Brazilian Female Population Research Articles

Description of deaths from cervical cancer in the population of Recife-PE, from 2019 to 2021

Cancer of the Uterus (UCC) is a disease that affects thousands of women worldwide, where, present the factor for the pathology, the presence of HPV viruses 16 and 18. The screening of UCC in Brazil is performed through the cytological exam, however, along with this and examination there are barriers that need to be overcome. It is identified that this neoplasm has a high incidence and prevalence in the Brazilian female population, especially in the State of Pernambuco in its capital Recife. Thence, in the State every day occurs a death as a result of UCC. So, to occur an organized screening of the and accurate to get diagnosis of where the women in the age group are for screening, focus on women of higher risk age group and who do not do the pathological cite examination. To verify the data for organized UCC screening, number of women in eligible age group, locality of residence and cytological coverage in the population of Recife-PE. This is an epidemiological cohort study with a cross-sectional, descriptive approach , with a quantitative approach, whose data were collected through the secondary database of the Primary Care Information System (SISAB/SUS), E-SUS AB, provided by DATASUS/Ministry of Health. The population consisted of women registered in the E-SUS AB, registered in the Health Units of the Health Districts (SD) in the city of Recife-PE, in the temporal cohort from the years 2019 to 2021. The results showed that in a total population of 481,453 women, 164,650 women underwent the preventive examination. That is not even 34% of the population. Deaths from UCC is predominant among the 40-49 years, with 26% of the population, between the years 2019-2021. Confirming 67 deaths in 2021, with predominance in the II, IV and VII District. That with the high number of incidence and deaths from UCC, the present study can raise awareness of women for the participation of screening, whether by the "Papanicolau" or by HPV-DNA, and thus contribute to the reduction of the incidence and deaths from UCC.

Hospitalization and ambulatory costs related to breast cancer due to physical inactivity in the Brazilian state capitals.

The aim of this study was to estimate the hospitalization and ambulatory costs related to breast cancer due to physical inactivity in the female population from Brazilian capitals over a three-year period (2015 to 2017). This study was carried out with data from the Brazilian health system and had as metrics incidence of breast cancer, total and standardized rate hospitalizations by breast cancer, hospitalization and ambulatory costs by breast cancer and prevalence of physical inactivity. The Population Attributable Fraction (PAF) calculation was used. The total hospitalization cost by breast cancer in women aged ≥ 20 years in Brazil from 2015 to 2017 was US$ 33,484,920.54. Of this total, US$ 182,736.76 was due to physical inactivity. Outpatient expenses related to breast cancer in the Brazilian female population from 2015 to 2017 was US$ 207,993,744.39. Of this total, US$ 1,178,841.86 was due to physical inactivity. Outpatient and hospitalization expenses were higher in the states of Southeastern, Southern and Northeastern regions. Physical inactivity has contributed to the high number of hospitalizations for breast cancer in Brazil, which resulted in economic burden for health services (inpatient and outpatient) of more than US$ 1,300,000.00 from 2015 to 2017.

Physical activity to prevent stroke mortality in Brazil (1990-2019)

INTRODUCTION: This study aimed to estimate the burden of stroke mortality due to low levels of physical activity (PA) in Brazil from 1990 to 2019. METHODS: Data from the 2019 Global Burden of Disease (GBD) study for Brazil and Brazilian states were used. We used the number of deaths, age-standardized mortality rates, summary exposure value, and fraction of population risk attributable to low levels of PA. To standardize all estimates, data from the population aged 25 years or older were considered. RESULTS: The risk of exposure to low PA, SEV values, for the Brazilian male population was 11.8% (95%UI: 6.7; 19.9) and for the Brazilian female population was 13.2% (95%UI: 8.6; 19.2) in 2019. For males, it was estimated that there were, respectively, 2,025 (95%UI: 271; 4,839) and 3,595 (95%UI: 658; 7,302) deaths in 1990 and 2019 due to stroke attributable to low PA. For females, there were 2,518 (95%UI: 498; 5,006) and 4,735 (95%UI: 1,286; 8,495) deaths in 1990 and 2019 due to stroke attributable to low PA, respectively. From 1990 to 2019, reductions of 44.0% for males (95%UI: −0.54; -0.05) and 52.0% for females (95%UI: −0.60; -0.30) in age-standardized mortality rates due to stroke attributed to low PA were observed. Approximately 6.1% (for males) and 7.3% (for females) of deaths in 2019 due to stroke could be avoided if the Brazilian population were physically active. CONCLUSIONS: These findings support the promotion of PA in all Brazilian states for preventing early mortality due to stroke.

