Breast Cancer In Brazilian Women Research Articles

Abstract PO2-08-03: Developing a polygenic risk score for precision prevention of estrogen receptor-positive (ER+)/HER2- breast cancer in Brazilian women

Abstract Polygenic risk scores (PRS) quantify the genetic risk of diseases based on risk alleles in genomic loci identified in genome-wide association studies (GWAS). As individuals of European ancestry are overrepresented in GWAS, PRS performance may vary in individuals of different ancestries. Brazil is the largest and most populated country in Latin America, with around 43% of admixed individuals, and data on breast cancer PRS performance for this population is lacking. We aimed to evaluate the performance of a breast cancer PRS with 313 SNPs generated with Europeans in Brazilian population. In this case-control study, we expect to include 1000 women age >= 18 years old with current or previous diagnosis of ER+/HER2- breast cancer. Germline DNA samples are genotyped with Illumina Infinium Global Screening Array-24 v3.0 chip. Controls are healthy woman previously genotyped with Global Screening Array-24 v1.0 chip. We selected the 313 SNPs PRS for ER+/HER2- breast cancer from PGS Catalog for evaluation. Quality control, imputation, PRS calculation and statistical analysis were performed in PLINK v2.0, Michigan server, PGS Catalog and R, respectively. We present the preliminary results for 1347 women (504 cases and 843 controls) included until March of 2023. After quality control and imputation, we calculated PRS for 1212 subjects (475 cases and 737 controls). Out of 313 SNPs, 211 were validated in our samples. For ER+/HER2- breast cancer, the odds ratio per SD of the 211-variant PRS (PRS211) was 1.363 (95% confidence interval [CI]: 1.211 to 1.537). Compared with women with average risk (40th-60th PRS percentile), women in the top 10% of PRS211 had a 1.623-fold increased risk (95% CI: 1.047 to 2.522). The area under the receiver operating characteristic curve of 0.581. Our preliminary results indicate that a PRS derived from European-ancestry population correlates with ER+/HER2- breast cancer in admixed Brazilian population, although with attenuated performance. Further work is needed to better characterize PRS risk stratification in admixed populations. Citation Format: Marina Candido Visontai Cormedi, Álison Luís Eburnêo Pereira, Fernanda Borchers Coeli-Lacchini, Sabrina Baroni, Lívia Mara Torres Bueno, Evelyn Ayumi Onga, Victor Girelli Piloto De Oliveira, Fabiana De Oliveira Buono, Aline Fares, Tatiana Strava Correa, Iasmin Alves Chirichela, Fernanda Peria, Romulado Barroso-Sousa, Rodrigo Santa Cruz Guindalini, Taisa Manuela Bonfim Machado Lopes, Rosimeire Aparecida Roela, Maria Aparecida Azevedo Koike Folgueira, Daniel Guimarães Tiezzi, Leandro Machado Colli, Liane Rapatoni. Developing a polygenic risk score for precision prevention of estrogen receptor-positive (ER+)/HER2- breast cancer in Brazilian women [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-08-03.

Abstract 5207: Hypermethylation of SOX17 is an important epigenetic mark in Afro-Brazilian breast cancers

