Breast Cancer Prognosis and Exposure to Hazardous Contaminants: An Observational Retrospective Study at Hermosillo, Sonora, Mexico

Abstract

Breast cancer prognosis is related to genetic and non-genetic risk factors. Distinct models for risk prediction have been reported to evaluate the 5-year overall survival at the time of diagnosis. However, those models do not account for non-genetic risk factors, like residential exposure to hazards. In this work, the residential exposure to hazards (gas power plants (GPP), residual water sites (RWS), hazardous air pollutants (HAPs)) has been included for assessing prognosis. We hypothesize that there is a statistically significant association between a 5-year breast cancer prognosis and residential exposure to hazards at Hermosillo city.The main findings include the association between 5-year prognosis and residential exposure to hazards in Hermosillo residents. Association models developed included, in addition to hazard exposure, the variables of age, high cholesterol and triglycerides, previous cancer(s), diabetes mellitus type 2, menopausal status, and the 5-year prognosis as the response variable. CMH test included the variables of residential exposure and 5-year prognosis in combination with one of the remaining risk factors. Non-significant models developed included hazard exposure, and the variables of familiar history of cancer, presence of chronic illness(es), presence of elements of metabolic syndrome, hypertension, elevated HDL-cholesterol, and LDL-cholesterol.The conclusions of this work are that the associations between residential exposure to hazards, in combination with other variables (age, previous cancer(s), diabetes mellitus type 2, and menopausal status), predict for a poor 5-year prognosis. Models including the factors of older age, the presence of previous cancer(s), and postmenopausal status; predict a poorer 5-year prognosis (overall survival of 69 % or less).

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“…This work is based on a large observational retrospective study that collected clinical cases of female breast cancers from the period of 2013 to 2019 in Hermosillo, Sonora, Mexico [Villa-Guillen et al 2020]. Briefly, a breast cancer database REDCap, Harris et al [9] compiled data from women residing at least 10 years in the Hermosillo municipality.…”

“…Physicians from public and private health institutions evaluated clinical files and estimated the 5-year prognosis post-diagnosis. The criteria were explained in a prior publication Villa-Guillen et al [13]. Concisely, physicians estimated the 5-year overall survival rate based on clinical data as reported in files.…”

“…Tumor characteristics at the time of diagnosis: Clinical data included breast cancer type by surgery (ductal carcinoma in situ (DCIS), invasive ductal carcinoma (IDC), lobular carcinoma in situ (LCIS), invasive lobular carcinoma (ILC), metastatic breast cancer (MBC), or rare cancers), tumor stage (I to IV) or grade (I to III), size (x ≥ 2 cm, 2 cm < x ≤ 5 cm, x > 5 cm ), and hormonal status of the tumor (hormonal positive (ER+ and PR-, ER+ and PR+, ERand PR+), or triple negative breast cancer (TNBC)) at the time of diagnosis. Clinical data is described elsewhere Villa-Guillen et al [13].…”

“…Hazard exposure as a modifiable risk factor: Other variables considered for this research as modifiable risk factors, but nonconsidered by physicians, were the residential exposure to hazards (HAPs, RWS, GPP). A prior study Villa-Guillen et al [13] used proximity analysis using geographic information systems (ArcGIS version 10.7.1) to classify neighbourhoods as hazard-exposed or non-hazard exposed. Physicians had no access to the residential information of the patient, neither had knowledge of the patient's status in terms of hazard exposure.…”

“…The clinical characteristics of the study cohort (tumor characteristics at the time of diagnosis, modifiable, and nonmodifiable breast cancer risk factors) are described elsewhere Villa-Guillen et al [13]. According to the physicians' criteria, the estimated 5-year prognosis classified 37.37 % of the patients (n=111) with a favorable overall survival (life expectancy of 5 years post-diagnosis is that of 90 % to 100 %), 29.97 % (n=89) with an intermediary prognosis (life expectancy of 70 % to 89 %) and 32.66 % (n=97) with an unfavourable 5-year prognosis (life expectancy of 69 % or less).…”