Objective:To analyze the clinical, pathological, and sociodemographic aspects between triple-negative breast cancer (TNBC) and non-TNBC in a Brazilian cohort and identify potential prognostic factors.Methods:This hospital-based retrospective cohort study included 447 women with breast cancer treated at referral centers in Southeastern Brazil. Overall and disease-free survival were compared; prognostic factors were evaluated.Results:Triple-negative breast cancer corresponded to 19.5% of breast cancer diagnosis and was more prevalent among nonwhite and less educated women. The patients with TNBC tended to present with stage III cancer, high p53 expression, lymphocytic infiltration, and multifocality and treated with radical surgery and chemotherapy. The 5-year overall and disease-free survival were 62.1% and 57.5% for TNBC and 80.8% and 75.3% for non-TNBC, respectively (P < .001). The TNBC recurrence was associated with multicentricity, whereas lymph node involvement increased the risk of both recurrence and death. Non-TNBC worse clinical course was associated with nonwhite ethnicity, lower education level, lymph node involvement, and advanced stage.Conclusions:Triple-negative breast cancer exhibited a more aggressive behavior, earlier and more frequent recurrence, and worse survival compared with non-TNBC. While biological and social variables were associated with poorer prognosis in non-TNBC, only lymph node involvement and multicentricity were correlated with worse clinical outcomes in TNBC.
Resumo Objetivo Avaliar os indicadores relacionados à oferta de exames citopatológicos do colo do útero, sua qualidade, frequência de alterações celulares e seguimento informado de lesões de alto grau, em Minas Gerais e suas macrorregiões de saúde. Métodos Estudo descritivo com base em dados do Sistema de Informação do Câncer do Colo do Útero (SISCOLO), de 2006 a 2011. Resultados A razão de exames citopatológicos do colo do útero em mulheres de 25 a 59 anos manteve-se estável, porém sem alcançar a meta estadual pactuada. Aproximadamente 75% dos exames foram realizados na população-alvo e houve progressiva redução na proporção de citopatológicos do colo do útero sem citologia anterior. Em média, 51,2% dos exames foram realizados no período de até um ano. Quanto à qualidade do exame, destaca-se o índice de positividade, categorizado como baixo durante todo o período analisado. Observou-se baixo percentual de seguimento informado no estado. Conclusão Os resultados evidenciam a necessidade de aprimoramento do programa de rastreamento em relação à oferta e qualidade do exame, bem como ao direcionamento correto quanto à faixa etária e à periodicidade, visando garantir o acesso da população-alvo e o encaminhamento para a investigação diagnóstica e tratamento das lesões precursoras, quando indicado.
REVISÃO DE LITERATURA RESUMO | Contexto:A saúde do trabalhador vem expondo uma alteração no seu perfil e influenciando a capacidade de trabalho, o que configura um problema de saúde no Brasil e no mundo. Objetivo: Apresentar uma revisão sobre a capacidade para o trabalho e fatores associados em profissionais no Brasil. Métodos: Realizou-se uma revisão sistemática da literatura nacional do período de 1999 a 2015, mediante busca nas bases de dados Biblioteca Virtual em Saúde, PubMed, Scopus e Web of Science, utilizando os termos "capacidade de trabalho", "capacidade para o trabalho", "avaliação da capacidade de trabalho", "desempenho do trabalho", "work capacity evaluation", "work capacity", "work ability" e "work ability index". Resultados: Após aplicados os critérios de inclusão e exclusão sobre o total de estudos levantados (n=1.479), 59 artigos integraram a revisão. Desses, 12,1% evidenciaram uma prevalência de capacidade adequada para o trabalho e 1,7%, inadequada. Outros estudos apresentaram seus resultados do Índice de Capacidade para o trabalho (ICT) nas classificações (ruim, moderada, boa, ótima). Esta pesquisa encontrou que 3,4% dos estudos apresentaram prevalência de capacidade para o trabalho nas categorias moderada e boa; 10,4% na categoria moderada; 65,6% na categoria boa; e 20,6% na categoria ótima. Conclusões: A capacidade para o trabalho denota um indicador importante em função de suas implicações na saúde, no bem-estar e na empregabilidade dos trabalhadores. As questões sobre o tema, apesar de relevantes, ainda carecem de maior atenção no país. Palavras-chave | avaliação da capacidade de trabalho; condições de trabalho; saúde do trabalhador; carga de trabalho; desempenho profissional. ABSTRACT | Background:The workers' health profile is undergoing change affecting their work ability, which represents a health problem in Brazil and worldwide. Aim: To perform a literature review on work ability and associated factors among professionals in Brazil. Methods: A systematic review of articles published in Brazil from 1999 to 2015 was performed in databases Virtual Health Library, PubMed, Scopus and Web of Science, using terms "capacidade de trabalho", "capacidade para o trabalho", "avaliação da capacidade de trabalho", "desempenho do trabalho", "work capacity evaluation", "work capacity", "work ability" and "work ability index". Results: From the total number of articles located (n=1,479) 59 were selected for analysis after application of the insclusion and exclusion criteria. Among the analyzed studies 12.1% reported a prevalence of adequate work ability and 1.7% of inadequate work ability. Another group of studies analyzed the Work Ability Index (WAI) and expressed its results in categories (poor, moderate, good, high). In about 1.7% of the studies the work ability estimates corresponded to categories moderate and poor; in 5.2% to category moderate; in 32.8% to category good; and in 10.3% to category high. Conclusion: Work ability is a relevant indicator as a function of its implications for the worke...
Introduction: Breast cancer is an important public health issue in many parts of the world. Thus, it shows relevant incidence and is considered one of the main causes of death from cancer among women. Objective: To analyze ten-year survival and prognostic factors in women with invasive breast cancer. Methods: The cohort was composed of 195 women assisted in an oncology referral center in the municipality of Juiz de Fora, state of Minas Gerais, Brazil, who were diagnosed with the disease in 2000 and 2001. Sociodemographic, tumoral, health service, and treatment-related characteristics were analyzed. The Kaplan-Meier method was used to estimate the survival functions and the Cox model of proportional hazards for the evaluation of prognostic factors. Results: The ten-year survival after diagnosis was of 56.3%. The major independent prognostic factors associated with increased risk of death were tumor size > 2.0 cm (hazard ratio -HR = 1.9; confidence interval -95%CI 1.0 -3.2) and presence of compromised lymph nodes (HR = 3.7; 95%CI 2.1 -5.9). Conclusion: These findings reinforce the need of adopting actions that ensure access of the target population to the recommended diagnostic and therapeutic modalities, thus contributing to achieve earlier diagnosis and better survival rates.
the screening of breast neoplasms did not reach its goal in 2011 and there was a low rate of diagnostic confirmation for mammograms with suspicious findings of malignancy.
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