Survival and Prognostic Factors in Patients with Breast Cancer: Cohort Study

Authors

  • Rafael Everton Assunção Ribeiro da Costa Universidade Estadual do Piauí (Uespi), Centro de Ciências da Saúde (CCS). Teresina (PI), Brasil. https://orcid.org/0000-0002-0798-890X
  • Samya Viana da Silva Rodrigues Universidade Estadual do Maranhão (Uema), Departamento de Ciências da Saúde (DCS). Caxias (MA), Brasil. https://orcid.org/0000-0002-1809-6552
  • Ana Carolina Vieira Mendes Universidade Estadual do Maranhão (Uema), Departamento de Ciências da Saúde (DCS). Caxias (MA), Brasil. https://orcid.org/0000-0003-3761-4543
  • Rackell Ramos Everton Costa Universidade Estadual do Maranhão (Uema), Departamento de Ciências da Saúde (DCS). Caxias (MA), Brasil. https://orcid.org/0009-0001-4149-0961
  • Marcela Coêlho de Sá Centro Universitário Unifacid Wyden, Coordenação de Medicina. Teresina (PI), Brasil. https://orcid.org/0000-0002-3797-0997
  • Sabas Carlos Vieira Oncocenter, Tocoginecologia. Teresina (PI), Brasil. https://orcid.org/0000-0003-0935-7316
  • Carlos Eduardo Coelho de Sá Oncocenter, Oncologia Clínica. Teresina (PI), Brasil. https://orcid.org/0000-0002-9610-8010
  • Rodrigo José de Vasconcelos Valença Universidade Estadual do Piauí (Uespi), Centro de Ciências da Saúde (CCS). Teresina (PI), Brasil. https://orcid.org/0000-0002-8115-3951

DOI:

https://doi.org/10.32635/2176-9745.RBC.2024v70n4.4839

Keywords:

Prognosis, Anatomical Pathological Conditions, Health Care Outcome Assessment/statistics & numerical data, Breast Neoplasms/diagnosis

Abstract

Introduction: Breast cancer is the most common cancer in the world and an important cause of death among women. Objective: To analyze survival and prognostic factors in a cohort of patients with breast cancer. Method: Retrospective cohort of 201 patients with breast cancer treated between January 2018 and December 2022 at a tertiary hospital in Caxias, Maranhão, Brazil. Data were collected between January and June 2023 and analyzed with software R, version 4.0.2. Overall survival (OS) and disease-free survival (DFS) curves were constructed using the Kaplan-Meier model. A descriptive analysis was performed by calculating absolute (n) and relative frequencies (%) and evaluating prognostic factors with Cox regression. Statistical significance was evaluated through the Wald Test, with a level of 5%. Results: The 5-year OS and DFS were 91.3% and 72.4%, respectively. Women predominated (98.5%) over 40 years of age (86.1%) and with invasive carcinoma of no-special type (94%), G1 or G2 (79.1%), smaller than 5 cm (64.6%), without angiolymphatic (52.7%) and neural (77.6%) invasion and luminal molecular subtype (65.2%). Males had higher risk of death. Patients with angiolymphatic and neural invasion and non-expression of estrogen receptors (ER) had higher risk of recurrence. Conclusion: The 5-year OS and DFS were 91.3% and 72.4%, respectively. Male gender, angiolymphatic and neural invasion and non-expression of ER were prognostic factors associated with higher risk of death or recurrence.

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References

Momenimovahed Z, Salehiniya H. Epidemiological characteristics of and risk factors for breast cancer in the world. Breast Cancer (Dove Med Press). 2019;11:151-64. doi: https://www.doi.org/10.2147/BCTT.S176070 DOI: https://doi.org/10.2147/BCTT.S176070

Waks AG, Winer EP. Breast cancer treatment: a review. JAMA. 2019;321(3):288-300. doi: https://www.doi.org/10.1001/jama.2018.19323 DOI: https://doi.org/10.1001/jama.2018.19323

Cardoso F, Kyriakides S, Ohno S, et al. Early breast cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2019;30(8):1194-220. doi: https://www.doi.org/10.1093/annonc/mdz173. Errata in: Ann Oncol. 2019;30(10):1674. Errata in: Ann Oncol. 2021;32(2):284. DOI: https://doi.org/10.1093/annonc/mdz189

