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Introduction: Immunohistochemistry, in breast cancer samples, measures the expression of biomarkers such as estrogen receptor (ER), progesterone receptor (PR), HER2, and Ki67. Using the positivity or negativity of the receptors and the Ki67 value, this method, along with the histological results, allows the doctors to classify the tumors into four types as follows: Luminal A, Luminal B, HER2, and basal/triple negative. Genetic signature is a tool involving in numerous studies in this area; however owing to the difficulty of access to the tests, its usefulness is still limited. MammaPrint® was the first test approved by the Food and Drugs Administration (FDA) in 2007 to measure prognostic value associated with breast cancer recurrence and classify patients with breast cancer into “low risk” or “high risk” of developing metastases within the first 10 years after diagnosis and elucidates the patient’s need for adjuvant chemotherapy. It categorizes tumors into subtypes based on biological homogeneity. This study aims to analyze the concordance between the results of immunohistochemistry pathological subtyping and MammaPrint®, which is accompanied by BluePrint®, for the classification and stratification of luminal breast cancer. Material and Methods: Data were collected from the medical records of 19 patients in the Instituto Sul Paranaense de Oncologia (ISPON) who presented immunohistochemistry and genetic test compatible with luminal tumors. Immunohistochemistry was evaluated through hormone receptors, HER2 and mainly Ki67, as defined by the 2013 St. Gallen guidelines (50% of the sample were centrally assessed). For classification by the genetic test, BluePrint® provided the molecular subtype data and MammaPrint® stratified the risk, establishing Luminal A tumors as low risk and Luminal B as high risk. The concordance between the immunohistochemical classification and the genetic test was evaluated with the nonparametric McNemar-Bowker test. The Ki67 cutoff value predictive for recurrence risk compared with MammaPrint® was accessed by the ROC curve. Results: The results showed that, on one side, only 33.3% of patients classified as Luminal A by immunohistochemistry were also classified by the genetic signature as Luminal A. On the other side, on the tumors classified as Luminal B, 60% presented agreement between the classifications. Overall agreement among the tests was 47.3%. The cutoff value found for Ki67 predictive of tumor recurrence risk was ≤5, with a sensitivity of 100% and a specificity of 33%. The agreement between hormonal receptors and HER2 with BluePrint® was 100%. Conclusion: This study provides preliminary data regarding the prognostic and predictive value of genetic and molecular tests — represented by MammaPrint®/BluePrint® and immunohistochemistry—in a sample of Brazilian population, evidencing a discrepancy between the methods. The cutoff value of Ki67 predictive for recurrence risk remains under discussion, since there is no standardization of its measurement methodology. As a result, new studies could be developed, with larger and multicentric samples.

Introduction: This study observed the relation of ki-67 values with prognostic factors and sought which cutoff points would be the best predictors for tumor staging. Objectives: Find which cut-off points for ki-67 would be the best predictors of tumor staging in breast cancer. Methods: The medical records of patients diagnosed with breast cancer from Instituto Sul Paranaense de Oncologia (Ponta Grossa – PR) from 2016 to 2017 were analyzed, and statistical tests were performed to evaluate the relationship between ki-67 and prognostic factors in order to find the cutoff point with better sensitivity and specificity in the characterization of tumor staging. Results: The highest values of ki-67 were found in younger patients and histological grade III tumors. The 30% ki-67 cutoff point obtained 64.06% sensitivity and 62.67% specificity in differentiating tumors with lymph node metastasis (N +) or without lymph node metastasis (N0). The cutoff point of 40% obtained sensitivity of 74.3% and specificity of 70% in the prediction of early or advanced tumors. Ki-67 values were positively associated with prognostic factors such as histological grade, molecular profile, age, tumor size and lymph node involvement. Conclusions: The level of Ki-67 positivity is directly correlated with prognostic factors in breast cancer. Rates above 30% demonstrated a high correlation with lymph node involvement. The lack of studies in the literature that used the same methodology to calculate the sensitivity of ki-67 cutoff points in the prediction of lymph node metastasis was a differential point in this study, which may bring new perspectives for the use of this marker in the clinical and therapeutic orientation of breast cancer, requiring new studies with larger sampling to confirm the results found.

Background: Among the various strategies to avoid exaggerated foreign body reaction in the treatment of hernias is the limitation of the amount of polypropylene or the use of absorbable material. Aim: To evaluate the healing of defects in the abdominal wall of rats, comparing microporous polypropylene, macroporous polypropylene and polypropylene/polyglecaprone at the 30º, 60º and 120º postoperative day. Methods: Wistar rats were submitted to defect production in the ventral abdominal wall, with integrity of the parietal peritoneum. Prolene®, Ultrapro® and Bard Soft® meshes were used in the correction of the defect. Nine subgroups of 10 animals were submitted to euthanasia at 30th, 60th and 120th postoperative day. Fragments of the abdominal wall of the animals were submitted to tensiometric analysis. Results: The tensiometry at the 30th postoperative day showed greater resistance of the tissues with Bard Soft® (macroporous mesh) in relation to the tissues with Prolene® (microporous mesh). On the 60th postoperative day Bard Soft® maintained the superior resistance to the tissues comparing to Prolene Mesh®. On the 120th postoperative day the tissues repaired with Ultrapro® (macroporous mesh) proved to be more resistant than the ones by Prolene® (microporous mesh) and Bard Soft® (macroporous mesh). Conclusion: The tissues repaired with macroporous meshes showed greater resistance than with microporous meshes at all stages, and at 120 days postoperative Ultrapro® performed better than the others. RESUMO Racional: Dentre as várias estratégias para evitar exagerada reação de corpo estranho no tratamento das hérnias está a limitação da quantidade de polipropileno na tela ou utilização de material absorvível. Objetivo: Avaliar a cicatrização de defeito em parede abdominal de ratos, comparando-se as telas de polipropileno microporosa, polipropileno macroporosa e polipropileno/poliglecaprone. Métodos: Em 90 ratos Wistar foi produzido defeito na parede abdominal ventral, com integridade do peritônio parietal. Na correção foram utilizadas as telas Prolene®, Ultrapro® e Bard Soft®. Nove subgrupos de 10 animais foram submetidos à eutanásia no 30º, 60º e 120º dia do pós-operatório. Fragmentos da parede abdominal dos animais foram submetidos à análise tensiométrica. Resultados: A tensiometria aos 30dias mostrou maior resistência do tecido com tela Bard Soft® em relação à de Prolene®; no 60º dia a Bard Soft® manteve a resistência superior ao Prolene®; no 120º dia a reparação com tela macroporosa Ultrapro® mostrou-se mais resistentes que a de Prolene® e Bard Soft®. Conclusão: Os tecidos reparados com telas macroporosas demonstraram maior resistência do que as microporosas em todas as fases, sendo que aos 120 dias de pós-operatório a Ultrapro® teve melhor desempenho que as demais.