Abstract Afro-Brazilian women suffer from higher excess breast cancer mortality after adjusting for age, level of education and stage at diagnosis. Limited studies have researched disease characteristics in this population, which can benefit from the identification of molecular markers that can provide an insight into who is at greater risk of mortality. Epigenetic biomarkers represent the combined effect of environmental and genetic factors. Particularly DNA methylation biomarkers can be valuable as biomarkers of breast cancer risk and prognosis. While studies in other populations have identified DNA methylation biomarkers associated with breast cancer and its clinicopathological outcomes, research on Brazilian cohorts has been limited in scope and focused on women of European descent. The goal of this work was to determine the epigenetic makeup of breast cancer in Brazilian women of African descent. To identify epigenetic biomarkers in Brazilian women who self-identified as Black or Brown, we conducted a case-series analysis investigating DNA methylation patterns in tumor (T) and adjacent non-tumor (NT) tissue. For this, we used the Illumina EPIC (850k) arrays to carry out DNA methylation profiling in 48 frozen tissue paired T and NT samples of breast cancer patients treated at the National Cancer Institute Breast Cancer Hospital in Rio de Janeiro, Brazil. We identified a total of 7,749 probes with Benjamini-Hochberg adjusted p-value < 0.0001 and differences between T and NT tissue above |0.3|. Of these, 5,976 or 77.12% had lower DNA methylation in T when compared to NT tissue; while 1,773 (22.88%) had higher DNA methylation. These were used to identify 21 differentially methylated regions (DMRs) that contained a minimum of seven cg sites, a mean difference larger than |0.2| and a maximum difference above |0.4|. DMRs were mostly (12) hypermethylated in T, and included PCDHGA, NKAPL, ZKSCAN4, SPAG6, CA3, DPP6, RGS22, NXPH1, ANK3, OTX2, SOX17, and CDO1. We used pyrosequencing to validate the levels of SOX17 in eighty-eight tumor and non-adjacent tumor tissue DNAs. We found SOX17 to be hypermethylated in T (44.5±19.1% vs 10.2±10.6, p<0.0001). Differences in DNA methylation in T and NT tissue we still observed by race/ethnicity categories, 43.9±18.6% vs 11.0.±13.2% (p<0.0001) for Brown, and 45.1±20.7% vs 8.8±3.0% for Black women (p<0.0001), respectively. Similarly to previously reported, SOX17 hypermethylation was found to be associated with Luminal A and B molecular subtypes (p<0.0001). To our knowledge, this is the first study to use a discovery approach to identify epigenetic biomarkers in Black and Brown Brazilian women. Our findings confirming previously reported data on SOX17 hypermethylation in breast cancer are encouraging. We expect to validate other epigenetic markers unique to this population that can ultimately aid in the molecular characterization of Brazilian breast cancers. Citation Format: Lissette Delgado-Cruzata, Diego J. Gomes de Paula, Jennifer G. Vieira, André L. Christianes, Tatiana Simao, Leonor B. Gusmao, Luis Felipe Ribeiro Pinto, Sheila Coelho Soares Lima. Hypermethylation of SOX17 is an important epigenetic mark in Afro-Brazilian breast cancers [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 5207.

Screening and hospitalization of breast and cervical cancer in Brazil from 2010 to 2022: A time-series study.

In Brazil, during the pandemic caused by COVID-19, screening for breast and cervical cancers was postponed or interrupted due to the prevailing health conditions. These neoplasms, however, are responsible for high morbidity and mortality among women in Brazil and have a major impact on the quality of life of this population and public health. Thus, this study aims to evaluate the epidemiological behavior of hospitalization for cervical and breast cancer in Brazilian women, as well as the trend of screening tests of breast and cervical cancer in the years 2010 to 2022 according to the regions of Brazil. This is ecological research of time series, based on secondary data obtained from information systems of the country, about hospital admissions for breast and cervical cancer and screening methods used for these tumors. The data were analyzed in the Joinpoint Regression Program, to obtain the linear regression and temporal analysis of the variables. As a result, between 2010 and 2022, the rates of mammography varied from 36 to 71 exams, while in the pap smear, the variations were 126 and 226 cytopathological exams per 1000 women. Hospitalizations for these cancers peaked in 2019, with 48 hospitalizations for cervical cancer per 100,000 women and 147 hospitalizations for breast cancer for the same population. For both, in the pandemic years, between 2020 and 2022, there is a decrease in Brazil and in all its regions. As for the tracking of these diseases, it was observed that the performance of mammograms and preventive tests showed a similar behavior, in which there is a higher supply of these tests until 2019 and a drop during the pandemic period. This leads to the conclusion that even though Brazil has several policies for the screening of these diseases, there is still instability in the offering of these tests and that there was instability in this area during the pandemic.

