Cause Of Women Research Articles

Demethylation of CADM1 and SOCS1 using capsaicin in cervical cancer cell line.

Cervical cancer is one of the leading causes of women's mortality in developing countries. The prevalence of cervical cancer is higher in developing countries like India and continents like Africa. Hyper-methylation of tumor suppressor genes through human papillomavirus (HPV) infection is known to be one of the major causes of cervical cancer. The promoter hypermethylation of the cell adhesion molecule 1 (CADM1) and suppressor of cytokine signalling (SOCS1) genes due to DNMT1 overexpression leads to their epigenetic silencing followed by gene repression causing cervical cancer. In silico study on the inhibition effect of capsaicin on DNMT1 was simulated by different servers. The binding energy was observed to be -7.8 kcal/mol. In vitro studies on the effect of capsaicin on aberrant methylation of CADM1 and SOCS1 were performed on the adenocarcinoma cervical cancer cell line, HeLa. The IC50 of capsaicin was observed to be 160 μM through crystal violet assay. DNA methylation of the CADM1 and SOCS1 was analyzed by methylation-specific PCR along with their reversal using capsaicin (20 μM) by treating the cells for 72 h and 6 days. In silico results suggested that capsaicin has an inhibitory effect on DNMT1, which regulates DNA methylation leading to the hypermethylation of CADM1 and SOCS1 genes. The in vitro studies suggested that hypermethylation leads to the inhibition of CADM1 and SOCS1 expression, which could be reversed using capsaicin with visible changes in methylation-specific and unmethylation-specific bands in MS-PCR, respectively. The present study shows the reversal of methylation of CADM1 and SOCS1 after 72 h which showed a further increase in case of 6 days of treatment using 20 μM capsaicin, which makes capsaicin a potent candidate for causing demethylation of CADM1 and SOCS1 genes that may lead to the reactivation of the downregulated gene.

Issues and challenges for women in creating spaces at decision-making levels: A case study of Pakistan Muslim league-N

In many Western and Asian countries, women’s empowerment has increased significantly, yet women are still underrepresented in political participation and political decision-making. This study explores the political engagement of women in a society that discriminates against them on the basis of their sex, and in a political system that is heavily patriarchal. The study is aimed at exploring the issues and challenges that women confront in political participation and decision-making in the party political space. To achieve this goal, a qualitative approach has been adopted, in which data has been collected and processed in a qualitative manner. This research conducts a case study of Pakistan Muslim League (N) which served as a sample for data collection. Thematic analysis has been used to decipher the comments of important stakeholders interviewed for qualitative data, as described by Braun and Clarke. Although literature has studied the complex of multiple interlinked causes for women’s insufficient and ineffective political participation, this article presents a novel way to explore those issues and a thematic way to understand their complexity. However, the study's findings indicate that women's political engagement and decision-making are hampered for a variety of reasons. A male-dominated culture, lack of social acceptance, structural halts, gender-imbalanced political parties, societal vulnerability threats and an inability to empower women are a few of the main concerns. Numerous specific problems have been identified as well, such as the persistence of historical patterns and the opportunity gap as well as psychological satisfaction and religious excuses for the lack of political participation and the vulnerability of being scandalized, weak economic status and gender sensitivity in the workplace. In Pakistani society, these highlighted variables are so firmly ingrained in the political and social structure that they are mostly taken for granted and go unnoticed.

The Emerging Role of Chromatin Remodeling Complexes in Ovarian Cancer.

Ovarian cancer (OC) is the fifth leading cause of women's death from cancers. The high mortality rate is attributed to the late presence of the disease and the lack of modern diagnostic tools, including molecular biomarkers. Moreover, OC is a highly heterogeneous disease, which contributes to early treatment failure. Thus, exploring OC molecular mechanisms could significantly enhance our understanding of the disease and provide new treatment options. Chromatin remodeling complexes (CRCs) are ATP-dependent molecular machines responsible for chromatin reorganization and involved in many DNA-related processes, including transcriptional regulation, replication, and reparation. Dysregulation of chromatin remodeling machinery may be related to cancer development and chemoresistance in OC. Some forms of OC and other gynecologic diseases have been associated with mutations in specific CRC genes. Most notably, ARID1A in endometriosis-related OC, SMARCA4, and SMARCB1 in hypercalcemic type small cell ovarian carcinoma (SCCOHT), ACTL6A, CHRAC1, RSF1 amplification in high-grade serous OC. Here we review the available literature on CRCs' involvement in OC to improve our understanding of its development and investigate CRCs as possible biomarkers and treatment targets for OC.

