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CNAA / Theses / 2013 / July /

Clinical and biological particularities of breast cancer in menopause


Author: Cotruţă Alexandru
Degree:doctor of medicine
Speciality: 14.00.14 - Oncology and Radiotherapy
Year:2013
Scientific adviser: Nadejda Godoroja
doctor habilitat, Public Medical Sanitary Intitution Institute of Oncology
Scientific consultant: Grigore Bulbuc
doctor habilitat, associate professor (docent), Public Medical Sanitary Intitution Institute of Oncology
Institution: Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova

Status

The thesis was presented on the 12 July, 2013
Approved by NCAA on the 3 October, 2013

Abstract

Adobe PDF document – 2.22 Mb / in romanian

Thesis

CZU 618.19-006-618.173

Adobe PDF document 4.59 Mb / in romanian
123 pages

Keywords

breast cancer (BC), menopause, mammary gland, metabolic homeostasis, hormonal homeostasis, cellular and humoral immunity, ReEs, RePg, marker CEA, CA15.3

Summary

The thesis is presented in 123 text and includes general references, 4 chapters, conclusions, practical recommendations, and bibliography from 313 scientific articles. The thesis is illustrated with 38 tables and 9 figures.

Field of study:diagnosis and treatment of the BC.
Purpose of study: The main goal of thesis is to study the risk factors and estimation of clinical and biological particularities of mammary gland factors for women in menopause. For accomplishing the task were taken in consideration the following objectives: the study of weight of risk factors – social, genetic, constitutional, concomitant pathology – in the summary risk in BC at women in menopause; characteristic of metabolic disturbances of the women patients with BC; characteristic of hormonal homeostasis of the women patients with BC; complex study of immunological status – cellular and humoral – at the women patients with BC; characteristic of steroid hormone receptors in ReEs and RePg tumour, at the women patients with BC; estimate priority risk factors in triggering BC at women in menopause.
The novelty and scientific originality: the nature and frequency of factors - social, hereditary, comorbidity - BC in menopause; the significance of risk factors in BC is very large in the modern period, based on a clinical material for the first time; we have studied the different weight risks factors – exogenous and endogenous – in the appearance to the BC patients in menopause; it will make a comprehensive assessment of the particularities of homeostasis – metabolic, hormonal and immunological; for the first time will be studied hormone receptor expression - ReEs and RePg in the tumor of mammary gland cancer to the women patients in menopause, in the Republic of Moldova.

The solved scientific problem was to determine clinical and biological characteristic of breast cancer in the patients correlated with menopausal hormonal and immune status, the markers CEA, CA15.3, receptor expression Es, Pg and allows optimizing the treatment (surgery, chemotherapy and radiotherapy), which in turn improves remote results. Theoretical significance: Knowledge supplement is to study the risk factors and estimation of clinical and biological particularities of BC factors for women in menopause, level and type of immunological and hormonal deviations, the expression of molecular markers CEA,CA15.3 and RE and RP.

Practical value of the study: Based on research, will argue importance of complex examining of patients with BC in menopause and will determine the methods of investigation. Establishing these particularities will allow:

  1. Establishing the type of disorder – metabolic, hormonal, immunological and their correction - will be a way of prevention of mammary gland cancer for woman in menopausal period.
  2. Developing concrete recommendations for the volume of surgical treatment (mastectomy or economical operations), depending on the BC clinical-biological particularities.
  3. Identify the major clinical and biological risk factors for breast cancer in menopausal whose inclusion would reduce the risk of this disease.
  4. Will contribute to avoid unfounded indication and less effective for real woman patient cured by treatment with antiestrogen and / or chemotherapy.

The obtained results are implemented in curative activity of treatment of the Breast Cancer in menopause, in the departments of Institute Oncology , were included in Clinic National Protocol „Breast Cancer”.