Complex physical therapy employing self-adjusting garment (ReadyWrap®) in breast cancer-related lymphedema cases in Brazilian women: a protocol for a randomized controlled trial

BackgroundLymphedema is a common complication following breast cancer treatment. The aim of this study is to evaluate the effectiveness of a self-adjusting compression garment (ReadyWrap®) in reducing (phase 1) and maintaining (phase 2) upper limb volume in women presenting breast cancer-related lymphedema.MethodsThis study will comprise a randomized, controlled, single-blind clinical trial concerning women with breast cancer-related lymphedema undergoing treatment at a public cancer treatment reference hospital in the city of Rio de Janeiro, Brazil. The intervention will be carried out by adapting self-dressing versus the standard treatment of compressive bandaging (phase 1) and compressive mesh (phase 2). Both groups will be assessed at the beginning and end of intensive treatment and followed up for up to 12 months to evaluate immediate and late outcomes. Assessments will be carried out by physical upper limb examination (inspection, palpation, volume, dynamometry, and thermography) and questionnaires application to assess patient’s quality of life pertaining to the health, functionality, and symptoms of the affected upper limb, as well adverse effects and adherence to treatment. Data will be analyzed descriptively and analytically through univariate and multiple linear regressions. P values < 0.05 will be considered statistically significant.DiscussionThis study will evaluate the effectiveness of a self-adjustable garment (ReadyWrap®) in the treatment of lymphedema secondary to breast cancer in Brazilian women compared to the gold standard treatment for limb volume reduction (phase 1) and maintenance (phase 2) phases comprising, respectively, a compressive bandaging and a compressive mesh. The outcome results will provide data based on both quantitative responses and self-reported participant outcomes. The study will also assess the cost-effectiveness of the ReadyWrap® treatment versus standard care. Finally, we expect to reaffirm one more product/therapy as a treatment for this extremely complex and impactful condition following the data analysis.Trial registrationNCT04934098 [Clinical trials phase 1]. Registered on June 22, 2021. NCT04881604 [Clinical trials phase 2]. Registered on May 11, 2021.

Genetic Ancestry of 1127 Brazilian Breast Cancer Patients and Its Correlation With Molecular Subtype and Geographic Region

PurposeBreast cancer molecular subtypes show significant differences in different ethnic groups in the United States, but no study has evaluated genetic ancestry in breast cancer in Brazilian women. MethodsBreast cancer patients from distinct parts of Brazil were evaluated. Molecular subtypes were determined by immunohistochemistry. Genetic ancestry was evaluated using a panel of 46 AIMs (ancestry informative markers), which classified genetic ancestry as European, African, Asian, and Amerindian. PCR products were subjected to capillary electrophoresis and analyzed using GeneMapper 4.0 software. Ancestry was evaluated with Structure v.2.3.3 software. Ancestry was tested for correlations with geographic region and molecular subtype. The chi-square test and ANOVA with Bonferroni adjustment were applied. ResultsGenetic ancestry and clinical data were evaluated in 1127 patients. Higher rates of self-reported white ethnicity, European ancestry, and HER-2− luminal tumors were identified in the South region, which may influence age at diagnosis and result in a higher rate of early tumors. Conversely, higher rates of African ancestry in the North and Northeast regions, self-reported nonwhite ethnicity, HER-2+ tumors, and triple-negative tumors were noted. Triple-negative and HER-2+ tumors were associated with higher advanced and metastatic disease rates at diagnosis, with triple-negative tumors being more frequent in young women. ConclusionDifferences in genetic ancestry, self-reported ethnicity, and molecular subtype were found between Brazilian demographic regions. Knowledge of these features may contribute to a better understanding of age at diagnosis and the molecular distribution of breast cancer in Brazil.

Evaluation of the g473a polymorphism in the lysyl oxidase gene as a risk factor related to the occurrence of breast cancer in brazilian women

