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Introduction: nowadays, the aerobic exercise and the exercise program benefits neoadjuvant and adjuvant setting in the breast cancer treatment are being investigated. Objective: analyze the available scientific evidence on the benefits of the aerobic exercise and the best modalities for women with breast cancer. Material and method: a review of the scientific literature has been carried out in the databases Cinhal, Medline, Pubmed and Scopus, using the descriptor MeSH: Breast Neoplasms, and the free term aerobic exercise. Results: after applying the exclusion and inclusion criteria 14 articles were analyzed. 42.86 % of the researchers studied exclusively aerobic exercise programs, while the remaining 57.14 % also added strengthening and/or resistance training. Conclusions: aerobic exercise is a safe and effective exercise modality and it has positive repercussions on such common breast cancer symptoms as fatigue, loss of aerobic capacity, strengthening, endurance, increase in body mass index, weight, pain, quality of life and quality of sleep. [ABSTRACT FROM AUTHOR]

Breast cancer is the most common type of cancer and with the most mortality among women. Breast cancer's treatment in older women is well tolerated and it shouldn't vary from its younger counterparts. However, changes may exist in the therapeutic approach due to factors such as: functionality, life expectancy or the patient's wish, and the tumor's nature. The following study was made in two tertiary hospitals in Mexico, analyzing the clinical files of patients older than 18 years of age, who were diagnosed with breast cancer in January of 2010 to December of 2015. The variables to consider were: age, tumor characteristics (location, size, clinical stage of node, metastatic state, type and histological grade, clinical stage, hormonal receptor, and HER2 expression); initial treatment, screening method; and comorbidity index of each patient. A descriptive statistic, Pearson's correlation, and Chi square statistic was realized for the data analysis. 393 files were analyzed, with 241 (71.1%) being from women younger than 60 years and 98 (28.9%) from women older than this age. In the multivariate analysis the tumor, histological, and epidemiological characteristics resulted statistically significant when correlated with the patient's age. Having tumor characteristics and clinical stages more advanced in patients < 60 years, unlike the less aggressive ancestries, the presence of estrogen receptors and early clinical stages prevailed in women 60 years of age or older. [ABSTRACT FROM AUTHOR]

Introduction: Breast cancer is a public health problem that generates various factors and feelings which affect the quality of life. Objective: to evaluate factors associated with quality of life in breast cancer patients. Methods: Descriptive cross-sectional study involving 82 patients. Quality of life was calculated with WHQOL-BREF and the associated factors were determined using a binary logistic regression model. Results: 73.1% rated quality of life at least as good. The physical sphere was the most affected (65.1 ± 15.9), while the environment was the least affected (78.2 ± 14.2). The variables that explain the deterioration of the quality of life were: age <50 years, diagnosis of advanced cancer upon admission to the benefit plan management (EAPB), while protective variables were satisfaction with the service and hormonal therapy. Conclusion: it becomes necessary to emphasize and to create a better satisfaction with the service in women under fifty and those who were admitted to the program with an advanced diagnosis. [ABSTRACT FROM AUTHOR]

Introduction: Breast cancer is a growing public health problem and it represents a challenge for health systems.In 2012, in the world, 1.6 million new cases of breast cancer which correspond to 25.0% of all cases in the female population were registered. It is a multifactorial disease with great clinical variety and diverse histological types.Immunohistochemistry is used to classify the tumor, assess the prognosis, improve the diagnosis and guide the management of breast neoplasias. Objective: To review the current literature regarding the immunohistochemical classification of breast cancer with emphasis on diagnosis, prognosis and management of it. Methodology: This review article was performed with 50 articles retrieved, as a result of a comprehensive search strategy of publications from 2000. Outcomes: The main biomarkers used for prognostic or predictive purposes are: histological grade, estrogen-receptor-positive (ER), progesterone (PR) and the presence of oncogene Her2/neu; being these last 3 the foundation of the current immunohistochemical classification.The expression of these molecules is used to refer to tumor lesions; luminal tumors are those that express ER or PR and, not luminal tumors those that lack such receptors. In these subtypes have described and demonstrated differences in response to various therapeut ic modalities.Conclusions: Immunohistochemical classification of breast cancer allows ersonalizing each case and plays a key role in the diagnosis, prognosis and selection of a more effective specific oncological therapy. [ABSTRACT FROM AUTHOR]

