RESUMO
BACKGROUND: Use of breast magnetic resonance imaging (MRI) to detect breast cancer has generated significant debate. We analyze the role of breast MRI in the detection of additional disease and the need to perform additional biopsies in early breast carcinoma patients. In addition, we correlate the detection of new foci with tumor pathological features. METHODS: Early breast carcinoma patients that had undergone an MRI as well as a mammography as diagnostic procedures were included in the study. The following pathologic features were studied: carcinoma type, histological grade, estrogen receptors (ER), progesterone receptors (PR), HER2 and Ki67. Univariate analysis was conducted to ascertain significant correlation among detection of new foci and each of the tumor pathological features. RESULTS: Data from 98 patients have been analyzed: median age 49 years (range 35-79); carcinoma type: (a) infiltrative ductal carcinoma (n = 73, 74 %), (b) infiltrative lobular cancer (n = 12, 12 %), (c) ductal carcinoma in situ (n = 6, 6 %); amplified HER2 (n = 18, 18 %); grade III (n = 33, 33 %); Ki67 ≥ 25 % (n = 33, 33.67 %); positive ER and PR (n = 79, 80 %); triple negative tumors (n = 8, 8 %). MRI detected additional disease in 38 cases (39.58 %), and 20 led to an additional biopsy (20.4 %). Thirty-eight patients (39 %) underwent mastectomy. We found a statistically significant correlation between new foci in MRI and high Ki67 ≥ 25 % (p < 0.005). No other statistically significant correlation was established. CONCLUSION: MRI detected additional disease in 39 % cases, requiring an additional biopsy 20 %. Tumors with high proliferative index were significantly correlated with the detection of new foci in MRI.
Assuntos
Neoplasias da Mama/diagnóstico , Carcinoma Ductal de Mama/diagnóstico , Carcinoma Intraductal não Infiltrante/diagnóstico , Carcinoma Lobular/diagnóstico , Imageamento por Ressonância Magnética , Adulto , Idoso , Neoplasias da Mama/metabolismo , Carcinoma Ductal de Mama/metabolismo , Carcinoma Intraductal não Infiltrante/metabolismo , Carcinoma Lobular/metabolismo , Detecção Precoce de Câncer , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Gradação de Tumores , Prognóstico , Receptor ErbB-2/metabolismo , Receptores de Estrogênio/metabolismo , Receptores de Progesterona/metabolismo , Estudos Retrospectivos , Taxa de SobrevidaRESUMO
OBJECTIVES: The detection of anti-Trypanosoma cruzi antibodies has become one of the priorities of the clinical establishments in the health sector, due both to the increase in positive cases found in transfusion centres as well as to the appearance of patients with characteristic Chagas cardiopathies that seek emergency treatment in the main hospitals of Querétaro (Mexico). DESIGN AND METHODS: The present study seeks to establish for the first time the infection level of Trypanosoma cruzi, in the rural communities of this state and implement the preventive measures necessary to control and/or eradicate this infection. A transversal study was conducted, examining seriologically 1029 blood samples of the inhabitants of rural areas of the state of Querétaro, to detect anti-Trypanosoma cruzi antibodies. RESULTS: The indirect serological diagnostic tests were indirect hemagglutination, enzymo-immunoenzymatic absorbent, recombinant ELISA, and indirect immunofluorescence. For the diagnostic evaluation of serological tests used, ELISA was considered the control test. CONCLUSIONS: The first conclusion was that the two tests with the greatest serological reactivity were ELISA and recombinant ELISA, followed by IFA and IHA, respectively, with the final percentage of positives being 6.6%, far above the national mean of seroprevalence in Mexico (1.6%). On the other hand, the sensitivity, specificity, VP+, VP-, percentage of concordance and Kappa index of the recombinant ELISA tests, IFA, and IHA were determined against the control ELISA. It was found that ELISA and recombinant ELISA presented a greater sensitivity level, as well as the highest values for the different parameters studied.