Introduction: breast cancer is the most diagnosed type of cancer and the leading cause of death among women worldwide. Approximately 1.67 million new cases of breast cancer were diagnosed in 2012, leading to more than half a million deaths. Breast cancer accounted for 11.6% of newly diagnosed cancers (2,089 million) and 9.2% (787,000) of cancer-related deaths for both sexes and at all ages worldwide in 2018. Objective: breast cancer, as the most diagnosed carcinoma in the world and the leading cause of death among women, is a morbidity of outstanding importance, and the object of this study is to evaluate the association between the LOX gene G473A (rs1800449) polymorphism and breast cancer occurrence, potentially establishing a new finding in the identification of risks, prevention, and care for a specific group of women. Methods:in this retrospective cohort study, LOX G473A polymorphism frequency was assessed in 148 women with breast cancer and 245 women without breast cancer. All patients completed a questionnaire to identify possible risk factors and subsequently underwent peripheral blood collection to study the LOX gene. DNA was extracted followed by gene amplification via PCR, and the polymorphism was studied by specific fragment electrophoresis after digestion of the samples with the restriction endonuclease Pstl. Results: this study identified the use of oral contraceptives and family history of breast cancer as risk factors for breast cancer; the G473A polymorphism in LOX was not identified as a risk factor. Conclusion: a relationship was not observed between the LOX G473A polymorphism and the occurrence of breast cancer.

Association between matrix metalloproteinase-9 gene polymorphism and breast cancer in Brazilian women

OBJECTIVE:This study aimed to determine the relationship between rs17576 (MMP-9) polymorphism and increased cancer risk in a Brazilian breast cancer cohort.METHODS:This study included 141 women (71 breast cancer patients and 70 controls without breast cancer) who donated 3 mL of their peripheral blood for genomic DNA extraction. This DNA was then genotyped using a real-time polymerase chain reaction.RESULTS:The AG (rs17576) genotype was identified in 26 (18.43%) participants in the case group and in 22 (15.60%) participants in the control group (p=0.274), while the GG genotype was identified in ten (7.09%) participants in the case group and in one (0.70%) participant in the control group (p<0.003 - OR (95% CI) 13.13 (1.73, 593.08). No significant difference in the incidence rates was observed for AG or GG rs17576 genotypes in premenopausal women, p=0.813 and p=0.556, respectively. However, in postmenopausal women, the AG genotype was shown to occur in 14 (22.5%) participants in the case group and in 4 (6.45%) participants in the control (p<0.043), while GG genotype occurred in eight (12.90%) of the individuals in the case group and in none of the individuals in the control group (p<0.006).CONCLUSION:In this study, the MMP-9 rs17576 GG polymorphic variant was shown to be significantly associated with breast cancer risk in premenopausal women, while the AG and GG genotypes were associated with increased cancer risk in postmenopausal women.

Eficácia da campanha “Outubro Rosa” no rastreamento do câncer de mama baseada no BIRADS®

Introdução: O câncer de mama é a segunda neoplasia mais comum entre as mulheres do mundo e a causamais frequente de óbitos. A mamografia é o principal método de imagem para o rastreio e diagnóstico precoce. Objetivo: Analisar o impacto da política de saúde da campanha “Outubro Rosa” sobre o diagnóstico precocedo câncer de mama e os resultados de suas estratégias de marketing social. Métodos: Estudo observacional, descritivo, transversal e retrospectivo, a partir da coleta e análise deregistros de mamografias no SISMAMA, padronizados no Breast Imaging Reporting and Data System(BIRADS®) realizado em um hospital quaternário no ano de 2016. Resultados: Foram realizadas 1.844 mamografias no serviço de diagnóstico por imagem. A análise do número de exames realizados nos meses anteriores (janeiro a setembro) e posteriores (outubro a dezembro)à campanha evidenciou um aumento estatisticamente significativo no número médio de exames após o“Outubro Rosa” (125,8 exames/mês vs 237,3 exames/mês; p = 0,003). Observou-se que a categoriaBIRADS® 2 (achados mamográficos benignos) representou a maioria dos resultados (40,9%). Não houve diferença estatisticamente significativa entre a categorização BIRADS® para o mês de outubro emcomparação com os demais meses do ano. Conclusão: Foi possível demonstrar que a campanha do “Outubro Rosa” cumpriu seu objetivo, como políticade saúde pública, de estimular o rastreamento do câncer de mama pelas mulheres brasileiras.

Factors influencing delay in symptomatic presentation of breast cancer in Brazilian women.

