Molecular subtypes as a prognostic breast cancer factor in women users of the São Paulo public health system, Brazil.

Autor:	Peres SV; Fundação Oncocentro de São Paulo, Department of Information and Epidemiology - São Paulo (SP), Brazil., Arantes PE; A.C. Camargo Cancer Center, Centro International de Pesquisa, Cancer Epidemiology and Statistics Group - São Paulo (SP), Brazil., Fagundes MA; A.C. Camargo Cancer Center, Centro International de Pesquisa, Cancer Epidemiology and Statistics Group - São Paulo (SP), Brazil., Ab'Saber AM; Fundação Oncocentro de São Paulo, Department of Pathology - São Paulo (SP), Brazil.; Universidade de São Paulo, Clinical Hospital - São Paulo (SP), Brazil., Gimenes DL; Grupo Oncoclínicas de São Paulo, Department of Mastology - São Paulo (SP), Brazil., Curado MP; A.C. Camargo Cancer Center, Centro International de Pesquisa, Cancer Epidemiology and Statistics Group - São Paulo (SP), Brazil., Vieira RADC; Universidade de São Paulo, Faculty of Medicine of Botucatu, Graduate Program in Obstetrics and Gynecology - Botucatu (SP), Brazil.; Hospital do Câncer de Barretos, Graduate Program in Oncology - Barretos (SP), Brazil.
Jazyk:	angličtina
Zdroj:	Revista brasileira de epidemiologia = Brazilian journal of epidemiology [Rev Bras Epidemiol] 2023 May 29; Vol. 26, pp. e230028. Date of Electronic Publication: 2023 May 29 (Print Publication: 2023).
DOI:	10.1590/1980-549720230028
Abstrakt:	Objective: This study aimed to analyze the prognosis of women with breast cancer by molecular subtypes, sociodemographic variables, and clinical and treatment characteristics. Methods: This hospital-based retrospective cohort study analyzed 1,654 women over 18 years of age diagnosed with invasive breast cancer from 2000 to 2018. Data were extracted from Brazil's Oncocenter Foundation of São Paulo. The variables analyzed were age, histology, molecular subtypes, clinical staging, treatment type, and diagnosis-to-treatment time. Cox regression analysis was applied to estimate death risk. Results: Women with HER-2-positive (nonluminal) and triple-negative molecular subtypes were more than twice more likely to be at risk of death, with adjusted hazard ratio - HRadj=2.30 (95% confidence interval - 95%CI 1.34-3.94) and HRadj=2.51 (95%CI 1.61-3.92), respectively. A delayed treatment associated with an advanced clinical stage at diagnosis increased fourfold the risk of death (HRadj=4.20 (95%CI 2.36-7.49). Conclusion: In summary, besides that interaction between advanced clinical stage and longer time between diagnosis and treatment, HER-2-positive (nonluminal) and triple-negative phenotypes were associated with a worse prognosis. Therefore, actions to reduce barriers in diagnosis and treatment can provide better outcome, even in aggressive phenotypes.
Databáze:	MEDLINE
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