Efeitos de fatores de risco na probabilidade de subtipos do câncer de mama em mulheres brasileiras
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Introdução: O câncer de mama é uma doença heterogênea, multifatorial e que necessita de mais estudos relacionados aos fatores de riscos. Objetivo: Analisar a probabilidade dos subtipos tumorais do câncer de mama receptores de estrogênio (RE) ou progesterona (RP) positivos, com ou sem expressão de HER2, em relação aos fatores de risco: idade, parto, diabetes mellitus, hipertensão arterial, ocorrência de câncer de mama familiar e índice de massa corporal (IMC). Métodos: A análise da amostra de 79 pacientes dividida nos subtipos 1 (RE+/RP-), 2 (RE+/RP+) e 3 (RE+/RP+/HER+), foi feita por meio de métodos quantitativos usando o Modelo Linear Generalizado Ordinal (MLGO) para estimar os efeitos marginais dos fatores de risco para os subtipos estudados, e ao mesmo tempo modelando a heterocedasticidade do termo de erro. Resultados: Nos resultados foram observados os seguintes efeitos positivos estatisticamente significantes: (1) da idade para o subtipo tumoral 1 (RE+/RP-) e (2) do número de partos para o subtipo 2 (RE+/RP+); enquanto os efeitos negativos significativos foram os seguintes: (1) da idade para o subtipo 3 (RE+/RP+/HER2+); (2) do número de partos para o sutipos 1 (RE+/RP) e 3 (RE+/RP+/HER2+); e da hipertensão arterial para o o subtipo 1 (RE+/RP-). Não foram observados efeitos estatisticamente significativos das variáveis IMC, Diabetes mellitus e ocorrência de câncer de mama familiar sobre os subtipos tumorais estudados. Conclusão: Os fatores de risco idade e número de partos têm efeitos variados para os subtipos do câncer de mama segundo a expressão de receptores para estrogênio, progesterona e HER2.
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Referências
Global Burden of Disease Cancer Collaboration. Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 29 cancer groups, 1990 to 2017: a systematic analysis for the global burden of disease study. JAMA Oncol. 2019;5(12):1749-68. http://doi.org/10.1001/jamaoncol.2019.2996
Azamjah N, Soltan-Zadeh Y, Zayeri F. Global Trend of Breast Cancer Mortality Rate: A 25-Year Study. Asian Pac J Cancer Prev. 2019;20(7):2015-20. http://doi.org/10.31557/APJCP.2019.20.7.2015
Brasil. Instituto Nacional de Câncer José Alencar Gomes da Silva. Estimativa 2020: incidência de câncer no Brasil. Rio de Janeiro: INCA, 2019.
Brinton LA, Gaudet MM, Gierach GL. Breast cancer. In: Thun MJ, Linet MS, Cerhan JR, Haiman CA, Schottenfeld D. Cancer Epidemiology and Prevention. 4th ed. New York: Oxford University Press, 2018.
Couch FJ, Nathanson KL, Offit K. Two decades after BRCA: setting paradigms in personalized cancer care and prevention. Science. 2014;343(6178):1466-70. http://doi.org/10.1126/science.1251827
Danaei G, Hoorn SV, Lopez AD, Murray CJL, Ezzati M. Causes of cancer in the world: comparative risk assessment of nine behavioural and environmental risk factors. Lancet. 2005;366(9499):1784-93. http://doi.org/10.1016/S0140-6736(05)67725-2
Britt K, Ashworth A, Smalley M. Pregnancy and the risk of breast cancer. Endocr Relat Cancer. 2007;14(4):907-33. http://doi.org/10.1677/ERC-07-0137
Li CI, Malone KE, Daling JR. Differences in breast cancer hormone receptor status and histology by race and ethnicity among women 50 years of age and older. Cancer Epidemiol Biomark Prev. 2002;11(7):601-7.