The aim of this study was to evaluate delays in the presentation of symptomatic breast cancer in women (time interval between the perception of their first sign or symptom until the first medical appointment) and its risk factors. A cohort study composed of patients with breast cancer (symptomatic) admitted to an oncological centre in the city of Rio de Janeiro, Brazil was performed. The patients were interviewed during their first hospital visit. To assess time interval as a continuous variable, the median and interquartile ranges (IQR) were calculated. The outcome comprised delay in breast cancer presentation when time from the first sign or symptom perception to the first medical appointment was ≥90days. A descriptive analysis was performed. The association between independent variables (epidemiological, social and demographic data, related to individual healthcare, clinical and current disease) and the outcome (delay in symptomatic presentation) was assessed by a univariate analysis applying odds ratios (OR). Associations with p<.20 in the univariate analysis were included in the multiple logistic regression model. Variables with a p<.05 were retained in the final model. A total of 388 women were included. The median time was of 41days (interquartile range - IQR: 13.2-130.0); 34.3% delayed presentation at≥90days. After adjustment, the variables associated with a delay in presentation were frequency of gynaecological examination of over than 1year (OR: 2.59, 95% CI: 1.67-4.05), no family history of breast cancer (OR: 1.96, 95% CI: 1.15-3.35), and income lower than the minimum wage (OR: 1.62, 95% CI: 1.03-2.55). A higher score in tangible support (OR: 0.98; 95% CI: 0.96-0.99) was associated with a lesser chance of delay in presentation. Thus, delay in presentation was associated with social barriers, access to health service, health information and individual factors.

Perfil epidemiológico de mulheres mastectomizadas em um serviço de referência localizado no Vale do Taquari/RS

Justificativa e Objetivos:O câncer de mama é o de maior incidência entre as mulheres no país, sendo a cirurgia a principal medida de &#x0D; tratamento, associada ou não a terapias adjuvantes. O objetivo deste trabalho é verificar o número e identificar o perfil epidemiológico de &#x0D; mulheres diagnosticadas com câncer de mama que realizaram mastectomia radical modificada em um hospital de referência, localizado &#x0D; no Vale do Taquari, no Rio Grande do Sul. Métodos:Estudo epidemiológico retrospectivo, de abordagem quantitativa, no qual foram &#x0D; averiguados 329 prontuários. As variáveis analisadas foram: idade, município de encaminhamento, escolaridade e raça. Resultados: Foram &#x0D; realizadas 150 cirurgias de mastectomia radical entre janeiro de 2008 a junho de 2016, identificando-se mulheres de maioria branca, com &#x0D; baixa escolaridade, na faixa etária superior a 50 anos, provenientes de 29 municípios da região estudada. Conclusão:O perfil epidemio-lógico da população atendida na referida região segue as características locorregionais e nacionais. Dada a alta incidência de câncer de &#x0D; mama em brasileiras, o número acentuado de mulheres com baixa escolaridade acometidas e, o impacto da doença na qualidade de vida, &#x0D; sugere-se a realização de estudos que verifiquem a evolução pós-operatória, reabilitação clínica, física, psicológica e social após cirurgia &#x0D; de mastectomia radical.&#x0D; Descritores:Mastectomia de Patey. Perfil de saúde. Epidemiologia. Câncer de Mama.

Effects of the high-inequality of income on the breast cancer mortality in Brazil

As well as breast cancer mortality, the income inequality in Brazil is different between Federative units, including between units of the same region. To assess the effects of the high-inequality of income on breast cancer mortality in Brazilian Federative Units, in the 2010 year. This is an ecologic study. Deaths from breast cancer in Brazilian women according to Federative units were obtained from the Department of Informatics of the Unified Health System. Mortality by breast cancer was estimated per 100,000 women and age-standardized by the direct method according to World Health Organization population. Income inequality was measured by the Gini index obtained from the United Nations Development Programme. The High-inequality of income was classified by the third tercile of the distribution from the Gini index of the Federative units. Univariate analysis was performed according to data normality. Linear regressions were performed by the stepwise backward method. The confidence level was 5%. Stata® (Stata Corp, LC) 11.0. was used. The High-inequality of income was associated with worse social and demographic indicators. The age-standardized breast cancer mortality was larger in the high-inequality of income Federative units. In the adjusted analysis, these Federative units presented a mean of 2 more deaths (ranging from the 0.4 to 3.7 deaths, r² = 0.79; p = 0.018) by breast cancer per 100,000 women when compared to the Federative units without high-inequality of income. In the Brazilian Federative units, the high-inequality of income was associated with age-standardized breast cancer mortality more.

