Sergio Hatschbach - Academia.edu (original) (raw)
Papers by Sergio Hatschbach
Rev. bras. mastologia, 2011
Supportive Care in Cancer, Oct 13, 2011
Fatigue is a phenomenon that may persist for years after completion of adjuvant therapy, and is o... more Fatigue is a phenomenon that may persist for years after completion of adjuvant therapy, and is one of the most frequent symptoms associated with breast cancer survivors. The purposes of this study were to investigate the occurrence of fatigue in disease-free breast cancer survivors after treatment, to identify variables associated with fatigue, and to evaluate the impact of fatigue on health-related quality of life. A cross-sectional study was conducted on 202 consecutive women diagnosed with in-situ to Stage III breast cancer attending in outpatient facilities of two large hospitals, one year or more after diagnosis. They completed the Piper Fatigue Scale-Revised and the European Organization for Research and Treatment of Cancer QLQ-C30. Multiple logistic regression models were used to identify predictive factors associated with fatigue. EORTC QLQC-30 scores for fatigued survivors were compared to non-fatigued survivors. The prevalence of fatigue reported by the breast cancer survivors was 37.6%. Multiple logistic regression analysis revealed that predictive factors for fatigue included younger age (odds ratio [OR]=2.23, 95% confidence interval [CI]=1.11-4.45, p = 0.024); presence of pain (OR = 3.87, 95% CI = 1.88-7.98, p = 0.000); dyspnea (OR = 3.72, 95% CI = 1.46-9.50, p = 0.006); insomnia (OR = 2.40, 95% CI = 1.19-4.86, p = 0.015); and nausea and vomiting (OR = 12.25, 95% CI = 1.18-126.75, p = 0.036). Fatigued women had poorer health-related quality of life than non-fatigued women in all domains. Our results suggest that many disease-free breast cancer survivors after treatment experienced fatigue that compromises their health-related quality of life.
Mastology, 2020
Introduction: For the past few years, Nipple-Sparing Mastectomy (NSM) has been a tendency, and ro... more Introduction: For the past few years, Nipple-Sparing Mastectomy (NSM) has been a tendency, and robotic breast surgery has become a reality. Until August, 2019, three robotic adenomastectmy procedures were carried out in Hospital Erasto Gaertner. The objective of this article is to demonstrate our results and publicize the knowledge in robotic surgery. Methods: Surgical Technique. The Da Vinci Surgical System Si® (Intuitive Surgical, Sunnyvale, CA) was used to perform the NSM surgeries. The 3 cm long incision was initiated in the axillary region, and the subcutaneous cellular tissue was resected to an area of 5 cm in diameter, to the portal. One mg/ml of adrenaline diluted in physiological serum 0.9% was infiltered in the subdermal breast tissue. Tunneling is executed with Metzenbaum scissors in the subdermal region. The device is coupled (GelPOINT Advanced Access Platform tm), and gas pressure of 8 mmHg is activated. The ProGrasp Forceps, the monopolar curved scissors and the 30º video camera are allocated in the robotic arms. The upper quadrants are superficially dissected, and then the lower quadrants, the retro-mammillary region and, finally, the breast muscle tissue. The expander is allocated between the chests with the open technique. Result: The duration of the mammary gland extirpation was 5 hours in the first unilateral adenomastectomy surgery, and 1 hour and 45 minutes in the last for the same type of surgery. In total, the first surgery took 6 hours and 20 minutes, which reduced to 3 hours in the last. In two surgeries we observed skin burns caused by electrocautery. These were solved in weeks, however, without the need for surgical intervention. We did not observe complications such as seroma, hematoma, loss of prosthesis, major pain, infection or subcutaneous emphysema due to carbon dioxide. Discussion: Complication rates are low, as shown by Lai et al. (2019), who analyzed a case series and showed transient nipple ischemia (10.3%) as the highest rate of complication; however, without nipple necrosis or loss of prosthesis. In the cases operated in Hospital Erasto Gaertner, the aesthetic results were very well evaluated both by the patients and the plastic surgery and mastology staff. Minor complications were solved in weeks, which maintained an excellent final outcome. The learning curve of the robotic technique was extremely fast, with considerable reduction in surgical time. Conclusion: We believe that innovative robotic surgery can contribute with the advancement of breast surgery around the world.
