RESUMEN

OBJECTIVE: We conducted a meta-analysis of the current literature to deduce the strength of association between breast arterial calcification (BAC) and coronary artery disease (CAD) and/or stroke. METHODS: PubMed, Google Scholar, ClinicalTrials.gov, and Ovid were searched for English-language literature up to August 2013 using the terms "breast arterial calcification," "breast vascular calcification," "coronary artery disease," "coronary heart disease," "cardiovascular disease," "abnormal coronary angiography," and "stroke." A hand search of the reference lists of key articles was performed to supplement the literature search. Our literature search revealed 75 articles for further abstract review. Limiting our search to articles that quantitatively assessed the correlation between BAC and stroke or angiographically proven CAD, we reviewed 35 full manuscripts. Of these articles, 14 were included in the final analysis. RESULTS: We analyzed 10 cross-sectional studies (n = 3,952) with CAD as the primary outcome (diagnosed by coronary angiography). The odds ratio (95% CI) for CAD in those with BAC versus those without BAC is 3.86 (3.25-4.59) (P < 0.0001). For stroke, six cross-sectional studies were analyzed (n = 18,888). The odds ratio (95% CI) for stroke in those with BAC versus those without BAC is 1.54 (1.25-1.90) (P < 0.0001). CONCLUSIONS: These results suggest that BAC is significantly associated with both CAD and stroke. Although more prospective studies are warranted to clarify whether BAC is truly a predictor of the future development of CAD and stroke, the concept that BAC is a benign finding is waning.

Asunto(s)

Mama/irrigación sanguínea , Enfermedad de la Arteria Coronaria/etiología , Accidente Cerebrovascular/etiología , Calcificación Vascular/complicaciones , Angiografía Coronaria , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Estudios Transversales , Femenino , Humanos , Oportunidad Relativa

RESUMEN

PURPOSE: To analyze associations between mammographic arterial mammary calcifications in menopausal women and risk factors for cardiovascular disease. METHODS: This was a cross-sectional retrospective study, in which we analyzed the mammograms and medical records of 197 patients treated between 2004 and 2005. Study variables were: breast arterial calcifications, stroke, acute coronary syndrome, age, obesity, diabetes mellitus, smoking, and hypertension. For statistical analysis, we used the Mann-Whitney, χ2 and Cochran-Armitage tests, and also evaluated the prevalence ratios between these variables and mammary artery calcifications. Data were analyzed with the SAS version 9.1 software. RESULTS: In the group of 197 women, there was a prevalence of 36.6% of arterial calcifications on mammograms. Among the risk factors analyzed, the most frequent were hypertension (56.4%), obesity (31.9%), smoking (15.2%), and diabetes (14.7%). Acute coronary syndrome and stroke presented 5.6 and 2.0% of prevalence, respectively. Among the mammograms of women with diabetes, the odds ratio of mammary artery calcifications was 2.1 (95%CI 1.0-4.1), with p-value of 0.02. On the other hand, the mammograms of smokers showed the low occurrence of breast arterial calcification, with an odds ratio of 0.3 (95%CI 0.1-0.8). Hypertension, obesity, diabetes mellitus, stroke and acute coronary syndrome were not significantly associated with breast arterial calcification. CONCLUSION: The occurrence of breast arterial calcification was associated with diabetes mellitus and was negatively associated with smoking. The presence of calcification was independent of the other risk factors for cardiovascular disease analyzed.

Asunto(s)

Mama/irrigación sanguínea , Enfermedades Cardiovasculares/etiología , Calcificación Vascular/complicaciones , Anciano , Enfermedades Cardiovasculares/epidemiología , Estudios Transversales , Femenino , Humanos , Mamografía , Menopausia , Persona de Mediana Edad , Prevalencia , Estudios Retrospectivos , Factores de Riesgo , Calcificación Vascular/diagnóstico por imagen , Calcificación Vascular/epidemiología