Cálculo do perfil de temperatura em um modelo tridimensional da mama para análise paramétrica da influência da posição e do tamanho de um tumor maligno

<span class="fontstyle0">Thermography is a technique that is being proposed as an auxiliary tool in breast cancer screening. It gains importance, especially due to the increased incidence of this cancer in the Brazilian female population. These images are also used for the validation of three-dimensional numerical simulations. The production of a more realistic and personalized breast model would allow a more accurate estimate of the sensitivity of thermography as a technique capable of early detection of breast cancer. This work proposes the development of a methodology to produce a custom three-dimensional breast geometry from the manually extracted curves of the thermograms contained in UFPE Thermographic Image Database. With this geometry, parametric analyzes were performed, seeking to understand the influence of tumor depth and size on the calculated temperature profile.</span> <br /><br />

Perfil sociodemográfico, clínico e familiar de mulheres recentemente diagnosticadas com câncer

In 2018, there were 227,920 deaths in Brazil due to neoplasms, 19,692 referring to the female population in the northwest of the state of Rio Grande do Sul. It is estimated that by 2020, 115,780 new cases of cancer affected the Brazilian female population, which justifies the main focus of the present study. This study assessed the association between the sociodemographic, clinical, and family characteristics of women recently diagnosed with cancer and their place of residence. This is a cross-sectional and observational study, in which data collection took place from August 2018 to January 2019 through the application of a questionnaire applied to 143 women recently diagnosed with cancer. These subjects were attended in a High Complexity Oncology Center (CACON) of a size IV general hospital (300 or more beds) which were subdivided into three groups: Rural, Urban without Rural Exposure, and Urban with Rural Exposure. It was found that 51% of women were under the age of 60 years old, and comorbidities such as obesity, depression, and breast cancer showed a significant association in relation to the place of residence (p=0.035, p=0.028 p=0.032, respectively). It is concluded that despite the urban environment providing greater infrastructure in the diagnosis, treatment, and measures to prevent the occurrence of cancer, urban, rural and women exposed to the rural environment, demonstrated similar occurrences for the incidence of some types of cancers.

EXAME CITOPATOLÓGICO DO COLO UTERINO: DESCRIÇÃO DOS PRINCIPAIS INDICADORES EM UM MUNICÍPIO NORDESTINO

Introdução: O câncer do colo do útero é um importante problema de saúde pública na população feminina brasileira e seu diagnóstico precoce aumenta consideravelmente a probabilidade de cura. A taxa de cura é próxima aos 100%, demonstrando que medidas preventivas, como o exame Papanicolau, são fundamentais para prevenção desse problema. Objetivo: O objetivo desse estudo foi descrever os resultados dos exames citopatológicos em mulheres de 25 a 64 anos no Município de Mossoró/RN. Metodologia: Levantamento retrospectivo analítico dos exames citopatológicos cadastrados no banco de dados do Sistema de Informação do Câncer de Colo de Útero (SICOLO) entre o período de 2014 e 2019 para o seu perfil epidemiológico. Resultados: Um total de 46606 casos foram incluídos e analisados. Houve uma tendência de aumento na realização dos testes ao longo dos anos. 83,8% dos casos representam células escamosas atípicas de significado indeterminado (ASC-US). 70% das lesões intraepiteliais escamosas (LIS) foram diagnosticadas como sendo de baixo grau (LISL). Não houve diagnóstico citopatológico de carcinoma de células escamosas e apenas 2 casos de adenocarcinoma in situ. Conclusões: Mossoró segue um padrão nacional de maiores resultados celulares atípicos representados por ASC-US e LSIL. Resultados sugestivos de alto grau de malignidade existem em menor frequência nos exames preventivos e necessitam ser avaliados por exames mais invasivos. 
 Palavras-Chave: Neoplasias do colo do útero; Teste de Papanicolaou; Saúde da Mulher.

