Of the various histological types, the most common was squamous cell carcinoma and the least common was large cell carcinoma. Most cases presented advanced stages at the moment of diagnosis, and less than 30% of the cases presented early stages. This accounts for the low survival rate and the small number of patients submitted to surgical treatment alone, the majority being submitted to chemotherapy alone.

Two tumor suppressor genes are candidates to be involved in GC: TRIM32 (9q33.1) and CDH19 (18q22.1). Gains of CBX2, CBX4 and CBX8 were frequently found in high risk prognostic score in GC. The in silico functional interaction analysis revealed the involvement of PTEN and PI3K-Akt signaling pathways. These data pointed out significant genomic alterations in GC, opening new avenues to better characterize the pathobiology of this disease.

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The aim of this preliminary study was to investigate whether religious practice can modify quality of life (QoL) in BC patients during chemotherapy. QoL and religion practice questionnaire (RPQ) scores were evaluated in a sample of BC patients in different moments. Before chemotherapy initiation, women with lower physical and social functional scores displayed higher RPQ scores. On the other hand, low RPQ patients worsened some QoL scores over time. Body image acceptance was positively correlated with religious practice and specifically praying activity. This preliminary study suggests the importance of religion in coping with cancer chemotherapy.

Neurokinin-1-receptor antagonist aprepitant has been approved for clinical use based on two prospective phase III trials conducted with cisplatin-based highly emetogenic chemotherapy.1 It was developed for use in combination with a 5-HT3-receptor antagonist and corticosteroid in order to prevent both acute and delayed chemotherapy-induced nausea and vomiting (CINV). Warr et al. 2 have suggested that aprepitant could be a useful antiemetic for prevention of CINV associated with moderately emetogenic chemotherapy, such as the adriamycin/cyclophosphamide (AC) regimen used for breast cancer treatment.Aprepitant is metabolized primarily via cytochrome P-450 (CYP) 3A4-mediated oxidation, with minor metabolism by other cytochromes.3 The alkylating agent cyclophosphamide is an inactive prodrug that requires activation to form its active metabolite 4-hydroxycyclophosphamide (4-HOCP), with major participation by CYP2A6, CYP2B6 and CYP3A4.3 de Jonge et al. 4 have shown that aprepitant inhibits cyclophosphamide metabolism, thus resulting in decreased formation of 4-HOCP.It was with great interest that we read the recent paper by Yeo et al. 5 concerning aprepitant-based CINV prophylaxis in moderately emetogenic chemotherapy. They studied a homogeneous group of Chinese breast cancer patients who underwent adjuvant AC chemotherapy (i.e. doxorubicin 60 mg/m 2 and cyclophosphamide 600 mg/m 2 ). They unexpectedly found lower incidences of neutropenia of grade ≥ 3, and delay in the subsequent chemotherapy cycle. These important results led us to consider the possibility that aprepitant and cyclophosphamide drug interactions could decrease 4-HOCP formation and affect treatment efficacy.By considering cytochrome P450 genetic polymorphisms among different breast cancer populations, we think that the clinical relevance of the aforementioned drug interaction should be urgently addressed in new studies and in different ethnic groups.