RESUMEN

OBJETIVO: Avaliar a presença de calcificações arteriais em mamografias de mulheres menopausadas e a sua associação com fatores de risco para doenças cardiovasculares. MÉTODOS: Trata-se de um estudo de corte transversal e retrospectivo, em que foram analisados as mamografias e os prontuários médicos de 197 pacientes atendidas no período entre 2004 e 2005. As variáveis do estudo foram: calcificação arterial mamária, acidente vascular cerebral, síndrome coronariana aguda, idade, obesidade, diabetes mellitus, tabagismo e hipertensão arterial sistêmica. Para a análise estatística dos dados, utilizaram-se os testes de Mann-Whitney, χ2 e Cochran-Armitage, sendo também avaliadas as razões de prevalência entre as variáveis descritas e calcificação arterial mamária. Os dados foram analisados com o software SAS, versão 9.1. RESULTADOS: Dos 197 exames e prontuários analisados, observou-se a prevalência de 36,6% para calcificações arteriais nas mamografias. Entre os fatores de risco para doença cardiovascular avaliados, os mais frequentes foram: hipertensão (56,4%), obesidade (31,9%), tabagismo (15,2%) e diabetes (14,7%). A síndrome coronariana aguda e o acidente vascular cerebral tiveram prevalências de 5,6 e 2,0% respectivamente. Entre as mamografias de mulheres diabéticas, a maior ocorrência foi de calcificação arterial mamária com razão de prevalência de 2,1 (IC95%1,0-4,1) e valor p de 0,02. Por outro lado, nas mamografias de pacientes fumantes, foi menor a ocorrência de calcificação arterial mamária com razão de prevalência de 0,3 (IC95% 0,1-0,8). Hipertensão arterial sistêmica, obesidade, diabetes mellitus, acidente vascular cerebral e síndrome coronariana aguda não apresentaram ...

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PURPOSE: To analyze associations between mammographic arterial mammary calcifications in menopausal women and risk factors for cardiovascular disease. METHODS: This was a cross-sectional retrospective study, in which we analyzed the mammograms and medical records of 197 patients treated between 2004 and 2005. Study variables were: breast arterial calcifications, stroke, acute coronary syndrome, age, obesity, diabetes mellitus, smoking, and hypertension. For statistical analysis, we used the Mann-Whitney, χ2 and Cochran-Armitage tests, and also evaluated the prevalence ratios between these variables and mammary artery calcifications. Data were analyzed with the SAS version 9.1 software. RESULTS: In the group of 197 women, there was a prevalence of 36.6% of arterial calcifications on mammograms. Among the risk factors analyzed, the most frequent were hypertension (56.4%), obesity (31.9%), smoking (15.2%), and diabetes (14.7%). Acute coronary syndrome and stroke presented 5.6 and 2.0% of prevalence, respectively. Among the mammograms of women with diabetes, the odds ratio of mammary artery calcifications was 2.1 (95%CI 1.0-4.1), with p-value of 0.02. On the other hand, the mammograms of smokers showed the low occurrence of breast arterial calcification, with an odds ratio of 0.3 (95%CI 0.1-0.8). Hypertension, obesity, diabetes mellitus, stroke and acute coronary syndrome were not significantly associated with breast arterial calcification. CONCLUSION: The occurrence of breast arterial calcification was associated with diabetes mellitus and was negatively associated with smoking. The presence of calcification was independent of the other risk factors for cardiovascular disease analyzed. .

Asunto(s)

Anciano , Femenino , Humanos , Persona de Mediana Edad , Mama/irrigación sanguínea , Enfermedades Cardiovasculares/etiología , Calcificación Vascular/complicaciones , Estudios Transversales , Enfermedades Cardiovasculares/epidemiología , Mamografía , Menopausia , Prevalencia , Estudios Retrospectivos , Factores de Riesgo , Calcificación Vascular/epidemiología , Calcificación Vascular

