Published: November 2024

The application of Freire's thinking in the context of elementary education can be seen through a dialogical and critical approach in teaching. Teachers not only convey knowledge, but also act as facilitators who help students to think critically and be actively involved in the learning process. The type of research used in this study is library research . Data sources in this library research consist of two categories: 1). Primary Data Sources: The main books written by Paulo Freire, especially Pedagogy of the Oppressed (1970). 2). Secondary Data Sources: Scientific articles, journals and research reports that discuss the application of Freire's thinking in elementary education. The results of the study show that 1). Critical Conscientization  in Elementary Education is a process in which individuals understand the social and political injustices around them. 2). Dialogical Education in Elementary Education is a key element in education, where teachers and students learn from each other through two-way communication. 3). Humanistic and Inclusive Education in Elementary Education is where every student is valued as an individual who has the potential to develop, without discrimination based on social and economic background. 4). Implications for Basic Education in Indonesia are that the recently introduced independent curriculum gives teachers and students more freedom to explore subject matter flexibly, in accordance with the principles of liberating and dialogical education as taught by Freire
Profile of Green Chemistry on Chemistry Education Students: Study on Developing Green Chemistry Practical Module to Support Sustainable Development Goals (SDGs)
Authors: Cahyani Mutiara Dwi , Gusman Tania Avianda , Akbar Ari Yustisia
Published: November 2024

The Society 5.0 era emphasizes production efficiency by transitioning from conventional to renewable energy sources. Thus, the Society 5.0 Era aligns with one of the goals of the SDGs, which is that industrial processes become more environmentally friendly and more efficient in using energy resources while increasing their value. Green chemistry is a comprehensive approach that designs safe chemicals ranging from environmentally friendly chemical products and processes to reducing the formation of harmful chemical substances. The type of research is descriptive and aimed at describing the student's early understanding of green chemistry. The subject of this study is a student of Prodi Education Chemistry at the University of Muhammadiyah Cirebon. The test instrument consists of 4 description questions compiled to measure the student's initial understanding of green chemistry. The analysis results show that the students understood the terminology for green chemistry. However, students still need to understand the 12 principles of green chemistry and their applications in everyday life.
Ethnobotany Study Tradition Buang Abu Melayu Sambas as a Biology Learning Resource
Authors: Nurdiana Nurdiana , Rahayu Hanum Mukti , Qurbaniah Mahwar
Published: November 2024

The district of Sambas has a variety of cultures and traditions. The distinctive characteristic of the district of Sambas is embodied in the uniqueness of the buang abu tradition, which differs from the tradition in other areas. Besides, the tradition involves the use of some local plants. The research is aimed at identifying the types of plants used in the process of buang abu and identifying the suitability and validity of the potential of the plant types in the process of buang abu in Malay Sambas as a source of biological learning. The research uses qualitative descriptive methods. The quality of the potential of plants used in the buang abu tradition as a source of biological learning in the interpretation is very worthy, with a 100% presentation. The relevance of the material to the study of ethnobotany of the tradition of buang abu Melayu Sambas is consistent in achieving basic competence on the material of the high school level, namely biodiversity, classification of living creatures, plantae, growth and development of living beings, and the structure and function of tissues in plants.
Canva-Based Animation Comic Video Media in Informatics Learning
Authors: Sari Liza Mustika , Huda Asrul , Effendi Hansi , Giatman Muhammad
Published: November 2024

This study aims to develop Canva-based animated comic video learning media that are valid, practical, and effective for Informatics in Grade VIII at SMP N 14 Padang. The research adopts a Research and Development (R&D) approach, applying the 4D model—Define, Design, Develop, and Disseminate. Primary data were collected from validators, teachers, and students, with descriptive and inferential analysis used to evaluate media validity, practicality, and effectiveness. Results show the media to be valid, scoring 0.963 for media and 0.975 for material aspects. The media is also highly practical, with teacher ratings at 97.04% and student ratings at 93.14%. Effectiveness is indicated by a Gain Score of 0.69 (medium category) and a significant improvement in student learning outcomes, as confirmed by t-test results (Sig. 2-tailed = 0.000; tcount > ttable). The findings confirm that Canva-based animated comic videos significantly enhance student learning outcomes over conventional methods.
Development of Salt Hydrolysis Module Based on Problem Based Learning Integrated with TPACK to Improve Numeracy Literacy Skills of Phase F SMA Students
Authors: Febrila Putty Zinda , Yerimadesi  , Andromeda  , Alizar
Published: November 2024

