We hypothesised that breast cancer risk for relatives of women with early-onset breast cancer could be predicted by tumour morphological features. We studied female first-degree relatives of a population-based sample of 452 index cases with a first primary invasive breast cancer diagnosed before the age of 40 years. For the index cases, a standardised tumour morphology review had been conducted for all; estrogen (ER) and progesterone receptor (PR) status was available for 401 (89%), and 77 (17%) had a high-risk mutation in a breast cancer susceptibility gene or methylation of the BRCA1 promoter region in peripheral blood DNA. We calculated standardised incidence ratios (SIR) by comparing the number of mothers and sisters with breast cancer with the number expected based on Australian incidence rates specific for age and year of birth. Using Cox proportional hazards modelling, absence of extensive sclerosis, extensive intraductal carcinoma, absence of acinar and glandular growth patterns, and the presence of trabecular and lobular growth patterns were independent predictors with between a 1.8- and 3.1-fold increased risk for relatives (all P <0.02). Excluding index cases with known genetic predisposition or BRCA1 promoter methylation, absence of extensive sclerosis, circumscribed growth, extensive intraductal carcinoma and lobular growth pattern were independent predictors with between a 2.0- and 3.3-fold increased risk for relatives (all P <0.02). Relatives of the 128 (34%) index cases with none of these four features were at population risk (SIR = 1.03, 95% CI = 0.57 to 1.85) while relatives of the 37 (10%) index cases with two or more features were at high risk (SIR = 5.18, 95% CI = 3.22 to 8.33). This wide variation in risks for relatives based on tumour characteristics could be of clinical value, help discover new breast cancer susceptibility genes and be an advance on the current clinical practice of using ER and PR as pathology-based predictors of familial and possibly genetic risks.

Na procura de novas alternativas para a terapeutica antitrombotica foi seguida uma estrategia de hibridizacao molecular de polissacaridos sulfatados e flavonoides sulfatados. Assim, foi efetuada a sintese e avaliacao de pequenas moleculas glicosiladas polissulfatadas, pertencentes a classe quimica dos flavonoides. Concluiu-se que os novos compostos desenvolvidos combinam atividades anticoagulante e antiagregante plaquetaria, e poderao permitir, desta forma, a prevencao tanto da trombose arterial como venosa. Estes resultados, acrescidos ao fato de terem apresentado estabilidade em plasma humano e um efeito anticoagulante eficaz, apos a administracao intraperitoneal em ratinhos, sem sinais preliminares de hepatotoxicidade, permitiram considerar o seu potencial para virem a constituir alternativas, na prevencao e tratamento, das doencas cardiovasculares.