Análise dos subtipos imunoistoquímicos de câncer de mama em um hospital de referência oncológica no Amazonas

Abstract

BACKGROUND:Breast cancer is the most frequent neoplasm in female population worldwide. In Brazil, a total of 59,700 new cases is estimated for 2018, being the main oncological cause of female death in the country. The expression of estrogen receptors (ERs) and progesterone receptors (PRs) and overexpression of human epidermal growth factor receptor-2 (HER2) have been identified as important predictive factors among breast cancer patients, being currently used to define the treatment and establish the prognosis of the disease. GOALS: The purpose of the present analysis was to identify the frequency of immunohistochemical subtypes of invasive breast cancers treated at Fundação Centro de Controle de Oncologia do Estado do Amazonas (FCECON), which are registered in the pathology laboratory of the institution, and to reach its purpose, specific objectives were set: i) to identify the frequency of hormone-receptor positivity in carcinomas-in-situ (CIS); ii) to identify the frequency of the histopathological subtypes of the case series; iii) to relate the age and gender of patients in the case series according to the histopathological and immunohistochemical status of the lesion; and; iv) suggest strategies that facilitate the dissemination and understanding of the meaning of the results of immunohistochemistry for breast cancer patients using research data. METHOD: For this, an observational, descriptive and retrospective study was conducted with breast cancer diagnosed patients and also those with an immunohistochemistry medical report in the files of the FCECON pathology laboratory, in Manaus, Amazonas, during a 9-year period. Data was obtained from secondary data sources and later included in an EXCEL database and transferred to STATA® Version 13 where the statistical calculations were performed. RESULTS: It had been studied 1604 cases of patients diagnosed with breast cancer treated at the FCECON from 2008 to 2016, averaging 178.2 cases per year. Of these cases, 1597 (99.6%) were female and 7 (0.4%) were male. In the female cases, the age ranged from 25 to 95 years (average 52.6 years). The percentage of women under 40 years was 14.8%, within 40 years to 65 years was 68.2% and more than 65 years was 17%. The most frequent histopathological type was invasive ductal carcinoma (IDC) with 89.9%. The most common subtype was Luminal B (LB) with 32.6% of cases, followed by Negative Triple (TN) 24.3%. In the frequency of immunohistochemical subtypes a difference was observed between age groups (p <0.001), with the average age of LA being the highest at 57.2 years and LH the lowest at 49.9 years followed by TN 51, 1 year (p <0.001). CONCLUSION: In general, thr patients are predominantly female, IDC and LB were the most frequent histological and immunohistochemical type. There was a statistically significant difference in the frequency by histological and immunohistochemical types. The most frequent carcinoma-in-situ was DCIS and most had negative hormone receptors. In men, IDC and LB were the most frequent histological and immunohistochemical types. It was suggested the development of an Android Platform software with these data in order to help in understanding prognostics and predictive meanings of these exams as well as to help in health policies for this sector.