Beyond gender stereotypes: the missing women in print advertising

This study explores female representation in Brazilian print advertising to reveal who the missing women are (i.e. the least common portrayals) and how this lack of representation can hinder women’s well-being. We undertook a content analysis of 1,387 portrayals in 1,207 advertisements covering 20 years of female representation in Brazil and involving four dimensions: the female role, age, body type, and skin color/race. By doing so, we provide both generalizable and specific evidence on the presence and portrayal of women over the years across magazine types and on intersectionality between the dimensions. Three new female roles (i.e. empowered, ornamental, and subaltern) emerged in the research process, thus extending the previous literature. Our results show that women portrayed as career-oriented, in nontraditional activities, or as being equal to men have been continuously ignored over the years. Women who are nonwhite, fat, and over 40 have also been very underrepresented, and their limited visual appearance becomes even more apparent when underrepresented features are combined (e.g. mature black women). The results indicate that the distribution of female representation in the advertisements is inconsistent with the distribution of the Brazilian female population. Theoretical and practical implications are provided so that advertising can move toward fostering and enhancing women’s well-being instead of reinforcing biased female roles and beauty standards.

Computational dosimetry evaluation in vertebral models using a radioactive bone cement with Sm-153, Ho-166 and Y-90

Background: Breast cancer is a disease that affects a large part of the Brazilian female population. Especially, those metastases developed in the spinal column can produce potential fractures with neurological compromise or reduction of the life’s quality of the patient due to chronic pain. Objective: The development of a computational dosimetry in vertebral models simulating bone metastasis applying a radioactive bone cement with Sm-153, Ho-166 and Y-90. Methods: 1. Based on radiological images of animal vertebrae was constructed in the code MCNPx. Absorbed doses were evaluated in the axial plane (XY) of the implant of the radioactive bone cement in the metastasis. The nearest organ of risk (OAR) was the spinal cord and the implant itself on the vertebras was the prescribed tumor volume (PTV). The Sm-153, Ho-166 and Y-90 radionuclides were considered. 2. The fluency of the electrons along the symmetrical axis of the vertebra x = 0 in the z = 0 planes was also studied. Results: The therapeutic absorbed dose obtained in the implant plane by radioactive bone cement reaches levels above 70 Gy for specific activities close to 3 GBq.mg-1 with suitable values for the Y-90 coupled to the cement. Exposure to Ho-166 produces a lower dose than in Y-90 but higher than in Sm-153. The doses obtained by radionuclide implants are better spatial distributed than IMRT, with a significant dose reduction in the spinal cord. Beta emitting from Y-90 found a greater range. Conclusions: The radioactive cement in an implant may potentially favor optimal tumor control and lower side effects in organs at risk.

