José Fougo

Centro Hospitalar de São João | CHSJ · Breast Centre

Introduction: Breast-conserving surgery associated with adjuvant radiotherapy is the state of the art in the surgical treatment of breast cancer. Oncoplastic surgery through dermo-adipose flaps based in perforating arteries (muscle sparing flaps) for partial reconstruction is increasingly used as a good option for avoiding musculocutaneous flaps. I...

Purpose We aimed to disclose the impact of the pandemic on breast cancer patients in a specialized breast cancer center (BCC). Methods A total of 501 breast cancer patients with a first appointment in the BCC from April 1st, 2019 to March 31st, 2021 were divided into four consecutive periods of 6 months. Data from the homologous semesters was comp...

Background: The increased focus on quality indicators (QIs) and the use of clinical registries in real-world cancer studies have increased compliance with therapeutic standards and patient survival. The European Society of Breast Cancer Specialists (EUSOMA) established QIs to assess compliance with current standards in breast cancer care. Methods...

Introduction Men born with pathogenic/likely pathogenic variants in genes associated with the Hereditary Breast and Ovarian Cancer Syndrome have a higher risk to develop breast cancer and other cancers (such as prostate cancer) and should undergo adequate surveillance protocols in highly specialized Centers. Methods A retrospective study was condu...

Men born with pathogenic/likely pathogenic variants in genes associated with the Hereditary Breast and Ovarian Cancer Syndrome have a higher risk to develop breast cancer and other cancers (such as prostate cancer) and should undergo adequate surveillance protocols in highly specialized Centers. A retrospective study was conducted to assess these g...

Purpose Women with BRCA1 and BRCA2 (BRCA1/2) pathogenic/likely pathogenic (P/LP) variants have a higher risk to develop breast and ovarian cancer. In structured high-risk clinics, risk-reducing measures are adopted. This study aimed at characterizing these women and identify factors that may have influenced their choice between risk reduction maste...

Age as a breast cancer (BC) prognostic factor remains debatable. Several studies have investigated clinicopathological features at different ages, but few make an age group direct comparison. The European Society of Breast Cancer Specialists quality indicators (EUSOMA-QIs) allow a standardized quality assurance of BC diagnosis, treatment, and follo...

X Consenso Nacional de Cancro da Mama, desenvolvido por dezenas de profissionais dos vários centros de todo o país e das diferentes especialidades dedicadas ao tratamento do cancro da mama, convocados para a revisão da literatura científica e elaboração das recomendações nacionais com o apoio da Sociedade Portuguesa de Senologia, nas seguintes área...

The Total Tumor Load (TTL) concept has been demonstrated to accurately predict the status of the non-sentinel lymph nodes (NSLN) in breast cancer patients. In 2019, our center implemented the TTL cut-off of 30,000 CK19 mRNA copies/μL as sole criterion for deciding on performing ALND. This retrospective, unicentric, study analyzed 87 cT1-3N0 breast...

Background The increased focus on quality indicators (QIs) and the use of clinical registries in real-world cancer studies have led to higher compliance with therapeutic standards and increased patient survival. The European Society of Breast Cancer Specialists (EUSOMA) defined QIs to assess compliance with current standards in breast cancer care....

Aims We analyzed the impact of the SARS-CoV-2 pandemic (COVID-19) on the quality of breast cancer care in certified EUSOMA breast centers. Materials and methods The results of the EUSOMA quality indicators (QIs) were compared, based on pseudonymized individual records, for the periods 1 March 2020 till 30 June 2020 (first COVID19 peak in most coun...

Purpose In breast cancer management not only mortality and surgical morbidity measurements are important but also patient satisfaction indexes. The authors evaluated the satisfaction and health-related quality of life (HRQOL) using the breast-conserving therapy (BCT) and breast reduction (BR) modules of BREAST-Q®. Methods This is a cross-sectional...

