Young Brazilian Women Research Articles

Pon1 and Sult1a1 Polymorphisms and Breast Cancer Among Young Women in Brazil.

Purpose: To investigate the association of genetic polymorphisms Gln192Arg and Leu55Met of Paraoxonase 1 (PON1) gene, and Arg213His of Sulfotransferase 1A1 (SUT1A1) gene with occurrence of breast cancer among young women living in Rio de Janeiro city. Methods: This is a hospital-based case-control study including 265 women aged 18-35 years, diagnosed with breast cancer at National Cancer Institute; and 277 controls in the same age group selected among women patients and companions of three general hospitals from Rio de Janeiro public health network. Polymorphisms genotyping was performed using the PCR-RFLP technique. Results: For PON1 gene, breast cancer women had a greater chance of being homozygote for Leu55Met polymorphism (ORadjusted = 1.42, 95% CI= 0.67-3.00, recessive model) and a lower chance of having at least one allele of Gln192Arg polymorphism (ORadjusted = 0.75, 95% CI = 0.50-1.13, dominant model), but without statistical significance. Accordingly, frequency of the haplotype Met55/Arg192 was lower among breast cancer women, but no statistically significant association was observed (ORadjusted = 0.85; 95% CI = 0.48-1.51). SULT1A1 His/His genotype was significantly associated with a protective effect for breast cancer (OR adjusted = 0.51, 95% CI = 0.28-0.91, recessive model). Conclusion: Arg213His polymorphism of SUT1A1 gene showed a protective effect against breast cancer among Brazilian young women. More studies with different designs are needed to understand the role of PON1 and SULT1A1 polymorphisms in breast cancer development in young Brazilian women.

TP53 Arg72Pro Genetic Polymorphism and Young Women with Breast Cancer: Case-Control Study in Brazil

Introduction: Breast cancer is the most common cancer in women and incidence and mortality rates are increasing among young women worldwide, including Brazil. TP53 Arg72Pro polymorphism (rs1042522) has been associated with breast cancer, due to its important role in cell cycle that impacts the development of cancer. Objective: To determine the magnitude of the association between TP53 Arg72Pro polymorphism and breast cancer development in young Brazilian women. Method: Hospital-based case-control study conducted in Rio de Janeiro with 268 confirmed breast cancer cases and 277 controls with women enrolled among hospitalized patients without neoplastic diseases or their companions at three public hospitals. Results: The genotype frequency was 46.57% for Arg/Pro, 35.74% for Arg/Arg, and 17.69% for Pro/Pro among healthy controls and 41.04% for Arg/Pro, 46.64% for Arg/Arg, and 12.31% for Pro/Pro among breast cancer cases. The genotypes Pro/Pro (OR=0.46; 95% CI=0.27-0.80, in comparison with Arg/Arg genotype) and Pro allele in dominant model (OR=0.65; 95% CI=0.45-0.92, in comparison with Arg/Arg genotype) were statistically associated with a protective effect for breast cancer among young Brazilian women. Also, family history of breast or ovary cancer (OR=2.18; 95% CI=1.37-3.46) and tobacco use (OR=1.74; 95% CI=1.14-2.68) were statistically associated with breast cancer. Conclusion: Further studies are necessary to confirm that Arg72Pro polymorphism can be a protective factor for breast cancer development among young women, since ethnicity can influence genotypes frequencies and the risk of developing breast cancer.

Body, eating, and exercise comparison orientation measure (BEECOM): Cross-cultural adaptation and psychometric properties among Brazilian female university students

The Body, Eating, and Exercise Comparison Orientation Measure (BEECOM) is an instrument that aims to quantify behaviors related to social comparison, specifically comparisons related to the body, eating and exercise, and was originally developed using a nonclinical population of American university women. The objective of this study was to perform a cross-cultural adaptation and verify the psychometric qualities of the BEECOM for young Brazilian adult women aged 18–35 years. In the present study, the cross-cultural adaptation of the instrument was performed through its translation, back-translation and evaluation by the target population. The instrument proved to be easy to understand among young women. Then, the psychometric qualities of the instrument were evaluated using a sample of 716 women (Mage = 22.47 ± 3.10). Exploratory and confirmatory factor analysis demonstrated the presence of three factors and satisfactory adjustment indexes. The BEECOM presented an invariant measurement across white vs. nonwhite and physically active vs. non-active individuals. In addition, the instrument showed adequate reliability and convergent validity. In conclusion, the BEECOM is a useful tool to evaluate social comparison behaviors related to eating disorders and body image in young Brazilian female adults, enabling further research on these constructs and supporting the development of preventive strategies.