Validação da escala curta de avaliação funcional do desejo sexual feminino

INTRODUÇÃO: a disfunção do desejo sexual feminino é prevalente e impacta negativamente sobre a função sexual e a qualidade de vida, mas não existem escalas funcionais que levem em conta função e disfunção. OBJETIVO: construir e validar uma escala curta para avaliação funcional do desejo sexual feminino. MÉTODO: Correlação dos resultados de função do desejo sexual avaliado pelo Índice de Função Sexual Feminina (FSFI) e a nova escala funcional, em uma amostra via internet da população feminina brasileira em geral por meio do teste T de Student e o coeficiente de Spearman. Curva ROC fomentou a análise de corroboração entre os dados do domínio disfunção do desejo do FSFI com a nova escala de avaliação funcional. RESULTADOS: Metade das mulheres da amostra apresentou disfunção sexual pelo FSFI, sendo que um terço apresentou disfunção do desejo sexual. Houve boa correlação entre os resultados da nova escala e do domínio desejo sexual do FSFI, bem como boa sensibilidade e especificidade do modelo pela curva ROC. CONCLUSÃO: a nova escala curta de avaliação funcional do desejo sexual feminino com base na Classificação Internacional de Funcionalidade, Incapacidade e Saúde pode ser uma ferramenta útil na avaliação da função do desejo sexual feminino.

Breast cancer in a 23-year-old nursing mother – case report

Introduction: Breast cancer is uncommon in women below 35 years of age, and the diagnosis can be delayed due to higher breast density and less attention during clinical examination. Survival in young women is worse than in individuals from an older age group, and treatment may have a greater physical and psychological impact on these patients. This relevant report describes the clinical case of a 23-year-old nursing mother, non-smoker, and without a family history of cancer, who detected a nodule in the left breast during self-examination. She sought medical care after three months due to nodule increase and local pain, which was treated as mastitis. Without improvement, she visited the mastology department, which identified, during clinical examination, a 9 cm, mobile, ill-defined nodule, and negative axillary nodes. Breast ultrasound found two spiculated, heterogeneous nodules, with ill-defined borders in the left upper outer quadrant. Core biopsy revealed an invasive breast carcinoma with luminal B immunophenotype. The patient underwent neoadjuvant chemotherapy with good response, lumpectomy, and sentinel lymph node biopsy. She has been receiving chemotherapy for subsequent radiotherapy and hormone therapy. Objectives: Since currently breast cancer has no proven preventive measure, this work aims at highlighting the importance of raising awareness about the possibility of cancer among young patients for early diagnosis and prompt treatment so as to increase the survival of diagnosed patients. Discussion: Breast cancer is the main death-related neoplasm in the Brazilian female population, representing a challenge for public health. The main risk factors are family history, advanced age, and reproductive characteristics. Studies show that the most common histological type in young individuals is invasive ductal and that this age group has peculiarities concerning risk factors, tumor biology, genetics, prognosis, and social and psychological impact. Classic symptoms, such as breast and axillary nodules and changes in the breast and nipple skin, indicate the need to seek medical help. Treatment is not distinct from that of older age groups, but the diagnostic difficulty warns about the importance of paying attention to any suspicious sign of this disease. Regarding prevalence, breast cancer in young people is rarer than in older individuals, but recurrence is higher. Clinical suspicion can be hindered by the greater breast density and the lack of disease screening among these patients. Conclusion: Early clinical suspicion based on detailed medical history and physical examination contributes to effective diagnosis and therapeutic approach, seeking a better quality of life and higher patient survival.

Opportunistic mammography screening by the Brazilian Unified Health System in 2019

Introduction: Mammography screening has been the best method for detecting early tumors and reducing breast cancer mortality according to different studies. In Brazil, the number of women who undergo mammography tests by the Brazilian Unified Health System (SUS) has been far below international recommendations. Objective: To describe the number of mammographies, mammography coverage, and the amount spent on this exam during 2019 by SUS, in Brazil. Method: Ecological study with data from the Department of Informatics of the Brazilian Unified Health System and the Brazilian Institute for Geography and Statistics in order to verify the number of mammographies performed by the SUS concerning the Brazilian female population in Brazil, in the age group of 50 to 69 years, in the states and in macro-regions during 2019. Results: In 2019, 2,660,469 mammographies were performed in the country out of the expected total of 12,154,979, accounting for a 21.9% mammography coverage by SUS at the cost of BRL 117,841,231.97. The lowest coverage rates were verified in the states of Amapá (0.6%) and the Federal District (4.9%), whereas the best rates were found in the states of Paraná (29.7%) and Alagoas (29.6%). Conclusions: The number of mammographies performed in Brazil in 2019 by SUS corresponded to almost ¼ of the country’s need, with mammography coverage far below the target and being widely different among the many Brazilian states

How does the ZIKA infection is higher among black women?