Women, fisheries technology and development: toward new research approaches

In fisheries and aquaculture, technology is a critical factor in sectoral development. Tracing the sectors’ post World War II development stages, we note strong links with internal and external economic and sustainability drivers but weak connections to largely external gender equality and human rights drivers. Three characteristics of the fish sectors situate women during technology change: technology linked gender divisions of labor, focus on the primary production nodes where women are least common, and multiple causes of women’s invisibility. These exclusionary characteristics, and lessons from two cases—a fish container for women petty traders in Tamil Nadu, India, and fish smoking kilns in Ghana—point to opportunities, using feminist technology studies, to understand how gender and technology shape each other. Although typically presented in a positivist manner, fish sector technology operates in complex, dynamic sociotechnical systems. To date, sociotechnical systems research has received little attention from gender researchers. In the emerging field of fisheries sociotechnical systems research, no studies have included gender. Because sociotechnical systems research deals with power, politics and transitions, feminist fisheries researchers should take an interest to ensure gender is incorporated in post hoc and anticipatory sociotechnical systems studies.

Heart Failure in Women

Heart failure (HF) in women is one of the leading causes in women after coronary artery diseases. There are gender differences at every aspect of HF. These females usually present in older age with significant comorbidities. Even though there are few risk factors common to males and females for the development of HF, diabetes and hypertension are considered more stronger association for the development of HF in females than in males. There are certain sex-specific factors such as abnormal pregnancies and breast cancer therapies in addition to genetic predisposition for the development of cardiomyopathies, especially postpartum cardiomyopathy in female. Usually, females have HF with preserved ejection fraction when compared to men who more frequently have HF due to reduced ejection fraction. Even in the left ventricular remodeling to injury is different in both sexes. The main aim of this review is to bring the sex differences in HF and to stress the need of separate guidelines for females with HF for better outcome.

Women empowerment in inherited land rights: end of violence in rural areas

Purpose The purpose of this study is to explore the dynamics behind the violence against the share of women in their inherited land. This study explores the subject matter from the perspective of actual victims and law experts in the domain. Design/methodology/approach Informed by the interpretivist paradigm, the authors studied the subject matter through qualitative inquiry. Through semistructured interviews, data were collected from 16 women who have been deprived of their share in inherited land and 11 law experts who have been dealing with property-related court cases. Findings Thematic analyses through NVivo-11 evinced five themes related to the possible causes of women depriving of their property rights. From the victims’ perspective, the major causes of violence against women’s share in their inherited property rights are fear of income disaggregation, male dominance, forceful gifting, relational bond and fear of physical violence. Law experts’ views on the subject matter were somehow in convergence with the views of the actual victims. They reported a lack of social support, court delays and lack of knowledge about the law as the major causes of violence against women’s inherited property rights. Originality/value A reasonable volume of research is available on the subject of women’s empowerment. However, little attention is paid to investigating the causes of violence against women sharing in their inherited property rights – and suggesting some suitable ways to resolve the problem. Against this backdrop, this study is intended to explore the dynamics behind the violence against the share of women in their inherited land from the perspective of actual victims and law experts in the domain.

Sex-differences in prevalence and outcomes of the different endotypes of chronic coronary syndrome – analysis from the multi-center international ILIAS Registry