A LINHA TÊNUE ENTRE MATERNIDADE E EVASÃO ESCOLAR

ABSTRACT The need to interrupt their studies is the reality for a large number of young Brazilian women who experience motherhood during their school years. This research aimed to analyze the mechanisms used by educational institutions from the perspective of students and former students, teenagers, and young adults in the Federal District. Such mechanisms can be used use to support or hinder the studies of young mothers. Six semi-structured individual interviews were carried out with adolescents and young women, between 17 and 30 years old, who experienced motherhood during their studies. Thematic content analysis was used to interpret the information. The article focuses on the first analytical category constructed. From the analysis, it was possible to understand that the phenomenon of school evasion is supported by historical and cultural biases related to sexist conceptions about binary gender norms that do not contemplate the diversity of women’s experiences regarding motherhood and femininity itself.

Effect of ribociclib on productivity losses due to breast cancer in young women in Brazil.

To evaluate the effect of ribociclib versus endocrine therapy on productivity losses due to advanced breast cancer. Productivity data from the MONALEESA-7 trial, obtained from the results of the application of the Work Productivity and Activity Impairment (WPAI) questionnaire on progression-free survival state (43-month follow-up), were extrapolated to the 10,936 Brazilian prevalent cases of premenopausal women with hormone receptor positive/human epidermal growth factor receptor 2 negative (HR+/HER2-) breast cancer. Productivity loss was determined by quantifying the economic costs of workforce dropout over time in both treatment arms and by discounting the economic costs of absenteeism and presenteeism from workforce retention. A human capital approach was used. Net productivity gains in the ribociclib arm were estimated at USD 4,285,525.00, representing 316,609 added work hours over 43 months and a mean of 2,009 added work weeks per year. The phase III MONALEESA-7 trial productivity results applied to the Brazilian premenopausal prevalent cases of hormone receptor positive/human epidermal growth factor receptor 2 negative (HR+/HER2-) breast cancer showed that treatment with ribociclib + endocrine therapy improves workforce participation compared with endocrine therapy alone in premenopausal women with hormone receptor positive/human epidermal growth factor receptor 2 negative (HR+/HER2-) metastatic breast cancer, with potential economic gains for the Brazilian society.

Avaliação preliminar das propriedades psicométricas do Fat Talk Questionnaire em uma amostra de mulheres jovens

Fat Talk (FT) is a term used to describe a behavior characterized by speech, thinking, and derogatory feelings towards one's own body and the body of another person. It is predominant in females and is related to worse body image and worse self-esteem. The Fat Talk Questionnaire (FTQ) is an instrument previously adapted cross-culturally for young women in Brazil. The aim of this study was to carry out a preliminary assessment of its psychometric properties. The FTQ was applied to 99 young females (18 to 19 years and 11 months), along with sociodemographic questions, the Rosenberg Self-Esteem Scale (RSS) and the Body Shape Questionnaire (BSQ8) to assess convergent validity (through the test Pearson’s correlation). Confirmatory factor analysis was performed using the structural equation model with the allocation sampling technique. Internal consistency was assessed using Cronbach's Alpha and MacDonald’s Omega. The structural equation model supported a one-dimensional scale (x2/gl = 1.62; CFI = 0.953; TLI = 0.935 and RMSEA = 0.079 [95%CI: 0.051-0.176]). The instrument presented an α-Cronbach of 0.89 [95%CI: 0.85-0.92] and an ω-MacDonald of 0.89; there was a high correlation with the BSQ8 (0.70) and a mean correlation (0.42) with the RSS. The instrument presented an adequate internal consistency, the confirmatory factor analysis of the FTQ supported a unidimensional instrument with satisfactory factor loadings, and a correlation was found between more Fat Talk behavior with greater concern with body shape and worse self-esteem.

