Franzoi Maria Alice, Rosa Daniela D, Zaffaroni Facundo, Werutsky Gustavo, Simon Sérgio, Bines José, Barrios Carlos, Cronemberger Eduardo, Queiroz Geraldo Silva, Cordeiro de Lima Vladmir, Júnior Ruffo Freitas, Couto José, Emerenciano Karla, Resende Heloísa, Crocamo Susanne, Reinert Tomás, Van Eyli Brigitte, Nerón Yeni, Dybal Vanessa, Lazaretti Nicolas, de Cassia Costamillan Rita, Pinto de Andrade Diocésio Alves, Mathias Clarissa, Vacaro Giovana Zerwes, Borges Giuliano, Morelle Alessandra, Filho Carlos Alberto Sampaio, Mano Max, Liedke Pedro E R
Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
Jules Bordet Institut, Brussels, Belgium.
J Glob Oncol. 2019 Nov;5:1-10. doi: 10.1200/JGO.19.00263.
Breast cancer (BC) in young women is uncommon and tends to present with more aggressive characteristics. To better understand and characterize this scenario in Brazil through real-world data, we performed a subanalysis of AMAZONA III study (ClinicalTrials.gov identifier: NCT02663973).
The AMAZONA III study (GBECAM 0115) is a prospective registry that included 2,950 women newly diagnosed with invasive BC in Brazil from January 2016 until March 2018 at 22 sites. Valid data were obtained from 2,888 patients regarding age at diagnosis and complete baseline information. To compare epidemiologic and clinicopathological features at the time of diagnosis, patients with BC were divided into two groups according to age: ≤ 40 years and > 40 years. Quantitative variables were described as means, and categorical variables were described as frequencies and percentages and compared using the Pearson's χ test.
Of 2,888 women diagnosed with BC, 486 (17%) were ≤ 40 years old. Young women had higher educational level, most were employed and a significant number were married (001 for all associations). Younger patients were more symptomatic at BC diagnosis (001), and they also presented more frequently with stage III, T3/T4, grade 3 tumors, HER-2-positive, luminal B, and triple-negative subtypes.
Brazilian women younger than age 40 years have unfavorable clinicopathological features of BC at diagnosis, with more aggressive subtypes and advanced stage when compared with older women. These differences are not explained by socioeconomic or ethnic imbalances. The causes of a higher prevalence of BC among young women in Brazil deserve additional investigation.
年轻女性乳腺癌(BC)并不常见,且往往具有更具侵袭性的特征。为了通过真实世界数据更好地了解和描述巴西的这种情况,我们对AMAZONA III研究(ClinicalTrials.gov标识符:NCT02663973)进行了亚分析。
AMAZONA III研究(GBECAM 0115)是一项前瞻性登记研究,纳入了2016年1月至2018年3月在巴西22个地点新诊断为浸润性BC的2950名女性。从2888名患者中获得了关于诊断年龄和完整基线信息的有效数据。为了比较诊断时的流行病学和临床病理特征,将BC患者按年龄分为两组:≤40岁和>40岁。定量变量用均值描述,分类变量用频率和百分比描述,并使用Pearson卡方检验进行比较。
在2888名诊断为BC的女性中,486名(17%)年龄≤40岁。年轻女性教育水平较高,大多数有工作,且相当一部分已婚(所有关联的P<0.001)。年轻患者在BC诊断时症状更明显(P<0.001),并且她们也更频繁地表现为III期、T3/T4、3级肿瘤、HER-2阳性、管腔B型和三阴性亚型。
巴西40岁以下的女性在诊断时具有不利的BC临床病理特征,与老年女性相比,具有更具侵袭性的亚型和晚期阶段。这些差异不能用社会经济或种族不平衡来解释。巴西年轻女性中BC患病率较高的原因值得进一步研究。