Collaborative Group on Hormonal Factors in Breast Cancer. Familial breast cancer: collaborative reanalysis of individual data from 52 epidemiological studies including 58.209 women with breast cancer and 101.986 women without the disease. Lancet. 2001;358(9291):1389-99. http://doi.org/10.1016/S0140-6736(01)06524-2
Harbeck N, Penault-Llorca F, Cortes J, Gnant M, Houssami N, Poortmans P, et al. Breast cancer. Nat Rev Dis Primers, 2019;5(66). https://doi.org/10.1038/s41572-019-0111-2
International Agency for Research on Cancer; Lakhani SR. WHO Classification of Tumours of the Breast. Fourth Edition. World Health Organization, 2012.
Perou CM, Therese Sørlie T, Eisen MB, Rijn M, Jeffrey SS, Rees CA, et al. Molecular portraits of human breast tumours. Nature. 2000;406:747-52. https://doi.org/10.1038/35021093
Parise CA, Bauer KR, Brown MM, Caggiano V. Breast cancer subtypes as defined by the estrogen receptor (ER), progesterone receptor (PR), and the human epidermal growth factor receptor 2 (HER2) among women with invasive breast cancer in California, 1999–2004. Breast J. 2009;15(6):593-602. https://doi.org/110.1111/j.1524-4741.2009.00822.x
Burstein MD, Tsimelzon A, Graham M Poage GM, Covington KR, Contreras A, Fuqua SAW, et al. Comprehensive genomic analysis identifies novel subtypes and targets of triple-negative breast cancer. Clin Cancer Res. 2015;21(7):1688-98. https://doi.org/110.1158/1078-0432.CCR-14-0432
Lobo-Cardoso R, Magalhães AT, Fougo JL. Neoadjuvant endocrine therapy in breast cancer patients. Porto Biomedical J. 2017;2(5):170-3. https://doi.org/10.1016/j.pbj.2017.03.007
Yang XR, Chang-Claude J, Goode EL, Couch FJ, Nevanlinna H, Milne RL, et al., Associations of Breast Cancer Risk Factors With Tumor Subtypes: A Pooled Analysis From the Breast Cancer Association Consortium Studies. J Natl Cancer Inst. 2011;103(3):250-63. https://doi.org/10.1093/jnci/djq526
Colditz GA, Sellers TA, Trapido E. Epidemiology - identifying the causes and preventability of cancer? Nat Rev Cancer. 2006;6(1):75-83. https://doi.org/10.1038/nrc1784
Barone I, Giordanoa C, Bonofiglio D, Andòa S, Catalano S. The weight of obesity in breast cancer progression and metastasis: Clinical and molecular perspectives. Semin Cancer Biol. 2020;60:274-84. https://doi.org/10.1016/j.semcancer.2019.09.001
Abudawood M. Diabetes and cancer: A comprehensive review. J Res Med Sci. 2019;24:94. https://doi.org/10.4103/jrms.JRMS_242_19
Seretis A, Cividini S, Markozannes G, Tseretopoulou X, Lopez DS, Ntzani EE, et al. Association between blood pressure and risk of cancer development: a systematic review and meta-analysis of observational studies. Sci Rep. 2019;9(1):8565. https://doi.org/10.1038/s41598-019-45014-4
Bonita R, Beaglehole R, Kjellströmb T. Epidemiologia básica. 2 ed. Santos: 2010.
