Sociodemographic and Clinical-pathological Study of Molecular Subtitles of Breast Carcinoma in a Reference Unit of Maranhão

Abstract

Objective To evaluate the distribution of the main sociodemographic and clinical-pathological characteristics in women with breast cancer according to the molecular profile by immunohistochemistry.

Methods A cross-sectional, retrospective, analytical and quantitative study was performed, with an analysis of 137 medical records from January 2015 to December 2018 of women attending the High Complexity in Oncology Unit of the city of Imperatriz, state of Maranhão, Brazil. The immunohistochemical profile of tumors based on the estrogen and progesterone receptor, Human Epidermal growth factor Receptor-type 2 (HER2) overexpression and Ki67 cell proliferation index was defined, from which six molecular subtypes were determined: luminal A, luminal B-HER2 negative, luminal B-HER2 positive, triple negative, overexpression of HER2 and inconclusive.

Results A total of 52.6% of the patients were postmenopausal, mean age 52.1 years old, brown (56.2%), had a schooling level < 9 years (40%), staging > IIB (52.6%) and 23.4% had metastasis. Invasive ductal carcinoma accounted for 84.7%, tumor size was 2 to 5 cm (48.9%), with lymph node involvement (56.2%), axillary lymphadenectomy in 67.2%, and mastectomy in 73.7% of the patients. The most frequent molecular subtype was the luminal B-HER2 negative (36.5%), and the luminal A subtype showed characteristics of better prognosis when compared with the others.

Conclusion It was concluded that in the association of molecular subtypes with sociodemographic and clinical-pathological characteristics, there were no statistically significant results obtained, except for complementary therapy, referring to hormone therapy, and there was a high index of metastasis at diagnosis, which was a worrying factor and indicative of failures in the screening and early diagnosis of this population.

Resumo

Objetivo Avaliar a distribuição das principais características sociodemográficas e clínico-patológicas em mulheres com câncer de mama segundo o perfil molecular pela imunohistoquímica.

Métodos Estudo transversal, retrospectivo, analítico, descritivo e quantitativo, com análise de 137 prontuários do período de janeiro de 2015 a dezembro de 2018 de mulheres atendidas na Unidade de Assistência da Alta Complexidade em Oncologia da cidade de Imperatriz, MA, Brasil. Foi definido o perfil imunohistoquímico dos tumores baseado na avaliação dos receptores de estrogênio e progesterona, superexpressão de HER2 e índice de proliferação celular Ki67, de onde foram determinados seis subtipos moleculares: luminal A, luminal B-HER2 negativo, luminal B-HER2 positivo, triplo negativo, superexpressão de HER2 e inconclusivo.

Resultados Foi demonstrado que 52,6% das pacientes eram pós-menopausadas, com idade média de 52,1 anos, pardas (56,2%), tinham grau de escolaridade < 9 anos (40%), estadiamento > IIB (52,6%) e 23,4% tinham metástase. Carcinoma ductal invasivo representou 84,7%, o tamanho tumoral foi de 2 a 5 cm (48,9%), com comprometimento linfonodal (56,2%), com linfadenectomia axilar em 67,2% e mastectomia em 73,7% das pacientes. O subtipo molecular mais frequente foi o luminal B-HER2 negativo (36,5%), e o subtipo luminal A apresentou características de melhor prognóstico em relação aos demais.

Conclusão Concluiu-se que na associação dos subtipos moleculares com as características sociodemográficas e clínico-patológicas não se obteve resultados com significância estatística, exceto para terapia complementar, referente à hormonioterapia, e houve elevado índice de metástase ao diagnóstico, o que representou um fator preocupante e indicativo de falhas no rastreio e diagnóstico precoce dessa população.

Keywords

breast neoplasms - immunohistochemistry - health profile - oncology - staging of neoplasms

Palavras-chave

neoplasias da mama - imunohistoquímica - perfil de saúde - oncologia - estadiamento de neoplasias

Contributions

Conception and design: Reis A. P. A. M., Teixeira C. M. S., Medeiros A. R. L., Chaves K. Z. C..

Data collection: Reis A. P. A. M., Melo M. R., Albuquerque C. R..

Analysis and interpretation of data: Reis A. P. A. M., Teixeira C. M. S., Medeiros A. R. L., Chaves K. Z. C., Melo M. R., Albuquerque C. R..

Writing of the article: Reis A. P. A. M., Teixeira C. M. S., Albuquerque C. R., Melo M. R..

Critical review of the intellectual content: Sousa C. M., Medeiros A. R. L., Chaves K. Z. C..

Final approval of the version to be published: Reis A. P. A. M., Teixeira C. M. S., Medeiros A. R. L., Chaves K. Z. C., Albuquerque C. R., Melo M. R,.

Publication History

Received: 26 March 2020

Accepted: 17 September 2020

Article published online:
21 December 2020

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