Breast cancer risk stratification is a strategy based using on clinical parameters to predict patients’ risk of recurrence or death, categorized as low, intermediate, or high risk. Both low and high risk are based on well-defined clinical parameters. However, the intermediate risk depends on more malleable parameters. It means an increased possibility for either suboptimal treatment, leading to disease recurrence, or systemic damage due to drug overload toxicity. Therefore, identifying new factors that help to characterize better the intermediate-risk stratification, such as environmental exposures, is necessary. For this purpose, we evaluated the impact of occupational exposure to pesticides on the systemic profile of cytokines (IL-12, IL-4, IL-17A, and TNF-α) and oxidative stress (hydroperoxides, total antioxidants, and nitric oxide metabolites), as well as TGF-β1, CTLA-4, CD8, and CD4 expression, investigated in tumor cells. Occupational exposure to pesticides decreased the levels of IL-12 and significantly increased the expression of TGF-β1 and CTLA-4 in the immune infiltrate. Nevertheless, we observed a decrease in CTLA-4 in tumor samples and CD8 in infiltrating cells of intermediate overweight or obese patients with at least one metastatic lymph node at the diagnosis. These findings indicate that occupational exposure to pesticides changes the molecular behavior of disease and should be considered for intermediate-risk stratification assessment in breast cancer patients.
To describe the clinicopathological profile of breast cancer patients and association with excess body weight. Methods: This was a descriptive observational study of 126 women with breast cancer lesions treated between 2015 and 2017 at a cancer referral hospital for 27 municipalities in southwestern Paraná. Patients were categorized according to age at diagnosis, body mass index, menopausal status, molecular subtyping of tumors, histological characteristics, and risk stratification. Data were coded for analysis using the Statistical Package for Social Sciences (SPSS) 22.0.0 software. Results: There were 126 patients diagnosed with breast cancer and more than half of these had an excessive body weight (mean BMI 27.5kg/m 2 ). There was a predominance of the triple negative molecular subtype in overweight women; they also had a higher frequency of tumors larger than 2cm and high histological grade tumors. There were significant associations in the overweight/ obese subgroup such as tumors in the intermediate grade luminal B subtype, presence of angiolymphatic emboli, and a high-risk of disease recurrence. Conclusion: The data indicate that being overweight is a determinant of worse prognosis in women with breast cancer in southwestern Paraná.
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