Introduction: The importance of sentinel lymph nodes (SL) metastasis at breast cancer patients has been questioned and observation without axillary dissection (AD) associated with adjuvant therapies has been the recommendation in recent years. Objective: To evaluate the macro (MA), micro (MI) and submicrometastasis (SM) of breast cancer in SL, and their impact on the posterior AD. Methods: We reviewed results of biopsies from patients with invasive breast cancer with MA, MI and SM found in the SL operated at our institution between May 1999 and December 2011. Results: We found 134 patients with MA, 33 patients with MI and 30 patients with SM, in a total of 632 patients with invasive breast cancer in those who underwent SL. These were operated 130, 24 and 17 patients respectively. The frequency of no sentinels lymph nodes (NSL) with metastases found on AD was 46.9% (61/130) for MA, 33.3% (8/24) for MI and 23.5% (4/17) for SM. The NSL metastasis from MA modified the TNM in 26.9% (35/130), those from MI in 20.8% (5/24) patients, while the SM only modified in one patient (5.9%). Conclusions: The frequency of lymph nodal involvement in AD is significantly higher in patients with MA. The number of AD without clear therapeutic input is high and increases with decreasing size of SL metastases. The results support to not perform AD in patients with MI and SM in the SL, who received conservative surgery and adjuvant therapy. [ABSTRACT FROM AUTHOR]

The new and important advances in Plastic and Reconstructive Surgery of the breast and specially in reconstruction after breast cancer, have lead the radiologist to observe multiple unknown images we were not used to see. Nowadays, lipofilling has replace other older techniques because of its results and advantages in front to mammary implants, autologous reconstruction and filling with hialuronic acid. However it's a technique with drawbacks or disadvantages we consider important that both surgeons and patients know. [ABSTRACT FROM AUTHOR]

Introduction. Cancer is uncontrolled cell growth regulation by normal cycles that lead to morbidity and mortality of the individual. On a global public health is a growing demographic phenomenon. In particular breast cancer is the leading cause of death in women. This condition is staged by TNM2 classification or histological grade Bloom-Richardson. Previous studies in malignant breast tissue have correlated the expression of TNF receptor 1-á (TNFR1), the phenomenon of apoptosis and expression of TNF receptor 2-á (TNFR2) with the phenomenon of hiperproliferation. Objective. To analyze the expression of the receptors TNFR1, TNFR2, ErbB2 and IL-10 receptor, estrogen and progesterone receptors in breast cancer tissue product made in modified radical mastectomy Specialty Clinic of Women and correlated with TNM stage and Bloom-Richardson histologic grade levels and gland tissue stroma. Material and methods. Immunohistochemistry technique was used to determine the expression of TNFR1, TNFR2, ErbB2 and IL-10 receptor, estrogen and progesterone on tissue samples from breast cancer and for the measurement of optical density unities under the Military Medical School's microscope confocal Axiocam zs -300 Carl Zeiss and correlate these measurements with TNM stage and histological grade Bloom-Richardson. Results. It was observed that the expression of TNFR1 was not associated with TNM stage or the degree of cellular differentiation of Bloom-Richardson. The expression of TNFR2 (normal transmembrane receptor localization in all cells of the hematopoietic system that infiltrate the tumors, except in erythrocytes) was associated with TNM stages in both the glandular portion of the stroma. The IL-10 receptor, showed an inverse association with stromal at TNM stage which agrees with the theoretical basis in this regard published in the literature. The ErbB2, trophic factor related to tissue growth, showed the level of the stromal matrix, an association directly proportional to TNM stage, and statistically significant differences when comparing the TNM2 and TNM4. Estrogen receptors and progesterone receptors, molecules of nuclear localization, showed an association directly proportional to the rate of Bloom-Richardson histological, whose approach to histopathological criteria include the assessment of nuclear pleomorphism or distortion. [ABSTRACT FROM AUTHOR]