Trends in mammography use in the Brazilian public healthcare system

BackgroundAlthough breast cancer mortality rates are declining in many developed countries, recent trends in Brazil reveal increasing mortality rates. As mammography is an important tool in the early diagnosis and improved prognosis for breast cancer, we aimed to explore recent trends of mammography in the Brazilian public healthcare system (SUS). MethodsWe extracted a range of data from the DATASUS and SISMAMA online databases for the period 2010–2013, for Brazil and all of its regions, to explore patterns and trends in mammography within SUS across Brazil. ResultsOn average, over 2010–2013, 18% and 14% of SUS-dependent Brazilian women aged 50–59 and 60–69 years respectively, were given a screening mammogram. Screening and diagnostic mammograms were recorded for females outside of this age range. The South and South-East had greater rates of screening and diagnostic mammograms respectively, than other regions. Most screening and diagnostic mammograms were categorised as BI-RADS category 1 (‘negative’) or 2 (‘benign’). There was an average annual increase in numbers of machines in use, machines available to SUS and machine usage within SUS in each region. ConclusionsScreening mammography rates were much lower than recommended in target age groups for mammography in Brazil and both types of mammograms were recorded for women younger than usually recommended. More appropriate use of mammography and better use of resources, will likely improve the outcomes of breast cancer in Brazilian women in a country with wide socio-economic differences, as well as minimise the potential risks associated with mammography in younger women.

Socioeconomic changes in Brazil impacted breast cancer indexes at the beginning of the 21st century?

ObjectivesTo analyze the relationship between Socioeconomic development, income inequality and breast cancer mortality in Brazil. SettingEcological study. ParticipantsBrazilian Women Primary and secondary outcome measures: Age-standardized Hospital admission rates and mortality due to breast cancer in Brazilian Women's were analyzed. Deaths due to breast cancer were obtained from Department of Informatics of the Unified Health System. Human Development Index (HDI) and Gini Index were obtained from the United Nations Development Program. The gross domestic product was obtained from the World Bank. The period was between 2010 and 2014. The annual percentage change (APC) and average annual percentage change (AAPC) were estimated. Linear regression adjusted for income per capita was performed. ResultsThere was a significant increase of 14.5% in breast cancer mortality (AAPC, 3%; 95% CI, 2–3%), an increase of 21.4% in the hospital admission rate (AAPC, 5%; 95% CI, 1–10%), a 4.6% decrease in the Gini index (AAPC, −0.09; 95% CI, 0.10 to −1.0%), and a 5.4% increase in the HDI (AAPC, 6%; 95% CI, 6–7%). Besides, the increase of 0.01 in the HDI is related to an increase of 1.4 deaths per 100,000 women. ConclusionsHuman Development Index was related to increases in breast cancer mortality in Brazil. Besides, the changes in income inequality indexes occurred in Brazil were not sufficient to impact the age-standardized mortality and hospital admission rate due to breast cancer.

Can MTHFR C677T and A1298C Polymorphisms Alter the Risk and Severity of Sporadic Breast Cancer in Brazilian Women?

