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Análise comparativa das características clínicas dos subtipos imunohistoquímicos de cancro da mama
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Contexto: O cancro da mama é a neoplasia maligna mais frequente no sexo feminino, e importante causa de mortalidade. Vários estudos têm vindo a dar relevância a características biológicas e marcadores imunohistoquímicos tumorais, que permitem definir 4 subgrupos principais, aparentemente com implicações terapêuticas e prognósticas. Objetivo: O objetivo principal do estudo é analisar as características clínicas e anatomopatológicas nos 4 subtipos imunohistoquímicos de cancro da mama. Métodos: Foram avaliados retrospetivamente 1253 casos de tumores da mama dos quais 868 foram estudados e divididos por subtipos tumorais. Foram avaliadas e comparadas as características clínicas e anatomopatológicas de cada subtipo e a evolução durante o seguimento. Resultados: Obteve-se uma distribuição por subtipos tumorais com 70,5% de Luminais A, 10,9% Luminais B, 5,3% HER2-type e 9,9% Triplos negativos (TN). Houve diferença estatisticamente significativa em relação a idade, índice de massa corporal (IMC), tamanho tumoral, grau de diferenciação, número de gânglios positivos, tipo de cirurgia e sobrevivência específica de doença. Concluiu-se que o subtipo Luminal A se associou a idades mais avançadas e o subtipo TN a menor IMC. Os subtipos HER2-type e TN associaram-se mais frequentemente a maior tamanho tumoral, maior grau histológico e maior número de gânglios positivos, o que condicionou um pior prognóstico em ambos os grupos, sendo que HER2-type mostrou ter o pior prognóstico. O subtipo Luminal A associou-se a menor tamanho tumoral e grau histológico, menor número de gânglios positivos e melhor sobrevivência para o período de estudo. Conclusão: Os subtipos imunohistoquímicos apresentam características clínicas, anatomopatológicas e prognósticas próprias.
Background: Breast cancer is globally the most common malignancy in women, and an important cause of death. Previous studies have been discussing the importance of biological and immunohistochemical (IHC) characteristics for the breast cancer classification, proposing them as being a tool capable of defining the 4 IHC subtypes, apparently with clinical, therapeutic and prognostic implications. Objective: The main objective of the work is to study the clinical and anatomopathological characteristics of the 4 immunohistochemical subtypes of breast cancer. Methods: The records of 1253 patients with breast cancer were retrospectively analyzed. 868 of these were included in the study and they were divided into subtypes. Clinical and anatomopathological characteristics were studied as well as the occurrences during the follow-up. Results: As the tumors were divided into subtypes, 70,5% were Luminal A, 10,9% Luminal B, 5,3% HER2-type and 9,9% Triple Negative (TN). There were significant differences in the distribution of tumor size, grade, type of surgery, node status, age, body mass index (BMI), recurrence and specific disease survival. Luminal A were associated with older age and TN were associated with lower BMI. HER2-type and TN subtypes were significantly associated with higher tumor size, grade and positive node status, which conditioned a worse prognosis. HER2-type have had the worse survival. Luminal A subtype were significantly associated with lower tumor size and grade, less positive node status and better disease specific survival in the follow-up studied. Conclusion: Immunohistochemical subtypes have typical clinical, anatomopathological and prognostic characteristics.
Background: Breast cancer is globally the most common malignancy in women, and an important cause of death. Previous studies have been discussing the importance of biological and immunohistochemical (IHC) characteristics for the breast cancer classification, proposing them as being a tool capable of defining the 4 IHC subtypes, apparently with clinical, therapeutic and prognostic implications. Objective: The main objective of the work is to study the clinical and anatomopathological characteristics of the 4 immunohistochemical subtypes of breast cancer. Methods: The records of 1253 patients with breast cancer were retrospectively analyzed. 868 of these were included in the study and they were divided into subtypes. Clinical and anatomopathological characteristics were studied as well as the occurrences during the follow-up. Results: As the tumors were divided into subtypes, 70,5% were Luminal A, 10,9% Luminal B, 5,3% HER2-type and 9,9% Triple Negative (TN). There were significant differences in the distribution of tumor size, grade, type of surgery, node status, age, body mass index (BMI), recurrence and specific disease survival. Luminal A were associated with older age and TN were associated with lower BMI. HER2-type and TN subtypes were significantly associated with higher tumor size, grade and positive node status, which conditioned a worse prognosis. HER2-type have had the worse survival. Luminal A subtype were significantly associated with lower tumor size and grade, less positive node status and better disease specific survival in the follow-up studied. Conclusion: Immunohistochemical subtypes have typical clinical, anatomopathological and prognostic characteristics.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2018
Palavras-chave
Cancro da mama Subtipos imunohistoquímicos Características clínicas