Adenoid cystic carcinoma of the breast (ACCb) is a rare type of breast cancer. The treatment is not consensual. The authors report two cases of ACCb.Case 1: A 59-year-old woman with T1bN0M0, who went for lumpectomy and adjuvant radiation therapy (RT) (60 Gy in 30 fractions);Case 2: A 43-year-old woman, who went for modified radical mastectomy with T3N1M0, and underwent adjuvant chemotherapy, and a sequential regimen with antracyclin and taxane, prior to adjuvant RT (50 Gy/25 fractions).
Leptomeningeal disease (LMD) represents a devastating complication of advanced breast cancer (ABC), with survival of <5 months with multimodal treatment. The role of endocrine therapy (ET), due to its favorable toxicity profile and first-line indication in luminal ABC, appears promising in the setting of LMD, where symptom stabilization and quality-of-life preservation are the main goals; however, evidenced-based data are lacking. We conducted a thorough review of published evidence, aiming to investigate the role of ET in LMD treatment in luminal ABC. Twenty-one of 342 articles, evaluating 1302 patients, met inclusion criteria. ET use was rarely reported. New targeted agents show CNS activity. Research is lacking on the role of ET and targeted agents in BC-LMD treatment.
Background: Breast cancer is the most commonly diagnosed cancer in women, mainly at an early stage, allowing treatment with curative intent. Aromatase inhibitors are widely used in the adjuvant treatment of oestrogen receptor-positive breast cancer, mainly in postmenopausal women. The most frequent adverse events associated with these therapies are musculoskeletal symptoms and an increased risk of bone fractures. Cutaneous adverse events have been rarely described. Sweet’s syndrome can present as an idiopathic disorder in addition to being malignancy-associated or drug-induced. Case presentation: We report the case of a 69-year old woman, diagnosed with early stage breast cancer, who underwent breast-conserving surgery, followed by adjuvant radio and endocrine treatment with letrozole 2.5 mg daily, for a foreseeable duration of 5 years. Three months after starting letrozole, she presented with sudden fever and exuberant and painful erythematous skin papules and plaques on her upper body. After a full work-up and exclusion of other potential causes, a skin biopsy confirmed the presence of dermal oedema and a diffuse neutrophilic infiltrate, suggesting Sweet’s syndrome. After discontinuation of letrozole and treatment with corticosteroids, the patient fully recovered. She resumed adjuvant treatment with tamoxifen, without symptom recurrence. Conclusions: Sweet’s syndrome is a rare condition and an association with aromatase inhibitors has not been previously reported. Although its occurrence has already been observed in the onset of malignancies such as breast cancer, aromatase inhibitors must be added to the list of potential causes of drug-induced Sweet’s syndrome.
Objectives: Breast cancer is the cancer with the highest incidence in women in Brazil. The revelation of this diagnosis is considered a crucial moment, responsible for uncertainties and even affecting the doctor–patient relationship. Although the communication of bad news is one of the most frequent practices among physicians, difficulties are common. The aim of this study was to evaluate the influence of the communication in the diagnosis of breast cancer and the repercussions on the treatment, using the parameters as suggested by the Centro Avançado de Diagnóstico de Câncer de Mama (CORA/ HC-UFG) in Goiânia-GO. Methodology: This qualitative and integrative study was conducted in the following databases: PubMed, SciELO, and MedLine with six selected articles. The keywords used were “communication,” “diagnosis,” “breast cancer,” “adherence to treatment,” and “doctor–patient relationship.” Based on the results, a comparison was made with the one carried out in the CORA/HC-UFG. Results: Through the analysis of the articles, it was observed that the no tification of the diagnosis of cancer is considered a critical moment and how professionals notify patients directly interferes in the relationship of the patients with the diagnosis itself. Thus, it is up to the professionals to provide psychological and informative support at the time of diagnosis in order to reduce pessimistic feelings and to avoid abandoning the medical–hospital follow-up. In addition, when analyzing the care provided at CORA, it was noted that the adoption of a more humanized and multiprofessional communication, with the help of the psychological team, it was noticed, in agreement with the studies, a better acceptance and treatment adherence. Conclusion: The notification of cancer should be done in the most empathetic way possible, using techniques of psychology and communication, so that the patient receives information about his health situation in a welcoming manner. Furthermore, although the diagnostic communication is a medical act, the presence of a psychologist to support the patient has shown benefits.
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