Women with breast cancer care at the public hospital of Macapá - Amapá: epidemiological and clinical aspects

Emílio Daniel Pacheco de Sousa; Givago  da Silva Souza

doi:10.31686/ijier.vol8.iss3.2209

Authors

Emílio Daniel Pacheco de Sousa

Federal University of Amapá

https://orcid.org/0000-0002-4148-1256
Givago da Silva Souza

Federal University of Pará

https://orcid.org/0000-0002-4525-3971

DOI:

https://doi.org/10.31686/ijier.vol8.iss3.2209

Keywords:

Cancer, Breast, Epidemiological aspects, Clinical features, Malignant Breast Neoplasia

Abstract

Breast cancer is a disease of widespread epidemiology worldwide and is considered a serious public health problem. Although it is well established that early diagnosis and appropriate treatment interfere with mortality rates and cancer prevalence, few data are available on the descriptive epidemiology of breast cancer in Brazil and in the state of Amapá. The general objective of this dissertation work was to study the epidemiological and clinical aspects of breast cancer patients treated at the Dr. Alberto Lima Clinical Hospital (HCAL), from January 2012 to December 2017 in the city of Macapá, Amapá. Breast cancer cases were reviewed, with analysis of 194 medical records, and the following variables were studied: Annual frequency of breast tumor, age, education level, origin, location of breast lesion, histological type of cancer, age at first childbirth, Menarche and Menopause, breastfeeding time, alcohol intake, smoking, family history of breast cancer in first-degree relatives, clinical staging of the disease, immunohistochemical panel, type of surgical treatment, Chemotherapy, Radiotherapy, Hormone Therapy and Target Therapy " It was noted that the year 2017 had the highest number of diagnosed cases, the age group between 41-50 years was the most affected, women with low education (Elementary Level) and coming from the capital of Amapá. In these women, the most frequent characteristics were: Age at first birth between 13-20 years, Menarche between 10-13 years, Menopause 41-50 years with significant number of patients in Menácme (out of menopause), Breastfeeding time between 02 -22 and 23-42 months, both intervals with the same number of records; Most of them did not drink alcohol, were not smokers, and had no family history of first-degree relatives of breast cancer. In the studied cases, the most common localization of the breast lesion was the Lateral Upper Quadrant, the most diagnosed histological type was Invasive Ductal Carcinoma, with clinical stage IIA, Luminal A molecular subtype, Radiotherapy and Hormomyotherapy were performed most of the time, but Target Therapy was not prevalent.

References

[1] AMERICAN CANCER SOCIETY. Cancer Statistics Center. Atlanta, 2018. Available at: <https://cancerstatisticscenter.cancer.org/#!/cancer-site/Breast>. Accessed on: 22 jun. 2018. (HOUR)
[2] AMERICAN COLLEGE OF RADIOLOGY. Breast Imaging Reporting Data System (BI-RADS®). 5. ed. Reston, VA: American College of Radiology, 2014.
[3] COLDMAN, A. et al. Pan-Canadian study of mammography screening and mortality from breast cancer. Journal of the National Cancer Institute, v. 106, n. 11, 2014.
[4] BARBOSA, R.S.; FERREIRA, R.K.R .; FAUSTINO, R.S .; SILVEIRA JUNIOR, L.S. Breast Cancer in Rio Grande do Norte, a retrospective study: Epidemiological, Clinical and Therapeutic Profile. NATAL, RN). Mastology. 2017; 27 (2): 109-16.
[5] BODMER, A. et al. Breast cancer in younger women in Switzerland 1996-2009: A longitudinal population-based study. Breast, v. 24, n. 2, p. 112-117, 2015.
[6] BRAZIL. Ministry of Health. Secretariat of Science, Technology and Strategic Inputs. National Commission for the Incorporation of Technologies in SUS (CONITEC). Trastuzumab for the treatment of metastatic HER 2- positive breast cancer in the first line of treatment. Recommendation Report. Brasília: Ministry of Health, 2017.
[7] COLDMAN, A. et al. Pan-Canadian study of mammography screening and mortality from breast cancer. Journal of the National Cancer Institute, v. 106, n. 11, 2014.
[8] COLLINS, L. C. et al. Pathologic features and molecular phenotype by patient age in a large cohort of young women with breast cancer. Breast Cancer Research and Treatment, v. 131, p. 1061–1066, 2012.
[9] ______. BI-RADS® classification. In.: URBAN, L. Breast diseases: evidence-based pocket guide. São Paulo: Atheneu, 2013. cap. 1, p. 2.
[10] ______. Staging and prognostic factors. In.: LUZZATO, F. Breast diseases: evidence-based pocket guide. São Paulo: Atheneu, 2013. cap. 27, p. 222.
[11] CHAGAS, C.R. Population aspects of breast cancer. Rev. Bras. Mastology. 1994; 3 (4): 11-6.
[12] FARINA, A. et al. Epidemiological, clinical, anatomopathological and immunohistochemical profile of patients with breast cancer in Cuiabá (MT). See. Bras. Mastology. 2017; 2 (1): 74-9.
[13] FRASSON, A. and Cols. Breast diseases: evidence-based pocket guide. 1st ed. São Paulo: Atheneu, 2013. P. 61-68.
[14] FRASSON, A. et al. Histopathological classification of invasive carcinomas. In.: BACCHI, C. Breast diseases: evidence-based pocket guide. São Paulo: Atheneu, 2013. cap. 26, p. 206-213.