Abstract Introduction Guideline-directed management of chronic coronary syndrome (CCS) remains focused on obstructive causes of angina, and is based on established therapies derived from studies predominantly including men. This occurs despite documented higher mortality from cardiovascular causes in women compared to men, which is hypothesized to be related to a higher prevalence of coronary microvascular dysfunction (CMD) in women. However, data on the relationship between sex, the different endotypes of CCS, and related sex-specific clinical outcomes are limited. Purpose This study aimed to investigate the relationship between sex and the different endotypes of CCS, as well as sex-specific clinical outcomes of CCS endotypes. Method In patients with stable angina undergoing coronary angiography, the following invasive coronary hemodynamics were characterized: fractional flow reserve (FFR; <0.80 considered abnormal), coronary flow reserve (CFR; <2.0 considered abnormal) and microcirculatory resistance (MR) (hyperemic microvascular resistance; >2.5mmHg/cm/sec or index of microvascular resistance >25 considered abnormal). Patients were stratified into three groups: 1) hemodynamically significant obstructive coronary artery disease (oCAD) (FFR abnormal or a severe coronary stenosis requiring revascularization), 2) no-obstructive coronary artery disease but with CMD (FFR normal, but abnormal CFR and/or MR), or 3) no-obstructive coronary artery disease and no CMD (FFR normal, and normal CFR and MR). We assessed the prevalence of the CCS endotypes across sex, and sex-specific cardiovascular outcomes over a follow-up of 7 years defined as the composite endpoint of death or acute myocardial infarction. Results Amongst a total of 1987 included patients, 1435 (72.2%) were men and 552 (27.8%) were women. oCAD occurred in 904 (45.5%) patients, which was significantly more prevalent in men (48.9% (701/1435) of men vs. 36.8% (203/552) of women, p<0.001). In contrast, CMD was significantly more prevalent in women (19.6% (281/1435) of men vs. 24.1% (133/552) of women, p=0.031). Across the population, either oCAD or CMD occurred in 68.4% of men versus 60.9% of women (p=0.002). There were no sex-specific differences in cardiovascular outcomes across CCS entities (Figure 1). Conclusion In patients evaluated for CCS who underwent clinically indicated coronary angiography and physiological assessment, men were more likely to have oCAD and women were more likely to be classified as CMD. There were no sex-related differences in the prognosis associated with the individual CCS endotypes. Therefore, pathophysiological changes in the coronary circulation potentially underlying angina pectoris are similarly prevalent in men and women, but the high incidence of CMD in women makes women prone to underdiagnosis if no additional physiological measurements are assessed. Funding Acknowledgement Type of funding sources: None.

‘An unfinished democracy’: gender and political representation in the Republic of Ireland

ABSTRACT Ireland’s Decade of Centenaries, beginning in 2012, has seen the commemoration of a period of significant social and political transformation. For scholars of gender and politics, it also provides the opportunity to take stock of women’s path to greater political representation (ultimately aided by the introduction of a candidate gender quota in 2016) and to highlight key areas where more work needs to be done in order to understand how women can enjoy greater inclusion and participation, as well as representation of their interests, going forward. This symposium provides an overview of what we know about the causes of women’s underrepresentation in Irish political life so far, before addressing some of these areas where our understanding is as yet underdeveloped. In doing so, it contributes to the developing knowledge of the Irish case. Overall, the symposium highlights diverse forms of women’s political participation in the Republic of Ireland.

Breast cancer heterogeneity

Background:Breast cancer (BC) is the most prevalent cancer in women and the leading cause of women's cancer-related deaths and morbidity worldwide. Conventionally considered as a single disease, recent advances suggest that BC is rather a heterogeneous disease with different molecular subtypes exhibiting distinct clinical presentation, anatomo-pathological features, response to treatment and survival outcomes. The purpose of this study was to compare tumor characteristics and epidemiologic risk factors associated with premenopausal versus postmenopausal BC and to assess heterogeneity by menopausal status.Methods:This was a comparative cross-sectional study. A total of 340 patients were included in the study (170 premenopausal vs. 170 postmenopausal BC). Patients' and tumor characteristics were compared in both populations. Percentages and means have been used for descriptive statistics. For categorical variables with comparison groups not exceeding 2, Fischer's exact test was used, otherwise, Chi-square test was used. For continuous variables, Mann–WhitneyU-test has been used to compare the numerical ranked variables. A value ofP= 0.05 or less was considered statistically significant. Odds ratio (OR) and 95% confidence interval (CI) was estimated using logistic regression analysis.Results:The median age of patients was 49 years (range: 18–89 years), with premenopausal median age of 41 years (range 18–50 years) and postmenopausal median age of 58 years (range 48–89 years). Factors associated more with the occurrence of premenopausal BC than postmenopausal BC were obesity/overweight in adolescence/early adulthood (OR = 0.29 95% CI 0.18–0.49,P< 0.001) and history of benign breast disease (OR 0.34 95% CI 0.14–0.83,P= 0.014), while factors associated more with postmenopausal than premenopausal BC included alcohol intake (OR = 2.47 95% CI 1.54–3.98,P< 0.001), history of breastfeeding (OR = 2.75 1.12–6.78,P= 0.036). However, sports activities (OR = 0.33 95% CI 0.16–0.65,P= 0.0015) and contraceptive use (OR = 0.19 95% CI 0.12–0.32,P< 0.001) seem to be protective for postmenopausal BC. In premenopausal period, patients presented more at advanced stages (Stage III and IV) (51.2% of premenopausal vs. 44.7% for postmenopausal,P= 0.0246), reported more intermediate-to-rapid disease progression (92% in premenopausal vs. 81.1% in postmenopausal (P< 0.001), had more invasive ductal carcinoma (98% in premenopausal vs. 93.5% in postmenopausal (P= 0.053) and had more poorly differentiated tumors (72% compared to 19.4% of postmenopausal BC patients (P< 0.0001). There was no statistically difference in molecular subtypes distribution between premenopausal and postmenopausal women (P= 0.062). However, progesterone receptor (PR) positivity was more associated with postmenopausal BC (P= 0.0165).Conclusion:BC is a heterogeneous disease. Premenopausal BC seems to be more aggressive than postmenopausal BC, with a relatively high prevalence of poorly differentiated and high-grade tumors with rapid progression. However, pre- and postmenopausal BC have similar molecular subtypes with different PR expression but similar ER and human epidermal growth factor receptor 2/Neu oncogene expression.