Introduction: ZIKA is a single-stranded RNA, from the Flaviviridae family. The infection of this virus became extremely visible during its epidemic in 2015 at South America, after the outbreak many speculations that includes newborns with central nervous system malformations and neurological disorders.
 Objective: determine the epidemiological profile of the Brazilian female population afflicted with Zika virus, by means of database research of 2017.
 Results: the higher incidence shows the social inequality of those affected by arboviruses: young, poor, black and brown women, the majority of population in the Northeast and North of Brazil.
 Conclusion: Brazilian epidemiology of Zika virus and Congenital Zika Virus is concentrated in the black and poor female population due to the historical and cultural Brazilian history of colonization, as it is concentrated in the same region where the Aedes mosquito has an easy procreation due to a wet and hot summer leading to propagation of arboviruses.

Extravasamiento de doxorubicina em punto de mano y tratamiento – Relato de caso

El cáncer de mama es una de las principales causas de mortalidad en la población femenina brasileña y la doxorubicina es uno de los medicamentos utilizados para evitar la replicación de células tumorales. Nuestro relato describe una paciente con neoplasia maligna de mama que sufrió el extravase de este fármaco durante el procedimiento de infusión. La evolución de la lesión en la mano de la paciente, el tratamiento y el pronóstico se evaluaron en este caso.

Content and Face Validity of the Mackey Childbirth Satisfaction Rating Scale Questionnaire Cross-culturally Adapted to Brazilian Portuguese.

The aim of this study was to determine the content and face validity of the Mackey Childbirth Satisfaction Rating Scale (MCSRS) questionnaire cross-culturally adapted to Brazilian Portuguese. The MCSRS is a questionnaire with 34 items related to childbirth satisfaction. The forward- and back-translated versions were compared with the original material, and 10 experts analyzed each item according to the following criteria: clarity, semantic equivalence, appropriateness, and cultural relevance. The final version was presented to 10 mothers for face validation to ensure the questionnaire would suit the target population. The total of 34 items assessed by experts for clarity, semantic equivalence, appropriateness, and relevance showed positive agreement of 0.85, 0.92, 0.97 and 0.97; negative agreement of 0.13, 0.09, 0.04 and 0.04; and total agreement of 0.75; 0.85, 0.94 and 0.94, respectively. Multilevel linear modeling was applied with crossed random effects and with nested random effects for each judge. The intercept of each criterion was as follows: clarity, 0.87; semantic equivalence, 0.92; appropriateness, 0.96; and cultural relevance, 0.96. The overall mean of agreement was 92.8%. The face validity measurement yielded 80% of agreement on the items, all of them clearly understood. The final version of the Brazilian Portuguese MCSRS questionnaire had face and content validity confirmed. This instrument of evaluation of maternal satisfaction during childbirth was validated to be applied in the Brazilian female population.

PCN155 ESTIMATIVE OF THE TOTAL NUMBER OF PATIENTS WITH ADVANCED OR METASTATIC BREAST CANCER HR+ / HER2-, STRATIFIED BY TREATMENT LINES IN BRAZIL