[15] FREITAS-JUNIOR, R. et al. Disparities in female breast cancer mortality rates in Brazil between 1980 and 2009. Clinics (São Paulo), v. 67, p. 731–7, 2012.
[16] GARICOCHEA, B. et al. Age as a prognostic factor in early stage breast cancer. Revista Saúde Pública, vol. 43, n. 2, p. 311-317, 2013.
[17] GOKSU, S. S. et al. Clinicopathologic features and molecular subtypes of breast cancer in young women (age ≤ 35). Asian Pacific Journal of Cancer Prevention, v. 15, p. 6665–6668, 2014.
[18] GONÇALVES, L.C.C. et al. Female breast cancer: Clinical and pathological aspects of cases registered from 2005 to 2008 in a public oncology service in Sergipe. ARACAJU (SE). Rev. Bras. Health Mater. Infant. 2012; 12 (1): 47-54.
[19] HARBEK, N.; GNANT, M.; THOMSSEN, C. St. Gallen 2013: Brief Preliminary Summary of the Consensus Discussion. Breast Care, v. 8, p. 102–109, 2013.
[20] INUMARU, L. E; SILVEIRA, A; NAVES, M. M. Risk and protective factors for breast cancer: a systematic review. Public Health Notebooks, v. 27, n. 7, p. 1259-1270, 2011.
[21] JONES, J. A. et al. Dietary energy density is positively associated with breast density among young women. Journal of the Academy of Nutrition and Dietetics, v. 115, n. 3, p. 353-359, 2015.
[22] KALLEL, M. et al. Breast cancer in young women in southern Tunisia: Anatomical study and clinical prognostic factors: About a series of 83 patients. Reports of Practical Oncology and Radiotherapy, v. 20, p. 155–160, 2015.
[23] LAUTER, D.S. et. al. Clinical and epidemiological profile of cancer patients. CONVIBRA, 2014. Available at: <https://www.convibra.org/uplo ad / paper / 2014/69 / 2014_69_9496.pdf>. Accessed on: 28 mai. 2019.

