Objective:To analyze the clinical, pathological, and sociodemographic aspects between
triple-negative breast cancer (TNBC) and non-TNBC in a Brazilian cohort and
identify potential prognostic factors.Methods:This hospital-based retrospective cohort study included 447 women with breast
cancer treated at referral centers in Southeastern Brazil. Overall and
disease-free survival were compared; prognostic factors were evaluated.Results:Triple-negative breast cancer corresponded to 19.5% of breast cancer
diagnosis and was more prevalent among nonwhite and less educated women. The
patients with TNBC tended to present with stage III cancer, high p53
expression, lymphocytic infiltration, and multifocality and treated with
radical surgery and chemotherapy. The 5-year overall and disease-free
survival were 62.1% and 57.5% for TNBC and 80.8% and 75.3% for non-TNBC,
respectively (P < .001). The TNBC recurrence was
associated with multicentricity, whereas lymph node involvement increased
the risk of both recurrence and death. Non-TNBC worse clinical course was
associated with nonwhite ethnicity, lower education level, lymph node
involvement, and advanced stage.Conclusions:Triple-negative breast cancer exhibited a more aggressive behavior, earlier
and more frequent recurrence, and worse survival compared with non-TNBC.
While biological and social variables were associated with poorer prognosis
in non-TNBC, only lymph node involvement and multicentricity were correlated
with worse clinical outcomes in TNBC.
The scope of the National Comprehensive Health Policy for the Black Population is to ensure equitable health care to this population. This policy is to compensate for the discrimination suffered by this ethnic group throughout the history of Brazil. The black population presents higher social and economic vulnerability, leading to shorter life expectancy and an increased susceptibility to diseases. The objective of the study is to investigate the black population's knowledge about this policy, its potential benefits and the difficulties of this population regarding access to health. It involves cross-sectional, quantitative and descriptive research. Structured interviews were conducted with 391 black people in Juiz de Fora. The sample was structured according to race (black and brown). Around 90% of the sample reported not knowing the existence of a health policy for the black population, and 53% stated that this policy could enhance racial discrimination. Having completed primary education and lower income was positively associated with higher discrimination in health care. Most of the sample didn't know the existence of the PNSIPN, but was in favor of its goals, despite the possibility that it can reinforce the legacy of Brazilian racial discrimination.
The majority of the elderly population displayed little knowledge on falls and were exposed to a variety of daily risk factors. Individuals who were more advanced in years and who had more knowledge on falls, were exposed to less household risk factors. This may well have been due to the adoption of preventative measures through changing domestic environment.
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