RESUMEN

BACKGROUND: In developing countries, there is a deficiency of densitometers with which to screen the population for osteoporosis. Thus, strategies with which to select patients for a bone density test are desirable. OBJECTIVE: To determine whether breast vascular calcifications (BVCs) may be employed to identify postmenopausal women with osteoporosis/osteopenia. METHODS: This was a cross-sectional study of postmenopausal women subjected to bilateral mammography and bone densitometry (DXA) of the spine and hip. A medical interview registered possible confounding factors, such as age, length of menopause, previous use of postmenopausal hormone therapy, family history of osteoporosis, smoking, alcoholism, hypertension, diabetes, cardiovascular diseases, and medication use. RESULTS: The study included 211 postmenopausal women aged 62.1 ± 9.3 years, 38 of whom (18.0%) exhibited BVC. Osteoporosis was detected in 36 (17.1%), and a T-score < 21.0 for any site was found in 164 (77.7%). No statistically significant difference was found between the groups without BVC (n = 173) and with BVC (n = 38) for the prevalence of 'osteoporosis' or 'moderate/severe osteopenia or osteoporosis' at the spine or at any other site. There was a difference between the groups in terms of age (59.0 ± 7.8 vs. 71.9 ± 8.9 years, respectively; p < 0.001), sedentary lifestyle (57.8% vs. 84.2%, respectively; p = 0.002), smoking (27.7% vs. 7.9%, respectively; p = 0.009), and high blood pressure (65.3% vs. 92.1%, respectively; p = 0.001). Logistic regression analysis confirmed the lack of statistical significance for BVC as a predictor of an osteoporosis diagnosis. Sensitivity values of BVCs to detect osteoporosis or osteopenia ranged from 17.9% to 25.0%. CONCLUSION: BVCs have been shown to be inadequate to identify postmenopausal women with osteoporosis or osteopenia.

Asunto(s)

Enfermedades Óseas Metabólicas/diagnóstico , Enfermedades de la Mama , Osteoporosis Posmenopáusica/diagnóstico , Calcificación Vascular , Absorciometría de Fotón/métodos , Absorciometría de Fotón/estadística & datos numéricos , Anciano , Densidad Ósea , Enfermedades Óseas Metabólicas/epidemiología , Enfermedades Óseas Metabólicas/fisiopatología , Brasil/epidemiología , Mama/irrigación sanguínea , Mama/patología , Enfermedades de la Mama/diagnóstico , Enfermedades de la Mama/epidemiología , Enfermedades de la Mama/fisiopatología , Estudios Transversales , Femenino , Humanos , Modelos Logísticos , Mamografía/métodos , Mamografía/estadística & datos numéricos , Persona de Mediana Edad , Osteoporosis Posmenopáusica/epidemiología , Osteoporosis Posmenopáusica/fisiopatología , Posmenopausia , Valor Predictivo de las Pruebas , Prevalencia , Factores de Riesgo , Calcificación Vascular/diagnóstico , Calcificación Vascular/epidemiología , Calcificación Vascular/fisiopatología

RESUMEN

OBJECTIVES: We investigated the relationship between metabolic syndrome and breast arterial calcification detected via mammography in a cohort of postmenopausal subjects. METHODS: Among 837 patients referred to our radiology department for mammographic screening, 310 postmenopausal females (105 patients with and 205 patients without breast arterial calcification) aged 40 to 73 (mean 55.9 ± 8.4) years were included in this study. The groups were compared with respect to clinical characteristics and metabolic syndrome criteria. Univariate and multivariate analyses identified the factors related to breast arterial calcification. RESULTS: Age, postmenopausal duration and the frequencies of diabetes mellitus, hypertension and metabolic syndrome were significantly higher in the subjects with breast arterial calcification than in those without (p<0.05). Multivariate analysis indicated that age (OR=1.3, 95% CI=1.1-1.6, p=0.001) and metabolic syndrome (OR=4.0, 95% CI=1.5-10.4, p=0.005) were independent predictors of breast arterial calcification detected via mammography. The independent predictors among the features of metabolic syndrome were low levels of high-density lipoproteins (OR=8.1, 95% CI=1.0-64.0, p=0.047) and high blood pressure (OR=8.7, 95% CI=1.5-49.7, p=0.014). CONCLUSIONS: The likelihood of mammographic detection of breast arterial calcification increases with age and in the presence of hypertension or metabolic syndrome. For patients undergoing screening mammography who present with breast arterial calcification, the possibility of metabolic syndrome should be considered. These patients should be informed of their cardiovascular risk factors and counseled on appropriate lifestyle changes.