Preliminary assessment of the psychometric properties of the Fat Talk Questionnaire in a sample of young women

Fat Talk (FT) is a term used to describe a behavior characterized by speech, thinking, and derogatory feelings towards one's own body and the body of another person. It is predominant in females and is related to worse body image and worse self-esteem. The Fat Talk Questionnaire (FTQ) is an instrument previously adapted cross-culturally for young women in Brazil. The aim of this study was to carry out a preliminary assessment of its psychometric properties. The FTQ was applied to 99 young females (18 to 19 years and 11 months), along with sociodemographic questions, the Rosenberg Self-Esteem Scale (RSS) and the Body Shape Questionnaire (BSQ8) to assess convergent validity (through the test Pearson’s correlation). Confirmatory factor analysis was performed using the structural equation model with the allocation sampling technique. Internal consistency was assessed using Cronbach's Alpha and MacDonald’s Omega. The structural equation model supported a one-dimensional scale (x2/gl = 1.62; CFI = 0.953; TLI = 0.935 and RMSEA = 0.079 [95%CI: 0.051-0.176]). The instrument presented an α-Cronbach of 0.89 [95%CI: 0.85-0.92] and an ω-MacDonald of 0.89; there was a high correlation with the BSQ8 (0.70) and a mean correlation (0.42) with the RSS. The instrument presented an adequate internal consistency, the confirmatory factor analysis of the FTQ supported a unidimensional instrument with satisfactory factor loadings, and a correlation was found between more Fat Talk behavior with greater concern with body shape and worse self-esteem.

Intuition: Thinking Through Loopholes

Intuition, contrary to common sense, is not a natural gift. Intuition is born out of experience and it can be a valuable tool for researchers. But what has intuition to do with anticipation? To anticipate we usually rely on understanding current behavioral patterns and extrapolating them. Intuition is great at recognizing patterns and by trusting it more we can become even better researchers.As with any other skill in order to follow our intuition, we need to practice, to be exposed to a lot of fieldwork, to listen to a lot of people, so that we can not only notice what stands out of the common but give the right value to it. When we learn to use our intuition as a research tool, anticipating becomes natural.I will bring examples from a research project that aimed to explore the relationship of young women in Brazil with pregnancy and the most valuable insight in this project came from a girl who did not get pregnant.I will also draw from the world of chess ‐ a game where anticipation is the key to define the next move.Intuition can illuminate the atypical in order to understand the typical. And that's a powerful tool for any research.

Behavioral factors associated with multiple-type HPV genital infections: data from a cross-sectional study in young women in Brazil

ObjectivesTo investigate the pattern of multiple human papillomavirus (HPV) infections and associated factors in young women who access the Brazilian public health care system to better understand the characteristics of multiple HPV infections, a critical issue in this era of multivalent vaccines.MethodsThis was a cross-sectional, multicenter study with sexually active unvaccinated women (16–25 years old) from 119 primary Brazilian healthcare centers between September 2016 and November 2017. Cervical samples were collected by trained health professionals, and HPV detection was performed in a central laboratory by Linear Array.ResultsOf the 5268 women, 33.00% (95% CI 31.07–34.92) had multiple infections. At least one type of high-risk HPV was present in 85.50% of all multiple infections. All HPV types were detected more frequently in association with other types than alone. Young individuals who were single or in a casual relationship and those who had more than one sexual partner in the past year were more likely to have multiple infections.ConclusionsIn this work, a high rate of multiple HPV infections among unvaccinated young adults tended to increase due to certain risk factors. Such data can provide insight for decision makers in the development of public policies regarding HPV prevention.