Triple negative breast cancer (CMTN, Spanish acronym) is a malignant neoplasm characterized by the absence of expression of estrogen, progesterone and HER2 receptors. Recent studies have shown that CMTN is a heterogeneous group including different neoplasm with different prognosis. However, because genetic profiles are not a standard practice in conventional diagnosis of breast cancer, it is hard to properly identify this breast cancer subtype. CMTN is characterized by its high-incidence epidemiological patterns in African-American and Latin people, and lower incidence in Caucasian people, and constitutes a public health issue due to its high morbidity and mortality. Due to the absence of therapeutic targets, chemotherapy has a key role in treatment, and many efforts are being deployed to seek other combinations of chemotherapy and new drugs, while the current guides do not specify treatment for this type of cancer. This document reviews the epidemiological and clinical characteristics, the potential prognosis factors and some therapeutic strategies against CMTN. [ABSTRACT FROM AUTHOR]

Breast cancer is a common disease and recurrences are common and / or distant affection, 10% have metastatic disease, of which 10% will cause heart disease, such as malignant pericardial effusion may cause cardiac tamponade (CT) acute or subacute and requires rapid diagnosis and treatment. Confirmation through pericardiocentesis occurs in up to 92%. The CT data are presented with low cardiac output and venous congestion, the presentation is extremely serious, the treatment can lead to a good functional status, with survival rates of 10 to 13 months, although one of the main problems is recurrence. Definitive diagnosis is given by the echocardiogram and CT angiography. The ideal treatment to prevent recurrence with less morbidity and hospitalization, is successful if the patient survives, symptoms do not recur and do not require new interventions, without regard to the time the patient survives. Management depends on whether or not important hemodynamic data and if there are not, is conservative. If there are, depends on the long term prognosis of neoplasia: pericardiocentesis, pericardial window or pericardiectomy. We present two cases, one patient required pericardial window and another not. [ABSTRACT FROM AUTHOR]

The gangliosides are glycosphingolipids that are distributed in the organism in different forms. The presence of the ganglioside N-Glycolil GM3 (NGcGM3) has been described in human tumoral cells, that is why it has became an attractive target for the specific antitumoral therapy. This molecule is the main component of the vaccine candidate for breast cancer in clinical trials phase. Lactose acceptor is a key intermediate to obtain this ganglioside by chemical synthesis, the protection of the positions 3',4' of lactose with an isopropiliden group is necessary in the synthesis of lactose acceptors that will be used to form part of oligosaccharides and glycoconjugates. This work is focused in the reaction to obtain 3',4'-lactose-isopropiliden, an intermediate in lactose acceptor synthesis. The reaction conditions were studied and the best results were found working at +1 level of temperature and -1 level of time reaction. The reaction was made in a 5 L reactor and the results were reproducible. The thin layer semi-quantitative chromatography was chosen to quantify the amount of the isomers 3',4' and 4',6'-lactose isopropiliden obtained in the reaction. [ABSTRACT FROM AUTHOR]

