PURPOSE To provide expert guidance to clinicians and policymakers in resource-constrained settings on the management of patients with late-stage colorectal cancer. METHODS ASCO convened a multidisciplinary, multinational Expert Panel that reviewed existing guidelines, conducted a modified ADAPTE process, and used a formal consensus process with additional experts for two rounds of formal ratings. RESULTS Existing sets of guidelines from four guideline developers were identified and reviewed; adapted recommendations from five guidelines form the evidence base and provided evidence to inform the formal consensus process, which resulted in agreement of ≥ 75% on all recommendations. RECOMMENDATIONS Common elements of symptom management include addressing clinically acute situations. Diagnosis should involve the primary tumor and, in some cases, endoscopy, and staging should involve digital rectal exam and/or imaging, depending on resources available. Most patients receive treatment with chemotherapy, where chemotherapy is available. If, after a period of chemotherapy, patients become candidates for surgical resection with curative intent of both primary tumor and liver or lung metastatic lesions on the basis of evaluation in multidisciplinary tumor boards, the guidelines recommend patients undergo surgery in centers of expertise if possible. On-treatment surveillance includes a combination of taking medical history, performing physical examinations, blood work, and imaging; specifics, including frequency, depend on resource-based setting. Additional information is available at www.asco.org/resource-stratified-guidelines .

Objetivo: Conocer las conductas preventivas para el cáncer de mama en mujeres mayores de 20 años en la Ciudad de Sullana mediante técnicas de auto examen de mama y mamografias. Pacientes y Metodos: Se encuestaron 100 mujeres mayores de 20 años en Sullana mediante ramdomizacion de tres grupos socioeconómicos a través de una encuesta y los resultados se analizaron en Epi-Info mediante bioestadística básica descriptiva. Resultados: La mediana de la edad fue de 30-34 años, 58% tienen entre 2-5 hijos, 6% son nuliparas, el 16% de mujeres mayores de 40 años alguna vez tuvo una mamografia y solo el 7% de estas mujeres se realizan una mamografía anual. El 57% nunca se realizó un autoexamen de mama, sin embargo el 56% refiere conocer la utilidad del autoexamen de mama, 43% conocen la técnica pero solo un 8% lo practica correctamente. Conclusiones: Mas de la mitad de la población encuestada nunca se realizó un autoexamen de mama, y del 56% de mujeres que afirman conocer la utilidad de este examen solo el 8% lo realiza correctamente, lo que nos indica una desinformación para detección temprana de cáncer de mama, además solo un 7% se realiza una mamografía anual probablemente por desconocimiento de la utilidad, por el costo o por que en Sullana no hay mamógrafo a pesar de tener 56500 mujeres en edad fértil, creemos que urgen campañas de información sobre el tema además de ofertar mamografías a esta población. ( Rev Med Hered 2002; 13: 131-134 ).

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180 Background: The TN BC is the most agressive subtype. Previous studies suggested that DFS of women with TN-BC is shorter than any other subtype and they demonstrated racial differences. The behaviour of these tumours are characterised by poor prognosis affecting mostly African American young obese women. Our goal is to determine the incidence of TN in non metastatic (NM) BC, the recurrence rate (RR), the patterns of recurrence by anatomic region and the DFS. Methods: We reviewed the medical records of patients with BC diagnosed between Jan/2000 to Dec/2005 at Almenara Hospital in Lima, Peru. There were a total of 1042 patients with BC; of them 215 were identified as TN NM BC according to IHC ER, PR, and Her2/neu negatives. We collected the clinical data including age, menopausal status, staging, hormone receptor status as well as Her2/neu status. The data were analized by statistic software SPSS v. 17.0. Results: The incidence of TN NM BC were 20.6% (215); of them 18.6% (40) patients had recurrences. The median age of recurrence were 52.5 years (31-93); the median DFS were 27 months, with a median follow-up of 64 months. According to inicial staging the recurrences were 7.5% (3); 32.5% (13); and 60% (24) respectively for patients with stages I, II and III. Almost one third (35%) of patients with recurrences were lymphatic node negative at diagnosis after mastectomy. The most frequent involved organs were visceral (lung=12, liver=3) 37.5% (15); bone 25% (10); skin 20% (8); CNS 12.5% (5) and contralateral breast 5% (2). There were four nuliparus women two of them had skin recurrence and the others two had bone metastasis. Conclusions: TN NM BC constitutes 20.6% of all BC in our institution; the majority of relapses were stage III (60%). The median DFS for recurrence were 27 months and the most frequent sites involved were visceral (37%) and bone (25%). 12.5% of recurrences were to CNS and one third of the patients were lymph node negatives. This is to our knowledge the first study of patterns of recurrence in TN nonmetastatic BC in a Latino population. The incidence of TN-BC which is close to African-American population (25%).

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