Dados do Trabalho

Título

ESTADIAMENTO CLINICO INICIAL E INCIDENCIA DE SUBTIPO MOLECULAR EM PACIENTES COM CANCER DE MAMA TRATADAS DE JAN/2011 A DEZ/2019 NO HOSPITAL PEROLA BYINGTON

Título em Inglês

INITIAL CLINICAL STAGING AIND INCIDENCE OF MOLECULAR SUBTYPE IN BREAST CANCER PATIETS TREATED FROM JAN/2011 TO DEC/2019 AT PÉROLA BYINGTON HOSPITAL

Introdução

Clinical staging (CS) is of great importance for therapeutic programming and prognostic evaluation of patients diagnosed with breast cancer. Malignant breast tumors can be classified according to their immunohistochemical (IHC) profile. The study of IHC can also assist in public health strategies, since they determine therapeutic planning.

Objetivos

Compare our data base with literature data.

Métodos

The staging database (TNM) of the CRSM-SP (Pérola Byington Hospital) of patients with breast cancer treated at the Institution from January 2010 to December 2019.

Resultados

It was observed that 5.7% of the patients had tumors in situ. In the invasive forms, 22.7% of the patients were diagnosed in CS I. Stage II was the one with the highest occurrence, corresponding to 36.5%. Advanced cases belonging to stages III and IV respectively represented 28.2% and 3.26%. As for the IHC profile of our 10,665 patients, luminal tumors A represented 24.7%, luminal B 32.7%. Patients with overexpressed HER2 were subdivided into pure HER2 (7.7%) and triple positive (9.8%). Triple negative tumors represented 25.1% of patients. Brazilian study with SUS data included 201,079 women: 19.5% were stage I, 40.4% stage II, 30.9% stage III and 9.3% stage IV.¹ In comparison with the public health system in England, a population study of 86852 cases of breast cancer found 37% of diagnosis at stage I, 32% CS II, 8% at CS III, and 5% at CS IV. The high proportion of patients (17%) with unknown staging is noteworthy.² In the USA, a population study of 320,124 women, 72.6% were classified as luminal A, 11.2% luminal B, 4.8% overexpression of HER2 and 11.3% triple negative.³ Data from a Brazilian publication with 2,461 patients observed luminal A in 28.8% of the cases, luminal B 39.5%, pure HER2 7.9%, triple positive 9.7% and triple negative were 14%, with the exception of triple negatives, similar to our results.⁴ It is possible that the higher proportion of patients with triple negative tumors at CRSM is explained by our higher incidence of non screened patients, aged under 50, which are about 39%.

Conclusões

The finding of 28.4% of tumors in stage I and in situ, shows the results of an opportune screening. The predominance of patients in stage II (40.4%) shows the predominance of palpable tumors in our population and the importance of making the agile diagnosis, preventing progression to stage III. The predominance of luminal tumors 68.3% and HER 2 (16.7%) were similar to those in the literature. However, the proportion of 25.1% of triple-negative patients contributes to higher mortality in Brazil and requires greater diagnostic and therapeutic agility.

Palavras Chave

Área

EPIDEMIOLOGY, RISK, AND PREVENTION - Epidemiology