Asunto(s)

Mama/irrigación sanguínea , Síndrome Metabólico/complicaciones , Calcificación Vascular/etiología , Adulto , Anciano , Análisis de Varianza , Arterias , Estudios de Cohortes , Complicaciones de la Diabetes , Femenino , Humanos , Hipertensión/complicaciones , Mamografía/métodos , Persona de Mediana Edad , Análisis Multivariante , Posmenopausia/metabolismo , Factores de Riesgo , Calcificación Vascular/diagnóstico por imagen

RESUMEN

OBJECTIVES: We investigated the relationship between metabolic syndrome and breast arterial calcification detected via mammography in a cohort of postmenopausal subjects. METHODS: Among 837 patients referred to our radiology department for mammographic screening, 310 postmenopausal females (105 patients with and 205 patients without breast arterial calcification) aged 40 to 73 (mean 55.9±8.4) years were included in this study. The groups were compared with respect to clinical characteristics and metabolic syndrome criteria. Univariate and multivariate analyses identified the factors related to breast arterial calcification. RESULTS: Age, postmenopausal duration and the frequencies of diabetes mellitus, hypertension and metabolic syndrome were significantly higher in the subjects with breast arterial calcification than in those without (p<0.05). Multivariate analysis indicated that age (OR = 1.3, 95% CI = 1.1-1.6, p = 0.001) and metabolic syndrome (OR = 4.0, 95% CI = 1.5−10.4, p = 0.005) were independent predictors of breast arterial calcification detected via mammography. The independent predictors among the features of metabolic syndrome were low levels of high-density lipoproteins (OR = 8.1, 95% ...

Asunto(s)

Adulto , Anciano , Femenino , Humanos , Persona de Mediana Edad , Mama/irrigación sanguínea , Síndrome Metabólico/complicaciones , Calcificación Vascular/etiología , Análisis de Varianza , Arterias , Estudios de Cohortes , Complicaciones de la Diabetes , Hipertensión/complicaciones , Análisis Multivariante , Mamografía/métodos , Posmenopausia/metabolismo , Factores de Riesgo , Calcificación Vascular

RESUMEN

OBJECTIVE: The purpose of this study was to assess the parallel artery and vein sign at color Doppler breast ultrasound as a predictor of the benign nature of breast masses. SUBJECTS AND METHODS: A prospective study was performed to identify evidence of a parallel artery and vein in breast lesions consecutively biopsied with a 14-gauge needle under ultrasound guidance. Sensitivity, specificity, positive and negative predictive values, likelihood ratios, and 95% CIs for the parallel artery and vein sign were calculated. RESULTS: The parallel artery and vein sign was identified in 142 of the 1074 masses (13.2%). The specificity for benignity was 99.3% (CI 95%, 98.3-100.0%); sensitivity, 17.6% (CI 95%, 15.0-20.3%); positive predictive value, 99.0% (CI 95%, 96.7-100); negative predictive value, 30.0% (CI 95%, 27.0-32.9); positive likelihood ratio, 24.7 (CI 95%, 21.2-28.7); and negative likelihood ratio, 0.83 (CI 95%, 0.80-0.86). Among masses found to have the parallel artery and vein sign, all BI-RADS ultrasound category 3 and 95.1% of BI-RADS 4 lesions were determined to be benign. CONCLUSION: Although the parallel artery and vein sign is an uncommon finding, it has a significant association with benign pathologic results (96.5%) with a positive likelihood ratio of 24.7. The presence of this color Doppler ultrasound finding in breast masses in BI-RADS ultrasound categories 3 and 4 reinforces the benign nature and may allow follow-up rather than biopsy in the care of some patients.

Asunto(s)

Enfermedades de la Mama/diagnóstico por imagen , Mama/irrigación sanguínea , Ultrasonografía Doppler en Color , Ultrasonografía Mamaria , Adulto , Biopsia con Aguja , Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama Masculina/diagnóstico por imagen , Distribución de Chi-Cuadrado , Diagnóstico Diferencial , Femenino , Humanos , Funciones de Verosimilitud , Masculino , Valor Predictivo de las Pruebas , Estudios Prospectivos , Sensibilidad y Especificidad , Ultrasonografía Intervencional