Mastology, Dec 1, 2019
Introdução: O câncer de mama é a neoplasia que mais acomete mulheres no mundo, sendo uma a cada 1... more Introdução: O câncer de mama é a neoplasia que mais acomete mulheres no mundo, sendo uma a cada 10 mulheres que irão ser acometidas, no Brasil. Portanto, proporcionar cirurgias que tenham menor morbidade com as mesmas ou maiores taxas de cura é um desafio. De acordo com o exposto, até a década passada realizar linfadenectomia após quimioterapia neoadjuvante era mandatório, porém novos estudos estão conseguindo provar que para alguns casos a biópsia de linfonodo sentinela pode ser uma opção. Objetivo: Este estudo analisou o índice de positividade de linfadenectomias pós-quimioterapia neoadjuvante. Métodos: Foram avaliadas 152 pacientes, entre 2012 e 2014, que realizaram cirurgia de linfadenectomia, separado-as em dois braços, aquelas que eram axilas positivas clinicamente antes da quimioterapia em um braço, e no outro, axilas negativas antes do tratamento quimioterápico. Resultados: Desmembrando os 152 pacientes, 57 desses com axilas negativas anteriores à quimioterapia, obtivemos que 71% permaneceram negativas após linfadenectomia. No grupo de 95 pacientes com axilas positivas, após neoadjuvância quimioterápica, 43,6% resultaram estarem livres de comprometimento neoplásico após linfadenectomia. Discussão: Os resultados denotados no índice de positividade de linfonodos em todos os grupos foram muito semelhantes à literatura mundial, demonstrando que nosso estadiamento antes da quimioterapia e nosso tratamento neoadjuvante são realizados com a mesma eficácia do que de outros hospitais já estudados. Também pudemos denotar que estamos autorizados a realizar biópsia de linfonodo sentinela pós-quimioterapia naquelas pacientes as quais eram negativas as axilas clinicamente, antes do tratamento neoadjuvante. Conclusão: A biópsia de linfonodo sentinela é uma técnica segura e eficaz em pacientes pós-quimioterapia com axilas negativas e devemos sempre incentivar essa técnica, quando for indicado.
PubMed, Dec 1, 2009
Purpose: to evaluate the results of treatment to which patients with high grade intraepithelial c... more Purpose: to evaluate the results of treatment to which patients with high grade intraepithelial cervical neoplasia (HSIL) are submitted, as well as their follow-up during pregnancy. Methods: retrospective study based on the review of the medical report of 30 patients with diagnosis of high-grade squamous intraepithelial lesions (HSIL) during pregnancy and attended to at a tertiary hospital in southern Brazil from 1990 to 2002. Diagnosis was performed by colposcopy and biopsy, with repetition of the colposcopy during the pregnancy and after delivery. The diagnoses of regression and progression of lesions were evaluated. Results: from 30 patients, 3 were excluded of the sample because the diagnosis of high-grade squamous intraepithelial lesions (HSIL) was not confirmed by the colposcopy with biopsia. Four patients were submitted to treatment during pregnancy, and one of them presented preterm delivery at the 32nd week. Twenty-three patients were submitted to expectant treatment, underwent a new colposcopy and biopsy, and then were submitted to conisation surgery at about the 11(th) week after the end of pregnancy. In 7.4% of the cases, there was lesion regression in the surgical specimen. Conclusions: all patients with diagnosis should be submitted to colposcopy and biopsy to exclude the possibility of invasive lesion. The expectant procedure for intraepithelial lesions is the most widely chosen and safe due to the possibility of regression in the postpartum period.
Jornal Brasileiro de Ginecologia, 1994
Revista Brasileira de Mastologia, 2013
Neoplasias da mama masculina Câncer de mama oculto Relato de caso Mama Tamoxifeno RESUMO O câncer... more Neoplasias da mama masculina Câncer de mama oculto Relato de caso Mama Tamoxifeno RESUMO O câncer oculto de mama, que representa menos de 1% de todos os casos de câncer de mama, é definido como doença não identificada durante o exame físico do paciente nem por exames de imagem da mama, mas que apresenta linfadenopatia axilar compatível para câncer por meio de exames imuno-histoquímicos. Apenas 1% dos casos de câncer de mama acomete indivíduos do sexo masculino. Além disso, representa menos de 1% de todos os cânceres em homens, e tal o câncer representa menos de 1% de todos os cânceres em homens. Apresentou-se o caso de um homem de 54 anos com câncer de mama oculto apresentando metástase para tecido subcutâneo axilar, apresentado como nódulo em topografia axilar esquerda. Após a exérese da lesão, o paciente foi submetido à adenomastectomia bilateral e linfadenectomia axilar à esquerda, sendo o exame anatomopatológico das peças negativo para neoplasia. O paciente realizou radioterapia complementar e encontra-se em hormonioterapia com tamoxifeno (cinco anos). No momento, encontra-se em seguimento sem evidência de doença em atividade. Concluiu-se que o câncer de mama oculto em homem é raro e, por isso, ainda existem divergências sobre o tratamento definitivo, não devendo nunca se subestimar queixas mamárias.
