Sobrevida do câncer de mama em um centro de câncer brasileiro
um estudo de coorte de 5.095 pacientes
Palavras-chave:
câncer de mama, sobrevida, estadiamento de neoplasias, institutos de câncer, Brasil, América do SulResumo
Objetivos: Descrever as faixas etárias, estadiamento clínico ao diagnóstico, tratamento e sobrevida global das pacientes com câncer de mama tratadas em um centro de câncer brasileiro. Método: Estudo de uma coorte retrospectiva de base hospitalar, com mulheres diagnosticadas de câncer de mama entre 1º de janeiro de 2000 e 31 de dezembro de 2012. Os dados foram extraídos do Registro Hospitalar de Câncer do A. C. Camargo Cancer Center. Faixa etária, tipo histológico, classificação TNM, estadiamento clínico e tratamento foram descritos em frequência absoluta e relativa estratificados em três períodos. As curvas de sobrevida global foram estimadas pelo método de Kaplan-Meier. A Hazard ratio (HR) com intervalo de confiança de 95% foram calculados para todas as variáveis. Resultados: O total de 5.095 pacientes mulheres com câncer de mama foi identificado, a maioria era estágio inicial 60% (I e II). A sobrevida global foi de 82,7% para o período de 2000–2004 e 89,9% para 2010–2012 (p<0,001). Pacientes com carcinoma ductal invasivo que foram tratadas com cirurgia e hormonioterapia, mostraram redução do risco de morte no período mais recente HRaj=0,42 (0,34–0,53 em 2010–2012). Conclusões: Diagnóstico precoce e tratamento combinado (incluindo hormonioterapia) são fatores prognósticos preditivos para altas taxas de sobrevida em pacientes com câncer de mama invasivo. Centros especializados em câncer podem prover informações valiosas sobre as políticas de controle do câncer, avaliando a sobrevida global do câncer de mama e fatores associados ao prognóstico.
Downloads
Referências
Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136(5):E359-86. http://doi.org/10.1002/ijc.29210
Forman D, Bray F, Brewster DH, Mbalawa CG, Kohler B, Pineros M et al., eds. Cancer Incidence in Five Continents. Lyon: International Agency for Research on Cancer; 2014;10(164).
World Health Organization. WHO Databank. Health statistics and information systems [Internet]. Geneva, Switzerland: World Health Organization; 2018 [cited on Apr 30, 2018]. Available at: https://www.who.int/healthinfo/mortality_data/en/
Brasil. Ministerio da Saude. Instituto Nacional do Cancer Jose Alencar Gomes da Silva. Estimativa 2018 [Internet]. Brazil: Ministerio da Saude; 2018 [cited on Apr 24, 2018]. Available at: http://www1.inca.gov.br/estimativa/2018/
Kluthcovsky AC, Faria TN, Carneiro FH, Strona R. Female breast cancer mortality in Brazil and its regions. Rev Assoc Med Bras. 2014;60(4):387-393. http://dx.doi.org/10.1590/1806-9282.60.04.019
Guerra MR, Bustamante-Teixeira MT, Correa CSL, Abreu DMX, Curado MP, Mooney M, et al. Magnitude and variation of the burden of cancer mortality in Brazil and Federation Units, 1990 and 2015. Rev Bras Epidemiol. 2017;20(Suppl. 1):102-15. http://dx.doi.org/10.1590/1980-5497201700050009
Berry DA, Cronin KA, Plevritis SK, Fryback DG, Clarke L, Zelen M, et al. Cancer Intervention and Surveillance Modeling Network (CISNET) Collaborators. Effect of screening and adjuvant therapy on mortality from breast cancer. N Engl J Med. 2005;353(17):1784-92. https://doi.org/10.1056/NEJMoa050518
Plevritis SK, Munoz D, Kurian AW, Stout NK, Alagoz O, Near AM, et al. Association of Screening and Treatment with Breast Cancer Mortality by Molecular Subtype in US Women, 2000-2012. JAMA. 2018;319(2):154-64. https://doi.org/10.1001/ jama.2017.19130
Torre LA, Islami F, Siegel RL, Ward EM, Jemal A. Global Cancer in Women: Burden and Trends. Cancer Epidemiol Biomarkers Prev. 2017;26(4):444-57. https://doi.org/10.1158/1055-9965.EPI‑16-0858
Justo N, Wilking N, Jonsson B, Luciani S, Cazap E. A review of breast cancer care and outcomes in Latin America. Oncologist. 2013;18(3):248-56. https://doi.org/10.1634/theoncologist.2012‑0373 REFERENCES
Fayer VA, Guerra MR, Cintra JRD, Bustamante-Teixeira MT. Ten-year survival and prognostic factors for breast cancer in the southeast region of Brazil. Rev Bras Epidemiol. 2016;19(4):766‑78. https://doi.org/10.1590/1980-5497201600040007
Goss PE, Lee BL, Badovinac-Crnjevic T, Strasser-Weippl K, Chavarri-Guerra Y, St Louis J, et al. Planning cancer control in Latin America and the Caribbean. Lancet Oncol. 2013;14(5):391‑436. https://doi.org/10.1016/S1470-2045(13)70048-2
Brito C, Portela MC, Vasconcellos MT. Survival of breast cancer women in the state of Rio de Janeiro, Southeastern Brazil. Rev Saude Publica. 2009;43(3):481-9. http://dx.doi.org/10.1590/S0034-89102009000300012
