Fundação Oncocentro de São Paulo, Department of Information and Epidemiology - São Paulo (SP), Brazil.
A.C. Camargo Cancer Center, Centro International de Pesquisa, Cancer Epidemiology and Statistics Group - São Paulo (SP), Brazil.
Rev Bras Epidemiol. 2023 May 29;26:e230028. doi: 10.1590/1980-549720230028. eCollection 2023.
This study aimed to analyze the prognosis of women with breast cancer by molecular subtypes, sociodemographic variables, and clinical and treatment characteristics.
This hospital-based retrospective cohort study analyzed 1,654 women over 18 years of age diagnosed with invasive breast cancer from 2000 to 2018. Data were extracted from Brazil's Oncocenter Foundation of São Paulo. The variables analyzed were age, histology, molecular subtypes, clinical staging, treatment type, and diagnosis-to-treatment time. Cox regression analysis was applied to estimate death risk.
Women with HER-2-positive (nonluminal) and triple-negative molecular subtypes were more than twice more likely to be at risk of death, with adjusted hazard ratio - HRadj=2.30 (95% confidence interval - 95%CI 1.34-3.94) and HRadj=2.51 (95%CI 1.61-3.92), respectively. A delayed treatment associated with an advanced clinical stage at diagnosis increased fourfold the risk of death (HRadj=4.20 (95%CI 2.36-7.49).
In summary, besides that interaction between advanced clinical stage and longer time between diagnosis and treatment, HER-2-positive (nonluminal) and triple-negative phenotypes were associated with a worse prognosis. Therefore, actions to reduce barriers in diagnosis and treatment can provide better outcome, even in aggressive phenotypes.
本研究旨在通过分子亚型、社会人口统计学变量以及临床和治疗特征分析乳腺癌女性的预后。
本基于医院的回顾性队列研究分析了 2000 年至 2018 年间诊断为浸润性乳腺癌的 1654 名 18 岁以上的女性。数据来自巴西圣保罗肿瘤中心基金会。分析的变量包括年龄、组织学、分子亚型、临床分期、治疗类型和诊断至治疗时间。应用 Cox 回归分析估计死亡风险。
HER-2 阳性（非腔隙型）和三阴性分子亚型的女性死亡风险高出两倍以上，调整后的危险比（HRadj）分别为 2.30（95%置信区间 95%CI 1.34-3.94）和 2.51（95%CI 1.61-3.92）。与诊断时临床分期较晚相关的治疗延迟使死亡风险增加了四倍（HRadj=4.20（95%CI 2.36-7.49））。
总之，除了先进的临床阶段和诊断与治疗之间时间延长之间的相互作用外，HER-2 阳性（非腔隙型）和三阴性表型与预后较差相关。因此，减少诊断和治疗障碍的行动可以提供更好的结果，即使是在侵袭性表型中也是如此。