Zhenskaya prestupnost' v istoricheskom aspekte

The article examines the trends and features of women's crime in Russia in the 19th and 20th centuries, the evolution of views on the causes of women's crime and the means to combat it. It is noted that with the development of public relations and the more active inclusion of women's labor in the economy, the structure of women's crime has changed significantly.

Psychological suppressive profile and autoantibodies variability in women living with breast cancer: A prospective cross-sectional study

Breast cancer (BC) is a leading cause of women's morbimortality worldwide. Unfortunately, attempts to predict women's susceptibility to developing BC well before it becomes symptomatic, based on their genetic, family, and reproductive background have proved unsatisfactory. Here we analyze the matching of personality traits and protein serum profiles to predict women's susceptibility to developing cancer. We conducted a prospective study among 150 women (aged 18–70 years), who were distributed into three groups (n = 50): women without breast pathology and women diagnosed with BC or benign breast pathology. Psychological data were obtained through standardized psychological tests and serum protein samples were analyzed through semiquantitative protein immunoblotting. The matching for psychological and immunological profiles was constructed from these data using a mathematical generalized linear model.The model predicted that women who have stronger associations between high-intensity stress responses, emotional containment, and an increased number and reduced variability of serum proteins (detected by IgG autoantibodies) have the greatest susceptibility to develop BC before the disease has manifested clinically. Hence, the present study endorses the possibility of using psychological and biochemical tests in combination to increase the possibility of identifying women at risk of developing BC before the disease shows clinical manifestations. A longitudinal study must be instrumented to test the prediction ability of the instrument in real scenarios. Trial registrationCommittee of Ethical Research of the Hospital General de México “Dr. Eduardo Liceaga,” Ministry of Health (DI/12/111/03/064).

Approaching History through the Future: Some Thoughts from a Feminist Pragmatist

Approaching History through the Future: Some Thoughts from a Feminist Pragmatist

Ovarian tumors in women after hysterectomy for benign diseases

Varian cancer is one of the most common malignant neoplasms of the female reproductive systemand ranks first as the cause of women’s mortality from oncogynecological pathology. Over thepast 10 years, the increase in the incidence of ovarian cancer was 11.5% and remains high todaywithout a clear downward trend. According to the United Kingdom Collaborative Study, for one woman with a confirmed diagnosisof ovarian cancer, ten women underwent unnecessary surgical interventions and manipulationsbased on the results of imaging methods.Hysterectomy without accompanying ovariectomy has traditionally been considered one of theways to protect against ovarian cancer. But the latest data, which includes a large numberof contemporary studies of women recently diagnosed with ovarian cancer, did not find asimilar correlation. These findings may be related to changes in surgical practice, the use ofmenopausal hormone therapy, or perhaps improved reporting of oophorectomy.The risk of detecting epithelial ovarian cancer after hysterectomy has been repeatedly studied,but summarizing the data of most studies, no statistically reliable data were found that wouldindicate an increase in the risk of developing a malignant disease after this surgical intervention.However, the question needs further study in terms of the rapid development of modern oncology.

