Objetivo: Verificar a acurácia da codificação dos dados de carcinoma ductal in situ dentro do Registro de Câncer de Base Populacional de Goiânia, Goiás -Brasil. Métodos: Estudo ecológico de série temporal de casos codificados como carcinoma in situ da mama, pelo programa (ONCOSIS) do Registro de Câncer de Base Populacional de Goiânia, entre 1994 e 2010. Posteriormente realizou-se busca individual dos laudos histopatológicos de CDIS. Resultados: De 376 casos de CDIS, foram excluídos 115 casos após a revisão dos laudos anatomopatológicosas. As exclusões referem-se a carcinoma lobular in situ (21), Doença de Paget (4), carcinoma invasor (08); CDIS associado a carcinoma invasor (14); microinvasor (21), pacientes com endereço fora de Goiânia e dados duplicados (46). Conclusão: Há um grande número de casos que precisam ser recodificados, alterando o banco inicial. A padronização de laudos e o treinamento dos coletadores são etapas importantes para que não haja informações desconhecidas ao transcrever o CDIS para as fichas do RCBP.PALAVRAS-CHAVE: DCIS; epidemiologia; neoplasias da mama; carcinoma in situ; carcinoma intraductal não infiltrante. RESUMO ABSTRACTObjective: To verify data-coding accuracy for ductal carcinoma in situ at the Goiânia population-based cancer registry in the Brazilian state of Goiás. Methods: Ecological time series analysis of cases coded as ductal carcinoma in situ in the state cancer database (ONCOSIS), considering data from the Goiânia population-based cancer registry, from 1994 to 2010. Results: Of 376 cases originally coded as ductal carcinoma in situ, 115 were excluded following a review of the pathology reports. These exclusions referred to cases of lobular carcinoma in situ (n=21), Paget's disease (n=4), invasive carcinoma (n=08), ductal carcinoma in situ associated with invasive carcinoma (n=14), microinvasive carcinoma (n=21), records on non-residents in Goiânia, and duplicated data (n=46). Conclusion: Many cases needed recoding and, as a consequence, altered the initial database. Standardizing pathology reports and training data collection staff are crucial steps to avoid omissions and errors when transcribing cases of ductal carcinoma in situ in a population-based cancer registry database.
Objective: The aim of this study was to characterize chronic pain in women undergoing surgical treatment for breast cancer. Methods: This is a cross-sectional, retrospective, hospital-based study. All breast cancer patients undergoing clinical follow-up at a referral hospital in central Brazil were screened. Women with chronic pain after surgical treatment of breast cancer, defined by the presence of pain after 3 months of surgery, were included in the study. The questionnaires were applied by the responsible researcher in the form of an interview, which took place in a dedicated office. The McGill Pain Questionnaire (MPQ) and the visual analog scale (VAS) were used. Results: In all, 99 patients were interviewed, of which 46 were included in the study. Most patients were between 50 and 59 years old (39.1%), were married (45.7%), were housewives (58.7%), and had completed high school (45.7%). Arterial hypertension was the most prevalent clinical comorbidity (41.3%), followed by diabetes mellitus (13.0%). A total of 45 (97.8%) patients underwent sentinel lymph node biopsy, but 22 (47.8%) required axillary lymphadenectomy for some oncological reason; 35 (76.0%) patients underwent chemotherapy (neoadjuvant or adjuvant), and 40 underwent radiotherapy (87.0%). According to the VAS, the mean pain intensity was 5.5 (±2.6). Most patients reported worsening pain with movement, with 26 (52.2%) “sometimes”, and another 14 (30.4%) “always”. In the MPQ, there was a predominance of the sensory domain among the characteristics of chronic pain. Relaxation techniques (52.2%), stretching (50.0%) and deep breathing (47.8%) were the most mentioned therapeutic measures. Drug treatment was reported by 21 (45.7%) women and acupuncture by only one. Conclusion: In the analyzed population, chronic pain was observed with moderate intensity and with a predominance of sensitive characteristics according to the MPQ. The development of strategies for prevention, early diagnosis, and multidisciplinary treatment can help reduce chronic pain in breast cancer survivors.