Introduction: Although clear guidelines for breast cancer management have been developed and widespread, there are many variations between centers and even among breast cancer surgeons, with impact in clinical outcomes. Use of quality indicators to assess surgical care allows comparison with standards and with other centers and monitoring changes post intervention. Objective: To apply quality indicators to breast cancer surgery and evaluate usefulness. Material and Methods: Selected indicators obtained from EUSOMA 2008 workshop were applied to 213 consecutive surgical treatment breast cancer patients from Hospital Militar de Santiago de Chile between 2006 and 2011, comparing results with previously defined standards. Results: Benign/malignant index in surgical biopsies: 1: 2.27 (minimum standard: 1/2; Optimum: 1/4), patients with complete pathologic report percentage: 99,2% (minimum: 95%, optimum: 98%), breast conserving surgery percentage: 80.20% (minimum: 70%, optimum: 80%), patients with sufficient axillary sampling percentage: 92.4% (minimum: 95%, optimum: 98%), correct axillary dissection indication percentage: 100% (minimum: 95%, optimum: 98%) and patients who underwent single surgery percentage: 90.40% (minimum: 80%, optimum: 90%), most of them ranged between established standards. Conclusion: The use of quality indicators allows breast cancer surgery result evaluation, enabling comparison between centers and established standards, giving objective and reproducible information, helpful to plan process optimization. These or similar indicators are useful in all breast cancer treatment steps and for breast cancer unit accreditation processes. Our indicator values that are under the standard reveal that some specific local indicators are required. [ABSTRACT FROM AUTHOR]

In the first stages of cancer treatment, it was believed that it spreaded by continuity, so the first strategies to treat locally advanced breast cancer were highly aggressive, as well as mutilating. A deeper knowledge of the biology of cancer later resulted in important changes in its treatment, such as the use of neoadyuvant chemotherapy, administered prior to surgical treatment, as an alternative therapy. Initially described by the University of Milan, neoadyuvant chemotherapy has proven to be a better alternative than surgical treatment alone, adjuvant (or postsurgical) chemotherapy and radiotherapy alone or in combination with the previously mentioned techniques. Among its advantages we find an increase in the rate of breast-conserving surgeries and a reduction in the ipsilateral breast tumor recurrence rate. Furthermore, it facilitates breast cancer control and follow-up. On the other hand, its main disadvantage is that it cannot modify some of the disease's prognostic factors, such as the tumor breast relation, multicentric disease, scattered microcalcifications and the coexistence of medical elements which contraindicate radiation therapy. Currently, neoadyuvant chemotherapy is a pillar of the treatment of locally advanced breast cancer and is recommended in order to guarantee a more conservative evolution of the disease. [ABSTRACT FROM AUTHOR]

Background: Breast and cervical cancer are the major cause of cancer death in women in our country. For many years cervical cancer was the leading cause in incidence and mortality from neoplastic diseases. In the last years, the number of cases in these two particular types of cancers has been inverted. In 2002, according to the RHNM, the number of new cases of breast cancer exceeded by more than 1200 new cases compared with the average of previous years. The aim of this study is to compare the incidence these two cancers in the population attending our hospital against the national average reported in the literature. Methods: We performed a retrospective study, in which we reviewed the files of the reports of the Department of Pathology and Cytopathology, of the Hospital Universitario "Dr. José Eleuterio Gonzalez", from January 1, 2000 to December 31, 2009. Results: Of the 107.711 specimens received from January 2000 to December 2009, 1365 (1.26%) were of breast cancer and 1111 (1.03%) of cervical cancer. Breast cancer had a rising distribution, reaching twice the number of diagnosed cases compared with cervix, and this was statistically significant. Conclusions: The evidence presented in this article revealed a clear reversal of the number of cases in these two particular types of cancers. The findings show that while the trend in the incidence of breast cancer has been rising during the period from 2004 to 2009, the incidence of cervical cancer has remained without significant changes and it has been overtaken by breast cancer. [ABSTRACT FROM AUTHOR]

Nowadays, breast reconstruction is part of breast carcinoma treatment; patient's selection plays an important role in satisfactory results. The present paper reports our experience in breast reconstruction with tissue expander/implant and emphasizes the importance of choosing the candidates for this method of reconstruction We review the breast reconstructions realized in a 10 year period (1998-2008) by the same surgeon. We analyzed factors like type of mastectomy, age, time of the reconstruction (immediate or delayed), etiology, tissue expander and implant used complications and patients' satisfaction. All the patients except one underwent breast reconstruction in two stages, first sub-muscular tissue expander, and second reconstruction replacement of tissue expander with implant. A total of 24 breast were reconstructed in 19 patients using tissue expander/implant in a 10 years period, 14 unilateral and 5 bilateral. In terms of complications, they were present n 16,6% cases. The follow up period was between 2 and 10 years. There was only 1 patient with previous quadrantectomy who received radiotherapy (4,1%). In our opinion, breast reconstruction with tissue expander/ implant remains a safe and reliable method with minimal complications and without morbidity at the donor site. [ABSTRACT FROM AUTHOR]

