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Previous issue date: 2012-01-23 / Breast cancer is the main cause of death from malignant neoplasia in women worldwide, with its incidence on constant growing. In most of developed countries its mortality is declining, but in Brazil, in spite of recent advances in the therapeutic arsenal for treatment of the disease, death follows in steadily increase. Breast cancer mostly affects women in their fourth decade of life with a peak incidence in the sixth decade, and, although it is less common before the age of 40, is still responsible for more than 30% of cancer cases in women with less than 40 years old. Several studies consider the disease that affect the younger patients has a poorer outcome with increased risk of death compared with women in older age. This study was designed in order to determine the incidence and prognosis of breast cancer in women under 40 years of age at diagnosis, and to compare the disease-free survival and overall survival in relation to patients over 40 years. To conduct the study were reviewed medical records of patients diagnosed with breast cancer of four tertiary institutions specialized in the treatment of cancer patients from different regions of Rio Grande do Sul, totaling 649 patients in between the years 1992 and 2011. The age ranged from 24 to 92 years, 87.82% being women over 40 years, and 12.17% being younger women. The results revealed a balance on the staging at the moment of diagnosis, however, on the group of younger patients there was a higher incidence of triple negative phenotype and lower incidence of hormone receptor positivity. In relation to the treatment received both groups were similar.The curves of disease-free survival and overall survival showed a clear tendency to an increased risk of relapse and death in patients under 40 years. The findings confirm the literature data that associate early age with a more aggressive disease, as the worst prognosis persists even after correction by staging and it seems not to change with more intensive treatments. These results lead us to believe that breast cancer is a heterogeneous disease that has different biological characteristics for the different age groups studied. Further studies are needed to better understand the disease in this age group, therefore allowing to modify the course of the pathology in these patients. / O C?ncer de Mama ? a principal causa de ?bito por neoplasia maligna em mulheres no mundo, com incid?ncia em franco crescimento. Na maioria dos pa?ses desenvolvidos sua mortalidade est? em decl?nio, por?m, no Brasil, ? despeito de recentes avan?os no arsenal terap?utico para tratamento da doen?a, a mortalidade segue em cont?nua ascend?ncia. O c?ncer de mama acomete principalmente mulheres a partir da quarta d?cada de vida com um pico de incid?ncia na sexta d?cada, apesar de ser menos comum antes dos 40 anos de idade, ainda ? respons?vel por mais de 30% dos casos de c?ncer na mulher com menos de 40 anos. Diversos estudos consideram que a doen?a que acomete a paciente jovem tem uma evolu??o desfavor?vel com maior risco de morte quando comparado com mulheres de idade mais avan?ada. Este estudo foi concebido com a finalidade de determinar a incid?ncia do c?ncer de mama em mulheres com menos de 40 anos de idade ao diagn?stico, e comparar o progn?stico atrav?s da sobrevida livre de doen?a e sobrevida global em rela??o ? pacientes com mais de 40 anos. Para realiza??o do trabalho foram revisados prontu?rios de pacientes com diagn?stico de c?ncer de mama de quatro institui??es terci?rias especializadas em tratamento de pacientes oncol?gicos de diferentes regi?es do Rio Grande do Sul, totalizando 649 pacientes entre o per?odo de 1992 e 2011. A idade variou entre 24 e 92 anos sendo 87,82% no grupo maior de 40 anos e 12,17% no grupo menor de 40 anos.Os resultados demonstraram um equil?brio quanto ao estadiamento no momento do diagn?stico, por?m, no grupo de pacientes jovens houve maior incid?ncia do fen?tipo triplo negativo e menor incid?ncia de positividade para receptores hormonais. Em rela??o ao tratamento recebido ambos os grupos foram semelhantes. As curvas de sobrevida livre de doen?a e de sobrevida global demonstram uma clara tend?ncia a um maior risco de recidiva e morte no grupo de pacientes com menos de 40 anos. Os achados confirmam os dados de literatura que associam a idade precoce com uma doen?a mais agressiva, sendo que o pior progn?stico persiste mesmo ap?s a corre??o por est?gios e, parece n?o se alterar com tratamentos mais intensivos. Estes resultados nos levam a considerar que o c?ncer de mama ? uma doen?a heterog?nea que apresenta caracter?sticas biol?gicas distintas para os diferentes grupos et?rios estudados.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/1661 |
| Date | 23 January 2012 |
| Creators | Meller, Kelly Cristina |
| Contributors | Garicochea, Bernardo |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Medicina e Ci?ncias da Sa?de, PUCRS, BR, Faculdade de Medicina |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 7620745074616285884, 500, 600, -8624664729441623247 |
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