Artigos originaisResumo OBJETIVO: avaliar a resposta loco-regional à quimioterapia primária nas pacientes com câncer de mama nos estadios II e III. MÉTODOS: foi realizado um estudo clínico retrospectivo e analítico de 97 pacientes no estadios II e III, no período de janeiro de 1993 a dezembro de 2004, submetidas a três ou quatro ciclos de quimioterapia primária com 5-fl uorouracil (500 mg/m 2 ), epirrubicina (50 mg/m 2 ) e ciclofosfamida (500 mg/m 2 ) ou doxorrubicina (50 mg/m 2 ) e ciclofosfamida (500 mg/m 2 ) e posteriormente ao tratamento loco-regional cirúrgico conservador ou radical. Para estudo da associação entre as variáveis (idade, estado menopausal, volume tumoral pré-quimioterapia, estado axilar, estádio, esquema terapêutico e número de ciclos) foram utilizados os testes do χ 2 e o exato de Fisher. Para as variáveis quantitativas (volume tumoral pelo estudo anátomo-patológico e volume tumoral clínico pós-quimioterapia) foi utilizado o coefi ciente de correlação de Pearson. O nível de signifi cância utilizado foi de 5%. RESULTADOS: a média de idade da população estudada foi de 52,2 anos. No estádio II, tivemos 56,8% dos casos e no estádio III, 43,2%. Aproximadamente metade das pacientes receberam FEC50 e 50%, AC. Obtivemos uma resposta clínica objetiva com o tratamento quimioterápico primário em 64,9% dos casos. A resposta clínica completa ocorreu em 12,3% das pacientes; já a resposta patológica completa aconteceu em 10,3% dos casos. Observamos uma correlação signifi cante entre o número de ciclos e a resposta à quimioterapia primária. Também verifi camos uma concordância signifi cante entre a avaliação pelo exame clínico da resposta à quimioterapia primária e o achado anátomo-patológico. CONCLUSÕES: o número de ciclos foi importante para a resposta loco-regional, sendo que as pacientes que receberam maior número de ciclos obtiveram melhores respostas. Também foi possível avaliar a resposta tumoral pelo exame clínico, pois houve concordância com o anátomo-patológico.Abstract PURPOSE: to evaluate the loco-regional response to primary chemotherapy in patients with breast cancer at stages II and III. METHODS: a retrospective and analytical clinical study carried out in 97 patients with an average age of 52.2 years old, with breast cancer at stages II and III, attended from January 1993 to December 2004, and submitted to 3 to 4 cycles of primary chemotherapy with 5-fl uorouracil -500 mg/m2, epirubicin -50 mg/m2 and cyclophosphamide -500 mg/m2 or doxorubicin -50 mg/m2 e cyclophosphamide -500 mg/m2, and then to loco-regional surgical conservative or radical surgical treatment. Chi-square and Fisher's exact tests were used to study the association among the variables (age, menopausal state, pre-chemotherapy tumoral volume, axillary condition, stage, therapeutic scheme and number of cycles), while Pearson's correlation coeffi cient was used for the quantitative variables (tumoral volume according to the anatomo-pathological study and the post-chemotherapy clinical tumoral volume. The signifi cance level was 5%...

Abstract. to evaluate the tumor response to neoadjuvant chemotherapy, 99m tc-sestamibi breast scintigraphy was proposed as a quantitative method. Fifty-five patients with ductal carcinoma were studied. they underwent breast scintigraphy before and after neoadjuvant chemotherapy, along with clinical assessment and surgical specimen analysis. the regions of interest on the lesion and contralateral breast were identified, and the pixel counts were used to evaluate lesion uptake in relation to background radiation. the ratio of these counts before to after neoadjuvant chemotherapy was assessed. the decrease in uptake rate due to chemotherapy characterized the scintigraphy tumor response. the Kruskal-Wallis test was used to compare the mean scintigraphic tumor response and histological type. Dunn's multiple comparison test was used to detect differences between histological types. the MannWhitney test was used to compare means between quantitative and qualitative variables: scintigraphic tumor response vs. clinical response and uptake before chemotherapy vs. scintigraphic tumor response. the spearman's test was used to correlate the quantitative variables of clinical reduction in tumor size and scintigraphic tumor response. All of the variables compared presented significant differences. The change in 99m tc-sestamibi uptake noted on breast scintigraphy, before to after neoadjuvant chemotherapy, may be used as an effective method for evaluating the response to neoadjuvant chemotherapy, since this quantification reflects the biological behavior of the tumor towards the chemotherapy regimen.Furthermore, additional analysis on the uptake rate before chemotherapy may accurately predict treatment response. IntroductionBreast cancer is the second most common type of cancer worldwide and the most common among women. It accounts for approximately 22% of new cancer cases among women each year (1), and the 5-year survival rate among the worldwide population is 61%. this high mortality rate is related to late diagnosis, with the presence of tumors of large dimensions and lymph node metastases.locally advanced breast cancer comprises tumors greater than 5 cm in diameter, with wall or skin invasion, metastases to fixed lymph nodes (2,3) and inflammatory carcinoma. treatment for this is multidisciplinary, consisting of preoperative chemotherapy, surgery, radiotherapy and postoperative chemotherapy (4-6).Preoperative or neoadjuvant chemotherapy is standard treatment for individuals with locally advanced breast cancer (7-10). It has been found to substantially improve the survival of these patients (6,11,12). It provides better local control over the disease, with increased likelihood that the breast surgery will be conservative (4,5,13). Moreover, this type of chemotherapy treats preexisting microscopic systemic disease and enables the evaluation of tumor resistance in vivo (14). reduction in tumor volume has been used as the standard criterion for response evaluation among solid tumors such as breast carcinoma (15). techniques tha...