Esteva FJ, Hubbard-Lucey VM, Tang J, et al. Immunotherapy and targeted therapy combinations in metastatic breast cancer. Lancet Oncol. 2019;20(3):e175-86. doi: https://www.doi.org/10.1016/S1470-2045(19)30026-9 DOI: https://doi.org/10.1016/S1470-2045(19)30026-9

Gonçalves Junior H, Guerra MR, Duarte Cintra JR, et al. Survival study of triple-negative and non-triple-negative breast cancer in a brazilian cohort. Clin Med Insights Oncol. 2018;12:1179554918790563. doi: https://doi.org/10.1177/1179554918790563 DOI: https://doi.org/10.1177/1179554918790563

Phung MT, Tin Tin S, Elwood JM. Prognostic models for breast cancer: a systematic review. BMC Cancer. 2019;19(1):230. doi: https://www.doi.org/10.1186/s12885-019-5442-6 DOI: https://doi.org/10.1186/s12885-019-5442-6

Brierley JD, Gospodarowicz M, Wittekind Ch, editors. TNM Classification of Malignant Tumours. 8 ed. Chichester, West Sussex, UK: Wiley Blackwell; 2017. DOI: https://doi.org/10.1002/9780471420194.tnmc26.pub3

R: The R Project for Statistical Computing [Internet]. Version 4.0.2. Viena: The R foundation. [Acesso 2024 jul 25]. Disponível em: https://www.R-project.org

Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. J Amer Statist Assoc. 1958;53(282):457-81. doi: https://doi.org/10.2307/2281868 DOI: https://doi.org/10.1080/01621459.1958.10501452

Miot HA. Survival analysis in clinical and experimental studies. J Vasc Bras. 2017;16(4):267-9. doi: https://www.doi.org/10.1590/1677-5449.001604 DOI: https://doi.org/10.1590/1677-5449.001604

Conselho Nacional de Saúde (BR). Resolução n° 466, de 12 de dezembro de 2012. Aprova as diretrizes e normas regulamentadoras de pesquisas envolvendo seres humanos. Diário Oficial da União, Brasília, DF. 2013 jun 13; Seção I:59.

Zhang L, Hao J, Guo J, et al. Predicting of Ki-67 expression level using diffusion-weighted and synthetic magnetic resonance imaging in invasive ductal breast cancer. Breast J. 2023;2023:6746326. doi: https://www.doi.org/10.1155/2023/6746326 DOI: https://doi.org/10.1155/2023/6746326

SEER: Surveillance, Epidemiology, and End Results [Internet]. Versão 1975-2019. Washigton, DC: NCI; 2021. [Acesso 2024 jul 25]. Disponível em: https://seer.cancer.gov/data-software/documentation/seerstat/

Ayala ALM, Anjos JCD, Cassol GA, et al. Sobrevida em 10 anos em mulheres com câncer de mama: coorte história de 2000-2014. Ciênc saúde coletiva. 2019;24(4):1537-50. doi: https://www.doi.org/10.1590/1413-81232018244.16722017 DOI: https://doi.org/10.1590/1413-81232018244.16722017

Yazdani A, Haghighat S. Determining prognostic factors of disease-free survival in breast cancer using censored quantile regression. Breast Cancer (Auckl). 2022;16:11782234221108058. doi: https://www.doi.org/10.1177/11782234221108058 DOI: https://doi.org/10.1177/11782234221108058

Diniz RW, Guerra MR, Cintra JR, et al. Disease-free survival in patients with non-metastatic breast cancer. Rev Assoc Med Bras. 2016;62(5):407-13. doi: https://www.doi.org/10.1590/1806-9282.62.05.407 DOI: https://doi.org/10.1590/1806-9282.62.05.407

Chen Z, Xu L, Shi W, et al. Trends of female and male breast cancer incidence at the global, regional, and national levels, 1990-2017. Breast Cancer Res Treat. 2020;180(2):481-90. doi: https://doi.org/10.1007/s10549-020-05561-1 DOI: https://doi.org/10.1007/s10549-020-05561-1

Gucalp A, Traina TA, Eisner JR, et al. Male breast cancer: a disease distinct from female breast cancer. Breast Cancer Res Treat. 2019;173(1):37-48. doi: https://doi.org/10.1007/s10549-018-4921-9 DOI: https://doi.org/10.1007/s10549-018-4921-9

Hassett MJ, Somerfield MR, Baker ER, et al. Management of male breast cancer: ASCO Guideline. J Clin Oncol. 2020;38(16):1849-63. doi: https://doi.org/10.1200/JCO.19.03120 DOI: https://doi.org/10.1200/JCO.19.03120