ObjectiveDescribe and characterize the forms of presentation and manifestation of the cord present in the Axillary Web Syndrome.Materials and MethodsAfter a favorable opinion from the Research Ethics Committee of the Federal University of Goiás, the construction of items for the Axillary Web Syndrome Classification Scale began, based on the search for concepts involved in its diagnosis. The various steps of construction, application and validation of the instrument occurred from April 2020 to August 2021. The research took place at the outpatient clinic of Mastology at Hospital das Clínicas (Goiás). In the evaluation position: supine, upper limb ipsilateral to the breast operated in abduction, extension and external rotation of the shoulder, extension and supination of the elbow, extension of the wrist and fingers, information on the specific characteristics of the cord was recorded.ResultsThe means presented by the evaluators were almost identical for the variables related to the characterization of the cord, indicating a strong correlation, Cronbach's alpha was 0.894 for evaluator 1 and 0.879 for evaluator 2, indicating strong internal consistency. Inter-rater agreement was 100% (p>0.001) for almost all variables evaluated, with the lowest Kappa coefficient (0.77 p>0.001) for “Length”.ConclusionA consensus on classification criteria can be useful among researchers and practitioners. The fibrous cord classification items compiled in this study address its forms of presentation and manifestation and contribute to standardizing the assessment and classification of Axillary Web Syndrome.
O carcinoma ductal in situ (CDIS) tem sido detectado com maior frequência nas últimas décadas a partir do rastreamento mamográfico. O objetivo do presente estudo foi revisar os aspectos epidemiológicos do CDIS. Foi realizada uma revisão bibliográfica narrativa enfocando os aspectos do CDIS: epidemiologia, para discussão a respeito dos subtipos; história natural; rastreamento; e sobrevida. Foi possível verificar que o CDIS é atualmente considerado como uma lesão precursora do câncer de mama e apresenta aumento considerável e desigual em sua incidência entre países desenvolvidos e em desenvolvimento, devido, provavelmente, à inclusão dos programas de rastreamento mamográfico. Há controversas quanto ao benefício ou não da detecção, do diagnóstico, do tratamento e da sobrevida de pacientes que apresentam o CDIS. Conclui-se que o aumento considerável da incidência do CDIS levanta importante discussão sobre a necessidade real de seu diagnóstico, bem como do seu real significado biológico. PALAVRAS-CHAVE: carcinoma intraductal não infiltrante; neoplasias da mama; epidemiologia; incidência; carcinoma in situ.
Objective: The aim of this study was to discuss the physiotherapeutic approach to around the scar tissue release in a patient with axillary web syndrome (AWS). Methods: A case report was conducted at the Mastology Program Outpatient Clinic of the Hospital das Clínicas/CORA (Advanced Center in Breast Diagnosis) at the Federal University of Goias. The study was approved by the Ethics and Research Committee of CEP-HC/UFG (opinion Nº 4,217,374), and the participant signed an informed consent form. Case description: A 71-year-old patient was included in the 5th postoperative (PO) period with modified radical mastectomy and left axillary lymphadenectomy for the treatment of breast cancer. She was referred to the physiotherapy service due to edema, pain, and associated to around the scar retraction. The restriction of movement of the homolateral limb was diagnosed with AWS. The approach included manual therapy through tissue mobilization, combined with lymphatic drainage and the use of functional bandages in the surgical plastron and cord region. Result: After three sessions, there was an improvement in edema and to around the scar retraction, gain in amplitude, and reduction in pain, regardless of the presence of a single fibrous cord. Conclusion: Tissue release through techniques aimed at myofascial mobilization, associated with complementary therapies, improved the malleability of the tissue, organized the deposition of collagen fibers, and lubricated the connective tissue, preventing and treating fibrosis, the factors involved in the etiology of SARS. This physiotherapeutic approach in the immediate PO proved to be beneficial in limiting dysfunction and optimizing recovery. More research is needed to understand the clinical aspect and possibilities of interventions related to AWS.
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