Rev. ginecol. …, 1992
Base de dados : ADOLEC. Pesquisa : 154832 [Identificador único]. Referências encontradas : 1 [ref... more Base de dados : ADOLEC. Pesquisa : 154832 [Identificador único]. Referências encontradas : 1 [refinar]. Mostrando: 1 .. 1 no formato [Detalhado]. página 1 de 1, 1 / 1, ADOLEC, seleciona. para imprimir. Fotocópia. Id: 154832. Autor ...
Rev. bras. ginecol. …, 1989
Base de dados : LILACS. Pesquisa : 93796 [Identificador único]. Referências encontradas : 1 [refi... more Base de dados : LILACS. Pesquisa : 93796 [Identificador único]. Referências encontradas : 1 [refinar]. Mostrando: 1 .. 1 no formato [Detalhado]. página 1 de 1, 1 / 1, LILACS, seleciona. para imprimir. Fotocópia. experimental, Documentos relacionados. Id: 93796. ...
Rev. bras. mastologia, 2011
Mastology, 2020
Introduction: For the past few years, Nipple-Sparing Mastectomy (NSM) has been a tendency, and ro... more Introduction: For the past few years, Nipple-Sparing Mastectomy (NSM) has been a tendency, and robotic breast surgery has become a reality. Until August, 2019, three robotic adenomastectmy procedures were carried out in Hospital Erasto Gaertner. The objective of this article is to demonstrate our results and publicize the knowledge in robotic surgery. Methods: Surgical Technique. The Da Vinci Surgical System Si® (Intuitive Surgical, Sunnyvale, CA) was used to perform the NSM surgeries. The 3 cm long incision was initiated in the axillary region, and the subcutaneous cellular tissue was resected to an area of 5 cm in diameter, to the portal. One mg/ml of adrenaline diluted in physiological serum 0.9% was infiltered in the subdermal breast tissue. Tunneling is executed with Metzenbaum scissors in the subdermal region. The device is coupled (GelPOINT Advanced Access Platformtm), and gas pressure of 8 mmHg is activated. The ProGrasp Forceps, the monopolar curved scissors and the 30º vid...
Rev Bras Mastologia, Dec 1, 2009
Rev Bras Mastologia, Jun 1, 2001
Revista Brasileira de Mastologia, 2016
Objetivo: Estudar os casos novos de câncer de mama assim como avaliar o perfil epidemiológico e s... more Objetivo: Estudar os casos novos de câncer de mama assim como avaliar o perfil epidemiológico e sobrevida dos pacientes com câncer de mama atendidos no Hospital Erasto Gaertner, em Curitiba, Paraná. Métodos: Coleta de variáveis obtidas de prontuários e fichas de coleta de dados, através do Registro Hospitalar de Câncer, com posterior análise estatística auxiliada pelo programa Epi-Info. Resultados: No período de 1990 a 2009, foram diagnosticados 5.158 casos novos de câncer de mama na instituição. O tipo histológico mais frequente foi o carcinoma ductal infiltrante com 81,7% dos casos. Na década 1990, os pacientes com estádio clínico III e IV somaram 35,0%, enquanto que no período de 2000-2009 esta somatória caiu para 25,8%, evidenciando-se, assim, diminuição expressiva dos estádios mais avançados. Entre os pacientes tratados de 1990 a 1999, foi observada sobrevida global em cinco anos de 61,0%. Conclusão: O perfil de casos novos foi semelhante ao observado na literatura, com aumento dos casos precoces, e a sobrevida foi compatível com o observado para pacientes com câncer de mama no Brasil.