Breast Angiosarcoma is a malignant vascular neoplasm rare in the breast with an incidence of less than 0.05% of all primary tumors in the breast that seat. Given its age of onset is from the third to fourth decade of life, it is disturbing to the occurrence of increasingly early ages. We describe the case of a patient 25 years old with a history of benign breast fibroid from the 17 years that degenerates into a breast angiosarcoma. [ABSTRACT FROM AUTHOR]

Objective: Evaluating the psychometric properties of the Spanish version of the FACT-B scale using Colombian patients suffering from breast cancer. Materials and methods: A sample of 198 patients diagnosed as having breast cancer completed the FACT-B questionnaire and the European Organisation for Research and Treatment of Cancer (EORTC) questionnaire including the general quality of life questions (QLQ-C30) and the breast cancer-specific module (QLQ-BR23). 37 patients from such sample were re-evaluated two weeks after the first evaluation for determining questionnaire test-retest reliability and 50 patients one month after receiving surgical treatment for evaluating sensitivity to change. Statistical analysis involved factorial analysis, structural equation modelling (SEM), correlation coefficients (Pearson and Lin), Cronbach's alpha and ANOVA. Results: 5 factors were identified in exploratory factor analysis (EFA). Confirmatory EFA suggested poor original structure adjustment in this sample. Analysis of correlation between FACT-B and EORTC-QLQ BR23 suggested that these two scales evaluated the same construct. Internal consistency was above 0.65 for all domains; only the functional wellbeing domain (out of the 5 domains) revealed some change regarding results following surgical treatment. Conclusion: The Spanish version of the FACT-B questionnaire used in Colombia had suitable reliability and detected changes in some of the construct's domains following treatment. Content validity must be studied in greater depth. [ABSTRACT FROM AUTHOR]

There is consensus on imaging tests used for diagnosis and management of patients with breast cancer, but there is no clear pattern of monitoring for patients undergoing breast reconstruction with silicone implants. It is more institutionalized the type of tests to perform when we suspect the rupture of the prosthesis. Magnetic Resonance (MR) is recommended as the gold standard on suspicion of silicone breast implants rupture, although it's also accepted the use of ultrasonography as screening test in such patients. We should have a criterion that links the clinic with radiological findings, being the plastic surgeon who incorporates these criteria, along with the other members of the Breast Unit. We present the radiological and clinical results observed after an incidental finding of an intraprosthesic foreign body in a patient undergoing breast reconstruction with silicone implant, during a routine check. [ABSTRACT FROM AUTHOR]

Introduction. The purpose of the study was to evaluate the quality of screening images in full field digital mammography (FFDM) systems located in the Mexico City metropolitan area, and compare it with an optimized film-screen mammography (FSCM) system. In Mexico, the current rate of mortality due to breast cancer constitutes a public health problem and has become the leading cause of death among Mexican women. The primary purpose of mammography is to facilitate detection of breast cancer at an early stage of its natural history. Material and methods. Sampling was performed at 10 mammography services that use full field digital mammography systems of different makes and models. Also, a mammography service with an optimized film-screen mammography system was included. Image quality was evaluated with a manikin and with the American College of Radiology (ACR) scoring system. Discussion. In the evaluation of image quality, FFDM systems obtained lower scores than the FSCM system. Two FFDM systems had image quality lower than that established by the Food and Drug Administration (FDA) and by the ACR. Of the images from the FFDM systems, 40% present artifacts and lack of uniformity during acquisition, processing, or printing; these are the main quality issues in images from FFDM systems. Conclusion. In general, film-age quality in the FSCM system, with a quality control program, was equal or superior to that obtained in FFDM systems without a quality control program. The average glandular dose (AGD) was below the 3.0 mGy limit for both systems (FSCM and FFDM). [ABSTRACT FROM AUTHOR]