Platforms of inequality: gender dynamics of digital labour in Africa

ABSTRACT Paid work and gender equality are key elements of international development discourse on women’s economic empowerment. New digital technologies are considered to generate paid work opportunities for the marginalised groups in Africa, particularly women. The rise of the platform economy (work digitally mediated via platforms), for example, is framed as a panacea to poverty and informality among women. Yet the evidence remains anecdotal so far. Drawing on the author’s empirical research conducted between 2015 and 2021 on two kinds of digital labour (remote and place-based work) in Africa, the paper examines the job-quality outcomes among women gig workers in five African countries. The paper highlights new gender-based inequalities on platforms and the ways in which women cope with such outcomes. In particular, it outlines economic insecurities, discrimination at work, high work intensity and adverse physical and psychological impacts among women workers on platforms. It advances the cause for women’s labour rights and offers policy recommendations for a gender-equitable platform economy.

VIOLÊNCIA DOMÉSTICA CONTRA MULHERES DURANTE A PANDEMIA COVID-19: OS MOTIVOS QUE AS LEVAM A NÃO DENUNCIAR SEUS AGRESSORES

The present study addresses the issue of domestic violence against women. It aims to identify the causes of women, victims of domestic violence, not reporting their aggressors, during the covid 19 pandemic. In this way, the question is, what would be the factors that influence women who suffer domestic and family violence not to report their aggressors, during the covid-19 pandemic? In order to carry out this study, a bibliographic research was carried out in specialized vehicles available, and it has long been proven that among the factors that influence women who suffer domestic and family violence not to report their aggressors, during the covid-19 pandemic, are cited: mainly the financial issue (women are financially dependent on the aggressor); the cultural issue (women are ashamed of being emotionally dependent on the aggressor);and for not feeling supported by the State and family members.

Ovarian Cancer Incidence and Death in Average-Risk Women Undergoing Bilateral Salpingo-Oophorectomy at Benign Hysterectomy

(Abstracted from Am J Obstet Gynecol 2022;226:220.e1–220.e26) Opportunistic bilateral salpingo-oophorectomy (BSO) is the most common major surgery in nonpregnant women to prevent ovarian cancer later in life. Bilateral salpingo-oophorectomy has been shown to reduce the rates of ovarian cancer and death of any cause in women who carry the BRCA1 and BRACA2 pathogenic genes.

A NEW STRATEGY FOR AUTOMATIC BREAST CANCER SEGMENTATION IN MRI IMAGES

Breast tumor is one of the causes of women’s death in the world after cardiovascular diseases. Recently, the diagnosis and treatment planning of this kind of tumors are based on magnetic resonance imaging techniques, which are the reference imaging modality in breast tumors analysis since it can better differentiate soft tissues (compared to mammography and ultrasound). Segmentation of the breast cancer is a very important task for cancer response prediction in neoadjuvant chemotherapy treatment based either on texture analysis or parametric response maps. In most of the previous works in the literature, the segmentation is generally done with manual annotation of tumor regions, which is time-consuming and error-prone. In this paper, we propose a new strategy for an automatic segmentation of breast tumors in MRI images. We propose first to separate the two breasts, and then, we use the Expectation–Maximization Algorithm to segment and detect the tumor lesion.

Protein-protein Docking Studies of Estrogen Receptor Alpha and TRIM56 Interaction for Breast Cancer Drug Screening

Breast cancer is the highest mortality cause in women with cancer. Protein-protein docking for target-based screening is an effective approach in breast cancer drug discovery via estrogen receptor (ER) signaling. TRIM56, an E3 ubiquitin protein ligase, can bind to and stabilize ER alpha. Thus, drug screening that can inhibit or weaken the interaction between ER alpha and TRIM56 is promising to obtain novel yet specific breast cancer drugs. In this study, we performed protein-protein docking studies for ER alpha and TRIM56 interaction and virtual screening for FDA-approved drugs from the ZINC database against ER alpha and TRIM56 complex protein model structure. We utilized Cluspro 2.0, PyRx 0.8, and Pymol 2.4.1 to conduct protein-protein docking, virtual screening, and model structure visualization. PIP and PLIP software were also applied to analyze the amino acid residue between proteins or protein-ligands. Based on the protein-protein docking, ER alpha and TRIM56 established interaction. Utilizing this complex protein as a macromolecule in the virtual screen of 1071 molecules of FDA-approved drugs, we obtain the top five lowest binding energy molecules i.e., dutasteride, dihydroergotamine, nilotinib, ergotamine, and bromocriptine. In addition, the energy binding affinity between ER alpha-dutasteride complex with TRIM56 was weakened in the presence of dutasteride. In conclusion, protein-protein docking between ER alpha-TRIM56 was able to select FDA-approved drugs that could bind to the complex, and dutasteride binding to ER alpha-TRIM56 complex weakened the interaction.Keywords: protein-protein docking, estrogen receptor alpha, TRIM56, breast cancer, ubiquitin.

