Abstract
Breast cancer is the second most common malignancy in Brazilian women. It is estimated by the INCA (The Brazilian National Institute of Cancer) that 49,400 new cases will occur this year, a standardized incidence rate of 51 per 100,000 women. In South of Brazil, there is one of the highest incidences of breast cancer in the country: an estimation rate of 56,16 per 100,000 women. In this study we report the clinical and histopathological data from 142 breast cancer patients from this region. The mean age of the patients at diagnosis was 57.7 + 13.7 years, 17.6% of patients presented early menarche (up to 12 years old), 14.7% presented late menopause (after 55 years), 18.1% were nulliparous and 13.9% reported first delivery after 30 years old. Almost 40% of patients declared the use of oral contraceptives for more than 10 years, and 24% were smokers. Tumors of histological grade II and III tumors were found in 81.1% of patients. Metastases in the lymph nodes were present in 48% of the cases and tumor size bigger than 2 cm in 86%. These histopathological characteristics are indicative of a diagnosis of advanced disease. Considering that early detection is a decisive factor to prognostic determination and highly affects survival rates, epidemiological studies characterizing breast cancer patients in the different geographic regions of the country are important to improve cancer controls methods, such as the development of prevention and screening programs to the Brazilian population.
References
Instituto Nacional de Câncer, Ministério da Saúde - Inca/MS [boletim na internet]. Estimativas 2008, 2007 [acesso em 22 mar 2009]. Disponível em: http://www.inca.gov.br/estimativa/2008/versaofinal.pdf.
World Health Organization – WHO [boletim na internet]. Mortality - Baseline Scenario 2008 [acesso em 22 mar 2009]. Disponível em: http://www.who.int/healthinfo/global_burden_disease/Dth7_2008.xls.
Polyak K. Breast cancer: origins and evolution. J Clin Invest. 2007;117:3155-63.
Vargo-gogola T, Rosen JM. Modelling breast cancer: one size does not fit all. Nat Rev Cancer. 2007;7:659-72.
Lambe M, Hsieh CC, Chan HW, Ekbom A, Trichopoulos D, Adami HO. Parity, age at first and last birth, and risk of breast cancer: a population-based study in Sweden. Breast Cancer Res Treat. 1996; 38:305-11.
Greenlee RT, Murray T, Boldin S, Wingo P. Cancer statistics 2000. CA Cancer J Clin. 2000;50:7- 33.
Parkin DM, Bray FI, Devesa SS. Cancer burden in the year 2000. The global picture. Eur J Cancer. 2001;37:4-66.
Key TJ. Serum oestradiol and breast cancer risk. Endocr Relat Câncer. 1999;6:175-80.
McPherson K, Steel CM, Dixon JM. ABC of breast diseases. Breast cancer – epidemiology, risk factors and genetics. BMJ. 2000;321:624-8.
Dhingra K, Hortobagyi GN. Critical evaluation of prognostic factors. Semin Oncol. 2006;23:436-45.
Soerjomataram I, Louwman MW, Ribot JG, Roukema JA, Coebergh JW. An overview of prognostic factors for long-term survivor of breast. Breast Cancer Res Treat. 2008;107:309-30.
Schwartsmann G. Breast cancer in South America: challenges to improve early detection and medical management of a public health problem. J Clin Oncol. 2001;19:118-24.
Gonçalves ATC, Jobin PFC, Vanacor R, Nunes LN, Albuquerque IM, Bozzetti MC. Câncer de mama: mortalidade crescente na Região Sul do Brasil entre 1980 e 2002. Cad Saúde Pública. 2007;23:1785-90.
Freitas F, Menke CH, Passos EP, Rivoire WA. Rotinas em ginecologia. 6 ed. São Paulo: Artmed ; 2006.
Guimarães JRQ. Manual de Oncologia. São Paulo: BBS; 2004.
Pinho VFS, Coutinho ESF. Variáveis associadas ao câncer de mama em usuárias de unidades básicas de saúde. Cad Saúde Pública. 2007;23:1061-9.
Lamas JM, Pereira MG. Fatores de risco para o câncer de mama e para lesões pré-malignas em mulheres assintomáticas no Distrito Federal. Rev Bras Mastol. 1999;9:108-14.