IntroductionPolymorphisms in the methylenetetrahydrofolate reductase gene (MTHFR) modify the risk and severity of sporadic breast cancer (BC). In this context, the MTHFR C677T and A1298C polymorphisms have been associated with risk and severity of sporadic BC. Patients and MethodsIn total, 253 women with BC and 257 controls were enrolled in this study. Polymorphisms were analyzed using restriction fragment length polymorphism - polymerase chain reaction. Epidemiology, tumor characteristics, and reproductive factors were considered in the analysis. Statistical tests included the χ2 test, the Fisher exact test, and the Mann-Whitney and Kruskal-Wallis tests, or parametric equivalents. ResultsMTHFR polymorphisms were not a risk factor for BC. The 677CC genotype was associated with distant metastasis (odds ratio [OR] = 5.311; 95% confidence interval [CI] = 1.124-25.09) and lower estrogen receptor expression, whereas the 1298AA genotype was associated with stage 0 (OR = 0.244; 95% CI = 0.077-0.771) and increased estrogen receptor expression. In haplotype analysis, 677CC/1298AA was associated with hypertension (OR = 1.979; 95% CI = 1.036-3.782), and 677CT/1298AC was associated with invasive carcinoma of no special type (OR = 0.472; 95% CI = 0.243-0.918) and stage 0 (OR = 3.476; 95% CI = 1.341-10.47). ConclusionThe MTHFR C677T and A1298C polymorphisms do not alter the risk of BC, but are associated with the clinical severity of BC.

The Rise in Mortality from Breast Cancer in Young Women: Trend Analysis in Brazil.

IntroductionBreast cancer is the most common cause of cancer death among women.ObjectiveThe objective of this study was to analyze time trends in overall mortality from breast cancer in Brazil, Brazilian regions and States.MethodsThis is an exploratory study, of the time series of deaths from breast cancer contained in the Mortality Information System (SIM), of women living in Brazil, Brazilian regions and States, from 1996 to 2013. For the trend analysis, the polynomial regression model was used, and a significant trend was considered when the estimated model obtained a p value <0.05.ResultsThere was a tendency of increased mortality from breast cancer in Brazilian women (average increase of 0.18 per year; p <0.001), with regional differences, particularly in the age group 20–49 years (0.07 per year; p <0.001). The age group 50–69 years remained constant but had high average rates (37.14).ConclusionMore effective planning is needed to focus on the different scenarios of the Brazilian regions. Screening strategies for the incidence and mortality from breast cancer must also be rethought according to age group in the country.

Association of CYP1A1 A4889G and T6235C polymorphisms with the risk of sporadic breast cancer in Brazilian women

OBJECTIVES:We examined the influence of CYP1A1 A4889G and T6235C polymorphisms on the risk of sporadic breast cancer.METHOD:DNA from 742 sporadic breast cancer patients and 742 controls was analyzed using the polymerase chain reaction, followed by the restriction fragment length polymorphism technique.RESULTS:More patients had the CYP1A1 4889AG+GG genotype compared to controls (29.0% versus 23.2%, p=0.004). The G allele carriers had a 1.50-fold increased risk (95% CI: 1.14–1.97) of sporadic breast cancer compared to the other study participants. The frequency of the 4889AG+GG genotype among the Caucasian patients was higher than in the non-Caucasian patients (30.4% versus 20.2%, p=0.03) and controls (30.4% versus 23.2%, p=0.002). Caucasians and G allele carriers had a 1.61-fold increased risk (95% CI: 1.20–2.15) of sporadic breast cancer compared to other subjects. The CYP1A1 4889AG+GG genotype was more common among patients with a younger median age at first full-term pregnancy than among controls (33.8% versus 23.2%, p=0.001) and subjects whose first full-term pregnancies occurred at an older age (33.8% versus 26.1%, p=0.03). Women with the CYP1A1 4889AG+GG genotype and earlier first full-term pregnancies had a 1.87-fold (95% CI: 1.32–2.67) increased risk of sporadic breast cancer compared to the other study participants. Excess CYP1A1 4889AG+GG (39.8% versus 27.1%, p=0.01) and 6235TC+CC (48.4% versus 35.9%, p=0.02) genotypes were also observed in patients with grade I and II tumors compared to patients with grade III tumors and controls (39.8% versus 23.2%, p=0.04; 48.4% versus 38.6%, p=0.04). The G and C allele carriers had a 2.44-fold (95% CI: 1.48–4.02) and 1.67-fold (95% CI: 1.03–2.69) increased risk, respectively, of developing grade I and II tumors compared to other subjects.CONCLUSIONS:The CYP1A1 A4889G and T6235C polymorphisms may alter the risk of sporadic breast cancer in Brazilian women.