[24] LEITE, F.M.C. et al. Women diagnosed with breast cancer undergoing tamoxifen treatment: sociodemographic and clinical profile. Rev. Bras. Cancerology. 2011; 57 (1): 15-21.
[25] LEME, L.H.S. Epidemiological, Clinical and Therapeutic Aspects of Breast Cancer in Men. Dissertation (Master's Degree in Tocogynecology) - Graduate Program of the Faculty of Medical Sciences, State University of Campinas, Campinas. 2005.
[26] LIMA, G.R.; QUADROS, L.G.A. Breast cancer: epidemiology, risk factors and prevention attempts. GO Current 1992; 1 (2): 77-80.
[27] MAHMOOD, U. et al. Similar survival with breast conservation therapy or mastectomy in the management of young women with early-stage breast cancer. International Journal of Radiation Oncology Biology Physics, 2012.
[28] MARTINS, A. C. et al. Evolution of breast cancer mortality in young women: challenges for an oncology care policy. Brazilian Journal of Cancerology, v. 59, n. 30, p. 341-349, 2013.
[29] MCPHERSON, K.; STEEI, C. M.; Dixon, J.M. ABC of Breast Diseases Breast cancer—epidemiology, risk factors and genetics. British Medical Journal, v. 321, p. 624-628, 2000.
[30] MENKE, C.A.; BIAZÚS, J.V.; CAVALHEIRO J.A.; RABIN, E.G.; CERICATTO, R.; BITTELBRUNN, A.C.; XAVIER, N.L. Malignant breast pathology. IN: FREITAS, F.; MENKE C.H.; RIVOIRE, W.; PASSOS, E.P. Routines in Gynecology. 4th ed. Porto Alegre: Artmed, 2015. p. 340-56.
[31] MENKE, C.A.; BIAZÚS, J.V.; CAVALHEIRO, J.A, RABIN, E.G.; CERICATTO, R., BITTELBRUNN, A.C .; XAVIER, N.L. Mastology routines. 4th ed. Porto Alegre: Artmed, 2016. p.119-42.
[32] METCALFEE, K. et al. Predictors of contralateral breast cancer in BRCA1 and BRCA2 mutation carriers. British Journal of Cancer, v. 104, n. 9, p. 1384–1392, 2011.
[33] MILLES, R.C. et al. Local recurrence after breast-conserving surgery: multivariable analysis of risk factors and the impact of young age. Annals of Surgical Oncology, v. 19, p. 1153–1159, 2012.
[34] MINISTRY OF HEALTH; NATIONAL CANCER INSTITUTE JOSÉ ALENCAR GOMES DA SILVA (INCA). The situation of breast cancer in Brazil: synthesis of data from information systems. 1st ed. Rio de Janeiro: INCA, 2019.
[35] MOURA, L.N.M.; SILVA, B.B. Clinical and Epidemiological Profile Study of Patients with Breast Cancer seen at a public reference hospital in Terezina - PI, 2015. Available at:
<https://sis.ufpi.br/23sic/Documentos/RESUMOS/Modalidade/Vida/Lorena%20Norberta.pdf>. Accessed on: 28 mai. 2019.
[36] NAZÁRIO, A.C.P. Mastology: current conduct. 1st ed. São Paulo: 2016. P. 78-92.
[37] PEREIRA, H.F.B.E.S.A. Epidemiological and Clinical Profile of young women with breast cancer in Amazonas: 11-year study. Dissertation (Master in Health Sciences) - Postgraduate Program in Health Sciences, Federal University of Amazonas, Manaus. 2016.
[38] PIMENTEL, V.N.; SILVA, L.M.V.; PAIM, J.S.; COSTA, M.C.N. Evolution of breast cancer mortality. Salvador (BA) 1979-1996. Rev. Bras. Cancerology.2002; 48 (4) 505-9.
[39] PINOTTI, J.A.; TEIXEIRA, L.C. Breast cancer: importance, epidemiology and risk factors. In: Halbe HW. Gynecology Treaty. 4th ed. São Paulo: Roca; 2014. p. 2019-22.
[40] PINTO, N.T.; OLIVEIRA, T.S. Epidemiological aspects of patients with breast cancer treated at Hospital Ofir Loyola, from 1998 to 2000. (Course Conclusion Paper). Belém (PA): Pará State University - Center for Biological and Health Sciences, 2003.
[41] RIBEIRO, M.A. Effects of unpleasant symptoms of chemotherapy-induced peripheral neuropathy in patients with breast cancer. Dissertation (Master in Nursing) - Postgraduate Program in Nursing, State University of Pará / Federal University of Amazonas, Belém. 2018.
[42] SCHOEMAKER, M. J. et al. Association of Body Mass Index and Age with Subsequent Breast Cancer Risk in Premenopausal Women. JAMA Oncology, 2018. Available in:
<http://jamanetwork.com/doi:10.1001/jamaoncol.2018.1771>. Accessed on: 25 jun. 2018.
[43] SOUSA, E.D.P.; FILHO, A.B.S., DIAS, C.P. Breast sarcoma: case report. Rev. Bras. of Mastology. 2011; 21 (2): 78-80.
[44] ______. Estimate 2018: incidence of cancer in Brazil. Rio de Janeiro, 2018. Available at: <http://www.inca.gov.br/estimativa/2018/>. Accessed on: 23 jun. 2018.