Comparación de dos métodos diagnósticos en tumores mamarios en un Centro de Cancerología de Colima, México

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Abstract

Objetivo Determinar la relación entre los hallazgos de tumores mediante mamografía y el diagnóstico histopatológico de los mismos. Métodos Se realizó un estudio transversal descriptivo. Participaron pacientes del Centro Estatal de Cancerología de la ciudad de Colima, México. Los criterios de inclusión fueron: mujeres con mamografía y calificación BIRADS; mujeres con biopsia y diagnóstico histopatológico; mujeres de todas las edades, todos los estadios clínicos y con expediente clínico completo. Para la estadística descriptiva se utilizaron las frecuencias, porcentajes, promedios y desviación estándar. Para la estadística inferencial se utilizaron las pruebas de t de Student, de chi cuadrada y el cálculo del OR e IC (95 %). Las diferencias se consideran significativas cuando p<0,05. Resultados Al relacionar las categorías del BIRADS, dependiendo de la probabilidad de benignidad (BIRADS I-II-III) o malignidad (BIRADS IV-V) con los resultados histopatológicos (benigno o maligno), no se encontró relación (p=0,0666). En un análisis individual por categoría, las relaciones significativas fueron: categoría IV (OR=0,024, IC=0,005-0,11, p=0,0007) y categoría V (OR=40,5, IC=9,03-181,3, p=0,0002). Conclusiones La clasificación BIRADS I, III y V tuvo relación con el diagnóstico histopatológico, mientras que en el II y IV no hubo esta relación. Sin embargo, los únicos resultados estadísticamente significativos se obtuvieron en las categorías IV y V.

Translated abstract

Objective Determining the relationship between mammography neoplasm reports and histopathological diagnosis of neoplasms. Methods A descriptive cross-sectional study was carried out. Patients were included who were attending the state cancerology centre (Centro Estatal de Cancerología) in Colima, Mexico. Inclusion parameters were: females having mammography and BIRADS score of 1 or over; females having biopsy and histopathology diagnosis; females of all ages, all clinic stages having a complete clinic record. Frequency, percentages, means and standard deviations were applied for descriptive statistics. Student's t-test, the Chi square test, OR and 95 %CI were applied for inferential statistics. Differences were considered to be significant when p<0.05. Results No relationship between a BIRADS score classified as being benign (BIRADS I-II-III) or malign (BIRADS IV-V) was found with histopathological results (benign or malign) (p=0.0666). Significant relationships by category were found in a separate analysis: category IV (OR=0.024, 95 %CI=0.005-0.11, p=0.0007) and category V (OR=40.5, 95 %CI=9.03-181.3, p=0.0002). Conclusions I, III and V BIRADS scores had a relationship with histopathological diagnosis, while category II and IV BIRADS scores had no relationship. However, only categories 4 and5 were statistically significant.

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Molecular links between obesity and breast cancer.

S Sukumar, A Lorincz (2006)

Breast cancer continues to be a major health problem for women in the USA and worldwide. There is a need to identify and take steps to alter modifiable breast cancer risks. Conditions of obesity and overweight are risk factors that have reached epidemic proportions. This article reviews the evidence in the literature that test mechanism-based hypotheses which attempt to provide a molecular basis for a causal link between obesity and breast cancer risk, particularly the effects of metabolic syndrome and insulin resistance, peripheral estrogen aromatization in adipose tissue, and direct effect of adipokines. Future areas for study and implications for therapy are discussed.

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Estrogen-plus-progestin use and mammographic density in postmenopausal women: Women's Health Initiative randomized trial.

Jennifer Peck, , Jane M Kotchen … (2005)

Increased mammographic density reduces the sensitivity of screening mammography, is associated with increased breast cancer risk, and may be hormone related. We assessed the effect of estrogen-plus-progestin therapy on mammographic density. In a racially and ethnically diverse ancillary study of the Women's Health Initiative, we examined data from 413 postmenopausal women who had been randomly assigned to receive daily combined conjugated equine estrogens (0.625 mg) plus medroxyprogesterone acetate (i.e., progestin; 2.5 mg) (n = 202) or daily placebo (n = 211). We assessed the effect of estrogen plus progestin on measured mammographic percent density and abnormal findings over a 1-year and 2-year period. All tests of statistical significance were two-sided and were based on F tests or t tests from mixed-effects models. Mean mammographic percent density increased by 6.0% at year 1, compared with baseline, in the estrogen-plus-progestin group but decreased by 0.9% in the placebo group (difference = 6.9%, 95% confidence interval [CI] = 5.3% to 8.5%; P < .001). The mean changes in mammographic density persisted but were attenuated slightly after 2 years, with an absolute increase of 4.9% in the estrogen-plus-progestin group and a decrease of 0.8% in the placebo group (difference = 5.7%, 95% CI = 4.3% to 7.3%; P < .001). These effects were consistent across racial/ethnic groups but were higher among women aged 70-79 years in the estrogen-plus-progestin group (mean increase at year 1 = 11.6%) than in the placebo group (mean decrease at year 1 = 0.1%) (difference of the means = 11.7%, 95% CI = 8.2% to 15.4%; P < .001, comparing across age groups). At year 1, women who were adherent to treatment in the estrogen-plus-progestin group had a mean increase in density of 7.7% (95% CI = 5.9% to 9.5%), and women in the placebo group had a mean decrease in density of 1.1% (95% CI = 0.3% to 1.9%). Use of estrogen plus progestin was associated with an increased risk of having an abnormal mammogram at year 1 (relative risk = 3.9, 95% CI = 1.5 to 10.2; P = .003), compared with placebo, that was not explained by an increase in density. Use of up to 2 years of estrogen plus progestin was associated with increases in mammographic density.