Idade como fator prognóstico no câncer de mama em estádio inicial

Abstract

OBJECTIVE:To analyze age as a prognostic factor in early breast cancer. METHODS:Retrospective study analyzing the clinical profi le and diseasefree survival in a group of 280 subjects aged 25 to 81 years with stage I and II breast cancer followed-up in Porto Alegre, southern Brazil, from 1995 to 2000. Clinical, pathological, treatment and outcome data were obtained from medical records. Subjects were divided into two groups according to age at diagnosis (≤40 years and >40 years). The two groups were compared for clinical stage, histology, hormone receptor expression, therapy and radiotherapy using the chi-square and/or Fisher's exact test and for analysis of survival the KaplanMeier method with a long-rank test. RESULTS:Of 280 women studied, 54 (19.3%) were younger than 40 years. Both groups were similar regarding clinical stage, histology, and hormone receptor expression. The proportion of subjects with disease-free survival in the 56-month follow-up was signifi cantly higher in those over 40 years (84% versus 70%). Proportionally, younger subjects received more adjuvant therapy (88.8% vs. 77.8%). Those women over 40 years were signifi cantly more likely to remain disease-free (84%), and this difference was more remarkable when they were compared to those over 40 years at stage I breast cancer. CONCLUSIONS:The study fi ndings confi rm that women younger than 40 years with early breast cancer have a poorer prognosis. However, this prognosis does not seem to be related to increased number of hormone receptor-negative cases. Younger patients who remained disease-free received more adjuvant therapy, suggesting a positive effect of chemotherapy and endocrine therapy. DESCRIPTORS:

Age at diagnosis in relation to survival following breast cancer: a cohort study

“…As breast cancer is the most common malignancy in women under 40 years of age and approximately one third of breast cancer is diagnosed in women aged 70 years and older, it is important to clarify the association between age at diagnosis and breast cancer survival [ 2 ]. Previous data has been contradictory on whether the poor prognosis of young women exists in all stages, or only in women with small tumors and without axillary lymph node involvement (ALNI) [ 6 - 11 ]. Regarding the elderly, some studies have shown elderly women to have a poor outcome [ 5 , 12 , 13 ], whereas a few studies did not find an association [ 4 , 14 ] and one large study even found elderly women with ALNI-negative tumors to have a favorable outcome [ 15 ].…”

Análise de dados epidemiológicos de pacientes acompanhadas por neoplasia mamária em um hospital de Fortaleza (CE)

“…Pinheiro et al, em seu estudo sobre câncer de mama em mulheres jovens, encontraram o CDI como tipo mais comum, não havendo diferença entre mulheres jovens e muito jovens. Em estudo anterior, Garicochea et al encontraram o CDI como tipo mais comum tanto em mulheres com idade inferior a 40 anos como em mulheres com idade superior a 40 anos 16,21 .…”

Evaluation of an educational handbook as a knowledge-acquisition strategy for mastectomized women

“…Forty out the 125 studied women were younger than 45 years old. This is cause of concern among experts because women up to the age of 40 with early breast cancer present the worst prognosis (11) .…”

“…Even though the reasons younger patients present a worse prognosis are still uncertain, some studies suggest that the poor prognosis could be attributed to a late diagnosis in this group of patients (12) . The detection of early tumors among women younger than 40 years old through mammography may be hindered due to high breast density (11)(12) .…”