Background: Targeted axillary dissection (TAD) combines sentinel node biopsy (SNB) with the removal of the previously marked metastatic node. TAD is a promising concept for axillary restaging in node-positive breast cancer patients with pathological complete response (pCR) to neoadjuvant therapy (NAT). We aimed to evaluate TAD feasibility in this...

Purpose The management of older adults with breast cancer (BC) remains controversial. The challenging assessment of aging idiosyncrasies and the scarce evidence of therapeutic guidelines can lead to undertreatment. Our goal was to measure undertreatment and assess its impact on survival. Methods Consecutive patients with BC aged 70 years or older...

Introduction: Breast cancer is the most incident cancer in the world, accounting for 25% of new cancers per year in females. It is the most frequent malignancy in women, being the fifth cause of death from cancer worldwide. Approximately 5 to 10% of patients already present with metastases at diagnosis, and the liver is the site of metastases in h...

Introdução: A cirurgia oncológica da mama apresenta uma taxa de morbilidade importante que não deve ser menosprezada. O objetivo do nosso trabalho foi determinar os fatores de risco para complicações cirúrgicas após cirurgia oncológica mamária. Métodos: Estudo retrospetivo, unicêntrico e transversal de doentes submetidas a cirurgia por cancro da ma...

Introduction: The management of older patients with breast cancer remains controversial. The difficult assessment of ageing idiosyncrasies and the insufficient evidence of therapeutic guidelines can lead to undertreatment. Our goal was to measure undertreatment and assess its impact on survival. Materials and methods: Consecutive patients with brea...

The preoperative localisation of non-palpable lesions guided by breast imaging is an important and required procedure for breast-conserving surgery. We conducted a systematic review and meta-analysis of the literature on the comparative impact of different techniques for guided surgical excision of non-palpable breast lesions from reports of clinic...

Background: Cowden's syndrome is an autosomal dominant disease with variable penetrance, involving the tumor suppressor phosphatase and tension homolog gene, located on chromosome 10q22-23, responsible for cell proliferation, migration, and cellular apoptosis. Its clinical presentation encompasses mucocutaneous lesions, which are present around 99...

OSNA is a molecular assay for the detection of sentinel node metastasis. TTL emerged as a concept that seems to accurately predict the status of the NSN. Authors tried to confirm this motion. This is a retrospective and multicentric study that analyzed 2164 patients, 579 of whom had positive SN and completion AD. Logistic regression models were per...

Introducción – O Síndrome de Cancro Gástrico Difuso Hereditario (CGDH) apresenta uma hereditariedade autossómica dominante, atribuida a mutações germinativas do gene CDH1, apresentando uma elevada penetrância histológica. As mulheres portadoras apresentam, simultaneamente, um risco ao longo da vida de até 68% de Carcinoma Lobular Invasor (CLI) da M...

Introducción – A mamografía de rastreio aumentou cerca de 10 vezes o diagnóstico de Carcinoma Ductal In Situ (CDIS). A core-biópsia subestima componente invasor em até 25% dos casos. Está descrito até 1.8% de envolvimento ganglionar nos CDIS. Material y Método / Objetivos – Estudo retrospetivo, unicêntrico, de janeiro/2005 a dezembro/2012, engloban...

The preoperative localization of nonpalpable breast lesions (smaller than 10mm) guided by imaging is an important and required procedure for conservative breast surgery. The purpose of this study is to identify needs and outcomes that can be explored in order to develop and assess a new 3D breast image to aid preoperative localization of nonpalpabl...

Breast Cancer Liver Metastases

Introduction: Treatment of metastatic breast cancer (BC) has undergone considerable changes and recent advances in systemic therapies significantly increased survival. Regarding liver metastasis (LM), selected patients may benefit from combining systemic with liver-directed therapies, namely resection. With the benefits demonstrated after resection...