Evaluation of the knowledge about breast cancer in Brazilian women seeking assistance in basic health care units.

e20573 Background: Although breast cancer incidence, mortality, and survival rates vary in different continents, the overall data suggest that breast cancer incidence is increasing, and in regions ...

Association of CYP1A1 A4889G and T6235C polymorphisms with the risk of breast cancer in Brazilian women.

e11551 Background: Estrogen, activated by cytochrome P450 enzymes (CYP1A1), participates in the breast cancer (BC) development. G and C variant alleles of CYP1A1 A4889G and T6235C polymorphisms encode enzymes with increased activity in activation of this compound when compared with the respective wild alleles. This study aimed to clarify the roles of the polymorphisms in the risk of BC. Methods: CYP1A1 A4889G and T6235C genotypes of 742 sporadic breast cancer (SBC) patients (median age: 52 years, 638 Caucasians, 104 non-Caucasians) and 742 healthy women (median age: 40 years, 638 Caucasians, 104 non-Caucasians) were obtained in genomic DNA by PCR and enzymatic digestion. Results: Patient’s and control’s samples were in HW equilibrium at CYP1A1 A4889G (χ2= 0.15, P= 0.70; χ2= 1.15, P= 0.28) and T6235C (χ2= 2.65, P= 0.10; χ2= 1.93, P= 0.16) loci. The frequency of CYP1A1 4889AG+GG genotypes was higher in patients than in controls (29.0% versus 23.2%, P= 0.004). Carriers of the G allele were under a 1.50 (95% CI: 1.14-1.97)-fold increased risk for SBC than those with the wild AA genotype. The frequencies of 4889AG+GG genotypes in Caucasian SBC patients were higher than those found in Non-Caucasian (30.4% vs 20.2%, P= 0.03), and also in controls (30.4% vs 23.2%, P= 0.002). Carriers of G allele were under a 1.61 (95% CI: 1.20-2.15)-fold increased risk for SBC than others. A higher frequency of the CYP1A1 4889AG+GG genotypes was also seen in patients with an earlier median age at first full-term pregnancy (FFTP), compared to those who had the first pregnancy with a later medium age (33.8% vs 26.1%, P=0.03), and also when compared to controls (33.8% vs 23.2%, P= 0.001). Women with the CYP1A1 4889AG+GG genotypes and with earlier FFTP were under a 1.87 (95% CI: 1.32-2.67)-fold increased risk for SBC than others. The CYP1A1 6235CC genotype was more common in pre-obese or obese SBC patients than in underweight or normal SBC patients (6.8% vs 4.0%, P= 0.04). Conclusions: Our data suggest that CYP1A1 A4889G and T6235C polymorphisms alter BC risk in Brazilian women. We believe that women with variant alleles of the referred polymorphisms should receive additional medical attention for disease prevention and early diagnosis.

Triple-Negative Breast Cancer in Brazilian Women without Metastasis to Axillary Lymph Nodes: Ten-Year Survival and Prognostic Factors

Triple-Negative Breast Cancer in Brazilian Women without Metastasis to Axillary Lymph Nodes: Ten-Year Survival and Prognostic Factors

Triple-Negative Breast Cancer in Brazilian Women without Metastasis to Axillary Lymph Nodes: Ten-Year Survival and Prognostic Factors

Aims: To determine the 10-year overall survival (OS) in triple -negative (TN) and non-TN breast cancer (BC) patients, and to identify associated independent prognostic factors. Study Design:Descriptive and survival. Place and Duration of Study:Pathology Division at National Cancer Institute, Rio de Janeiro, Brazil, between 1992 -1996. Methodology: Population:348 women patients with invasive ductal carcinoma without lymph node metastasis. Analyzed variables: age, treatment, surgery type, tumor size, skin involvement, histological grade, vascular invasion, estrogen and progesterone receptors, HER-2, Ki-67 and p53. Statistical analysis performed: Kaplan -Meier survival curves, log rank test, and multivariate Cox models. Results:27% of the studied women were categorized as TNBC and 73%, as non-TNBC. The former showed higher frequency of age <50yr, preoperative che motherapy, tumors