Rev Bras Ginecol Obstet, Feb 1, 1997
Rev Bras Mastologia, Sep 1, 2011
Rev. bras. mastologia, 2011
Supportive Care in Cancer, Oct 13, 2011
Fatigue is a phenomenon that may persist for years after completion of adjuvant therapy, and is o... more Fatigue is a phenomenon that may persist for years after completion of adjuvant therapy, and is one of the most frequent symptoms associated with breast cancer survivors. The purposes of this study were to investigate the occurrence of fatigue in disease-free breast cancer survivors after treatment, to identify variables associated with fatigue, and to evaluate the impact of fatigue on health-related quality of life. A cross-sectional study was conducted on 202 consecutive women diagnosed with in-situ to Stage III breast cancer attending in outpatient facilities of two large hospitals, one year or more after diagnosis. They completed the Piper Fatigue Scale-Revised and the European Organization for Research and Treatment of Cancer QLQ-C30. Multiple logistic regression models were used to identify predictive factors associated with fatigue. EORTC QLQC-30 scores for fatigued survivors were compared to non-fatigued survivors. The prevalence of fatigue reported by the breast cancer survivors was 37.6%. Multiple logistic regression analysis revealed that predictive factors for fatigue included younger age (odds ratio [OR]=2.23, 95% confidence interval [CI]=1.11-4.45, p = 0.024); presence of pain (OR = 3.87, 95% CI = 1.88-7.98, p = 0.000); dyspnea (OR = 3.72, 95% CI = 1.46-9.50, p = 0.006); insomnia (OR = 2.40, 95% CI = 1.19-4.86, p = 0.015); and nausea and vomiting (OR = 12.25, 95% CI = 1.18-126.75, p = 0.036). Fatigued women had poorer health-related quality of life than non-fatigued women in all domains. Our results suggest that many disease-free breast cancer survivors after treatment experienced fatigue that compromises their health-related quality of life.
Mastology, 2020
Introduction: For the past few years, Nipple-Sparing Mastectomy (NSM) has been a tendency, and ro... more Introduction: For the past few years, Nipple-Sparing Mastectomy (NSM) has been a tendency, and robotic breast surgery has become a reality. Until August, 2019, three robotic adenomastectmy procedures were carried out in Hospital Erasto Gaertner. The objective of this article is to demonstrate our results and publicize the knowledge in robotic surgery. Methods: Surgical Technique. The Da Vinci Surgical System Si® (Intuitive Surgical, Sunnyvale, CA) was used to perform the NSM surgeries. The 3 cm long incision was initiated in the axillary region, and the subcutaneous cellular tissue was resected to an area of 5 cm in diameter, to the portal. One mg/ml of adrenaline diluted in physiological serum 0.9% was infiltered in the subdermal breast tissue. Tunneling is executed with Metzenbaum scissors in the subdermal region. The device is coupled (GelPOINT Advanced Access Platform tm), and gas pressure of 8 mmHg is activated. The ProGrasp Forceps, the monopolar curved scissors and the 30º video camera are allocated in the robotic arms. The upper quadrants are superficially dissected, and then the lower quadrants, the retro-mammillary region and, finally, the breast muscle tissue. The expander is allocated between the chests with the open technique. Result: The duration of the mammary gland extirpation was 5 hours in the first unilateral adenomastectomy surgery, and 1 hour and 45 minutes in the last for the same type of surgery. In total, the first surgery took 6 hours and 20 minutes, which reduced to 3 hours in the last. In two surgeries we observed skin burns caused by electrocautery. These were solved in weeks, however, without the need for surgical intervention. We did not observe complications such as seroma, hematoma, loss of prosthesis, major pain, infection or subcutaneous emphysema due to carbon dioxide. Discussion: Complication rates are low, as shown by Lai et al. (2019), who analyzed a case series and showed transient nipple ischemia (10.3%) as the highest rate of complication; however, without nipple necrosis or loss of prosthesis. In the cases operated in Hospital Erasto Gaertner, the aesthetic results were very well evaluated both by the patients and the plastic surgery and mastology staff. Minor complications were solved in weeks, which maintained an excellent final outcome. The learning curve of the robotic technique was extremely fast, with considerable reduction in surgical time. Conclusion: We believe that innovative robotic surgery can contribute with the advancement of breast surgery around the world.