Abstract 286: Patient derived explant culture (PDEC) as a model for treatment resistant ERα positive breast cancers

Abstract Breast cancer is the most frequent cancer and leading causes of women’s death. Two thirds of breast cancers express the luminal estrogen receptor-positive (ERα+) phenotype that is initially responsive to antihormonal therapies, but often drug resistance emerges. Three-dimensional ex vivo cultures from patient-derived tumor tissue offer new opportunities for drug development and personalized treatment of cancer. However, one of the main challenges in establishing a tumor type faithful ex vivo tissue culture system is in optimization of biochemical and physical microenvironment to preserve desired phenotypic features. The ERα+ phenotype is not stable in cultured cells for reasons not fully understood. Together with Helsinki University Hospital we examined 400 patient-derived breast epithelial and breast cancer explant cultures (PDECs) grown in various three-dimensional matrix scaffolds, finding that ERα is primarily regulated by the matrix stiffness. The finding that the matrix stiffness is a central cue to the ERα phenotype reveals a mechanobiological component in breast tissue hormonal signaling and enables the development of novel therapeutic interventions. In our current study we have utilized the PDEC model to identify novel biomarkers that could predict the emergence of tamoxifen resistance in primary breast tumors. Citation Format: Pauliina Munne, Iiris Räty, Aino Peura, Linda Patrikainen, Denis Belitskin, Juha Klefstrom. Patient derived explant culture (PDEC) as a model for treatment resistant ERα positive breast cancers [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 286.

Real-world survival outcomes associated with use of pertuzumab and trastuzumab emtansine (T-DM1) for HER2-positive (HER2+) metastatic breast cancer (MBC) in Brazilian private healthcare setting.

e13022 Background: Breast cancer is a leading death cause of women in Brazil. There are increased concerns with limited access to innovative therapies and the effectiveness of these agents outside clinical trials. This study aims to assess practice patterns and real-world outcomes of patients with HER2+ metastatic breast cancer (MBC) treated in the largest network of community oncology practices of Brazil after the introduction of pertuzumab and T-DM1 in routine care. Methods: De-identified electronic medical records from Oncoclínicas Group were aggregated in a cloud-based central database that allows technology-based abstraction, whereby trained data curators qualify the information using mCODE standards. We included data from all patients with a confirmed diagnosis of HER2+ MBC treated from 2014 to 2021. The primary objective was median overall survival (OS) from diagnosis of metastatic disease and other endpoints included adoption of pertuzumab-based regimen and T-DM1 in the palliative setting and their median Time to Treatment Discontinuation (TTD) in a real-world scenario. Results: Out of 21,559 patients with BC in our database, 6,215 had HER2+ disease and 1,250 had MBC treated with at least one palliative anti-HER2 therapy. Median age at diagnosis was 56 years, 29% had de novo metastatic disease, 81% received 2nd line therapy and 47% a 3rd line or beyond. With a median follow-up of 2 years, median OS was 49 months (CI95% 44-59). We found a ten-fold increase in the proportion of patients receiving pertuzumab or T-DM1 in the last two years when compared to 2014-2015. Overall, 62% received a pertuzumab-based regimen, mostly in the 1st line (76%), with median TTD of 9.9 months (CI95% 9-13). T-DM1 was accessible to 22% of the patients, mostly in 2nd (28%) or 3rd line and beyond (50%), with median TTD of 10.2 months (CI95% 9-13). Conclusions: In the largest Brazilian real-world study of patients with HER2+ MBC treated in the private health system, we found similar outcomes as those reported in North-American and European cohorts, both in terms of OS and TTD with standard-of-care therapies. Adoption of pertuzumab and T-DM1 was fast, but there are still gaps in access and the need to optimize clinical positioning of new anti-HER2 therapies recently approved for clinical use.