Introduction: Breast cancer is a relevant public health issue, and its incidence has increased in patients aged less than 50 years. This population usually receives a late diagnosis, which contributes with the poor prognosis of the condition. Objective: To assess the percentage of patients diagnosed with breast cancer before the age of 50 and compare them with the group that was diagnosed after the age of 50. Results: The general mean age was 54 years; 75.68% of the patients were younger than 50 years, aged between 40 and 49 years. Among the ones who were younger than 50, 35.14% were in stage T4; 55.41% underwent neoadjuvant chemotherapy; 16.22% presented distant metastasis; and 10.81%, locoregional metastasis. On the other hand, among those aged more than 50, 22.71% were in stage T4; 30.68% underwent neoadjuvant chemotherapy; 11.36% presented distant metastasis; and 6.82%, locoregional metastasis. Conclusion: Breast cancer in women aged less than 50 years in a Mastology service in the Federal District has been a matter of concern, for presenting more advanced tumors at the time of diagnosis; screening is still debatable.
Objective: A systematic review was carried out on the comparative analysis of the degree of satisfaction of patients undergoing breast-conserving surgery for the treatment of breast cancer, with and without oncoplastic surgery, in addition to performing a meta-analysis to integrate the results of studies carried out with different questionnaires to arrive at a summary measure that could homogenize and categorize this complex comparative analysis arising from such diverse quantitative collection methods. Methods: Systematic review with literature searches in MEDLINE (by PubMed), EMBASE, ClinicalTrials, Scopus, Web of Science, BVS, and OpenGrey. The Joanna Briggs Institute tools were used to evaluate the methodological quality of the studies. Data were summarized through meta-analyses using a random effects model and considered relative risk (RR) measures and their confidence intervals (95%CI). Results: After eligibility assessment, we included 6 studies in the systematic review and in the quantitative analysis, encompassing a total of 1,110 patients. The studies included seemed to have an overall good methodological quality. There was no statistically significant difference in the aesthetic outcome between women who underwent oncoplastic and conservative surgery (RR=0.98; 95%CI 0.91–1.04). Patients undergoing conservative surgery with oncoplastic surgery have more advanced staging, greater tumor size, and resected specimen weight compared to classical surgery. In addition, a higher frequency of breast tumor location is unfavorable to the best aesthetic result (central, medial, or inferior). Conclusion: The degree of patient satisfaction with conservative surgery, with or without oncoplastic surgery, is similar between the groups. The time elapsed from the surgery to the measurement of the outcome, and the tumor conditions seem to have an impact on this result. There is no specific or standardized questionnaire to assess patient satisfaction with conservative surgery, bringing limited and controversial results. Standardization in the quantification of these data in further studies is suggested.
A systematic review and meta-analysis were conducted to evaluate the benefit of an axillary surgical approach on overall survival and secondarily of breast surgery amongst patients with metastatic breast cancer which is considered to be an incurable disease. However, an axillary surgical approach showed no association with overall survival in patients with metastatic breast cancer. The true impact of locoregional therapies on longterm outcomes remains unknown, and randomised clinical trials are needed.
Objective: To evaluate the benefit of an axillary surgical approach on overall survival in patients with metastatic breast cancer. Summary background data: Metastatic breast cancer at diagnosis is considered to be an incurable disease, and systemic treatment is indicated. However, several retrospective studies have shown that local treatment is an independent factor in improving overall survival, but this issue is still controversial. Methods: Systematic review with literature searches in MEDLINE (by PubMed), EMBASE, Clinical Trials, Scopus, Web of Science, SciELO, Lilacs, Google Scholar and Proquest electronic databases, and gray literature without restrictions on date, language or study design. Study selection and data extraction were performed independently by two authors. Data were summarized through meta-analyses using a random effects model and considered hazard ratio (HR) measures and their confidence intervals (95%CI). Results: After eligibility assessment, we included 16 studies in the systematic review, encompassing a total of 16,692 patients. Twelve studies were used in the quantitative analysis. The studies included in this review seemed to have overall good methodological quality. There was no association between an axillary surgical approach and overall survival (HR= 0.82; 95%CI 0.60-1.13). We identified as a secondary finding that there was a benefit from a breast surgical approach related to overall survival in patients with metastatic breast cancer (HR 0.70; 95%CI 0.60-0.82). Conclusion: An axillary surgical approach showed no association with overall survival in patients with metastatic breast cancer, but the breast surgical approach seemed to show a benefit in terms of overall survival. The true impact of locoregional therapies on long-term outcomes remains unknown, and randomized clinical trials are needed.
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