Background: The intake of soy isoflavones among women with breast cancer has become a public health concern, because these compounds have weak estrogenic effects. There is little clinical evidence about their safety for patients with breast cancer who are receiving adjuvant endocrine therapy. Methods: For patients who underwent surgery for breast cancer between August 2002 and July 2003 and who were receiving adjuvant endocrine therapy, we examined associations between dietary intake of soy isoflavones and recurrence of breast cancer and death. We measured dietary intake of soy isoflavones at baseline using a validated food frequency questionnaire. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) by means of multivariable Cox proportional hazards regression models. We further stratified the analyses by hormonal receptor status and endocrine therapy. Results: The median follow-up period for the 524 patients in this study was 5.1 years. Among premenopausal patients, the overall death rate (30.6%) was not related to intake of soy isoflavones (HR = 1.05, 95% CI 0.78-1.71 for the highest quartile [> 42.3 mg/day] v. the lowest quartile [< 15.2 mg/day], p for trend = 0.87). Relative to postmenopausal patients in the lowest quartile of soy isoflavone intake, the risk of recurrence for postmenopausal patients in the highest quartile was significantly lower (HR = 0.67, 95% CI 0.54-0.85, p for trend = 0.02). Inverse associations were observed in patients with estrogen and progesterone receptor positive disease and those receiving anastrozole therapy. Interpretation: High dietary intake of soy isoflavones was associated with lower risk of recurrence among postmenopausal patients with breast cancer positive for estrogen and progesterone receptor and those who were receiving anastrozole as endocrine therapy. [ABSTRACT FROM AUTHOR]

Background and objective: About one-third of breast cancer patients experience significant emotional distress. There is a need to establish the severity of psychological distress and to determine associated factors to prioritize targets for psychological interventions. The aim of the present study was to evaluate distress in Lithuanian women with early stage of breast cancer undergoing radiotherapy and to determine factors associated with distress. Material and methods: We assessed 134 early breast cancer patients undergoing outpatient radiotherapy at the Institute of Oncology, Vilnius University between June 2009 and March 2010. The distress level was assessed using the Distress Thermometer (DT) altogether with the problems checklist. Participants also completed Hospital Anxiety and Depression Scale (HADS). Results: The average DT score was 2.67 ± 0.212. Twenty percent of patients indicated distress levels of 5 or more. Sixty percent of women of age 70 and over and eighty percent of married women reported severe distress (DT score = 8). Distress scores moderately correlated with the HADS depression scores. From the list if problems only family, emotional and physical problems were significantly associated with distress. Conclusions: Twenty percent of breast cancer patients undergoing radiotherapy experienced significant distress. Women of older age and married showed a greater vulnerability. The distress was related with family, emotional and physical problems. [ABSTRACT FROM AUTHOR]

Breast cancer is an important health problem particularly in developed countries. The psychological distress associated with such health condition is an important aspect of the problem, and studies show that women suffering from this type of cancer require specialized psychological care. An ongoing 12-year Australian experience with a supportive-expressive therapy group is presented and discussed, including the use of a mixed modality of participation, both presential and via teleconference, to overcome Queensland's geographical distances and allow different women to benefit from this service. [ABSTRACT FROM AUTHOR]

The aim of the investigation was to know the degree of relation and the predictive capacity that the psychological variables, have to the quality of life in patients with breast cancer. 50 women in different phases of treatment participated. The Life Quality Inventory and Health (InCaViSa), the Coping Strategies Scale MOOS, the Resiliency Scale SV-RES, and the Multidimensional Scale of Religiousness/Spirituality were applied. A positive and significant relation between the quality of life with the coping and the resiliency was confirmed. The coping style by logical analysis and fortress predicted the quality of life. The conclusion is that the coping and the resiliency included in intervention programs can increase the quality of life in patients with breast cancer. [ABSTRACT FROM AUTHOR]

