Sergio Daniel Simon1, José Bines2, Gustavo Werutsky3, João Soares Nunes4, Fernando Chalu Pacheco5, José Getúlio Segalla6, Andrea J S Gomes7, Brigitte Marie H R Adam Van Eyll8, Daniel Luiz Gimenes9, Susanne Crocamo10, Ruffo Freitas-Junior11, Lissandra Dal Lago12, Geraldo Silva Queiroz13, Sérgio Jobim de Azevedo14, Daniela Dornelles Rosa15, Gilson Delgado16, Giuliano Santos Borges17, Yeni Verônica do Nascimento18, Facundo Zaffaroni3, Jeovany Martínez-Mesa19, Carlos H E Barrios3. 1. Centro Paulista de Oncologia, Hospital Israelista Alber Einstein, São Paulo, Brazil. Electronic address: sergio.simon@sboc.org.br. 2. Instituto Nacional de Câncer, Rio de Janeiro, Brazil. 3. Latin American Cooperative Oncology Group, Porto Alegre, Brazil. 4. Hospital do Câncer de Barretos, Barretos, Brazil. 5. Hospital Ophir Loyola, Belém, Brazil. 6. Hospital Amaral Carvalho, Jaú, Brazil. 7. Liga Norte Riograndense Contra o Câncer, Natal, Brazil. 8. Hospital Dr. Arnaldo de Vieira de Carvalho, São Paulo, Brazil. 9. Hospital A. C. Camargo, São Paulo, Brazil. 10. Oncoclínica - Centro de Tratamento Oncológico, Rio de Janeiro, Brazil. 11. Hospital das Clínicas da Universidade Federal de Goiás, Goiânia, Brazil. 12. Universidade Federal de Santa Maria, Santa Maria, Brazil. 13. Hospital Araújo Jorge, Goiânia, Brazil. 14. Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil. 15. Hospital Fêmina, Grupo Hospitalar Conceição, Porto Alegre, Brazil. 16. Faculdade de Medicina de Sorocaba, Sorocaba, Brazil. 17. Clínica de Neoplasias Litoral, Itajaí, Brazil. 18. Centro de Pesquisas Oncológicas - CEPON, Florianopólis, Brazil. 19. IMED School of Medicine, Passo Fundo, Brazil.
Abstract
OBJECTIVE: To describe stage I-III breast cancer (BC) molecular subtypes and outcomes among a cohort of patients from Brazil. METHODS: AMAZONA study is a retrospective cohort conducted from June 2008 to January 2009 including women of at least 18 years old, with histologically proven breast cancer, diagnosed in 2001 (n = 2198) and 2006 (n = 2714). In this analysis, we included patients who underwent surgery, had stage I-III disease and available pathological information (n = 2296). We estimated molecular subtypes by local immunohistochemical stains. Data was obtained from medical charts and public databases. RESULTS: Mean age at diagnosis was 54 years and 41.1% were younger than 50 years. 23.3% were diagnosed in stage I, 53.5% in stage II and 23.2% in stage III. 80.8% were treated in the public health system. 71.3% had hormonal receptor positive disease, 15.7% were HER-2 positive and 21.1% had triple-negative breast cancer. 55.6% were treated with mastectomy and 96.2% received adjuvant treatment (82.2% chemotherapy). 13.4% of HER-2 positive patients received adjuvant trastuzumab. Overall survival rate at 5 years was 96.84% for stage I, 94.16% for stage II and 70.48% for stage III. Molecular subtypes were independent prognostic factor in stages II and III patients. CONCLUSIONS: Brazilian women have a higher risk of being diagnosed with late stage breast cancer and younger age than in high-income countries. Luminal-like disease is the most common molecular subtype in the country. Triple negative and HER-2 positive had the worst prognosis.
OBJECTIVE: To describe stage I-III breast cancer (BC) molecular subtypes and outcomes among a cohort of patients from Brazil. METHODS: AMAZONA study is a retrospective cohort conducted from June 2008 to January 2009 including women of at least 18 years old, with histologically proven breast cancer, diagnosed in 2001 (n = 2198) and 2006 (n = 2714). In this analysis, we included patients who underwent surgery, had stage I-III disease and available pathological information (n = 2296). We estimated molecular subtypes by local immunohistochemical stains. Data was obtained from medical charts and public databases. RESULTS: Mean age at diagnosis was 54 years and 41.1% were younger than 50 years. 23.3% were diagnosed in stage I, 53.5% in stage II and 23.2% in stage III. 80.8% were treated in the public health system. 71.3% had hormonal receptor positive disease, 15.7% were HER-2 positive and 21.1% had triple-negative breast cancer. 55.6% were treated with mastectomy and 96.2% received adjuvant treatment (82.2% chemotherapy). 13.4% of HER-2 positive patients received adjuvant trastuzumab. Overall survival rate at 5 years was 96.84% for stage I, 94.16% for stage II and 70.48% for stage III. Molecular subtypes were independent prognostic factor in stages II and III patients. CONCLUSIONS: Brazilian women have a higher risk of being diagnosed with late stage breast cancer and younger age than in high-income countries. Luminal-like disease is the most common molecular subtype in the country. Triple negative and HER-2 positive had the worst prognosis.
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