RESUMEN

OBJECTIVE: The purpose of this study was to describe the probable mechanism of the volume increase of laparoscopically harvested omentum flaps used to treat breast deformities. METHODS: A histological analysis of omentum samples was performed to study the volume increase of laparoscopically harvested omentum flaps. Samples were harvested immediately after the transposition of the omentum from the abdominal cavity to the breast region and during the second surgical procedure for breast symmetrization of eight patients submitted to the transposition of the omentum flap. Changes in the morphometric measurements of the adipocytes (perimeter, diameter, and area), microvascular density (as measured by the CD31 endothelial marker), and immunohistochemical expression of VEGF were documented. RESULTS: The increases in adipocyte size and microvascular density were statistically significant (P < 0.012). The expression levels of VEGF were lower in the second set of samples when compared to the first set, but the differences were not statistically significant (P < 0.093). CONCLUSION: These results demonstrate an increase in cellular volume as measured by adipocyte perimeter, diameter, and area. Moreover, the increase in the number of vessels in the second set of samples suggests that neoangiogenesis was stimulated by the initial increase in VEGF expression levels observed in the first set of samples. The increase in VEGF expression in the flap may have been caused by adipocyte hypertrophy resulting from neoangiogenesis.

Asunto(s)

Adipocitos/citología , Neoplasias de la Mama/cirugía , Mama/crecimiento & desarrollo , Epiplón/trasplante , Colgajos Quirúrgicos , Factores de Crecimiento Endotelial Vascular/fisiología , Adolescente , Adulto , Índice de Masa Corporal , Mama/irrigación sanguínea , Mama/cirugía , Neoplasias de la Mama/irrigación sanguínea , Neoplasias de la Mama/patología , Aumento de la Célula , Femenino , Humanos , Laparoscopía , Persona de Mediana Edad , Neovascularización Fisiológica/fisiología , Epiplón/irrigación sanguínea , Epiplón/citología , Tamaño de los Órganos , Periodo Posoperatorio , Estadísticas no Paramétricas , Colgajos Quirúrgicos/irrigación sanguínea , Colgajos Quirúrgicos/patología , Factores de Tiempo , Adulto Joven

RESUMEN

OBJECTIVE: The purpose of this study was to describe the probable mechanism of the volume increase of laparoscopically harvested omentum flaps used to treat breast deformities. METHODS: A histological analysis of omentum samples was performed to study the volume increase of laparoscopically harvested omentum flaps. Samples were harvested immediately after the transposition of the omentum from the abdominal cavity to the breast region and during the second surgical procedure for breast symmetrization of eight patients submitted to the transposition of the omentum flap. Changes in the morphometric measurements of the adipocytes (perimeter, diameter, and area), microvascular density (as measured by the CD31 endothelial marker), and immunohistochemical expression of VEGF were documented. RESULTS: The increases in adipocyte size and microvascular density were statistically significant (P < 0.012). The expression levels of VEGF were lower in the second set of samples when compared to the first set, but the differences were not statistically significant (P < 0.093). CONCLUSION: These results demonstrate an increase in cellular volume as measured by adipocyte perimeter, diameter, and area. Moreover, the increase in the number of vessels in the second set of samples suggests that neoangiogenesis was stimulated by the initial increase in VEGF expression levels observed in the first set of samples. The increase in VEGF expression in the flap may have been caused by adipocyte hypertrophy resulting from neoangiogenesis.

Asunto(s)

Adolescente , Adulto , Femenino , Humanos , Persona de Mediana Edad , Adulto Joven , Adipocitos/citología , Neoplasias de la Mama/cirugía , Mama/crecimiento & desarrollo , Epiplón/trasplante , Colgajos Quirúrgicos , Factores de Crecimiento Endotelial Vascular/fisiología , Índice de Masa Corporal , Neoplasias de la Mama/irrigación sanguínea , Neoplasias de la Mama/patología , Mama/irrigación sanguínea , Mama/cirugía , Aumento de la Célula , Laparoscopía , Neovascularización Fisiológica/fisiología , Tamaño de los Órganos , Epiplón/irrigación sanguínea , Epiplón/citología , Periodo Posoperatorio , Estadísticas no Paramétricas , Colgajos Quirúrgicos/irrigación sanguínea , Colgajos Quirúrgicos/patología , Factores de Tiempo

RESUMEN

The contribution of color Doppler sonography in the study of breast cancer remains a topic of discussion. However, in the daily clinical practice it has become an indispensable instrument, and an integral part of the breast ultrasound (US). The aim of this paper is to demonstrate its utility based on the available evidence as well as on our experience. We describe the technical considerations necessary to conduct a good study, the Doppler signs of benignity/malignancy in focal lesions of the breast and the benefits of its routine use in day-to-day practice. In our experience, it is a useful tool for this purpose. Neverthless, its diagnostic impact as described in the literature is variable. To evaluate its real usefulness, prospective studies along with standardization of the evaluation technique would be required.