Objective. To estimate the mortality age-standardized rates (ASR) for breast and cervical cancer from 2000-2007 and explore social indicators that explain the variability of rates in Antioquia. Material and Methods. The ASR was estimated by the direct method and linear regression was used to relate social indicators with rates by subregion. Results. Breast and cervical cancer mortality ASRs in Antioquia were 11.3 and 9.1 per 100 000 woman-years respectively. In Medellin, the breast cancer mortality ASR was 12.5, 1.8 times the rate of cervical cancer. A decrease of cervical cancer ASR between 2000 and 2007 was observed in Medellin (p-value=0.03) but not in the rest of Antioquia. Cervical cancer mortality ASR was related to the percentage of poverty (p-value=0.0003). Conclusions. Mortality due to these neoplasms has remained constant in Antioquia. The wide variation in mortality from cervical cancer between regions seems to be associated with poverty. [ABSTRACT FROM AUTHOR]

Objective. Establish provider delay for breast cancer and related factors. Material and Methods. 1 106 women with breast cancer were approached in health care institutions of Bogota, Colombia. According to the history of first consultation, we established diagnostic and treatment incidence rates, which were compared for different variables. A Cox hazard model was established. Results. Median time from first consultation to diagnosis and start of treatment were 91 days (CI95%:82-97 days) and 137 days (CI95%: 127-147 days) respectively. Diagnosis and treatment were faster in women with higher educational level, affiliated to the "special" social security, with better socioeconomic conditions and in screening-detected breast cancers. Conclusion. Provider delay is excessive. There are clear inequities in access to services and a need of reducing the waiting times for women with a suspicion of breast cancer. [ABSTRACT FROM AUTHOR]

Breast cancer has become an important health risk for women worldwide. The important growth of breast cancer-related deaths within those caused by malign tumors throughout the globe went past the 460 000 in 2008, becoming the deadliest disease worldwide. Demographic changes and lifestyles have modified the population exposure to risk factors of maladies such as cancer, and since 1980 breast cancer mortality has remained on an upward tendency, surpassing cervical cancer in 2006. After analyzing mortality rates along 30 years in Mexican women 25 or more years old, differences by state and age-groups are apparent. Although this cause of death has been associated with a highest regional development, some changes are taking place, since the number of deaths is also growing among women of less-developed regions in the country, as showed in this work. Mexico faces an evident challenge regarding breast cancer . Our country requires to join efforts and implement programs aimed at teaching self-care of health among the population, promoting healthier lifestyles, and reshaping our diagnostic infrastructure to achieve earlier detection and provide proper treatment. [ABSTRACT FROM AUTHOR]

Progesterone is an ovarian steroid hormone that is essential for normal breast development during puberty and in preparation for lactation and breastfeeding. The actions of progesterone are primarily mediated by its high-affinity receptors, which include the classical progesterone receptor (PR)-A and -8 isoforms, located in diverse tissues, including the brain, where progesterone controls reproductive behavior, and the breast and reproductive organs. Progestins are frequently prescribed for contraception or during postmenopausal hormone replacement therapy, in which progestins are combined with estrogen as a means to block estrogen-induced endometrial growth. The role of estrogen as a potent breast mitogen is undisputed, and inhibitors of the estrogen receptor and estrogen-producing enzymes (aromatases) are effective first-line cancer therapies. However, PR action in breast cancer is grossly understudied and remains controversial. Herein, we review existing evidence and discuss the challenges to defining a role for progesterone in breast cancer. [ABSTRACT FROM AUTHOR]

