Uncovering Surgical Dynamics and Trends in Early Breast Cancer Stage at Diagnosis: Key Insights From a Two-Decade Argentine Database Analysis.

Autor:	Mandó P; Breast and Gynecologic Cancer Unit, Centro de Educación Médica e Investigaciones Clínicas 'Dr Norberto Quirno' (CEMIC), Ciudad de Buenos Aires, Argentina., Fabiano V; Breast Cancer Unit, Instituto Alexander Fleming, Ciudad de Buenos Aires, Argentina., Gomez Guasch S; Breast Cancer Unit, Hospital Municipal de Chivilcoy, Buenos Aires, Argentina., Colucci G; Breast and Gynecologic Cancer Unit, Centro de Educación Médica e Investigaciones Clínicas 'Dr Norberto Quirno' (CEMIC), Ciudad de Buenos Aires, Argentina., Sánchez-Bayona R; Breast Cancer Unit, Hospital 12 de Octubre, Madrid, Spain., Coló F; Breast Cancer Unit, Instituto Alexander Fleming, Ciudad de Buenos Aires, Argentina., Loza M; Breast Cancer Unit, Instituto Alexander Fleming, Ciudad de Buenos Aires, Argentina., Von Stecher F; Breast and Gynecologic Cancer Unit, Centro de Educación Médica e Investigaciones Clínicas 'Dr Norberto Quirno' (CEMIC), Ciudad de Buenos Aires, Argentina., Amat M; Breast Cancer Unit, Instituto Alexander Fleming, Ciudad de Buenos Aires, Argentina., de la Vega M; Breast and Gynecologic Cancer Unit, Centro de Educación Médica e Investigaciones Clínicas 'Dr Norberto Quirno' (CEMIC), Ciudad de Buenos Aires, Argentina., Costanzo MV; Breast Cancer Unit, Instituto Alexander Fleming, Ciudad de Buenos Aires, Argentina., Nervo A; Breast Cancer Unit, Instituto Alexander Fleming, Ciudad de Buenos Aires, Argentina., Nadal J; Breast Cancer Unit, Instituto Alexander Fleming, Ciudad de Buenos Aires, Argentina., Chacón R; Breast Cancer Unit, Instituto Alexander Fleming, Ciudad de Buenos Aires, Argentina., Perazzo F; Breast and Gynecologic Cancer Unit, Centro de Educación Médica e Investigaciones Clínicas 'Dr Norberto Quirno' (CEMIC), Ciudad de Buenos Aires, Argentina.
Jazyk:	angličtina
Zdroj:	JCO global oncology [JCO Glob Oncol] 2024 Nov; Vol. 10, pp. e2400123. Date of Electronic Publication: 2024 Nov 27.
DOI:	10.1200/GO.24.00123
Abstrakt:	Purpose: Breast cancer remains a major public health challenge worldwide, and understanding the trends and changes in breast cancer diagnosis and treatment over time is crucial for improving patient outcomes and guiding public health strategies. The Argentine Society of Mastology has maintained a comprehensive Breast Cancer Registry that provides valuable data for analyzing these trends. Materials and Methods: This retrospective analysis of the Breast Cancer Registry database evaluated changes in stages at the time of surgery, patterns of surgical care, and factors associated with higher stage diagnoses in patients with breast cancer in Argentina from January 2000 to December 2019. Results: Overall, 13,239 patients met the inclusion criteria. Significant differences were observed in the axillary procedure performed, with sentinel lymph node biopsy increasing from 14.9% (2000-2004) to 69.5% (2015-2019; P < .001). A higher proportion of in situ carcinoma was detected in the last 5-year period compared with the first (11.3% v 9.4%; P = .01) and fewer patients were stage III (17.1% v 14.2%). In multivariate analysis, postmenopausal status (odds ratio [OR], 0.72 [95% CI, 0.64 to 0.80]; P < .001), health coverage (social health insurance OR, 0.53 [95% CI, 0.46 to 0.61]; P < .001 and private insurance OR, 0.36 [95% CI, 0.31 to 0.42]; P < .001), tumor grade (grade 3 OR, 2.97 [95% CI, 2.54 to 3.47]; P < .001), and phenotype (hormone receptor-positive [HR+]/human epidermal growth factor receptor 2 [HER2]+ OR, 1.36 [95% CI, 1.10 to 1.70]; P = .005; HR-/HER2+ OR, 2.14 [95% CI, 1.62 to 2.83]; P < .001; HR-/HER2- OR, 1.40 [95% CI, 1.19 to 1.66]; P < .001) were associated with the risk of diagnosis at stages II-III. Conclusion: Significant advances in the patterns of surgical care were identified. Numerous clinical and pathologic factors correlated with higher stage at diagnosis. However, multivariate analysis failed to show a noteworthy reduction in stage at diagnosis. This observation underscores the imperative to persistently strive to improve breast cancer care in Argentina.
Databáze:	MEDLINE
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