Perfil do câncer de mama em mulheres do Sudoeste do Paraná: identificação de possíveis fatores de risco regionais e correlação clínico-patológica

Abstract

INTRODUCTION: Breast cancer is the most frequent neoplasm in women, whose determinant risk factors involve aspects related to reproductive life, family history and life habits. PURPOSE: to describe the clinical-pathological profile, as well as to identify possible regional risk variables, comparing the distributions of the molecular subtypes intrinsic to breast cancer based on the immunohistochemical profile. METHODS: a case-control cohort study with a selection of 200 patients attended at the Francisco Beltrão Cancer Hospital (CEONC) from 2015 to 2017. Patients were divided according to molecular subtypes based on immunohistochemical expression estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), and Ki-67 proliferation index. The cases were classified as luminal A (ER and / or PR positive and HER2 negative, Ki-67 <14%), luminal B (ER and / or PR positive, HER2 negative and Ki-67> 14%), triple positive ER and / or PR positive and HER2 positive) enriched with HER2 (ER negative and PR negative and HER2 positive) and triple negative (TN) (negative for ER, negative for PR and negative for HER2). RESULTS: 127 patients with breast cancer, predominantly infiltrating ductal carcinoma, were found in this sample. The others presented benignity in the anatomopathological examination and served as control. Of these patients confirmed with malignant neoplasia, 25.8% were luminal A, 38.7% luminal B, 8.1% Triple positive 8.1% HER and 19.4% triple-negative. There was a predominance of young patients inserted in the most aggressive subtypes, 50% of the patients were below 50 years of age and 57.1% of the patients were above the recommended weight, and a strong relation to the exposure of pesticides was observed. CONCLUSIONS: Geographic regions differ according to the distribution of molecular subtypes of breast cancer in Brazil and in the World. There are multiple differences to be considered to explain the results, which are also justified by ethnic distribution and environmental exposure, in addition to the classical factors. Knowledge of the differences in the incidence and characteristics of breast cancer among geographical regions may help to better organize health policies and screening in continental countries such as Brazil.