Fox S, Speirs V, Shaaban AM. Male breast cancer: an update. Virchows Arch. 2022;480(1):85-93. doi: https://doi.org/10.1007/s00428-021-03190-7 DOI: https://doi.org/10.1007/s00428-021-03190-7

Fakhri N, Chad MA, Lahkim M, et al. Risk factors for breast cancer in women: an update review. Med Oncol. 2022;39(12):197. doi: https://doi.org/10.1007/s12032-022-01804-x DOI: https://doi.org/10.1007/s12032-022-01804-x

Gao Y, Samreen N, Heller SL. Non-BRCA early-onset breast cancer in young women. Radiographics. 2022;42(1):5-22. doi: https://doi.org/10.1148/rg.210109 DOI: https://doi.org/10.1148/rg.210109

Watkins EJ. Overview of breast cancer. JAAPA. 2019;32(10):13-7. doi: https://doi.org/10.1097/01.JAA.0000580524.95733.3d DOI: https://doi.org/10.1097/01.JAA.0000580524.95733.3d

Ingale YP, Buch AC, Jose M, et al. Invasive papillary carcinoma of the breast - a rare case report. Med J DY Patil Vidyapeeth. 2022;15:782-4. doi: https://doi.org/10.4103/mjdrdypu.mjdrdypu_171_21 DOI: https://doi.org/10.4103/mjdrdypu.mjdrdypu_171_21

Marrazzo E, Frusone F, Milana F, et al. Mucinous breast cancer: a narrative review of the literature and a retrospective tertiary single-centre analysis. Breast. 2020;49:87-92. doi: https://doi.org/10.1016/j.breast.2019.11.002 DOI: https://doi.org/10.1016/j.breast.2019.11.002

Valentim MH, Monteiro V, Marques JC. Primary neuroendocrine breast carcinoma: a case report and literature review. Radiol Bras. 2014;47(2):125-7. doi: https://doi.org/10.1590/S0100-39842014000200017 DOI: https://doi.org/10.1590/S0100-39842014000200017

Srivastava P, Wang T, Clark BZ, et al. Clinical-pathologic characteristics and response to neoadjuvant chemotherapy in triple-negative low Ki-67 proliferation (TNLP) breast cancers. NPJ Breast Cancer. 2022;8(1):51. doi: https://doi.org/10.1038/s41523-022-00415-z DOI: https://doi.org/10.1038/s41523-022-00415-z

Donegan WL. Tumor-related prognostic factors for breast cancer. CA Cancer J Clin. 1997;47(1):28-51. doi: https://doi.org/10.3322/canjclin.47.1.28 DOI: https://doi.org/10.3322/canjclin.47.1.28

Roses DF, Bell DA, Flotte TJ, et al. Pathologic predictors of recurrence in stage 1 (TINOMO) breast cancer. Am J Clin Pathol. 1982;78(6):817-20. doi: https://www.doi.org/10.1093/ajcp/78.6.817 DOI: https://doi.org/10.1093/ajcp/78.6.817

Zagami P, Carey LA. Triple negative breast cancer: pitfalls and progress. NPJ Breast Cancer. 2022;8(1):95. doi: https://www.doi.org/10.1038/s41523-022-00468-0 DOI: https://doi.org/10.1038/s41523-022-00468-0

American Cancer Society [Internet]. Atlanta: ACS; [sem data]. Breast Cancer Stages. [acesso 2023 set 9]. Disponível em: https://cancer.org/cancer/types/breast-cancer/understanding-a-breast-cancer-diagnosis/stages-of-breast-cancer.html

National Health Service [Internet]. Londres: NHS; [sem data]. Treatment: Breast cancer in women. [acesso 2023 set 9]. Disponível em: https://nhs.uk/conditions/breast-cancer/treatment/

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Published

2025-01-24

How to Cite

1.
Costa REAR da, Rodrigues SV da S, Mendes ACV, Costa RRE, Sá MC de, Vieira SC, Sá CEC de, Valença RJ de V. Survival and Prognostic Factors in Patients with Breast Cancer: Cohort Study. Rev. Bras. Cancerol. [Internet]. 2025 Jan. 24 [cited 2025 Mar. 17];70(4):e-154839. Available from: https://rbc.inca.gov.br/index.php/revista/article/view/4839

Issue

Vol. 70 No. 4 (2024): oct./nov./dec.

Section

ORIGINAL ARTICLE

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