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La contribución del Doppler color en el estudio de la mama sigue siendo un tema en discusión. No obstante, en la práctica clínica diaria se ha convertido en un instrumento indispensable, formando parte integral del Ultrasonido (US) mamario. El objetivo de este artículo es demostrar su utilidad según la evidencia disponible y a través de nuestra experiencia. Se describen las consideraciones técnicas indispensables para realizar un buen estudio, los signos Doppler de benignidad / malignidad en lesiones focales de la mama y las ventajas de su uso rutinario en la práctica diaria. En nuestra experiencia es una herramienta útil para este propósito, sin embargo su impacto diagnóstico descrito en la literatura es variable. Para evaluar su real utilidad, se requiere de la realización de estudios prospectivos y de la estandarización la técnica.

Asunto(s)

Humanos , Femenino , Ultrasonografía Mamaria , Neoplasias de la Mama , Neovascularización Patológica , Ultrasonografía Doppler en Color , Mama/irrigación sanguínea

Asunto(s)

Enfermedades de la Mama/diagnóstico por imagen , Mama/irrigación sanguínea , Calcinosis/diagnóstico por imagen , Mamografía , Enfermedades Vasculares/diagnóstico por imagen , Femenino , Humanos

Asunto(s)

Femenino , Humanos , Enfermedades de la Mama , Mama/irrigación sanguínea , Calcinosis , Mamografía , Enfermedades Vasculares

RESUMEN

OBJECTIVE: The objectives of this study were to evaluate the association between cardiovascular disease (CVD) and breast arterial calcification (BAC), as well as the prevalence rates of these conditions in Brazilian postmenopausal women. METHODS: A cross-sectional study was performed in 307 women over 40 years of age who were receiving care at the gynecology clinic of the Center for Women's Integrated Healthcare (CAISM), ABC School of Medicine. All these women had been amenorrheic for at least 12 months and had undergone mammography in the preceding 12 months. Cardiovascular disease and its subtypes were evaluated, as well as its association with BAC. Means and standard deviations, absolute frequencies and percentages were calculated, and univariate analysis and multiple logistic regression were performed. RESULTS: The mean age of the patients was 55.2 +/- 6.8 years; age at menopause was 48.5 +/- 4 years. Time since menopause was 80.2 +/- 75.4 months; 96.1% of the patients were non-smokers and 46.3% were using hormone therapy. Of the patients, 33.6% had systemic arterial hypertension, 4.9% had diabetes mellitus and 5.2% had hypercholesterolemia. The mean body mass index was 27.3 +/- 4.3 kg/m(2). CVD was found in 6.8% and BAC in 8.5% of the women. Significantly more women with BAC had CVD compared to the women who did not have this condition (23.1% vs. 5.3%, p = 0.0006). BAC was associated with an odds ratio of 8.13 (95% confidence interval 2.68-24.64) for predicting CVD. CONCLUSIONS: In postmenopausal women, breast arterial calcification may represent a higher likelihood of cardiovascular disease.

Asunto(s)

Mama/irrigación sanguínea , Calcinosis/epidemiología , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Vasculares Periféricas/epidemiología , Índice de Masa Corporal , Brasil/epidemiología , Calcinosis/diagnóstico por imagen , Enfermedades Cardiovasculares/epidemiología , Diabetes Mellitus/epidemiología , Terapia de Reemplazo de Estrógeno , Femenino , Humanos , Hipercolesterolemia/epidemiología , Hipertensión/epidemiología , Mamografía , Persona de Mediana Edad , Oportunidad Relativa , Enfermedades Vasculares Periféricas/diagnóstico por imagen , Posmenopausia

RESUMEN

A doença de Mondor da mama é uma tromboflebite superficial da mama que se apresenta como um cordão fibroso e espessado na região subcutânea da mama. É uma enfermidade rara, benigna e autolimitada que apresenta dor e retração da pele no nível do vaso afetado. Neste trabalho relatamos dois casos mostrando os achados mamográficos (caso 1) e ultra-sonográficos (caso 2) típicos desta anomalia.

