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Geographic differences in the distribution of molecular subtypes of breast cancer in Brazil.
BMC Womens Health. 2014 Aug 29; 14:102.BW

Abstract

BACKGROUND

To compare the distribution of the intrinsic molecular subtypes of breast cancer based on immunohistochemical profile in the five major geographic regions of Brazil, a country of continental dimension, with a wide racial variation of people.

METHODS

The study was retrospective observational. We classified 5,687 invasive breast cancers by molecular subtype based on immunohistochemical expression of estrogen-receptor (ER), progesterone-receptor (PR), human epidermal growth factor receptor 2 (HER2), and Ki-67 proliferation index. Cases were classified as luminal A (ER and/or PR positive and HER2 negative, Ki-67 < 14%), luminal B (ER and/or PR positive, HER2 negative, and Ki-67 > 14%), triple-positive (ER and/or PR positive and HER2 positive), HER2-enriched (ER and PR negative, and HER2- positive), and triple-negative (TN) (ER negative, PR negative, and HER2- negative). Comparisons of the ages of patients and molecular subtypes between different geographic regions were performed.

RESULTS

South and Southeast regions with a higher percentage of European ancestry and higher socioeconomic status presented with the highest proportion of luminal tumors. The North region presented with more aggressive subtypes (HER2-enriched and triple-negative), while the Central-West region predominated triple-positive carcinomas. The Northeast--a region with a high African influence--presented intermediate frequency of the different molecular subtypes. The differences persisted in subgroups of patients under and over 50 years.

CONCLUSIONS

The geographic regions differ according to the distribution of molecular subtypes of breast cancer. However, other differences, beside those related to African ancestry, such as socioeconomic, climatic, nutritional, and geographic, have to be considered to explain our results. The knowledge of the differences in breast cancer characteristics among the geographic regions may help to organize healthcare programs in large countries like Brazil with diverse economic and race composition among different geographic regions.

Authors+Show Affiliations

Department of Pathology, Faculdade de Medicina da Universidade de São Paulo, Av, Dr, Arnaldo, 455 - room 1149, São Paulo, SP 01246-903, Brazil. filomena@usp.br.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

25174527

Citation

Carvalho, Filomena M., et al. "Geographic Differences in the Distribution of Molecular Subtypes of Breast Cancer in Brazil." BMC Women's Health, vol. 14, 2014, p. 102.
Carvalho FM, Bacchi LM, Pincerato KM, et al. Geographic differences in the distribution of molecular subtypes of breast cancer in Brazil. BMC Womens Health. 2014;14:102.
Carvalho, F. M., Bacchi, L. M., Pincerato, K. M., Van de Rijn, M., & Bacchi, C. E. (2014). Geographic differences in the distribution of molecular subtypes of breast cancer in Brazil. BMC Women's Health, 14, 102. https://doi.org/10.1186/1472-6874-14-102
Carvalho FM, et al. Geographic Differences in the Distribution of Molecular Subtypes of Breast Cancer in Brazil. BMC Womens Health. 2014 Aug 29;14:102. PubMed PMID: 25174527.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Geographic differences in the distribution of molecular subtypes of breast cancer in Brazil. AU - Carvalho,Filomena M, AU - Bacchi,Lívia M, AU - Pincerato,Kátia M, AU - Van de Rijn,Matt, AU - Bacchi,Carlos E, Y1 - 2014/08/29/ PY - 2014/06/22/received PY - 2014/08/19/accepted PY - 2014/9/2/entrez PY - 2014/9/2/pubmed PY - 2015/5/13/medline SP - 102 EP - 102 JF - BMC women's health JO - BMC Womens Health VL - 14 N2 - BACKGROUND: To compare the distribution of the intrinsic molecular subtypes of breast cancer based on immunohistochemical profile in the five major geographic regions of Brazil, a country of continental dimension, with a wide racial variation of people. METHODS: The study was retrospective observational. We classified 5,687 invasive breast cancers by molecular subtype based on immunohistochemical expression of estrogen-receptor (ER), progesterone-receptor (PR), human epidermal growth factor receptor 2 (HER2), and Ki-67 proliferation index. Cases were classified as luminal A (ER and/or PR positive and HER2 negative, Ki-67 < 14%), luminal B (ER and/or PR positive, HER2 negative, and Ki-67 > 14%), triple-positive (ER and/or PR positive and HER2 positive), HER2-enriched (ER and PR negative, and HER2- positive), and triple-negative (TN) (ER negative, PR negative, and HER2- negative). Comparisons of the ages of patients and molecular subtypes between different geographic regions were performed. RESULTS: South and Southeast regions with a higher percentage of European ancestry and higher socioeconomic status presented with the highest proportion of luminal tumors. The North region presented with more aggressive subtypes (HER2-enriched and triple-negative), while the Central-West region predominated triple-positive carcinomas. The Northeast--a region with a high African influence--presented intermediate frequency of the different molecular subtypes. The differences persisted in subgroups of patients under and over 50 years. CONCLUSIONS: The geographic regions differ according to the distribution of molecular subtypes of breast cancer. However, other differences, beside those related to African ancestry, such as socioeconomic, climatic, nutritional, and geographic, have to be considered to explain our results. The knowledge of the differences in breast cancer characteristics among the geographic regions may help to organize healthcare programs in large countries like Brazil with diverse economic and race composition among different geographic regions. SN - 1472-6874 UR - https://www.unboundmedicine.com/medline/citation/25174527/Geographic_differences_in_the_distribution_of_molecular_subtypes_of_breast_cancer_in_Brazil_ L2 - https://bmcwomenshealth.biomedcentral.com/articles/10.1186/1472-6874-14-102 DB - PRIME DP - Unbound Medicine ER -