Dissonance-based eating disorder prevention among Brazilian young women: A randomized efficacy trial of the Body Project

A randomized controlled trial was conducted to assess the efficacy of the Body Project eating disorder prevention program in reducing eating disorder risk factors and symptoms in young Brazilian women. A total of 141 female university students aged 18–30 years old were randomly assigned to one of two conditions: assessment-only condition (n = 78) and Body Project condition (n = 63). Participants completed scales assessing body dissatisfaction, sociocultural influence, disordered eating attitudes and behaviors, eating disorders symptoms, body appreciation, depressive mood and negative affect at baseline, posttest, and at 1- and 6-month follow-ups. Body Project participants showed significantly greater reductions in body dissatisfaction, sociocultural influence, disordered eating, eating disorder symptoms, depressive symptoms, and negative affect, and greater increases in body appreciation (d = .35–.48) compared to assessment-only participants. Most of the effects persisted through 6-month follow-up (d = .35–.74). Results provide evidence that the Body Project is an effective intervention to reduce eating disorder risk factors and eating disorder symptoms among Brazilian young women, and that this intervention is naturally culturally adaptive.

Effectiveness of a universal vaccination program with an HPV quadrivalent vaccine in young Brazilian women

We examined human papillomavirus (HPV) vaccine effectiveness in a nationwide sample of women aged 16 to 25 years who utilized the public health system in Brazil. This was a cross-sectional, multicentric survey conducted between September 2016 and November 2017 (POP-Brazil Study). A total of 5,945 young adult women were recruited from 119 public primary care units from all 27 federative units of Brazil by trained health professionals. The participants participated in a face-to-face interview and provided biological samples for genital HPV analysis. HPV genotyping was performed using a Linear Array HPV genotyping test in a central laboratory. Sampling weights were applied to the data. Overall, 11.92% (95% CI 10.65, 13.20) of the participants reported having been vaccinated. The frequency of vaccination was highest in 16- to 17-year-old women, with a decreasing vaccination rate with increasing age, and vaccinated women were more likely to belong to the high socioeconomic status group. The use of a quadrivalent vaccine decreased the HPV types 6, 11, 16, and 18 by 56.78%, from 15.64% in unvaccinated women to 6.76% in vaccinated women (P < 0.01), even after adjustment for age. Those who received the vaccine had lower HPV 16 (2.34% in vaccinated vs 8.91% in unvaccinated, P < 0.01) and 6 rates (2.06% vs 5.77%, P < 0.01). Additionally, a higher rate of high-risk HPV types other than HPV 16 and 18 (40.47% in vaccinated vs 32.63% in unvaccinated, P < 0.01) was observed. In conclusion, the results of this study support the effectiveness of HPV vaccination in Brazil. Continuous surveillance must be assured to monitor the HPV infection rate in the vaccination era.

Breast Cancer Mortality in Young Women in Brazil.

ObjectiveMalignant breast cancer is the leading cause of death by cancer in young women. The study aimed to determine if breast cancer mortality among young women has increased between the period from 1996 to 2017 in Brazil.MethodsA time-series analysis of breast cancer mortality rate in young women (20–39 years old) was carried out. Mortality data, from 1996 to 2017, were collected from the Mortality Information System of the Health Ministry, and demographic data, from the Brazilian Institute of Geography and Statistics. Trends in mortality were performed by Joinpoint Regression, the spatial distribution of the mortality rate was done with the QGIZ Software version 2.18, and Spearman’s correlation coefficient was used to correlate the mortality rates with the Human Development Index.ResultsThere was an increase in breast cancer mortality rates in young women in the majority of Brazilian states, with an upward trend in all regions. The correlation with the Municipal Human Development Index, income, and education had a significant impact on the mortality rate for women from 30–39 years old in both time frames evaluated and for women from 20–29 years old, only from 1996 to 2000.ConclusionThe data obtained in the study, showed that even though the breast cancer mortality rate of young women is lower than women over 40 years old, it has been increasing in all regions of Brazil, mostly for women from 30–39 years old, suggesting that this group should be included in screening programs.

Epidemiological Analyses Reveal a High Incidence of Breast Cancer in Young Women in Brazil.