Mastology, Dec 1, 2019
Introdução: O câncer de mama é a neoplasia que mais acomete mulheres no mundo, sendo uma a cada 1... more Introdução: O câncer de mama é a neoplasia que mais acomete mulheres no mundo, sendo uma a cada 10 mulheres que irão ser acometidas, no Brasil. Portanto, proporcionar cirurgias que tenham menor morbidade com as mesmas ou maiores taxas de cura é um desafio. De acordo com o exposto, até a década passada realizar linfadenectomia após quimioterapia neoadjuvante era mandatório, porém novos estudos estão conseguindo provar que para alguns casos a biópsia de linfonodo sentinela pode ser uma opção. Objetivo: Este estudo analisou o índice de positividade de linfadenectomias pós-quimioterapia neoadjuvante. Métodos: Foram avaliadas 152 pacientes, entre 2012 e 2014, que realizaram cirurgia de linfadenectomia, separado-as em dois braços, aquelas que eram axilas positivas clinicamente antes da quimioterapia em um braço, e no outro, axilas negativas antes do tratamento quimioterápico. Resultados: Desmembrando os 152 pacientes, 57 desses com axilas negativas anteriores à quimioterapia, obtivemos que 71% permaneceram negativas após linfadenectomia. No grupo de 95 pacientes com axilas positivas, após neoadjuvância quimioterápica, 43,6% resultaram estarem livres de comprometimento neoplásico após linfadenectomia. Discussão: Os resultados denotados no índice de positividade de linfonodos em todos os grupos foram muito semelhantes à literatura mundial, demonstrando que nosso estadiamento antes da quimioterapia e nosso tratamento neoadjuvante são realizados com a mesma eficácia do que de outros hospitais já estudados. Também pudemos denotar que estamos autorizados a realizar biópsia de linfonodo sentinela pós-quimioterapia naquelas pacientes as quais eram negativas as axilas clinicamente, antes do tratamento neoadjuvante. Conclusão: A biópsia de linfonodo sentinela é uma técnica segura e eficaz em pacientes pós-quimioterapia com axilas negativas e devemos sempre incentivar essa técnica, quando for indicado.
PubMed, Dec 1, 2009
Purpose: to evaluate the results of treatment to which patients with high grade intraepithelial c... more Purpose: to evaluate the results of treatment to which patients with high grade intraepithelial cervical neoplasia (HSIL) are submitted, as well as their follow-up during pregnancy. Methods: retrospective study based on the review of the medical report of 30 patients with diagnosis of high-grade squamous intraepithelial lesions (HSIL) during pregnancy and attended to at a tertiary hospital in southern Brazil from 1990 to 2002. Diagnosis was performed by colposcopy and biopsy, with repetition of the colposcopy during the pregnancy and after delivery. The diagnoses of regression and progression of lesions were evaluated. Results: from 30 patients, 3 were excluded of the sample because the diagnosis of high-grade squamous intraepithelial lesions (HSIL) was not confirmed by the colposcopy with biopsia. Four patients were submitted to treatment during pregnancy, and one of them presented preterm delivery at the 32nd week. Twenty-three patients were submitted to expectant treatment, underwent a new colposcopy and biopsy, and then were submitted to conisation surgery at about the 11(th) week after the end of pregnancy. In 7.4% of the cases, there was lesion regression in the surgical specimen. Conclusions: all patients with diagnosis should be submitted to colposcopy and biopsy to exclude the possibility of invasive lesion. The expectant procedure for intraepithelial lesions is the most widely chosen and safe due to the possibility of regression in the postpartum period.
Jornal Brasileiro de Ginecologia, 1994
Revista Brasileira de Mastologia, 2013
Neoplasias da mama masculina Câncer de mama oculto Relato de caso Mama Tamoxifeno RESUMO O câncer... more Neoplasias da mama masculina Câncer de mama oculto Relato de caso Mama Tamoxifeno RESUMO O câncer oculto de mama, que representa menos de 1% de todos os casos de câncer de mama, é definido como doença não identificada durante o exame físico do paciente nem por exames de imagem da mama, mas que apresenta linfadenopatia axilar compatível para câncer por meio de exames imuno-histoquímicos. Apenas 1% dos casos de câncer de mama acomete indivíduos do sexo masculino. Além disso, representa menos de 1% de todos os cânceres em homens, e tal o câncer representa menos de 1% de todos os cânceres em homens. Apresentou-se o caso de um homem de 54 anos com câncer de mama oculto apresentando metástase para tecido subcutâneo axilar, apresentado como nódulo em topografia axilar esquerda. Após a exérese da lesão, o paciente foi submetido à adenomastectomia bilateral e linfadenectomia axilar à esquerda, sendo o exame anatomopatológico das peças negativo para neoplasia. O paciente realizou radioterapia complementar e encontra-se em hormonioterapia com tamoxifeno (cinco anos). No momento, encontra-se em seguimento sem evidência de doença em atividade. Concluiu-se que o câncer de mama oculto em homem é raro e, por isso, ainda existem divergências sobre o tratamento definitivo, não devendo nunca se subestimar queixas mamárias.
