Abstract
Clinical management of breast cancer, making a prognosis and deciding on treatment, currently depend on defining prognostic factors, especially hormone receptors (HR). In addition to confirming the heterogeneity of the disease, these biological parameters are indispensable tools for designing personalized treatment. In this study, 1509 tumors from Cuban women diagnosed with breast cancer were examined. Hormone receptor (HR) expression was determined and correlated with a group of prognostic factors, such as age, tumor size, histological type, nuclear grade, histological grade, number of metastatic axillary lymph nodes, and clinical stage. Estrogen receptor (ER) expression was associated with low nuclear grade and histological grade, and with smaller tumor size (p < 0.05). Analysis of age at the time of diagnosis showed that ER expression was greater in patients in the group aged >50 years (p < 0.05). In general, ER expression was greater in patients in earlier clinical stages (p < 0.05). With regard to HR expression, 53% of tumors in this sample were ER+ and 49% were PR+. In 38% of cases, both receptors were positive and in 28% both receptors proved negative. The ER+/PR- combination was observed in 23% of cases while only 11% exhibited the ER-/PR+ combination. These findings indicate that approximately 72% of the tumors studied expressed some level of hormone dependency. This is the first report of HR expression in Cuba using immunohistochemical techniques and a representative sample of breast tumors diagnosed in different provinces around the country.
Highlights
Cancer is the second cause of death in Cuba and the first cause of potential years of life lost, and the cause most affecting increase in life expectancy of Cubans at birth
Prognostic factors in breast cancer are indicators that reflect the individual characteristics of the tumor and the patient.[13]
Analysis and evaluation of these factors play a fundamental role in selection of the most effective cancer-specific therapy with the least unnecessary toxic effects produced by inadequate treatment regimens
Summary
Cancer is the second cause of death in Cuba and the first cause of potential years of life lost, and the cause most affecting increase in life expectancy of Cubans at birth. Among Cuban women, breast cancer has the highest incidence (excluding skin tumors) and is the second leading cause of cancer mortality. Given that approximately 2500 new cases are diagnosed annually, and more than 1000 women die of breast cancer each year,[1] malignant breast tumors are considered a major health problem in the Cuban population. Knowledge of the prognosis plays a fundamental role in medical decision-making and disease management.[2] Prognostic factors have been defined as variables that help explain heterogeneity in the course and development of a disease, regardless of the treatment administered, and that are associated with event-free and overall survival. Treatments are becoming increasingly more personalized, significantly improving patients’ quality of life.[4]
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