Autologous fat graft to the breast is a useful tool to correct defects after breast conservative treatment (BCT). Although this procedure gains popularity, little is known about the interaction between the fat graft and the prior oncological environment. Evidences of safety of this procedure in healthy breast and after post-mastectomy reconstruction exist. However, there is paucity of data among patients who underwent BCT which are hypothetically under a higher risk of local recurrence (LR). Fifty-nine patients, with prior BCT, underwent 75 autologous fat graft procedures using the Coleman's technique, between October 2005 and July 2008. Follow-up was made by clinical and radiologic examination at least once, after 6 months of the procedure. Mean age was 50 ± 8.5 years, and mean follow-up was 34.4 ± 15.3 months. Mean time from oncological surgery to the first fat grafting procedure was 76.6 ± 30.9 months. Most of patients were at initial stage 0 (11.8%), I (33.8%), or IIA (23.7%). Immediate complication was observed in three cases (4%). Only three cases of true LR (4%) associated with the procedure were observed during the follow-up. Abnormal breast images were present in 20% of the postoperative mammograms, and in 8% of the cases, biopsy was warranted. Autologous fat graft is a safe procedure to correct breast defects after BCT, with low postoperative complications. Although it was not associated with increased risk of LR in the group of patients studied, prospective trials are needed to certify that it does not interfere in patient's oncological prognosis.

Background: The placenta is a multifunctional organ that can suffer with imbalances between pro-and antioxidant molecules, contributing for inflammatory imbalance. The inflammation generated by oxidative stress may induce inflammasome activation, an essential complex for pro-inflammatory cytokine production. Objective: The aim of this study was to evaluate whether hydrogen peroxide (H 2 O 2) mediated oxidative stress induces inflammasome activation on placental explants. Study design: Tissue cultures of placental explants obtained from normotensive pregnant women were performed in different concentrations of H 2 O 2. Gene expressions of NLRP3, caspase-1, IL-1β, TNF-α and IL-10 were evaluated by qPCR. Superoxide dismutase (SOD), catalase, Heat shock protein 70 (Hsp70), Caspase-1, TNF-α, IL-1β, IL-10 and human Chorionic Gonadotropin (hCG) were determined by ELISA. Results: Concentrations of catalase, Hsp70, hCG and SOD were higher in cultures with 100 and 1000 µM H 2 O 2 compared to controls. Gene and protein expressions of TNF-α and IL-1β were elevated in cultures with 1000 μM H 2 O 2 compared to controls. This concentration led to inflammasome activation, by increasing gene expressions of NLRP3, caspase-1 and IL-1β. In contrast, gene and protein expressions of IL-10 were reduced at 100 and 1000 μM H 2 O 2. Protein expression of caspase-1 was higher in cultures of 100 μM H 2 O 2 compared to controls. Treatment with Glybenclamide at 200 μM was used to prevent NLRP3 inflammasome activation. This concentration reduced protein expression of caspase-1 compared to culture with only H 2 O 2 and control cultures. Conclusions: Our results confirm that H 2 O 2 induces oxidative stress on placental explants and demonstrate that cell responses to this stress involve inflammasome activation.

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%...

The identification of CK5/6, CK8/18 and SMA by immunohistochemistry in cell blocks can be a reliable method that yields results close to those obtained in surgical specimens, and can contribute to the classification of breast carcinomas with luminal and basal expression patterns, providing helpful information in the choice of treatment and in the evaluation of prognostic and predictive factors.