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CC BY 4.0 · Rev Bras Ginecol Obstet 2022; 44(08): 761-770
DOI: 10.1055/s-0042-1743103
Original Article
Mastology

Histological and Immunohistochemical Characteristics for Hereditary Breast Cancer Risk in a Cohort of Brazilian Women

Características histológicas e imunohistoquímicas para risco hereditário de câncer de mama em uma coorte de mulheres brasileiras
Renata Mendes de Freitas 
1   Department of Public Health, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
2   Epidemiology of Congenital Malformations Laboratory, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
,
Maximiliano Ribeiro Guerra 
1   Department of Public Health, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
,
Vívian Assis Fayer 
1   Department of Public Health, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
,
Angélica Atala Lombelo Campos 
1   Department of Public Health, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
,
Jane Rocha Duarte Cintra 
3   Oncology Institute, Hospital 9 de Julho, Juiz de Fora, MG, Brazil
,
Joan Warren 
4   Independent Researcher, Washington, United States
,
Rafaela Russi Ervilha 
1   Department of Public Health, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
,
Camila Damasceno de Paula 
1   Department of Public Health, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
,
Maria Teresa Bustamante-Teixeira 
1   Department of Public Health, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
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Abstract

Objective The study aimed to characterize the clinical, histological, and immunohistochemical profile of women with invasive breast cancer, according to the risk for Hereditary Predisposition Breast and Ovarian Cancer Syndrome in a Brazilian population.

Methods This is a retrospective study performed from a hospital-based cohort of 522 women, diagnosed with breast cancer treated at an oncology referral center in the Southeast region of Brazil, between 2014 and 2016.

Results Among the 430 women diagnosed with invasive breast cancer who composed the study population, 127 (29.5%) were classified as at increased risk for hereditary predisposition to breast and ovarian cancer syndrome. There was a lower level of education in patients at increased risk (34.6%) when compared with those at usual risk (46.0%). Regarding tumor characteristics, women at increased risk had higher percentages of the disease diagnosed at an advanced stage (32.3%), and with tumors > 2cm (63.0%), with increased prevalence for both characteristics, when compared with those at usual risk. Furthermore, we found higher percentages of HG3 (43.3%) and Ki-67 ≥ 25% (64.6%) in women at increased risk, with prevalence being about twice as high in this group. The presence of triple-negative tumors was observed as 25.2% in women at increased risk and 6.0% in women at usual risk, with the prevalence of absence of biomarkers being 2.5 times higher among women in the increased risk group.

Conclusion From the clinical criteria routinely used in the diagnosis of breast cancer, the care practice of genetic counseling for patients at increased risk of hereditary breast cancer in contexts such as Brazil is still scarce.

Resumo

Objetivo O presente estudo buscou caracterizar o perfil clínico, histológico e imunohistoquímico de mulheres com câncer de mama invasivo segundo o risco para a Síndrome de Predisposição Hereditária ao Câncer de Mama e Ovário em uma população brasileira.

Métodos Trata-se de um estudo retrospectivo realizado a partir de uma coorte hospitalar composta por 522 mulheres diagnosticadas com câncer de mama entre 2014 e 2016 assistidas em um centro de referência oncológica localizado na região sudeste brasileira.

Resultados Entre as 430 mulheres diagnosticadas com câncer de mama invasivo que compuseram a população de estudo, 127 (29,5%) foram classificadas como de risco aumentado para a síndrome de predisposição hereditária ao câncer de mama e ovário. Verificou-se menor nível de escolaridade nas pacientes com risco aumentado (34,6%) quando comparadas àquelas consideradas como de risco habitual (46,0%). Quanto às características do tumor, as mulheres de risco aumentado apresentaram maiores percentuais de doença diagnosticada em estádio avançado (32,3%) e com tumores > 2cm (63,0%), com prevalência aumentada para ambas as características, quando comparadas àquelas de risco habitual. Ainda nas mulheres de risco aumentado, foram encontrados maiores percentuais de GH3 (43,3%) e Ki-67 ≥ 25% (64,6%), com prevalência cerca de duas vezes maior neste grupo. A presença de tumores triplo-negativos foi observada em 25,2% nas mulheres de risco aumentado e 6,0% nas mulheres de risco habitual, com prevalência de ausência de biomarcadores 2,5 vezes maior entre as mulheres do grupo de risco aumentado.

Conclusão A partir dos critérios clínicos rotineiramente utilizados no diagnóstico do câncer de mama, a prática assistencial do aconselhamento genético para as pacientes com risco aumentado de câncer de mama hereditário em contextos como o do Brasil ainda é escarça.

Keywords

breast cancer - hereditary breast and ovarian cancer syndrome - cohort studies - immunohistochemistry - genetic counseling

Palavras-chave

câncer de mama - síndrome hereditária de câncer de mama e ovário - estudos de coorte - imuno-histoquímica - aconselhamento genético

Contributions

Freitas analyzed the data, and promoted the conception and design of the article. Guerra helped in the analysis and writing of the article. Fayer and Campos participated in data collection. Cintra contributed to the screening of patients in the cohort and the collection of clinical information. Warren contributed substantially to the interpretation of the data and performed a critical review of its intellectual content. Ervilha participated in the data collection and writing of the article. De Paula acted in the graphic presentation of the results, and Teixeira performed a relevant critical review of the intellectual content presented with approval of the final version to be published.




Publication History

Received: 29 October 2021

Accepted: 01 December 2021

Article published online:
25 April 2022

© 2022. Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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