PURPOSEBreast cancer screening is not recommended for young women (< 40 years old); therefore, those diagnosed are more likely to have advanced and metastatic disease, reducing treatment outcomes. This study aimed to investigate breast cancer epidemiology among young women in Brazil.METHODSData from three publicly available databases and a cohort from a university hospital in Brazil were analyzed in a retrospective study. Descriptive statistics was performed on disease prevalence and stage distribution across age groups. Incidence was estimated using age-standardized incidence ratio. The impact of age in disease-specific survival was also analyzed.RESULTSInvasive breast cancer prevalence data by age group revealed that 4.4% and 20.6% of patients were < 35 and < 45 years old, respectively. In the United States, this prevalence was 1.85% and 11.5%, respectively (odds ratio [OR], 2.2; P < .0001). The percentage of regional and metastatic diseases were higher in São Paulo State (Fundação Oncocentro de São Paulo [FOSP]) compared with the United States (45% and 9.8% v 29% and 5.7%, respectively; P < .0001). In FOSP, regional and metastatic disease prevalence were higher among young patients (53.5% and 11.3%, respectively). The median tumor size in patients < 40 years old was higher (25.0 mm × 20.9 mm; P < .0001), and young patients have higher risk to be diagnosed with positive lymph nodes (OR, 1.5; P = .004) and higher proportion of luminal-B and triple-negative (TNBC) tumors. Young patients have a poor disease-specific survival because of late-stage diagnosis and more aggressive breast cancer subtypes (human epidermal growth factor receptor 2–enriched and TNBC) (P < .0001).CONCLUSIONIn Brazil, breast cancer prevalence among young patients and late-stage incidence during this age span is higher. Advanced disease and more aggressive subtypes lead to a significant impact on breast cancer-specific survival in young patients.

Psychometric Evaluation of the Thin-Ideal Internalization Scale (TIIS) for Brazilian Young Women

Abstract Internalization is an important dimension of body image, which can be assessed using the Thin-Ideal Internalization Scale (TIIS). This study aims to carry out the cross-cultural adaptation and psychometric assessment of the TIIS for young Brazilian women. A total of 448 young university women participated in the research (M age = 21.4 years; SD = 2.91). Exploratory and confirmatory factor analysis, association with body dissatisfaction (Body Shape Questionnaire-8) and eating attitudes (Eating Attitudes Test-26), and assessment of reliability (internal consistency and test-retest) were performed. The instrument had its semantic, idiomatic, cultural and conceptual equivalences ensured. The factor analysis demonstrated the presence of three factors and satisfactory adjustment indexes. In addition, the scale showed adequate values for convergent validity and reliability. The final version of the TIIS (18 items) obtained adequate psychometric properties for the evaluation of the body-ideal internalization among Brazilian young women. We suggest new studies to prove the factor structure for other populations.

Female sexual dysfunctions: prevalence and related factors in a sample of young university women – a cross-sectional study

This study aims to evaluate the prevalence of female sexual dysfunctions (FSD) and associated factors in young women attending a healthcare degree course. Sexual function and sexual discomfort of 187 young college women were assessed by The Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale-Revised (FSDS-R). A total of 23% of participants reported FSD, and the most affected area was pain, followed by orgasm and lubrication, arousal, desire, and satisfaction. This study provides valuable insights into the sexual behavior of young women in Brazil, including the number of lifetime sexual partners, duration of relationships, type of sexual activities and their frequency, sexual orientation, use of antidepressant, and contraceptives methods.

