European Journal of Breast Health (Eur J Breast Health) is an international, scientific, open access periodical published by independent, unbiased, and double-blinded peer-review principles. It is the official publication of the Turkish Federation of Breast Diseases Societies, and Senologic International Society is the official supporter of the journal.

This study aimed to evaluate the association of axillary lymph node ratio (LNR) and number of positive lymph nodes (pN) with the risk of breast cancer recurrence and death. Methods: A retrospective cohort study of node-positive stage II e III breast cancer patients diagnosed and treated between 2008 and 2009 at the Brazilian National Cancer Institute (INCA), Brazil. Overall and disease-free survival curves for number of positive lymph nodes (pN) and lymph node ratio (LNR) risk groups were constructed using the Kaplan-Meier method and compared by the log-rank test. Multivariate analysis was performed using stepwise forward Cox regression models. Results: In total, 628 women with node-positive breast cancer were included. Most patients (69.5%) had advanced clinical stage tumors (≥ IIB). The median follow-up was 58 months (range: 3-92 months). The adjusted recurrence hazard of pN2 and pN3 patients was 2.47 (95% Confidence Interval [CI] 1.72-3.56) and 2.42 (1.62-3.60), respectively, compared to pN1 patients (p<0.001), while the hazard of intermediate (0.21-0.65) and high-risk (>0.65) LNR was 2.11 (1.49-3.00) and 3.19 (2.12-4.80), respectively, compared to low-risk LNR (≤0.20) patients (p<0.001). On the other hand, the hazard of death of pN2 and pN3 patients was 2.17 (1.42-3.30) and 2.41 (1.53-3.78), respectively (p<0.001), and the hazard of intermediate (0.21-0.65) and high-risk (>0.65) LNR patients was 1.70 (1.13-2.56) and 2.74 (1.75-4.28), respectively (p≤0.001). Conclusion: Higher pN and LNR were associated with shorter disease-free survival and overall survival times.

No abstract

97 Background: To reduce arm morbidity the sentinel lymph node biopsy was implemented in the breast cancer treatment. The aim of this study was to investigate the arm morbidity after sentinel lymph node biopsy or axillary lymph node dissection. Methods: This is a prospective cohort study of women who underwent surgical treatment of breast cancer at a single institution. Arm and shoulder morbidity were measured before, 1 and 6 months after the operation. Analyses were performed to compare morbidity between sentinel lymph node biopsy (SLND) and axillary lymph node dissection (ALND). This study obtained approval from the National Cancer Institute research and ethics committee. Results: Were included 203 patients and, during the study, 6 were excluded and there was 23 losses of follow-up. The average age of women was 58 years (DP=13). SLND was made in 31,6% with an average of 3 lymph nodes removed. Among those submitted to ALND, the average lymph node removed was 18 (p<0.0001). After 45 days of surgery, the incidence of arm morbidity was: 23% of shoulder restriction (ALND 22%, SLND 1%, p<0.001); 28% of axillar web syndrome (ALND 24%, SLND 4%, p<0.001); 38% of seroma (ALND 32%, SLND 6%, p<0.001); 5% of arm edema (ALND 4%, SLND 1%, p<0.001). In the final evaluation occurred 6 months after the surgery, it was observed de following incidence: 4% of shoulder restriction (ALND 3%, SLND 1%, p=0.371); 18% of arm pain (ALND 12%, SLND 6%, p=0.460); 18% of axillar web syndrome (ALND 16%, SLND 2%, p<0.002); 5% of arm edema (ALND 4%, SLND 1%, p=0.417). Conclusions: After 45 days of surgery, patients with SLND has less arm morbidity compared with patients submitted to ALND. After 6 months, it was observed less incidence of arm symptoms and only axillary web syndrome were more incident in patients with axillary dissection.

No abstract

A pandemia provocada pelo COVID-19 trouxe inúmeras mudanças na sociedade afetando os serviços de saúde, tanto pela demanda não prevista para o atendimento, quanto pela necessidade de instituir e manter o tratamento regular de diversas condições de saúde. É necessário discutir os benefícios de iniciar, manter ou suspender o tratamento do câncer de mama durante a pandemia. Esse artigo tem como objetivo descrever as recomendações para abordagem das pacientes que necessitam de tratamento cirúrgico para o câncer de mama com reconstrução mamária no Hospital do Câncer III do Instituto Nacional de Câncer José Gomes de Alencar, no período de pandemia do Sars-CoV-2/Covid-19. Em um cenário de grande demanda e dificuldades de diagnóstico e acesso, o retardo de um procedimento previsto pode fazer a diferença para o desfecho final. Toda a equipe multidisciplinar deve estar informada dos cuidados necessários e participar de todos as etapas do atendimento. O fornecimento de informação e compartilhamento na tomada de decisões são fundamentais.

93 Background: Male breast cancer is an uncommon disease and the therapy is mainly based on what is know from female breast cancer. Objective: To investigate the clinicopathologic characteristics of male breast cancer and the overall survival in a single institution. Methods: The clinical data and survival status of 75 male breast cancer treated in a Brazilian public cancer hospital from 2000 to 2009 were collected. The association with clinicopathological characteristics and overall survival was analyzed using Kaplan-Meier curves and the Cox proportional hazards regression (enter method) was used to assess survival differences after adjusting for confounders. The study was approved by National Cancer Institute Research and Ethics Committee (number 128/11). Results: The median patient age was 64 years (range 33-86). Estrogen receptor (ER) was positive in 58 (77.3%) patients, while progesterone receptor (PR) were positive in 47 (62.7%). Histology type was ductal infiltrant carcinoma for 57 (76.0%) and 51 (68.0%) patients underwent surgery. The median follow-up period was 43,1 months (range 2.7-147.8). The median survival from the diagnosis of breast cancer was 97.0 months (95%CI 53.6 -140.4) with a 61.7% 5-year overall survival (OS). In the final Cox regression model, independent factors associated with increased risk of death were metastasis at diagnosis (HR = 18.1; 95%CI: 5.9-55.2), ≥ 65 years old (HR = 4.3; 95%CI: 1.7-10.5); tumor stages ≥ IIb (HR = 3.5; 95%CI: 1.3-9.7) and smoking (HR = 1.6; 95%CI: 1.04-2.6). Conclusions: Invasive ductal carcinoma is the main pathologic type. The median survival from the diagnosis of breast cancer was 97.0 months and metastasis at diagnosis, patient age, tumor stage and smoking are independent prognostic factors.

No abstract