Objective: This longitudinal study tested the effectiveness of a group intervention designed to facilitate Posttraumatic Growth (PTG). The effects of group participation on components of the PTG model were also explored. Methods: Sample consisted of 205 women diagnosed with non-metastatic breast cancer who were either assigned to an intervention...

Background The aim of this study is to evaluate if the extension of neoadjuvant endocrine therapy (NET), beyond the conventional time, allows additional downstage of the tumour, in order to perform a breast conservative surgery (BCS), and to analyze if it is a good option for long-term control in patients who refuse or are unfit for surgery. Patie...

Highlights: Secondary lymphedema is a late iatrogenic side effect of breast cancer treatment.Despite multimodal decongestive therapy in their daily life breast cancer survivors with lymphedema have few alternatives but to use a compressive sleeve.Concerned with the well-known low compliance to the daily use of traditional sleeves, we conducted a c...

Background: Our purpose was to obtain the subjective assessment of PRADEX®, a class 1 (15-21mmHg wrist compression) elastic therapeutic sleeve, compared to commercially available sleeves, in patients with lymphoedema secondary to breast cancer treatment. Material and methods: This analysis includes 46 women with grade 1 arm lymphoedema due to axill...

The need to perform an Axillary Dissection when the Sentinel Node is metastasized, in Breast Cancer patients, is being questioned. Most part of the patients do not have any additional metastasis in the Non Sentinel Nodes and, in many cases, the decision to perform adjuvant treatments is not dependent on the axillary nodes analysis. The recent publi...

Introduction and aims: The Sentinel Node (SN) concept emerged as a way to improve Breast Cancer (BC) staging and to reduce the morbidity of the Axillary Dissection (AD). But the influence of the SN concept on long term BC outcomes is not well defined. The aim of this work is to assess the impact of the SN concept on the overall and disease-free sur...

Background The sentinel node (SN) concept has brought numerous advantages to women with breast cancer. Sparing axillary node anatomy and physiology may enhance the cosmetic results of breast cancer conservative surgery, either owing to less breast edema or to a better tolerance to the effects of surgery and radiotherapy. Our aim was to compare the...

This chapter deals with the nature of Huber needles, its different types and applications and the systems recently developed to permit their use without the risk of puncture.

Although not scientifically proven yet, there are patient-driven data that suggest that TIVADs have brought gains to the quality of life of oncologic patients.

IntroductionTo determine the impact of axillary lymphadenectomy on regional recurrence, the overall and disease free survival, and upper limb morbidity in patients with breast cancer and negative sentinel node (SN).

To determine the impact of axillary lymphadenectomy on regional recurrence, the overall and disease free survival, and upper limb morbidity in patients with breast cancer and negative sentinel node (SN). A total of 176 patients with breast cancer and negative SN (pN0(sn)) were either randomised to lymphadenectomy (Group I) or to observation only (G...

In order to assess the risk of non-sentinel node involvement in breast cancer patients, some prediction tools have been developed and tested. However, a wide range of results are observed. We tested a simplified clinical decision rule, against the complex nomogram created from the MSKCC sentinel node database. Two single institutional consecutive s...

Long term central venous catheters

Sentinel node (SN) biopsy to predict axillary involvement in breast cancer patients is a common practice. After a positive SN, additional metastases are present in an unpredictable percentage, as variable as 13-66%, of axillary clearances. Our aim is to define variables associated with non-sentinel node (NSN) metastases and to determine the predict...

The Subclavian vein has been traditionally the vein of choice for central venous catheterization by general surgeons. Alternative settings for the introduction of totally implantable venous access devices (TIVAD) and the search for lower rates of morbidity led to the choice of other central veins. This study compares two different venous accesses,...

Twelve expert observers from nine different countries convened in a workshop to evaluate the validity of the Breast Cancer Conservative Treatment. Cosmetic results (BCCT.core) software, an objective method for the aesthetic evaluation of breast cancer conservative treatment. Experts were initially asked to subjectively classify the aesthetic result...