Parise CA, Bauer KR, Caggiano V. Variation in breast cancer subtypes with age and race/ethnicity. Crit Rev Oncol Hematol. 2010;76(1):44-52. https://doi.org/10.1016/j.critrevonc.2009.09.002
Wong FY, Tham WY, Nei WL, Lim C, Miao H. Age exerts a continuous effect in the outcomes of Asian breast cancer patients treated with breast-conserving therapy. Cancer Commun. 2018;38(1):39. https://doi.org/10.1186/s40880-018-0310-3
Ma H, Bernstein L, Pike MC, Ursin G. Reproductive factors and breast cancer risk according to joint estrogen and progesterone receptor status: a meta-analysis of epidemiological studies. Breast Cancer Res. 2006;8(4):R43. https://doi.org/10.1186/bcr1525
Attner B, Landin-Olsson M, Lithman T, Noreen D, Olsson H. Cancer among patients with diabetes, obesity and abnormal blood lipids: a population-based register study in Sweden. Cancer Causes Control. 2012;23(5):769-77. https://doi.org/10.1007/s10552-012-9946-5
Bosco JLF, Palmer JR, Boggs DA, Hatch EE, Rosenberg L. Cardiometabolic factors and breast cancer risk in U.S. black women. Breast Cancer Res Treat. 2012;134:1247-56. https://doi.org/10.1007/s10549-012-2131-4
Suzuki Y, Tsunoda H, Kimura T, Yamauchi H. BMI change and abdominal circumference are risk factors for breast cancer, even in Asian women. Breast Cancer research and treatment. 2017;166(3):919-25. https://doi.org/10.1007/s10549-017-4481-4
Allison PD. Comparing logit and probit coefficients across groups. Sociol Methods Res. 1999;28(2):186-208. https://doi.org/10.1177/0049124199028002003
Williams R. Fitting heterogeneous choice models with oglm. Stata J. 2010;10(4):540-67. https://doi.org/10.1177/1536867X1101000402
Oliveira MMD, Malta DC, Guauche H, Moura LD, Silva GA. Estimativa de pessoas com diagnóstico de câncer no Brasil: dados da Pesquisa Nacional de Saúde, 2013. Rev Bras Epidemiol. 2015;8(Suppl 2):146-57. https://doi.org/10.1590/1980-5497201500060013
Anderson WF, Rosenberg PS, Prat A, Perou CM, Sherman ME. How many etiological subtypes of breast cancer: two, three, four, or more?. J Natl Cancer Inst. 2014;106(8):165. https://doi.org/10.1093/jnci/dju165
Pirone JR, D'arcy M, Stewart DA, Hines WC, Johnson M, Gould MN, et al. Age-associated gene expression in normal breast tissue mirrors qualitative age-at-incidence patterns for breast cancer. Cancer Epidemiol Biomarkers Prev. 2012;21(10):1735-44. https://doi.org/10.1158/1055-9965.EPI-12-0451
Howlader N, Altekruse SF, Li CI, Chen VW, Clarke CA, Ries LA, et al. US incidence of breast cancer subtypes defined by joint hormone receptor and HER2 status. J Natl Cancer Inst. 2014;106(5);459-552. https://doi.org/10.1093/jnci/dju055
Huo D, Adebamowo CA, Ogundiran TO, Akang EE, Campbell O, Adenipekun A, et al. Parity and breastfeeding are protective against breast cancer in Nigerian women. Br J Cancer. 2008;98(5):992-6. https://doi.org/10.1038/sj.bjc.6604275
Colditz GA, Rosner B. Cumulative risk of breast cancer to age 70 years according to risk factor status: data from the Nurses' Health Study. Am J Epidemiol. 2000;152(10):950-64. https://doi.org/10.1093/aje/152.10.950
Instituto Brasileiro de Geografia e Estatística (IBGE). Síntese de indicadores sociais: uma análise das condições de vida da população brasileira. Rio de Janeiro: IBGE, 2015.
Tamimi RM, Colditz GA, Hazra A, Baer HJ, Hankinson SE, Rosner B, et al. Traditional breast cancer risk factors in relation to molecular subtypes of breast cancer. Breast Cancer Res Treat. 2012;131(1):159-67. https://doi.org/10.1007/s10549-011-1702-0
Fortner RT, Sisti J, Chai B, Collins LC, Rosner B, Hankinson SE, et al. Parity, breastfeeding, and breast cancer risk by hormone receptor status and molecular phenotype: results from the Nurses’ Health Studies. Breast Cancer Res. 2019;21(40). https://doi.org/10.1186/s13058-019-1119-y
Instituto Brasileiro de Geografia e Estatística (IBGE). Pesquisa Nacional de Saúde 2013: Percepção do estado de saúde, estilos de vida e doenças crônicas. Rio de Janeiro: IBGE, 2014.
Peeters PH, van Noord PA, Hoes AW, Fracheboud J, Gimbrère CH, Grobbee DE. Hypertension and breast cancer risk in a 19-year follow-up study (the DOM cohort). Diagnostic Investigation Into Mammarian Cancer. J Hypertens. 2000;18(3):249-54. https://doi.org/10.1097/00004872-200018030-00002