Perfil imuno-histoquímico e variáveis clinicopatológicas no câncer de mama

ResumoObjetivoDescrever as principais caracteristicas em mulheres com cancer de mama, de acordo com o perfil imuno-histoquimico.MétodosA populacao foi composta a partir de coorte hospitalar formada por mulheres com diagnostico de cancer de mama efetuado entre 2003 e 2005 (n = 601) e atendidas em centro de referencia em assistencia oncologica de Juiz de Fora-MG. Foram selecionadas apenas 397 mulheres que possuiam imunohistoquimica completa. Para definicao dos grupos segundo perfil imuno-histoquimico, optou-se por classificacao baseada na avaliacao dos receptores de estrogeno e de progesterona, indice de proliferacao celular Ki67 e superexpressao de HER2. De acordo com os diferentes fenotipos, foram definidos cinco subtipos: luminal A, luminal B-HER2 negativo, luminal B-HER2 positivo, triplo negativo e HER2 superexpresso.ResultadosA maioria dos pacientes tinha pele branca (80,7%) e era pos-menopausada (64,9%), com idade media de 57,4 anos (±13,5). Ao diagnostico, 57,5% delas tinha tumor de tamanho ≥ 2,0 cm, e 41,7% exibiam comprometimento linfonodal. Os subtipos mais frequentes foram luminal B-HER2 negativo (41,8%) e triplo negativo (24,2%). No subtipo luminal A, 72,1% das pacientes eram pos-menopausadas, enquanto que os maiores percentuais na pre-menopausa foram observados nos subtipos luminal B-HER2 positivo e triplo negativo (45,2% e 44,2%, respectivamente). Verificou-se maior frequencia de tumores > 2,0 cm e com linfonodos comprometidos nos subtipos triplo negativo e HER2 positivo.ConclusãoEsta pesquisa possibilitou avaliar a distribuicao das principais caracteristicas clinicopatologicas e relacionadas aos servicos de saude em coorte de mulheres brasileiras com cancer de mama, segundo os subtipos tumorais imuno-histoquimicos.

SummaryObjectiveTo describe the main characteristics of women with breast cancer, according to the immunohistochemical profile.MethodsThe population comprised a hospital cohort, consisting of women diagnosed with breast cancer between 2003 and 2005 (n = 601) and treated at a referral center for cancer care in Juiz de Fora, MG, Brazil. Only 397 women who had complete immunohistochemistry analysis were selected. To define the groups according to the immunohistochemical profile, the assessment of estrogen and progesterone receptors, Ki-67 cell proliferation index, and overexpression of human epidermal growth factor receptor 2 (HER2) was chosen. According to the different phenotypes, five subtypes were defined: luminal A, luminal B HER2 negative, luminal B HER2 positive, triple negative, and HER2 overexpression.ResultsMost patients were white (80.7%) and post-menopausal (64.9%), with a mean age of 57.4 years (± 13.5). At diagnosis, 57.5% had tumor size ≥ 2.0 cm, and 41.7% had lymph node involvement. The most common subtypes were luminal B - HER2 negative (41.8%) and triple negative (24.2%). In the luminal A subtype, 72.1% of patients were post-menopausal, while the highest percentage of premenopausal women were observed in the luminal B - HER2 positive and triple negative subtypes (45.2% and 44.2%, respectively). A higher frequency of tumors > 2.0 cm and lymph node involvement was observed in triple negative and HER2 positive subtypes.ConclusionThis study allowed the distribution assessment of the main clinical and pathological characteristics and those related to health services in a cohort of Brazilian women with breast cancer, according to the immunohistochemical tumor subtypes.