To estimate the total number of patients with advanced or metastatic breast cancer hormone receptor positive (HR+), human epidermal growth factor receptor 2 negative (HER2-) in Brazil and also the number of patients in each treatment lines (first and second lines). A retrospective analysis was performed based on epidemiological and published data from Instituto Nacional do Câncer (INCA). Were considered the Brazilian female population in 2018 and the prevalence of advanced or metastatic breast cancer to estimate the number of patients with advanced or metastatic breast cancer HR+ / HER2-, followed by the prevalence of postmenopausal patients in each treatment lines. An average rate of 0.7% of female population growth in Brazil was considered based on the last five years data from Instituto Brasileiro de Geografia e Estatística (IBGE) to estimate the population for the next four years (2019 to 2022). According to available data, it was possible to estimate that there were a total of 7,724 women with advanced or metastatic breast cancer HR+ /HER2- in 2018, of which 2,248 are pre-menopausal and 5,476 are in postmenopausal phase. For those in postmenopausal, considering the profile of Brazilian patients, it is estimated that, 3,177 women will receive the first line of treatment. Furthermore it was estimated a total of 3,192 that will receive second line treatment. Breast cancer presents several histological subtypes that can be directly related to prognosis, therefore, it is relevant to estimate these populations in order to customize the treatment for the patients. In this context, it is possible to conclude that this is a significant result considering the studied population, and it is necessary to increase the efficacy and the access to treatment for these patients in Brazil.

Mortalidade de mulheres em idade fértil no Piauí, Brasil, 2008-2012: causas básicas dos óbitos e fatores associados

Justificativa e Objetivos: A morte de mulheres em idade reprodutiva é um evento de grande magnitude em todo o mundo, mas o perfil é distinto entre as regiões de alta e baixa renda. O presente estudo teve como objetivo analisar causas básicas e fatores associados aos óbitos de mulheres em idade reprodutiva no Piauí, de 2008 a 2012. Métodos: Estudo descritivo de base populacional, com dados de todas as declarações de óbitos de mulheres entre 10 a 49 anos registradas no Comitê de Mortalidade Materna do Piauí. Foram calculados odds ratio (OR) e intervalos de confiança de 95% (IC95%) para avaliar a associação entre as variáveis. Resultados: Neoplasias (20,9%), doenças cardiovasculares (18,8%), causas externas (18,6%) e maternas (5,5%) foram as causas básicas mais encontradas. Causas externas e maternas predominaram entre 10 a 29 anos e, a partir de 35 anos, neoplasias e doenças cardiovasculares. A mortalidade materna foi mais provável de ocorrer em municípios do interior (OR=2,04; IC95% 1,51-2,33), com até 50.000 habitantes (OR=1,33; IC95% 1,16-1,78) e com IDH-M < 0,566 (OR=1,42; IC95% 1,34-2,01). Conclusões: O padrão de mortalidade é semelhante ao encontrado na população feminina brasileira em idade fértil, sendo que as principais causas básicas encontradas poderiam ser evitadas mediante a implementação de medidas de intervenção.

Mortality and years of life lost due to breast cancer attributable to physical inactivity in the Brazilian female population (1990\u20132015)

The aims of this study were as follows: to estimate the mortality and years of life lost, assessed by disability-adjusted life years (DALYs), due to breast cancer attributable to physical inactivity in Brazilian women; to compare the estimates attributable to physical inactivity and to other modifiable risk factors; and to analyse the temporal evolution of these estimates within Brazilian states over 25 years (1990–2015), compared with global estimates. Databases from the Global Burden of Disease Study for Brazil, Brazilian states, and other parts of the world were used. Physical inactivity has contributed to a substantial number of deaths (1990: 875; 2015: 2,075) and DALYs (1990: 28,089; 2015: 60,585) due to breast cancer in Brazil. Physical inactivity was responsible for more deaths and DALYs (~12.0%) due to breast cancer than other modifiable risk factors (~5.0%). The Brazilian states with better socioeconomic indicators had higher age-standardized rates of mortality and morbidity due to breast cancer attributable to physical inactivity. From 1990 to 2015, mortality due to breast cancer attributable to physical inactivity increased in Brazil (0.77%; 95%U.I.: 0.27–1.47) and decreased (−2.84%; 95%U.I.: −4.35 – −0.10) around the world. These findings support the promotion of physical activity in the Brazilian female population to prevent and manage breast cancer.

