Breast cancer is a heterogeneous disease with various histological and molecular subtypes. Among them, salivary gland tumors are rare and can be divided into three groups: pure myoepithelial differentiation, pure epithelial differentiation and myoepithelial with mixed epithelial differentiation. In the last group, adenoid cystic carcinoma stands out, a rare entity with low malignant potential. It represents less than 0.1–3% of breast cancer cases and has the most frequent clinical presentation as a palpable mass. The diagnosis is confirmed by histology and immunohistochemistry. Classically, they are low-aggressive triple-negative tumors, with overall survival and specific cancer survival at five and ten years greater than 95%. However, there are rare reports of aggressive variants with a risk of distant metastasis and death. Treatment is based on surgical resection with margins. Lymphatic dissemination is rare, and there is no consensus regarding the indication of an axillary approach. Adjuvant radiotherapy is indicated in cases of conservative surgery and should be discussed in other cases. The benefit of chemotherapy remains uncertain, as most tumors are indolent. We report a case that required individualized decisions based on its peculiarities of presentation, diagnosed in an asymptomatic elderly patient during screening, in which mammography showed heterogeneous gross calcifications clustered covering 1.6 cm. Stereotacticguided vacuum-assisted biopsy was performed, and the area was marked with a clip. The anatomopathological examination led to a diagnosis of salivary gland-type carcinoma, triple-negative. The patient underwent segmental resection of the right breast and sentinel lymph node biopsy. The final anatomopathological result was similar to that of the biopsy, with an immunohistochemical profile of the adenoid cystic type and two sentinel lymph nodes free of neoplasia. Considering age and histological subtype, adjuvant therapy was not indicated. Follow-up for three years showed no evidence of disease.

Objective Premature ovarian insufficiency (POI) is characterized by early hypoestrogenism. An increased risk of cardiovascular (CV) disease is a long-term consequence of POI. A challenge of hormone therapy (HT) is to reduce the CV risk. Methods Cross-sectional study with lipid profile analysis (total cholesterol, LDL-C, HDL-C, VLDL-C and triglycerides), blood glucose levels and arterial blood pressure of women with POI using HT, compared with age and BMI-matched women with normal ovarian function (controls). Results The mean age and BMI of 102 POI patients using HT and 102 controls were 37.2 ± 6.0 and 37.3 ± 5.9 years, respectively; 27.0 ± 5.2 and 27.1 ± 5.4 kg/m2. There wasn't difference between groups in arterial systolic and diastolic blood pressure, blood glucose levels, total cholesterol, LDL-C, VLDL-C and triglycerides. HDL-C levels were significantly higher in the POI group (56.3 ± 14.6 and 52 ± 13.9mg/dL; p = 0.03). Arterial hypertension was the most prevalent chronic disease (12% in the POI group, 19% in the control group, p = ns), followed by dyslipidemia (6 and 5%, in POI and control women). Conclusion Women with POI using HT have blood pressure levels, lipid and glycemic profile and prevalence of hypertension and dyslipidemia similar to women of the same age and BMI with preserved gonadal function, in addition to better HDL levels.

Introduction: Most breast and ovarian cancers in women are sporadic. However, five to ten percent of these individuals may have an inherited predisposition to cancer (Famorca-Tram, 2015). Women with pathogenic variants in BRCA1 are at risk of breast cancer of up to 72% and of ovarian cancer of up to 44%. Pathogenic variants of the BRCA2 gene increase the risk of breast cancer by up to 69% and of ovarian cancer by up to 25%. Risk reduction measures include: risk-reducing mastectomy, salpingo-oophorectomy, and chemoprevention. For women who do not choose any of these measures, follow-up with periodic examinations is necessary. In this work, the risk reduction measures adopted by 52 women with pathogenic variants in BRCA1 or BRCA2 in a tertiary hospital in São Paulo, Brazil, are analyzed. In addition, it was analyzed what factors could influence the risk-reducing measure adopted. Materials and methods: cross-sectional study with a sample of 52 women with pathogenic variants identified in the BRCA1 and BRCA2 genes seen at a tertiary hospital. Results: 80.8% opted for surgical management as a risk-reducing measure, with 46.2% of women having had prophylactic mastectomy, 11.5% having had bilateral salpingo-oophorectomy, and 23.1% having undergone both surgical procedures. Non-surgical management occurred in 19.2% of the cases, with 8% (3 cases) undergoing chemoprophylaxis with tamoxifen and 15.4% undergoing surveillance. Conclusion: Most patients opted for surgical intervention, with risk-reducing mastectomy being the most frequent one, followed by salpingo-oophorectomy. When testing was not requested by the geneticist, there was a greater tendency toward the surgical option.

e12595 Background: Preoperative breast MRI can provide important clinical information on the surgical management of BC patients (pts). However, there is no evidence that it can produce a statistical impact on surgical outcomes in the early BC setting. This retrospective study sought to evaluate whether preoperative MRI was significantly correlated with CSur among early BC pts. Methods: Digital and physical records from 532 pts treated in a specialized BC center in Brazil from 2005 to 2018 were analyzed. The institutional database registered pathological, radiological and clinical information. The categorical variables CSur and MRI were analyzed by Chi-squared coefficient of correlation, whereas significant correlations were included in a multivariate logistic regression model. All statistical analysis were performed in STATA version 15.1C. Results: The present analysis included 532 pts. The diagnosis was suspected through suspicious self-exam in 380 pts (71%), while 129 pts (24%) had altered mammary screening tests. Clinical T and N stages were: T0-1=154pts (29%); T2=179 pts (33%); T3=135 pts (25%); T4=49 pts (9%); N0=267 pts (50%); N1=172 pts (32%); N2=80 pts (15%). Neoadjuvant treatment was performed in 223 pts (42%). MRI was indicated in 248 pts (46%). CSur was performed in 149 pts (28%). Margins were positive in 15 cases. This study found a statistically significant correlation between CSur and MRI ( X2 = 8.07; p=0.018). Although, when controlled for neoadjuvant treatment, T, N, and age, the independent variable MRI was not a statistical predictor of CSur (R=0.008; t=0.25; p=0.8; 95%CI -0.57 – 0.74). Advanced T and neoadjuvant treatment were inversely correlated with CSur in the multivariate analysis (R= -0.11; t= -7.8; p<0.001 and R= -0.11; t= -2.88; p=0.004, respectively). One multivariate analysis to evaluate predictors of T stages showed that suspicious self-exam and N stage had a significant linear relationship with T stages when controlled for age (R=0.70; t=7.9; p<0.001; and R=0.76; t=15; p<0.001, respectively). Conclusions: Preoperative MRI can have impact on the conservative surgical management of curable BC patients and the present analysis showed a positive correlation. In the logistic regression model, MRI was not identified as a predictor of CSur, however the proportion of locally advanced BC may have influenced the results. Further studies must be strengthened for identifying in which subgroup of patients MRI may be a predictor of surgical outcomes.