Papers by Andre Vallejo da Silva
Revista Brasileira de Mastologia, 2014
Mastology, 2017
The Ethics Committee of the Liga Paranaense de Combate ao Câncer approved the project under the n... more The Ethics Committee of the Liga Paranaense de Combate ao Câncer approved the project under the number 44093515.6.1001.0098.
International Journal of General Medicine, Jun 1, 2013
We report two rare cases of breast cancer in men treated with modified radical mastectomy. The pa... more We report two rare cases of breast cancer in men treated with modified radical mastectomy. The patients were aged 67 and 45 years at the time of diagnosis. Tumor sizes were 2 cm and 8 cm in the older and younger patient, respectively. The histopathologic diagnosis was infiltrating ductal carcinoma in the first patient and infiltrating papillary carcinoma in the second patient. Immunohistochemical tests demonstrated estrogen and progesterone receptor positivity and HER2/c-erbB-2 negativity in both cases. The rarity of these cases is noted, in view of their uncommon occurrence at an early age in men and their immunophenotypic positivity, similar to breast cancer in women.
The Breast, Dec 1, 2012
Though removing of the pectorals fascia has always been routinely performed in modified radical m... more Though removing of the pectorals fascia has always been routinely performed in modified radical mastectomy for invasive breast cancer, there is no evidence that this routine is justified. The authors present some of the scarce data found in literature, and discuss the advantages of living the pectorals fascia in situ to facilitate implant based reconstruction.
BMC Cancer, 2015
Background: Neurofibromatosis 1 is one of the most common genetic diseases in humans, presenting ... more Background: Neurofibromatosis 1 is one of the most common genetic diseases in humans, presenting with multiple neurofibromas and an increased risk of various benign and malignant tumors, including breast cancer. Case presentation: In this paper we report a case of a woman with neurofibromatosis 1 and the challenge associated with detecting an advanced breast cancer because of numerous skin neurofibromas, which were responsible for a substantial delay in cancer diagnosis. Literature concerning the association of neurofibromatosis 1 and breast cancer is reviewed and discussed. Conclusions: Best practice guidelines for breast cancer detection are not sufficient for the screening of neurofibromatosis 1 carriers. A more intensive clinical and imaging approach should be used if the same early detection rate as in non-neurofibromatosis 1 women is to be achieved.
Journal of Cancer Science & Therapy, 2011
Thyroid carcinomas account for approximately 1% of all human cancers with the incidence of Differ... more Thyroid carcinomas account for approximately 1% of all human cancers with the incidence of Differentiated Thyroid Carcinoma (DTC) varying from 2-10 per 100, 000 but having a high prevalence due to good prognosis. It is reported that the survival rates of patients with DTC can reach as high as 90% as a result of effective therapy consisting of total thyroidectomy; with or without radioiodine ablation. Iodine-131therapy is an integral component in the management protocol for DTC worldwide. The effectiveness of radioiodine therapy is linked to sufficiently elevated serum TSH levels in DTC patients at the time of treatment and the effective half-life of 131 I in these patients respectively. Sufficiently elevated TSH is important in using thyroglobulin as a tumour marker especially in patients with total thyroidectomy. The effective half life of 131 I in DTC patients is linked to the effective radiation dose (absorbed dose) to the remnant thyroid tissue which in turn is linked directly to the effectiveness and efficacy of radioiodine remnant ablation (RRA). This study was aimed at finding the relationship between the two entities. We studied 38 patients with DTC, 18 patients (47.4%) had total thyroidectomy and 20 (52.6%) had non-total thyroidectomy (subtotal, near-total, partial thyroidectomy or lobectomy). There were 29 females (76.3%) and 9 males (23.7%), age range 20-58 years (mean 36.74 ± 9.61 years), mean weight 72.29 ± 18.24 Kg. The patients had 131 I treatment, mean dose 4.93 ± 1.93GBq (dose range 3.26GBq-12.21GBq,). The effective half life of 131 I in these patients as calculated from measurements of the retained activity in the patients after 24h of 131 I administration ranged between 0.31-0.96 days, (mean 0.61 ± 0.18 days and median = 0.6 days). The TSH results for the patients ranged between 25.6-499.8mIU/ml (mean = 179.49 ± 125.59mIU/ml and median = 148.4mIU/ml). There is a significant positive correlation between the patients' serum TSH and the effective half life (P = 0.00119, r = 0.506), therefore, it is concluded that there is a direct linear relationship between the serum TSH level of patients with differentiated thyroid cancer and the effective half-life of 131 I during radioiodine therapy.
Rev Bras Mastologia, Dec 1, 2007
Plastic and Reconstructive Surgery, 2013
Pectoralis fascia removal has always been considered a standard procedure in oncological mastecto... more Pectoralis fascia removal has always been considered a standard procedure in oncological mastectomies due to possible lymphatic dissemination of the primary tumor, though the existence of lymphatic vessels in the retromammary space has always been debated. In our study, we compared the density and area of lymphatic vessels in pectoralis fascia and breast skin using tissue microarrays (TMAs) and immunohistochemistry with the podoplanin (D2-40) antibody. Our results show that although lymphatic vessels do exist in the pectoralis fascia and are associated with the fat pad, they are 3.4x less frequent and with a mean diameter 6.5x smaller than the overlying breast skin. Therefore, we conclude that there is no justification for routine excision of the macroscopically uninvaded pectoralis fascia.
This report provides the results of our research concerning the oncological safety of pectoralis ... more This report provides the results of our research concerning the oncological safety of pectoralis fascia (PF) preservation in modified radical mastectomy (MRM) and it’s usefulness. As the PF can be an excellent aid in implant based reconstruction, to demonstrate in which cases PF invasion is not to be expected is of ultimate importance. To our knowledge, no papers in the literature have clearly demonstrated the clinical and pathological factors that correlates with invasion of the PF. We studied the specimens from 30 cases of MRM in order to establish those factors. Tumor characteristics including histopathological and immunohistochemical data were recorded, and statistical analysis was used to search association between them and the possibility of PF invasion. The demonstration that tumor-PF distance is the only significant independent variable to predict this invasion allow us to safely preserve PF in selected cases. Better image methods to preoperatively foretell this distance are an open field of research.
Breast, 2007
A definition of oncoplastic surgery of the breast is presented, and its objectives and advantages... more A definition of oncoplastic surgery of the breast is presented, and its objectives and advantages over the usual conservative procedures are discussed. The oncological safety of these procedures are demonstrated, especially in surgery of larger tumors. Technical possibilities are discussed and a classification of the procedures presented. Data from 30 cases operated in our institution are depicted. The need for better training of the breast surgeon is discussed and the advantages of the same surgeon to perform the whole procedure presented.
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Papers by Andre Vallejo da Silva