Narod SA, Foulkes WD. BRCA1 and BRCA2. Nature Reviews. 2004;4:665-76.
Russo IH, Russo J. Mammary gland neoplasia in long-term rodent studies. Environ Health Perspect. 1996;104:938-67.
Kahlenborn C, Modugno F, Potter DM, Severs WB. Oral contraceptive use as a risk factor for premenopausal breast cancer: a meta-analysis. Mayo Clin Proc. 2006;81:1290-302.
Innes KE, Byers TE. Smoking during pregnancy and breast cancer risk in very young women (United States). Cancer Causes Control. 2001;12:179-85.
Hamajima N, Hirose K, Tajima K, Rohan T, Calle EE, Heath CW Jr et al. Alcohol, tobacco and breast cancer: collaborative reanalysis of individual data from 53 epidemiological studies, including 58,515 women with breast cancer and 95,067 women without the disease. Br J Cancer. 2002;87:1234-45.
Clarke MF, Fuller M. Stem cells and cancer: two faces of eve. Cell. 2006;124:1111-5.
Chia SK, Speers CH, Bryce CJ, Hayes MM, Olivotto IA. Ten-year outcomes in a population-based cohort of node-negative, lymphatic, and vascular invasion-negative early breast cancers without adjuvant systemic therapies. J Clin Oncol. 2004;22:1630-7.
Scarff R, Torloni F. Histological typing of breast tumors. International histological classification of tumors. World Health Organization. 1968;2:20.
Einsenberg AJA, Koifman S. Câncer de mama: marcadores tumorais. Rev Bras Cancerol. 2001;47:377-88.
Boecker W, Buerger H. Evidence of progenitor cells of glandular and myoepithelial cell lineage in the human adult breast epithelium: a new progenitor (adult steam) cell concept. Cell Prolif. 2003;36:73-84.
Arpino G, Bardou VJ, Clark GM, Elledge RM. Infiltrating lobular carcinoma of the breast: tumor characteristics and clinical outcome. Breast Cancer Res. 2004;6:149–56.
Sorensen J, Hertz A. Cost-effectiveness of a systematic training programme in breast selfexamination. Eur J Cancer Prev. 2003;12:289-94.
McEvoy SP, Ingram DM, Byrne MJ, Joseph DJ, Dewar J, Trotter J, et al. Breast cancer in Western Australia: clinical practice and clinical guidelines. Med J. 2004;181:305-9.
Olinto MTA, Gigante DP, Menezes AM, Macedo S, Fuchs SC. Cobertura do exame físico de mama: estudo de base populacional em Pelotas, RS. Rev. Bras. Epidemiol. 2003;1:39-48.
Kligerman J. Fundamentos para uma política nacional de prevenção e controle do câncer. Rev Bras Cancerol. 2002;48:3-7.
Marchi AA, Maria MSC, Fonsechi-Carvasan GA. Rastreamento mamográfico do câncer de mama em serviços de saúde públicos e privados. Rev Bras Ginecol Obstet. 2006;28:214-9.
Taplin SH, Ichikawa L, Yood MU, Manos MM, Geiger AM, Weinmann S, et al. Reason for latestage breast cancer: absence of screening or detection, or breakdwon in follow up? J Natl Cancer Inst. 2004;96:1518-27.
Fogaça EIC, Garrote LF. Câncer de mama: atenção primária e detecção precoce. Arq Ciênc Saúde. 2004;11:179-81.
Curi Hallal AL, Gotlieb SLD, Latorre MRDO. Evolução da mortalidade por neoplasias malignas no Rio Grande do Sul, 1979-1995. Rev Bras Epidemiol. 2001;4:169-77.
Olsen O, Gotzsche PC. Cochrane review on screening for breast cancer with mammography. Lancet. 2001;358:1340-2.
Schwartsmann G. Breast cancer in South America: challenges to improve early detection and medical management of a public health problem. J Clin Oncol. 2001;19:118-24.
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Copyright (c) 2009 Marcia Maria Costa de Oliveira, Clarissa Torresan, Sarah Franco Vieira de Oliveira, Giovana Tardin Torrezan, Carolina Sens Abuazar, Rubens Silveira Lima, Cicero de Andrade Urban, Luciane Regina Cavalli, Enilze Maria de Souza Fonseca Ribeiro, Iglenir João Cavalli