Clinical and Histopathological Comparison of Two Historical Series of 142 Wertheim-Meigs Operations Performed in a Reference Center in Brazil

Cervical cancer is the third-leading cause of death from cancer in Brazilian female population. Treatment depends on the clinical stage of the disease according to the classification of the International Federation of Gynecology and Obstetrics (FIGO). Radical hysterectomy with pelvic lymphadenectomy, the “Wertheim-Meigs” surgery, is a key intervention for tumors restricted to the cervix.

Risk Factors Associated With HIV Prevalence Among Female Sex Workers in 10 Brazilian Cities

HIV prevalence is 15 times higher among female sex workers (FSWs) than in the overall Brazilian female population. In this article, we investigated factors associated to HIV infection among FSW, recruited by Respondent-driven sampling (RDS), in 10 Brazilian cities in 2008-2009. The total sampling was 2523 FSWs. The variables considered in the study included sociodemographic characteristics and those related to profession, knowledge, and source of information on sexually transmitted infection/AIDS, access to condoms, sexual behavior, health care and sexually transmitted infection signs, discrimination and violence, and the use of alcohol and drugs. Sampling weights were proportional to the inverse of network size and for the generation of global results for the 10 cities, data were calibrated by the population size. Multivariate logistic regression models were used, taking into account the dependency structure of observations. The longest period of prostitution (odds ratio [OR], 1.040; 95% confidence interval [CI], 1.013-1.067), the lowest price charged for sex (OR, 0.713; 95% CI, 0.522-0.970), the association with other sexually transmitted infections such as syphilis (OR, 2.186; 95% CI, 1.064-4.488), and the fact of would waive the use of condom on client's request (OR, 3.735; 95% CI, 1.449-9.661) were the most important associated risk factors to HIV infection among FSWs. Purchase of condoms (OR, 0.503; 95% CI, 0.304-0.833) was a relevant preventive factor. The use of RDS proved to be appropriate for the recruitment of FSWs as long as the statistical analysis takes into account the dependency structure of observations. The HIV infection predictors here depicted can support public health policies focused on this population group in Brazil.

Myocardial Perfusion Imaging Is a Strong Predictor of Death in Women

We sought to assess the prognostic value and risk classification improvement using contemporary single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI) to predict all-cause mortality. Myocardial perfusion is a strong estimator of prognosis. Evidence published to date has not established the added prognostic value of SPECT-MPI nor defined an approach to detect improve classification of risk in women from a developing nation. A total of 2,225 women referred for SPECT-MPI were followed by a mean period of 3.7 ± 1.4 years. SPECT-MPI results were classified as abnormal on the presence of any perfusion defect. Abnormal scans were further classified as with mild/moderate reversible, severe reversible, partial reversible, or fixed perfusion defects. Risk estimates for incident mortality were categorized as <1%/year, 1% to 2%/year, and >2%/year using Cox proportional hazard models. Risk-adjusted models incorporated clinical risk factors, left ventricular ejection fraction (LVEF), and perfusion variables. All-cause death occurred in 139 patients. SPECT-MPI significantly risk stratified the population; patients with abnormal scans had significantly higher death rates compared with patients with normal scans, 13.1% versus 4.0%, respectively (p < 0.001). Cox analysis demonstrated that after adjusting for clinical risk factors and LVEF, SPECT-MPI improved the model discrimination (integrated discrimination index = 0.009; p = 0.02), added significant incremental prognostic information (global chi-square increased from 87.7 to 127.1; p < 0.0001), and improved risk prediction (net reclassification improvement = 0.12; p = 0.005). SPECT-MPI added significant incremental prognostic information to clinical and left ventricular functional variables while enhancing the ability to classify this Brazilian female population into low- and high-risk categories of all-cause mortality.