Rev. ginecol. …, 1992
Base de dados : ADOLEC. Pesquisa : 154832 [Identificador único]. Referências encontradas : 1 [ref... more Base de dados : ADOLEC. Pesquisa : 154832 [Identificador único]. Referências encontradas : 1 [refinar]. Mostrando: 1 .. 1 no formato [Detalhado]. página 1 de 1, 1 / 1, ADOLEC, seleciona. para imprimir. Fotocópia. Id: 154832. Autor ...
Rev. bras. ginecol. …, 1989
Base de dados : LILACS. Pesquisa : 93796 [Identificador único]. Referências encontradas : 1 [refi... more Base de dados : LILACS. Pesquisa : 93796 [Identificador único]. Referências encontradas : 1 [refinar]. Mostrando: 1 .. 1 no formato [Detalhado]. página 1 de 1, 1 / 1, LILACS, seleciona. para imprimir. Fotocópia. experimental, Documentos relacionados. Id: 93796. ...
Rev. bras. mastologia, 2011
Mastology, 2020
Introduction: For the past few years, Nipple-Sparing Mastectomy (NSM) has been a tendency, and ro... more Introduction: For the past few years, Nipple-Sparing Mastectomy (NSM) has been a tendency, and robotic breast surgery has become a reality. Until August, 2019, three robotic adenomastectmy procedures were carried out in Hospital Erasto Gaertner. The objective of this article is to demonstrate our results and publicize the knowledge in robotic surgery. Methods: Surgical Technique. The Da Vinci Surgical System Si® (Intuitive Surgical, Sunnyvale, CA) was used to perform the NSM surgeries. The 3 cm long incision was initiated in the axillary region, and the subcutaneous cellular tissue was resected to an area of 5 cm in diameter, to the portal. One mg/ml of adrenaline diluted in physiological serum 0.9% was infiltered in the subdermal breast tissue. Tunneling is executed with Metzenbaum scissors in the subdermal region. The device is coupled (GelPOINT Advanced Access Platformtm), and gas pressure of 8 mmHg is activated. The ProGrasp Forceps, the monopolar curved scissors and the 30º vid...
Rev Bras Mastologia, Dec 1, 2009
Rev Bras Mastologia, Jun 1, 2001
Revista Brasileira de Mastologia, 2016
Objetivo: Estudar os casos novos de câncer de mama assim como avaliar o perfil epidemiológico e s... more Objetivo: Estudar os casos novos de câncer de mama assim como avaliar o perfil epidemiológico e sobrevida dos pacientes com câncer de mama atendidos no Hospital Erasto Gaertner, em Curitiba, Paraná. Métodos: Coleta de variáveis obtidas de prontuários e fichas de coleta de dados, através do Registro Hospitalar de Câncer, com posterior análise estatística auxiliada pelo programa Epi-Info. Resultados: No período de 1990 a 2009, foram diagnosticados 5.158 casos novos de câncer de mama na instituição. O tipo histológico mais frequente foi o carcinoma ductal infiltrante com 81,7% dos casos. Na década 1990, os pacientes com estádio clínico III e IV somaram 35,0%, enquanto que no período de 2000-2009 esta somatória caiu para 25,8%, evidenciando-se, assim, diminuição expressiva dos estádios mais avançados. Entre os pacientes tratados de 1990 a 1999, foi observada sobrevida global em cinco anos de 61,0%. Conclusão: O perfil de casos novos foi semelhante ao observado na literatura, com aumento dos casos precoces, e a sobrevida foi compatível com o observado para pacientes com câncer de mama no Brasil.
Rev Bras Ginecol Obstet, Feb 1, 1997
Rev Bras Mastologia, Sep 1, 2011