Allemani C, Matsuda T, Di Carlo V, Harewood R, Matz M, Niksic M, et al. Global surveillance of trends in cancer survival 2000‑14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 populationbased registries in 71 countries. Lancet. 2018;391(10125):1023‑75. https://doi.org/10.1016/S0140-6736(17)33326-3
Sao Paulo. Secretaria de Estado da Saude de Sao Paulo. Fundacao Oncocentro de Sao Paulo. Banco de dados RHC [Internet]. Sao Paulo: Fundacao Oncocentro de Sao Paulo; 2018 [cited on Apr 20, 2018]. Available at: http://200.144.1.68/cgi-bin/dh?rhc/rhc-geral.def
Tiezzi DG. Breast cancer screening in Brazil: there is still time to rethink. Rev Bras Ginecol Obstet. 2013;35(9):385-7. http://dx.doi.org/10.1590/S0100-72032013000900001
Nigenda G, Gonzalez-Robledo MC, Gonzalez-Robledo LM, Bejarano-Arias RM. Breast cancer policy in Latin America: account of achievements and challenges in five countries. Global Health. 2016;12(1):39. http://dx.doi.org/10.1186/s12992-016-0177-5
Azevedo e Silva G, Bustamante-Teixeira MT, Aquino EM, Tomazelli JG, Dos-Santos-Silva I. Access to early breast cancer diagnosis in the Brazilian Unified National Health System: an analysis of data from the Health Information System. Cad Saude Publica. 2014;30(7):1537-50. http://dx.doi.org/10.1590/0102-311X00156513
Gennari R, Curigliano G, Rotmensz N, Robertson C, Colleoni M, Zurrida S, et al. Breast carcinoma in elderly women: features of disease presentation, choice of local and systemic treatments compared with younger postmenopausal patients. Cancer. 2004;101(6):1302-10. https://doi.org/10.1002/cncr.20535
Schneider IJC, d’Orsi E. Sobrevida em cinco anos e fatores prognosticos em mulheres com cancer de mama em Santa Catarina, Brasil. Cad Saude Publica. 2009;25(6):1285-96. http://dx.doi.org/10.1590/S0102-311X2009000600011
Guerra MR, Mendonca GA, Bustamante-Teixeira MT, Cintra JR, Carvalho LM, Magalhaes LM. Five-year survival and prognostic factors in a cohort of breast cancer patients treated in Juiz de Fora, Minas Gerais State, Brazil). Cad Saude Publica. 2009;25(11):2455-66. http://dx.doi.org/10.1590/S0102-311X2009001100015
Medeiros JMD, Linhares JC, Hatschbach SBB, Hubie DP, Rahman SA, Orlandi D, et al. Perfil epidemiologico e estudo de sobrevida dos pacientes com cancer de mama atendidos no Hospital Erasto Gaertner em Curitiba, PR. Rev Bras Mastologia. 2016;26(3):107-12. http://dx.doi.org/10.5327/Z201600030005RBM
de Moraes AB, Zanini RR, Turchiello MS, Riboldi J, de Medeiros LR. Survival study of breast cancer patients treated at the hospital of the Federal University in Santa Maria, Rio Grande do Sul, Brazil. Cad Saude Publica. 2006;22(10):2219-28. http://dx.doi.org/10.1590/S0102-311X2006001000028
Freitas-Junior R, Rodrigues DC, Correa RD, Peixoto JE, de Oliveira HV, Rahal RM. Contribution of the Unified Health Care System to mammography screening in Brazil, 2013. Radiol Bras. 2016;49(5):305-10. http://dx.doi.org/10.1590/0100-3984.2014.0129
Simon SD, Bines J, Barrios CH, Nunes J, Gomes E, Pacheco F, et al. Clinical characteristics and outcome of treatment of Brazilian women with breast cancer treated at public and private institutions—the AMAZONE project of the Brazilian breast cancer study group (GBECAM). San Antonio Breast Cancer Symposium 2009; San Antonio, TX, USA; Dec 11, 2009. Abstr 3082. http://dx.doi.org/10.1158/0008-5472.SABCS-09-3082
Lee BL, Liedke PE, Barrios CH, Simon SD, Finkelstein DM, Goss PE. Breast cancer in Brazil: present status and future goals. Lancet Oncol. 2012;13(3):e95-e102. http://dx.doi.org/10.1016/S1470-2045(11)70323-0
Autier P, Boniol M, Gavin A, Vatten LJ. Breast cancer mortality in neighbouring European countries with different levels of screening but similar access to treatment: trend analysis of WHO mortality database. BMJ. 2011;343:d4411. http://dx.doi.org/10.1136/bmj.d4411
Migowski A, Silva GA, Dias MBK, Diz MPE, Sant’Ana DR, Nadanovsky P. Guidelines for early detection of breast cancer in Brazil. II - New national recommendations, main evidence, and controversies. Cad Saude Publica. 2018;34(6):e00074817. https://dx.doi.org/10.1590/0102-311x00074817
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Copyright (c) 2019 Fabiana Baroni Makdissi, Fernanda Perez Magnani Leite, Stela Verzinhasse Peres, Diego Rodrigues Mendonça e Silva, Max Moura de Oliveira, Rossana Veronica Mendonza Lopez, Solange Moraes Sanches, Guilherme Rocha Melo Gondim, Hirofumi Iyeyasu, Vinicius Fernando Calsavara, Maria Paula Curado
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
