Breast cancer in younger patients in Southeast of Brazil: 10-year analysis.

Abstract

e13567 Background: Breast cancer in Brazil is the most common cancer among women and is also responsible for the highest number of cancer deaths in this group. For Brazil, 66,280 new cases of breast cancer are estimated for the year 2020. This corresponds to an estimated risk of 61.61 new cases per 100 thousand women. For Espírito Santo, the estimate is 790 new cases.. Affection in women under the age of 40 is still infrequent, but it has been growing in the country with more aggressive and advanced cancer at diagnoses. It happens that in Brazil, with the publication of Ordinance 61/2015 by the Ministry of Health, the procedure became exclusive to women aged 50 to 69 years, contrary to what Federal Law 11.664 / 2008 requires, which determines the right mammography exam for all women over 40 years of age. In other words, asymptomatic women who are under 50 or over 70 years of age cannot take the exam on the public network. Methods: The data presented in this study correspond to patients diagnosed with breast cancer from 2007 to 2017 and were extracted from the database of the Hospital Cancer Registry of the Evangelical Hospital of Cachoeiro de Itapemirim (RHC / HECI) through SisRHC, a tool of management of the computerized database for Hospital Cancer Records. Results: Over the 10 years analyzed, in the south Espírito Santo region, 1,546 women started treatment for breast cancer and of these 528 were aged 49 years or less, stratified by age group: 15-24 years 9 cases (1.71%), 25-34 years 64 cases (12.13%)., 35-39 years 96 cases (18.18%), 40-44 years 156 cases (29.54%), 45-49 years. 203 cases (38.44%). A very important factor when making the diagnosis is the clinical staging (EC) of the disease, a fact that directly influences the type of treatment and the woman's survival. Of the cases analyzed, 464 had complete staging data, of these 27 (5.82%) of the cases were EC 0, EC I were 89 (19.18%), 193 (41.60%) with EC II, 122 ( 26.30%) with EC III and, finally, 33 (7.10%) in EC IV. Conclusions: In Brazil, there is a divergence between the guidance of the INCA (National Cancer Institute), an organ linked to the Ministry of Health, which recommends routine mammography after the age of 50, and the Brazilian Mastology Societies and the Brazilian College of Radiology, which indicate the exam for women over 40 years of age. In this scenario, the reduction in the supply of mammograms puts the country against the recommendations of specialists and medical societies. Mammography is a right for all Brazilian women over 40 years of age. This is the law and we need to enforce it, since the incidence of cancer cases in this age group represented one third of the cases.