Abstract P5-01-19: Circulating tumor DNA (ctDNA) analysis for investigating resistance to chemotherapy with DNA-damage agents in patients with hereditary or sporadic triple-negative breast cancer

Abstract Background: Triple-negative breast cancer (TNBC), a very aggressive breast cancer subtype, exhibits high variability at both molecular and clinical aspects. Loss of function (LOF) germline mutation in BRCA1 has a very close association with this subtype of breast cancer. BRCA1 impairment is associated with homologous recombination deficiency (HRD) and tumor with HRD may benefit from treatment with drugs that induces DNA damage and also with PARP1 inhibitors. We previously detected that a significant fraction of TNBC diagnosed in young Brazilian women exhibits BRCA1 impairment by mechanisms including germline pathogenic mutation and promoter hypermethylation and that this group of tumors presented better overall survival. In the current study our aim is to comprehensively characterize the resistance to chemotherapy (DNA-damage agents) in patients with Hereditary or Sporadic TNBC by investigating somatic mutations in circulating tumor DNA (ctDNA). Methods: A series of 34 TNBC patients were subjected to germline genetic testing using a 26- or 96-gene panel, including homologous recombination-related genes, for classifying the TNBC as Hereditary or Sporadic. Tumor mutation burden (TMB) analysis was assessed in 20 cases using a panel containing 409 cancer-associated genes. Tumor somatic mutations were detected by evaluating DNA from tumor biopsies (Formalin-fixed, paraffin-embedded tissue) and matched leucocyte and were screened in cell-free DNA from 6 serial plasma samples during neoadjuvant treatment and for 6 months after surgery. Results: Pathogenic germline mutations were identified in BRCA1 (17.6% - 6/34), BRCA2 (2.9% -1/34) and TP53 (2.9% - 1/34) genes. Additionally, variants of uncertain significance (VUS) were identified in 21 patients (61.7% - 21/34), being ATM, BUB1B and PMS2 the most affected genes by VUS. Based on the 34 patients that underwent pre-operative chemotherapy and surgery, 47% exhibited pathological complete response (pCR), 50% in hereditary and 48% in sporadic. In terms of somatic variants, tumor mutation burden (TMB) analysis showed that 20% had high and 80% low TMB, with no association with hereditary or sporadic status. Also, we found, on average, three somatic variants per tumor (range 0-7) and used them as tumor marks in the screening of ctDNA in plasma. Somatic mutations in TP53 were identified in 80% (16 of 21) tumor biopsy samples investigated. In DNA from plasma before treatment, confident detection of at least one tumor mutation (ctDNA) was observed in 60% of patients (10 of 16). Persistent ctDNA detection in plasma during treatment was observed in 6 out 10 (60%) patients with residual disease after surgery and only in 1 out of 6 (16%) in patients with pCR. For 3 patients persistent ctDNA was detected after surgery at increasing levels showing clear anticipation of disease progression or metastasis. Serial plasma ctDNA samples showed great association with the clinical response data suggesting that the chemotherapy-resistance mechanisms can be investigated by ctDNA in TNBC. Conclusions: Germline and somatic evaluation of TNBC can provide valuable information for improving the clinical management of patients. For somatic evaluation, development of gene panels optimized for FFPE samples and low DNA input is enabling a comprehensive detection of potentially clinically-actionable somatic variants with better success rate in cancer treatment. Although still challenging, investigation of somatic variants in ctDNA from plasma samples is feasible and presents huge potential in monitoring patients during chemotherapy, especially regarding both the presence of residual disease and monitoring of disease progression. Citation Format: Dirce M Carraro, Rafael C Brianese, Giovana T Torrezan, Marina de Brot, Claudia AA de Paula, Maria NC Formiga, Solange M Sanches, Vladmir CC de Lima, Fabiana BA Makdissi. Circulating tumor DNA (ctDNA) analysis for investigating resistance to chemotherapy with DNA-damage agents in patients with hereditary or sporadic triple-negative breast cancer [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P5-01-19.

Former une ambiance sacrée

Cette recherche s’intéresse au processus de mise en scène d’une « ambiance sacrée » à travers des productions audiovisuelles publiées et diffusées par de jeunes femmes laïques chrétiennes brésiliennes sur la plateforme YouTube. À partir des productions qui ont pour ambition d’apprendre aux internautes à créer un cahier de prières, une ambiance sacrée s’élabore en deux temps : d’une part, à partir de l’assemblage d’objets ordinaires du quotidien et dans un espace physique qui lui est réservé, correspondant le plus souvent à la chambre des youtubeuses ; d’autre part, lors de l’édition de vidéos grâce à l’usage des dispositifs socio-numériques conçus à cet effet. Bien que s’inscrivant dans une démarche pédagogique d’incitation à une pratique de piété populaire, ces productions audiovisuelles cherchent également à donner à voir un « éthos » de l’idéal de la femme chrétienne ainsi que de parler du dieu chrétien dont elles sont les interlocutrices.

