Sociodemographic and Clinical-pathological Study of Molecular Subtitles of Breast Carcinoma in a Reference Unit of Maranhão

Reis, Ana Paula Almeida Miranda; Teixeira, Cecilma Miranda de Sousa; Medeiros, Adriano Rêgo Lima de; Chaves, Karlla Zolinda Cantão; Albuquerque, Camila Rosa de; Melo, Mateus Rufino

doi:10.1055/s-0040-1719147

Acessibilidade / Reportar erro

Brasil

Revista Brasileira de Ginecologia e Obstetrícia

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Original Article • Rev. Bras. Ginecol. Obstet. 42 (12) • Dec 2020 • https://doi.org/10.1055/s-0040-1719147 copy

Sociodemographic and Clinical-pathological Study of Molecular Subtitles of Breast Carcinoma in a Reference Unit of Maranhão

Estudo sociodemográfico e clínico-patológico de legendas moleculares de carcinoma de mama em uma unidade de referência do Maranhão

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

To evaluate the distribution of the main sociodemographic and clinicalpathological characteristics in women with breast cancer according to the molecular profile by immunohistochemistry.

Methods

A cross-sectional, retrospective, analytical and quantitative study was performed, with an analysis of 137 medical records from January 2015 to December 2018 of women attending the High Complexity in Oncology Unit of the city of Imperatriz, state of Maranhão, Brazil. The immunohistochemical profile of tumors based on the estrogen and progesterone receptor, Human Epidermal growth factor Receptor-type 2 (HER2) overexpression and Ki67 cell proliferation indexwas defined, fromwhich six molecular subtypes were determined: luminal A, luminal B-HER2 negative, luminal B-HER2 positive, triple negative, overexpression of HER2 and inconclusive.

Results

A total of 52.6% of the patients were postmenopausal, mean age 52.1 years old, brown (56.2%), had a schooling level < 9 years (40%), staging > IIB (52.6%) and 23.4% hadmetastasis. Invasive ductal carcinoma accounted for 84.7%, tumor size was 2 to 5 cm (48.9%), with lymph node involvement (56.2%), axillary lymphadenectomy in 67.2%, andmastectomy in 73.7% of the patients. Themost frequentmolecular subtype was the luminal B-HER2 negative (36.5%), and the luminal A subtype showed characteristics of better prognosis when compared with the others.

Conclusion

It was concluded that in the association of molecular subtypes with sociodemographic and clinical-pathological characteristics, there were no statistically significant results obtained, except for complementary therapy, referring to hormone therapy, and there was a high index of metastasis at diagnosis, which was a worrying factor and indicative of failures in the screening and early diagnosis of this population.

Keywords:
breast neoplasms; immunohistochemistry; health profile; oncology; staging of neoplasms

Variables		n	%
Age at diagnosis (n = 137)	Average	52.1	–
Age at diagnosis (n = 137)	Standard deviation	11.8	–
Menopausal State	Premenopause	65	47.4
	Postmenopause	72	52.6
	TOTAL	137	100.0
Race	White	39	28.4
	Brown	77	56.2
	Black	2	1.4
	Yellow	19	14.0
	TOTAL	137	100.0
Regrouped Races	White	39	28.4
	Non-white	98	71.6
	TOTAL
City	Imperatriz-MA	51	37.2
	Other cities in MA	83	60.6
	Other states	3	2.2
	TOTAL	137	100.0
Marital Status	Unmarried	32	23.4
	Married or Cohabitant	85	62.0
	Divorced	6	4.4
	Widowed	14	10.2
	TOTAL	137	100.0
Level of Schooling	Illiterate	19	14.1
	< 9 years	54	40.0
	9 to 12 years	43	31.9
	> 12 years	19	14.1
	TOTAL	135	100.0
Smoking	Yes (current or past)	35	29.2
	No	85	70.8
	TOTAL	120	100.0
Alcohol Consumption	Yes (current or past)	41	34.2
	No	79	65.8
	TOTAL	120	100.0
Family history of cancer	Yes	62	51.7
	No	58	48.3
	TOTAL	120	100.0