Asunto(s)

Humanos , Femenino , Adulto , Persona de Mediana Edad , Enfermedades de la Mama/diagnóstico , Mama/irrigación sanguínea , Tromboflebitis/diagnóstico , Ultrasonografía Mamaria , Mamografía

RESUMEN

A manifestação de afecções mamárias lactacionais (AML) é um determinante negativo para o estabelecimento e manutenção do aleitamento materno em condições ideais para o binômio mãe-filho. Estas afecções comportam problemas com a mama puerperal que podem ter início com uma evolução inadequada da lactação promovendo estase láctea e evoluindo para ingurgitamento, traumatismos mamilo-areolares, mastite ou abscesso mamário. Similarmente ao que ocorre com animais leiteiros, a manifestação das AML em humanos sugere uma modificação nas condições de produção e secreção do leite materno, com repercussões em sua leucometria e composição em macronutrientes. Para verificar a ocorrência das AML, foram analisados 3201 registros realizados em 1916 Fichas de atendimento individual utilizadas em seis Bancos de Leite Humano (BLH) da rede pública de saúde do Distrito Federal, preenchidas entre os anos de 1992 e 1995. Durante o ano de 1994, o mais representativo por conter informações de todos os BLH, 34 por cento dos registros referiram-se a AML sendo 45 por cento de casos de ingurgitamento mamário, 26 por cento de fissuras, 20 por cento de mastites e 9 por cento de abscessos. O impacto sobre o curso de lactação e composição do leite foi avaliado transversalmente em 206 nutrizes recrutadas nos BLH, estando 52 por cento em fase colostral (C), 9 por cento secretando leite de transição (LT) e 39 por cento leite maduro (LM). As nutrizes distribuíram-se em 88 portadoras de algum tipo de AML e 118 com mamas hígidas. A natureza das AML foi classificada em 70 por cento de casos de ingurgitamentos associados ou não a traumatismos mamilo-areolares, 6 por cento de fissuras e 24 por cento de mastites e abscessos. Entre as 88 mães portadoras de AML, 12 já haviam interrompido provisoriamente o aleitamento exclusivo e 3 manifestaram a intenção de fazê-lo definitivamente. A vigência de AML não determinou diferença significativa na leucometria do C, LT e LM...

Asunto(s)

Lactancia Materna , Enfermedades de la Mama , Leche Humana/química , Mama/irrigación sanguínea , Mastitis

RESUMEN

A doença de Mondor da mama é um evento pouco frequënte na prática clínica, com cerca de 281 casos na literatura mundial de 1966 a 2002, caracterizando-se por uma tromboflebite de veia superficial da região toracoabdominal de natureza benigna. Pode manifestar-se secundariamente a doenças sistêmicas, a intervenções cirúrgicas ou idiopáticas. Geralmente tem regressão espontânea em poucas semanas. Os autores relatam o caso de uma paciente do sexo feminino, 35 anos, que apresentou-se com dor e cordão fibroso na região toracoabdominal ântero-lateral esquerda havia um mês, sem outros sintomas associados. Ao exame físico apresentava bom estado geral, mamas normais e presença de endurecimento em todo o trajeto da veia torácica lateral esquerda. Com diagnóstico clínico de doença de Mondor, submeteu-se à realização de exames complementares que foram normais. Recebeu antiinflamatórios não-hormonais, com melhora sintomática em duas semanas. A resolução completa do cordão fibroso ocorreu após 18 meses de seguimento.