Background: Recurrence of breast cancer has been defined as the presence of a new local or distant tumor after a year of initial treatment. The aim of this study was to assess the prevalence and characteristics of breast cancer recurrence in women diagnosed with breast cancer in northwestern Mexico. Methods: We designed a cross-sectional study in a cohort of women with breast cancer to determine the prevalence of disease recurrence. We analyzed age, tumor stage, axillary lymph node status, type of tumor, histological grade, estrogen receptor (ER), progesterone receptor (PR) and protein HER2, treatment used and death. Results: We included 397 women, with 23% of recurrence in a follow up to five years. There was a higher frequency of recurrence in those cases where diagnosis was stage III of the disease (48%; OR = 3.54; p = 0.0001). Axillary lymph node metastases (21%; OR = 1.12; p = 0.05) and ER positive (19%; OR = 0.64; p = 0.07) and protein HER2 (28%; OR = 1.53; p = 0.08). Of 121 women who received endocrine therapy, 35 had recurrence (29%; OR = 1.63; p = 0.04) and 15/30 women who received trastuzumab presented recurrence (50%; OR = 3.89; p = 0.01). Death was reported in 77% of cases of disease recurrence (OR = 12.66; p = 0.001). Conclusions: In the late stage of breast cancer, HER2-positive expression in women with ER positive, axillary node involvement and metastases is associated with a higher frequency of recurrence and death. [ABSTRACT FROM AUTHOR]

La Sra. B, mujer de 45 años de edad, casada, premenopáusica, fue diagnosticada de trastorno depresivo mayor hace 10 años y posteriormente tratada con éxito durante 12 meses con fluoxetina (20 mg/día), sin efectos secundarios significativos. Permaneció sin síntomas depresivos durante los siguientes 8-9 años. Hace 1 año se le diagnosticó un cáncer de mama invasivo con receptor de estrógeno positivo y se sometió a tratamiento quirúrgico, seguido de quimioterapia y posterior radioterapia. La Sra. B ha sido tratada con tamoxifeno (un modulador selectivo de los receptores de estrógenos) durante los últimos 6 meses, para reducir la probabilidad de recurrencia del cáncer de mama. Ha tolerado el tamoxifeno relativamente bien, excepto por la aparición de sofocos moderadamente molestos, para los que no ha recibido tratamiento farmacológico. Sin embargo, hace poco tiempo, desarrolló síntomas depresivos recurrentes y solicitó tratamiento a su psiquiatra. ¿Cuáles son los agentes farmacológicos eficaces contra la depresión y los sofocos en mujeres con cáncer de mama? ¿Podría alguno de dichos fármacos alterar la eficacia del tamoxifeno o aumentar su toxicidad a través de una interacción medicamentosa? [ABSTRACT FROM AUTHOR]

Se compara los resultados del tratamiento de cáncer de mama en las mujeres posmenopaúsicas con tamoxifeno solo y con tamoxifeno más ciclofosfamida, doxorrubicina y fluorouracilo (CAF). De un estudio de casi 1,500 mujeres a lo largo de 13 años, se concluye que el tratamiento con CAF más tamoxifeno es más efectivo que el tratamiento con tamoxifeno solo.

Se presentan reseñas de los artículos "Tasas de progresión del grosor de la íntima-media carotídea y el diámetro de la adventicia durante la transición a la menopausia" de S. R. El Khoudary y otros, "Entendimiento de la suspensión de la terapia endocrina coadyuvante oral en mujeres con cáncer de mama invasor positivo para receptores hormonales casi cuatro años después del diagnóstico" de R. J. Bell y otros y "Mujeres de mediana edad: síntomas relacionados con la transición a la menopausia y la posmenopausia temprana y la calidad de vida" de C. A. Greenblum y otros.

Se presenta una revisión del artículo "Longer Therapy, Iatrogenic Amenorrhea, and Survival in Early Breast Cancer" de varios autores, incluyendo S.M. Swain, J-H Jeong, C.E. Geyer y J.P. Costantino y publicado en la revista "New England Journal of Medicine" en el año 2010.

Se presenta una reseña del estudio "Competing causes of death from a randomized trial of extended adjuvant endocrine therapy for breast cancer," por J.A. Chapman, D. Meng y L. Shepherd.