Variables		n	%
Molecular Subtype	Luminal A	27	19,7
	Luminal B- HER2 negative	50	36.5
	Luminal B- HER2 positive	18	13.1
	Triple-negative	18	13.1
	HER2-enriched	17	12.4
	Inconclusive	7	5.1
	TOTAL	137	100.0
Surgery type	Mastectomy	101	73.7
	Breast-conserving	34	24.8
	Not performed	2	1.5
	TOTAL	137	100.0
Axillary approach	Sentinel node biopsy	20	14.6
	Axillary lymph node dissection	92	67.2
	Not performed	25	18.2
	TOTAL	137	100.0
Histological type	Invasive ductal carcinoma	116	84.7
	Invasive lobular carcinoma	14	10.2
	Others	7	5.1
	TOTAL	137	100.0
TNM staging	≤ II B	65	47.4
	> II B	72	52.6
	TOTAL	137	100.0
Tumor size	< 2 cm	35	25.5
	2 to 5 cm	67	48.9
	> 5 cm	35	25.5
	TOTAL	137	100.0
Lymph node impairment	Positive	77	56.2
	Negative	60	43.8
	TOTAL	137	100.0
Metastasis	Positive	32	23.4
	Negative	105	76.6
	TOTAL	137	100.0
Location of metastasis	Bones	17	43.6
	Lungs	15	38.5
	Liver	7	17.9
	TOTAL	39	100.0
Complementary therapy	Chemotherapy	89	45.6
	Radiation therapy	54	27.7
	Hormone therapy	47	24.1
	Not performed	5	2.6
	TOTAL	195	100.0

	MOLECULAR SUBTYPE
	LA		LB neg		LB pos		HER2-enr		TN		Inc		p-value
Age at diagnosis (menopausal status)
≤ 50 years old	12	18.5	25	38.5	9	13.8	8	12.3	7	10.8	4	6.2	0.96 ^* * Chi-squared test.
> 50 years old	15	20.8	25	34.7	9	12.5	9	12.5	11	15.3	3	4.2	0.96 ^* * Chi-squared test.
Race
White	9	23.7	11	28.9	6	15.8	6	15.8	3	7.9	3	7.9	0.56 ^* * Chi-squared test.
Non-white	18	18.2	39	39.4	12	12.1	11	11.1	15	15.2	4	4.0	0.56 ^* * Chi-squared test.
Family history of cancer
Yes	13	21.0	26	41.9	8	12.9	10	16.1	4	6.5	1	1.6	0.09 ^* * Chi-squared test.
No	9	15.5	19	32.8	7	12.1	6	10.3	12	20.7	5	8.6	0.09 ^* * Chi-squared test.
TNM Staging
≤ II B	18	27.7	24	36.9	7	10.8	6	9.2	6	9.2	4	6.2	0.20 ^* * Chi-squared test.
> II B	9	12.5	26	36.1	11	15.3	11	15.3	12	16.7	3	4.2	0.20 ^* * Chi-squared test.
Tumor size
< 2 cm	12	34.3	11	31.4	4	11.4	2	5.7	4	11.4	2	5.7	0.41 ^ Fisher-Freeman-Halton test.
2 to 5 cm	10	14.9	25	37.3	8	11.9	12	17.9	8	11.9	4	6.0
> 5 cm	5	14.3	14	40.0	6	17.1	3	8.6	6	17.1	1	2.9
Lymph node impairment
Positive	11	14.3	27	35.1	13	16.9	11	14.3	11	14.3	4	5.2	0.38 ^* * Chi-squared test.
Negative	16	26.7	23	38.3	5	8.3	6	10.0	7	11.7	3	5.0	0.38 ^* * Chi-squared test.
Metastasis
Positive	4	12.5	12	37.5	4	12.5	5	15.6	7	21.9	0	0.0	0.30 ^ Fisher-Freeman-Halton test.
Negative	23	21.9	38	36.2	14	13.3	12	11.4	11	10.5	7	6.7	0.30 ^ Fisher-Freeman-Halton test.
Performed chemotherapy
Yes	18	20.2	25	28.1	14	15.7	13	14.6	14	15.7	5	5.6	0.14 ^ Fisher-Freeman-Halton test.
No	9	18.8	25	52.1	4	8.3	4	8.3	4	8.3	2	4.2	0.14 ^ Fisher-Freeman-Halton test.
Performed radiation therapy
Yes	12	22.2	23	42.6	8	14.8	4	7.4	6	11.1	1	1.9	0.39 ^* * Chi-squared test.
No	15	18.1	27	32.5	10	12.0	13	15.7	12	14.5	6	7.2	0.39 ^* * Chi-squared test.
Performed hormonotherapy
Yes	12	25.5	26	55.3	4	8.5	1	2.1	1	2.1	3	6.4	< 0.001^ Fisher-Freeman-Halton test.
No	15	16.7	24	26.7	14	15.6	16	17.8	17	18.9	4	4.4	< 0.001^ Fisher-Freeman-Halton test.

Federação Brasileira das Sociedades de Ginecologia e Obstetrícia Av. Brigadeiro Luís Antônio, 3421, sala 903 - Jardim Paulista, 01401-001 São Paulo SP - Brasil, Tel. (55 11) 5573-4919 - Rio de Janeiro - RJ - Brazil
E-mail: editorial.office@febrasgo.org.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Address for correspondence Ana Paula Almeida Miranda Reis, Av. da Universidade, S/N, Imperatriz, MA, 65915-240, Brazil (e-mail: anapaulaamr08@gmail.com).