Advanced Stage at Diagnosis and Worse Clinicopathologic Features in Young Women with Breast Cancer in Brazil: A Subanalysis of the AMAZONA III Study (GBECAM 0115).

PURPOSEBreast cancer (BC) in young women is uncommon and tends to present with more aggressive characteristics. To better understand and characterize this scenario in Brazil through real-world data, we performed a subanalysis of AMAZONA III study (ClinicalTrials.gov identifier: NCT02663973).METHODSThe AMAZONA III study (GBECAM 0115) is a prospective registry that included 2,950 women newly diagnosed with invasive BC in Brazil from January 2016 until March 2018 at 22 sites. Valid data were obtained from 2,888 patients regarding age at diagnosis and complete baseline information. To compare epidemiologic and clinicopathological features at the time of diagnosis, patients with BC were divided into two groups according to age: ≤ 40 years and > 40 years. Quantitative variables were described as means, and categorical variables were described as frequencies and percentages and compared using the Pearson’s χ2 test.RESULTSOf 2,888 women diagnosed with BC, 486 (17%) were ≤ 40 years old. Young women had higher educational level, most were employed and a significant number were married (P < .001 for all associations). Younger patients were more symptomatic at BC diagnosis (P < .001), and they also presented more frequently with stage III, T3/T4, grade 3 tumors, HER-2–positive, luminal B, and triple-negative subtypes.CONCLUSIONBrazilian women younger than age 40 years have unfavorable clinicopathological features of BC at diagnosis, with more aggressive subtypes and advanced stage when compared with older women. These differences are not explained by socioeconomic or ethnic imbalances. The causes of a higher prevalence of BC among young women in Brazil deserve additional investigation.

Secondary School Enrolment and Teenage Childbearing: Evidence from Brazilian Municipalities

This article investigates whether increasing secondary education opportunities influences childbearing among young women in Brazil. We examine a novel dataset reflecting the vast expansion of secondary education in Brazil between 1997 and 2009 and exploit variation in the introduction of schools across 4,884 municipalities to instrument for school enrolment. Our most conservative estimate suggests that for every 9.7 students enrolled there is one fewer teenage births. These findings are robust to a number of specifications and sensitivity tests. Our estimates imply that Brazil’s secondary school expansion accounts for 34% of the substantial decline in teenage childbearing observed over the same period. We further look at heterogeneous effects across a number of municipal characteristics and discuss what these results suggest about the mechanisms underlying the school-childbearing relationship.

Photoanthropometry of the Face in the Young White Brazilian Population.

The aim of the present study is to describe the simplified facial pattern of young Brazilian men and women using the facial index (FI), upper face index (UFI), and nasal index (NI) in indirect anthropometric measurements applied to frontal photographic images. The images were obtained from 660 adult white men and 689 adult white women aged 30 years ± 6 months, and classified according to regions of birth, as follows: south (S), southeast (SE), midwest (MW), northeast (NE), and north (N). The nasion, zygion, gnathion, stomion, subnasale, and alare landmarks were labeled on the images using the SAFF 2D® software. Based on the coordinates, the linear distances between the landmarks of interest were calculated and presented as indices. The analysis of variance and Student's t-test were used for assessing the regions of birth and gender, respectively. The collected data allowed obtaining the facial profile of the young adult Brazilian population. There were differences in the facial profiles between men and women and also between some regions, especially between the N and the other Brazilian regions (p<0.05). The UFI did not show a statistically significant difference (p>0.05) between genders for any of the regions. The discriminant analysis for gender assessment demonstrated higher accuracy when the three indices were analyzed together. In the decision tree for gender assessment, the NI showed better results than the other indices.