Characteristics and prognosis of stage I-III breast cancer subtypes in Brazil: The AMAZONA retrospective cohort study

Simon, Sérgio Daniel; Bines, José; Werutsky, Gustavo; Nunes, João; Pacheco, Fernando Chalu; Segalla, J. G. M.; Gomes, Andrea J.S.; Eyll, Brigitte Marie H.R. Adam Van; Gimenes, Daniel Luiz; Crocamo, Susanne; Freitas‐Junior, Ruffo; Lago, Lissandra Dal; Queiroz, Geraldo Silva; Azevedo, Sérgio Jobim; Rosa, Daniela Dornelles; Delgado, Gilson Luchezi; Borges, Giuliano Santos; Nascimento, Yeni Verônica do; Zaffaroni, Facundo; Martínez-Mesa, Jeovany; Barrios, Carlos H.

doi:10.1016/j.breast.2019.01.008

Cited by 76 publications

(81 citation statements)

References 25 publications

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“…Previous studies have demonstrated that the prognosis of breast cancer is closely associated with tumor state, luminal type and axillary lymph node metastasis ( 22 , 23 ). It was previously demonstrated that the prognosis of patients with luminal A type breast cancer was the superior to that of patients with luminal B type breast cancer, whereas patients with HER2-positive and triple-negative breast cancer had the worst prognosis ( 24 ).…”

Section: Discussionmentioning

confidence: 99%

Predictive value of T2‑weighted magnetic resonance imaging for the prognosis of patients with mass‑type breast cancer with peritumoral edema

Liang

et al. 2020

Oncol Lett

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The aim of the present study was to investigate the role of edema surrounding breast cancer masses in the prognostic prediction of magnetic resonance imaging (MRI) T2-weighted fat suppression sequence. For this purpose, 80 patients with mass-type breast cancer underwent conventional plain breast MRI, dynamic contrast-enhanced (DCE)-MRI or diffusion-weighted MRI scan. The associations between edema around the mass on MRI T2 fat suppression sequence plain scan and tumor stage, pathological findings, immunohistochemical findings and axillary lymph node metastasis were analyzed. The results revealed the presence of edema around the mass on the MRI T2 fat suppression sequence plain scan in 35 patients. By contrast, there was no abnormal enhancement on the DCE-MRI, and the apparent diffusion coefficient value did not decrease in these areas. Compared with the remaining 45 patients, the 35 patients with peritumoral edema exhibited a higher tumor stage and a higher rate of axillary lymph node metastasis (all P<0.05). However, there was no significant difference in pathological classification or the expression of estrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 (as determined by immunohistochemistry) between the two groups. In total, 12 cases of tumor shrinkage during neoadjuvant chemotherapy were accompanied by an improvement in edema. Taken together, the findings of the present study indicated that the presence of edema around the mass on the MRI T2 fat suppression sequence may predict poor prognosis in patients with mass-type breast cancer. Furthermore, the improvement of the peritumoral edema post-neoadjuvant chemotherapy may also be a predictor of a more favorable prognosis.

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Section: Discussionmentioning

confidence: 99%

Predictive value of T2‑weighted magnetic resonance imaging for the prognosis of patients with mass‑type breast cancer with peritumoral edema

Liang

et al. 2020

Oncol Lett

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“…Although the recommendation favors a part of the population, it does not violate individual rights, as asymptomatic patients will still have access to screening mammogram in their routine visits to their primary healthcare providers. Moreover, the proposed recommendation promotes equal access to breast cancer diagnosis and treatment as it removes the age boundaries, starting to provide care to women below the age of 50 years old, an age range responsible for a large amount of new cases in developing countries and that were not previously included in the past recommendation [6].…”

Section: Recommendation and Discussion Of The Ethical Dilemmamentioning

confidence: 99%

“…In the Brazilian setting, breast cancer is the most frequent type of cancer, responsible for 16,724 deaths in 2017 and with an estimate of 66,280 new cases in 2020 [5]. This scenario, however, has some peculiarities when compared to developed countries in the North America or Europe; 41.1% of all cases in Brazil happen in women younger than 50 years old and the majority of the operable cases is diagnosed in locally advanced stages, being 53.3% of the cases in stage II and 23.2% in stage III [6]. These characteristics are not typical of a country with a well-established breast cancer-screening program.…”

Section: Introductionmentioning

confidence: 99%

Ethical Concerns Regarding Breast Cancer Screening

Gonçalves¹,

Formigoni²,

Soares³

et al. 2021

Bioethics in Medicine and Society

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The incidence and mortality of breast cancer are rising in the whole world in the past few decades, adding up to a total of around two million new cases and 620,000 deaths in 2018. Unlike what occurs in developed countries, most of the cases diagnosed in the developing world are already in advanced stages and also in women younger than 50 years old. As most screening programs suggest annual mammograms starting at the age of 50, we can infer that a considerable portion of the new breast cancer cases is missed with this strategy. Here, we will propose the adoption of an alternative hierarchical patient flow, with the creation of a diagnostic fast track with referral to timely treatment, promoting better resources reallocation favoring the least advantaged strata of the population, which is not only ethically acceptable but also a way of promoting social justice.

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“…They concluded that survival was suboptimal in part because of delays in diagnosis and treatment. Previous studies have suggested an association between the type of care provided and breast cancer mortality in Brazil [ 8 ], with women treated in the public system facing significantly longer time from diagnosis to treatment, poorer outcomes, and lower disease-free survival [ 16 ]. Post-relapse survival was also significantly worse in public healthcare patients, suggesting that type of coverage and care received in public and private settings may play an important role.…”

Section: Discussionmentioning

confidence: 99%

Breast cancer survival in Brazil: How much health care access impact on cancer outcomes?

et al. 2020

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Background Breast cancer has a high incidence and increasing mortality in Southern Brazil. The present study evaluated clinical and sociodemographic characteristics, and their association with overall survival in a private cancer center. Methods 1113 breast cancer patients were included in this study. The association between survival and clinicopathological and sociodemographic characteristics was analyzed using Cox regression and Kaplan-Meyer curves. Results Median age at diagnosis was 52 years (SD 13.5). Most patients were diagnosed in stages 0 and I (62.7%), while only 1.3% had stage IV disease. Five- and 10-year overall survival were 93.5% and 83.8%, respectively. According to multivariate analysis, age at diagnosis (HR 1.05; CI95 1.03–1.06), staging (stage III: HR 4.04; CI95 1.34–12.19; stage IV: HR 9.61; CI95 2.17–42.50), high KI67 (HR 5.46; CI95 1.27–23.32) and distant recurrence (HR 7.28; CI95 4.79–11.06) were significantly associated with survival. Smoking status, years of education, BMI, and tumor biological status were not significantly associated with mortality. Conclusions This cohort of Brazilian patients, who received timely and appropriate treatment, achieved outcomes that are comparable to those from high income countries. Breast cancer mortality seems dependent on the quality of health care available to patients.

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Characteristics and prognosis of stage I-III breast cancer subtypes in Brazil: The AMAZONA retrospective cohort study

Cited by 76 publications

References 25 publications

Predictive value of T2‑weighted magnetic resonance imaging for the prognosis of patients with mass‑type breast cancer with peritumoral edema

Predictive value of T2‑weighted magnetic resonance imaging for the prognosis of patients with mass‑type breast cancer with peritumoral edema

Ethical Concerns Regarding Breast Cancer Screening

Breast cancer survival in Brazil: How much health care access impact on cancer outcomes?

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