This research aims to analyze the validity, practicality and effectiveness of the salt hydrolysis module based on problem based learning integrated with TPACK on students numeracy literacy skills. The development model used is the 4-D model. The module developed was validated by two lecturers and three chemistry teachers. The practicality testing of the module was carried out by three chemistry teachers and 32 SMA students. Testing the effectiveness of the module was carried out using a pre-experimental method with a non-equivalent control group design. The validity test was analyzed using the Aiken's V formula where content and construct validity were obtained respectively 0.91 and 0.92 with the valid category. The practicality test was analyzed using the Aiken's V formula where the practicality scores for teachers and students were obtained respectively 0.94 and 0.86 in the practical category. The module effectiveness test was analyzed using N-Gain where an N-Gain value of 0.76 was obtained in the high category. Based on the results of data analysis, it can be concluded that the salt hydrolysis module based on problem based learning integrated with TPACK developed is valid, practical and effective to improve the numeracy literacy skills of Phase F SMA students.
Evaluation of Environmental Risk from Heavy Metals in Sediments in Port Areas
Authors: Yusrizal  , Abdillah Nuryasin , Hendrizal Andri
Published: November 2024

This research aims to evaluate the concentration and distribution of heavy metals in sediment in the Port area of ​​PT Pelindo Dumai Branch, which is one of the main ports in Riau Province, Indonesia. Heavy metals such as cadmium, copper, lead, mercury and zinc are known to have significant toxic effects on maritime ecosystems and can accumulate in the food chain, potentially endangering aquatic life and human health. The research methodology involves taking sediment samples from various points around the port area, which are then analyzed using spectroscopic techniques to determine heavy metal concentrations. The results showed that the concentration of heavy metals in sediments varied, with zinc having the highest concentration (average 0.019724 mg/L), followed by copper, lead, cadmium, and mercury. This variation indicates the existence of diverse sources of pollution and uneven distribution in the port area. Although cadmium and mercury concentrations are relatively low, they still raise concerns due to their high toxicity and potential accumulation in the food chain. These results emphasize the need for more intensive environmental monitoring and targeted risk management to reduce the negative impacts of heavy metals on maritime ecosystems and human health. This research provides an important scientific basis for mitigation efforts in port areas, which are crucial to ensuring the sustainability of ecosystems and the well-being of communities that depend on marine resources.
Development of Learning Media for the Katapel Quiz Application on the Concept of Energy in Living Systems
Authors: Dunggio Sridiyanti S. , Abdjul Tirtawaty , Payu Citron S. , Pikoli Masrid , Uloli Ritin , Odja Abdul Haris
Published: November 2024

This research aims to produce a product and describe the validity, practicality, and effectiveness of the Katapel quiz application learning media on energy in living systems. The research method used is Research and Development (R&D) research and uses the 4D development model. The research target was class VII of SMP Negeri 1 Asparaga, involving 22 students. The results of Katapel quiz application consist of validity obtained 3.73 in the "valid" category; practicality obtained 85.71% in the "Very Good" category, and through student response questionnaires, which received 88.59% in the "Very Good" category; the effectiveness obtained 84.42% in the "Good" category and through learning outcomes tests of students who obtained a pretest score of 39.09% and a posttest of 90.55% with an N-Gain of 0.84 in the "high" category. The research results concluded that the learning media for the Katapel quiz application had met the valid, practical, and effective criteria for improving student learning outcomes on the subject of Energy in Living Systems.
Development of an E-Module Based on 3D Pageflip Professional on the Concept of Vibration and Wave
Authors: Saleh Melisa Damayanti R. , Abdjul Tirtawaty , Jahja Mohamad , Mursalin  , Uloli Ritin , Arbie Asri
Published: November 2024

This e-module based on 3D Pageflip Professional can support and facilitate students in the learning process. This research aims to determine the quality of the E-module based on validity, practicality, and effectiveness. The method used is Research and Development (R & D) with a 4D model. This research was conducted in class VIII, namely Class VIII.1 and Class VIII.2, at SMP Negeri 1 Telaga Jaya. Data collection techniques are carried out through observation, questionnaires, tests, and data analysis using descriptive analysis. The research results show that the validity determined through media expert validation reached 3.69 and material expert 3.77, obtaining valid criteria. The practicality is determined through learning implementation, reaching 90% with very good criteria, and student response reaching 87% with good criteria. The effectiveness is determined through student activity, reaching 89% with good criteria and student learning outcomes with an N-Gain value of 0.8 with high N-Gain criteria. Based on the research results, the E-module based on 3D Pageflip Professional is suitable for use and meets the valid, practical, and effective criteria.