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Mondor's disease of breast is an uncommon benign condition with approximately 281 cases related in world literature from 1966 to 2002, characterized by thoracoabdominal superficial vein thrombophlebitis. It can be secondary to sistemic diseases, surgical procedures, or idiopathic. It is generally a self-limited condition. The authors present a case of a 35-year-old female who complained of pain and a fibrous "string" on the left anterolateral thoracoabdominal region for one month, without correlated symptoms. At a physical examination she presented good health, normal breast and skin induration along left lateral thoracic vein. With clinical diagnosis of Mondor's disease she was submitted to complementary exams which were normal. She received nonsteroidal anti-inflammatory drug with symptomatic relief in two weeks. After 18 months, complete resolution of the fibrous "string" ocurred.

Asunto(s)

Humanos , Femenino , Mama/irrigación sanguínea , Pared Abdominal/irrigación sanguínea , Pared Torácica/irrigación sanguínea , Tromboflebitis/tratamiento farmacológico , Tromboflebitis

RESUMEN

Os autores relatam um caso da doença de Mondor em mulher jovem. A síndrome foi identificada como uma tromboflebite da veia toracoepigástrica direito, com o aparecimento do sinal característico: cordão duro e doloroso, visível e palpável no hemitórax direito, indo da região axilar até o epigástrio, mais visível quando o braço é elevado. Todos os exames complementares realizados mostraram-se dentro da faixa de normalidade, evidenciando, mais uma vez, a soberania da clínica.

Asunto(s)

Femenino , Enfermedades de la Mama/diagnóstico , Mama/irrigación sanguínea , Tromboflebitis/diagnóstico , Arterias Epigástricas/fisiopatología , Ultrasonografía Mamaria

RESUMEN

Os autores estudaram 30 pacientes, portadoras de nódulos mam rios, através da ultra-sonografia associada ao Doppler puls til näo colorido, para detectar fluxo sangüíneo anormal. O fluxo, quando presente, foi classificado em três tipos: leve, moderado e acentuado, procurando-se associá-los ao tipo de tumor. Os resultados mostraram para o método uma sensibilidade de 0,84; especificidade de 0,82; valor preditivo positivo de 0,89 e valor preditivo negativo de 0,75.

Asunto(s)

Humanos , Femenino , Neoplasias de la Mama , Ultrasonografía Doppler , Neoplasias de la Mama , Mama/irrigación sanguínea , Mamografía , Valor Predictivo de las Pruebas , Flujo Sanguíneo Regional , Sensibilidad y Especificidad

RESUMEN

Em funçäo das complicaçöes existentes e descritas em diferentes técnicas de mamoplastia redutora e sendo a maior parte de ordem circulatória, foi realizado um estudo de irrigaçäo mamária. Foram dissecadas dez mamas de cadáveres frecos, fornecidos pelo Serviço de Verificaçäo de Obitos da Escola Paulista de Medicina, com retirada em bloco único da glândula e estruturas retromamárias e realizada injeçäo de látex, para melhor identificaçäo das artérias. Diante dos achados anatômicos, nos quais observou-se ser a irrigaçäo mamária realizada pelas artérias torácica interna, torácica lateral e intercostais posteriores, assim como uma grande participaçäo da torácica superior, procurou-se correlacionar esses resultados com as diversas técnicas de mamoplastia redutora, criando-se uma classificaçäo em seis grupos, de acordo com os pedículos preservados: superior, inferior, central, lateral, medial e duplo

Asunto(s)

Humanos , Femenino , Mama/irrigación sanguínea , Mamoplastia/métodos , Mama/cirugía , Cadáver

RESUMEN

Based on existing and repeated complications of different techniques of reduction mammaplasty, which are mostly of circulatory nature, a study of breast irrigation was made. The Service of Verification of Deaths of the Escola Paulista de Medicina supplied fresh cadavers. Ten breasts were dissected with single block removal of glandular and retromammary structures. Then, injections with latex were applied in order to better identify the arteries. In view of the anatomic findings, it was verified that breast irrigation was carried out by the internal thoracic, the lateral thoracic, and the posterior intercostal arteries and, in a great proportion, by the superior thoracic. An attempt was made to correlate such results with the different techniques of reduction mammaplasty in order to create a six group classification according to the preserved pedicles: superior, inferior, central, lateral, medial and double pedicle.

Asunto(s)

Mama/irrigación sanguínea , Mamoplastia/métodos , Mama/cirugía , Cadáver , Femenino , Humanos , Flujo Sanguíneo Regional