Background: Ductal carcinoma in situ is a non-obligate precursor of invasive breast carcinoma and presents a potential risk of over or undertreatment. Finding molecular biomarkers of disease progression could allow for more adequate patient treatment. We aimed to identify potential biomarkers that can predict invasiveness risk. Methods: In this epithelial cell-based study archival formalin-fixed paraffin-embedded blocks from six patients diagnosed with invasive lesions (pure invasive ductal carcinoma), six with in-situ lesions (pure ductal carcinoma in situ), six with synchronous lesions (invasive ductal carcinoma with an in-situ component) and three non-neoplastic breast epithelium tissues were analyzed by gene expression profiling of 770 genes, using the nCounter® PanCancer Pathways panel of NanoString Technologies. Results: The results showed that in comparison with non-neoplastic tissue the pure ductal carcinoma in situ was one with the most altered gene expression profile. Comparing pure ductal carcinoma in situ and in-situ component six differentially expressed genes were found, three of them (FGF2, GAS1, and SFRP1), play a role in cell invasiveness. Importantly, these genes were also differentially expressed between invasive and noninvasive groups and were negatively regulated in later stages of carcinogenesis. Conclusions: We propose these three genes (FGF2, GAS1, and SFRP1) as potential biomarkers of ductal carcinoma in situ progression, suggesting that their downregulation may be involved in the transition of stationary to migrating invasive epithelial cells.

Colorectal cancer may yield metastasis to the choroid. Its management may be challenging, since there is no consensus about treatment. We describe a case of a 70-year-old male with colon cancer who complained of worsening visual acuity of his better-seeing eye to 20/40 secondary to a nonpigmented choroidal mass of medium reflectivity under the inferior temporal arcade and neurosensory foveal detachment. Besides systemic chemotherapy, local treatment with verteporfin photodynamic therapy (vPDT) was performed. After one month, visual acuity improved to 20/25 and subretinal fluid faded. In conclusion, vPDT may be a useful adjuvant treatment modality for choroidal metastasis secondary to colorectal cancer.

for robotic-assisted laparoscopic prostatectomy (RALP), which is a treatment for prostate cancer with rapidly increasing popularity but indeterminate benefits over traditional open surgery. Since patients are increasingly turning to the internet media as a source for education, it is important for this information to be accurate and objective. The purpose of this study was to assess the quality, content, and validity of information presented online related to robotic prostatectomy.METHODS: A web search was performed using the search term robotic prostatectomy in Google, Yahoo!, and Bing. The first fifty websites presented from each engine were evaluated for authorship, content, and validity. A Freeman-Halton extension of Fisher's Exact Test was used to compare difference between the 3 search engines. A second search using a more technical search term robotic assisted laparoscopic radical prostatectomy was then performed using Google. Differences between the two search terms was compared using Fischer's Exact Test.RESULTS: Most websites mentioned benefits of RALP (78%) and allowed readers to schedule appointments (72.7%), however only a minority referenced peer-reviewed literature (16.7%) or mentioned risks (34%). In total, 43.3% of websites mentioned faster return of continence and potency as benefits of RALP. (Graph 1) The more technical search yielded more mention of risks (p<0.001), more description of the procedure (p¼0.048), and more references to peer-reviewed literature (p<0.001).CONCLUSIONS: The results of our study also showed that the information presented by online sources of patient education may not parallel current academic literature. Return of continence and erectile function were used by many websites in this study as quality metrics of successful prostatectomies despite a lack of conclusive evidence in literature supporting either of these claims. A more technical search term did improve the quality of results, which may help physicians guide patients towards higher quality patient education material in the future.

Background Ductal carcinoma in situ is a non-obligate precursor of invasive breast carcinoma and presents a potential risk of over or undertreatment. Finding molecular biomarkers of disease progression could allow for more adequate patient treatment. We aimed to identify potential biomarkers that can predict invasiveness risk.Methods In this epithelial cell-based study archival formalin-fixed paraffin-embedded blocks from six patients diagnosed with invasive lesions (pure invasive ductal carcinoma), six with in-situ lesions (pure ductal carcinoma in situ) , six with synchronous lesions (invasive ductal carcinoma with an in-situ component) and three non-neoplastic breast epithelium tissues were analyzed by gene expression profiling of 770 genes, using the nCounter® PanCancer Pathways panel of NanoString Technologies. Results The results showed that in comparison with non-neoplastic tissue the pure ductal carcinoma in situ was one with the most altered gene expression profile. Comparing pure ductal carcinoma in situ and in-situ component six differentially expressed genes were found, three of them ( FGF2 , GAS1, and SFRP1 ), play a role in cell invasiveness. Importantly, these genes were also differentially expressed between invasive and noninvasive groups and were negatively regulated in later stages of carcinogenesis. Conclusions We propose these three genes ( FGF2 , GAS1, and SFRP1 ) as potential biomarkers of ductal carcinoma in situ progression, suggesting that their downregulation may be involved in the transition of stationary to migrating invasive epithelial cells.

e19307 Background: Given the increase in cancer cases worlwide, there has been a high demand for urgent and emergency care by oncologic patients. Despite the high demand there is still a lack of studies on the oncological population in the context of urgency and emergency especially in the developing countries like Brazil. Methods: Retrospective longitudinal study. Sample consisted of the medical records of cancer patients who were admitted to the service, selected according to the inclusion and exclusion criteria, covering a period of one year. The variables evaluated were: age, gender, comorbidities, primary site, metastasis, intrahospital transfer, discharge type, days of hospitalization, hospitalizations within one year. Results: Identified 388 patients with a total of 1235 consults among them.; 237 (60.9%) were male, with mean age of 66.5 years old; 151 (39.1%) were female with a mean age of 59.77 years old. The most frequent primary site of cancer was intestine/colon/rectum (14.9%), followed up by hematological cancer (13.8%), and breast cancer (11.5%). Metastasis was identified in 93 patients, with liver as the most commom site of metastasis. The most commom complaints were pain(37.3%), dyspnoea (9.7%), weakness (7.6%), and nausea/vomiting (7.6%). Most patients were not transfered for other hospital units, 20.6% of the consults resulted in transfer to the Oncology Nursery, and 2.7% of the consults resulted in transfer to the Intensive Care Unit. Regarding to type of discharge, 85% of the admissions resulted in discharge, 10% resulted in death, 0.89% resulted on evasion, and the rest of the patients were still hospitalized at the end of this research. The minimum of consults in one year was 1, while one patient visited the ER 35 times. Conclusions: We found that the oncology population seek frequently for ER consults, with pain as the most common complaint.The most common cancer on our service was intestine, followed up by hematological cancer and breast cancer. The majority of the consults resulted in discharge. We suggest more research approaching different ways to assess, classify and to treat oncologic pain, considering that most patients have follow up with their attending physician and yet they seek ER to treat this symptom. Also,we suggest that the population must be clarified and educated about the real role of the ER service to avoid excessive consults.