Breast Cancer in Young Brazilian Women: Challenge for the Oncology Care

Abstract

Objective. To investigate and compare aspects of breast cancer in young women (<40 years old) with older women (>40 years old). Methods. Retrospective, cross-sectional, analytical, and exploratory study based on data from 2009 to 2012 obtained from the Breast Cancer Information System (SISMAMA) and the Unified Health System Information Data (DATASUS). The studied population consisted of women (n=31.195) with malignant breast cancer. The analysed variables were education level, race, nodule detection at the clinical examination or image studies, presence of palpable axillary lymph nodes, surgical approach, and tumor histological type and grade. Results. There was increasing detection of breast cancer cases in young women among the studied years. Young women had more palpable lymph nodes (OR 1.28, 95% CI: 1.18–1.39), ductal carcinoma as the most frequent histologic type (OR 1.36, 95% CI: 1.22 to 1.53), and grades II and III tumor (OR 16.01 , 95% CI: 13.30 to 19.28 ). The lesion detection by clinical examination was higher in women <40 years (OR 1.34, 95% CI: 1.24 to 1.45). Conclusion. Although there are early detection measures related to breast cancer, they are not the usual practice of the young female public, suggesting the need for a review of existing public policies in the country.

The Rise in Mortality from Breast Cancer in Young Women: Trend Analysis in Brazil

“…In Brazil, the public health service gives priority to screening women aged over 50 years, and the occurrence of breast cancer in young women is still poorly understood [37]. There is a shortage of information in Latin America on the clinical and histological characteristics, gene expression, molecular patterns, prognosis, survival and risk factors among young women with breast cancer compared with what is known in the US and other developed countries [36].…”

“…Thus, the clinical protocols and public policies that encourage this form of detection for young women are recommended in Brazil [37]. …”

Special Needs of Young Women with Breast Cancer in Limited Resource Settings

“…(3) Finally, YWBC is subject to significant psychosocial vulnerability resulting from high levels of emotional distress and depression associated with oncological interventions 2,6,10 . The preceding factors pose complex issues for YWBC, particularly in regard to their family, social, and professional lives 8,11 , thereby substantially undermining their quality of life 2,10,12 .…”

“…As it can be expected, one of the most intense psychological demands among young patients, who would otherwise be healthy, relates to the constant threat of recurrence and death 2,12 .…”

“…This clearly calls for targeted information strategies designed to raise awareness of the importance of timely diagnosis and treatment, and to modify the cultural habits and religious beliefs that might be hindering access of YW to healthcare services 46 . Healthcare interventions are also required to improve the quality of life, and written resources and web-based decision aids should be developed and routinely provided in young patients' native language 2,12,47 .…”