scholarly journals Survival and prognostic factors of breast cancer in women in the state of São Paulo

Mastology ◽  
2020 ◽  
Vol 30 (Suppl 1) ◽  
Author(s):  
Raissa Janine de Almeida ◽  
Carolina Terra de Moraes Luizaga ◽  
Cristiane Murta-Nascimento
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Clinical Stage ◽  
Sao Paulo ◽  
The State ◽  
Rank Test ◽  
São Paulo ◽  
Historical Cohort ◽  
Female Population

Introduction: Breast cancer is the first most common malignancy in the female population worldwide. Monitoring the survival of women with breast cancer has been a strategy often adopted at the international level as a measure to assess public policy progress for disease control. Objectives: To estimate the probability of five-year survival and to investigate the prognostic factors of women with breast cancer included in the São Paulo State Cancer Hospital Records Base (RHC-SP), established in 2000 and maintained by the Oncocentro Foundation of São Paulo (Fundação Oncocentro de São Paulo – FOSP). Material and methods: This is a historical cohort. The sample consisted of women with breast cancer diagnosed between 2002 and 2012 and included in the RHC-FOSP. The event studied was specific mortality from breast cancer. Live cases at the end of follow-up (December 31st, 2017), loss of follow-up and those who died from causes other than breast cancer were considered censures on the date of the last contact or date of death. Survival analysis was performed using the Kaplan-Meyer method and the survival curves were compared using the log-rank test. Hazard ratios (HR) and respective 95% confidence intervals (95%CI) were also estimated using the Cox's proportional hazards model. This study was approved by the Human Research Ethics Committee of the School of Medicine of Botucatu, UNESP. Results: In the period between 2002‒2012, 53,146 cases of invasive breast cancer were registered at RHC-FOSP. The median age of women at diagnosis was 55.9 years. By the end of the follow-up (December 31st, 2017), 20,683 patients died and 71.4% were due to breast cancer. The probability of specific survival for the entire cohort at 5 and 10 years was 76.1% (95%CI 75.7‒76.5%) and 64.8% (95%CI 64.2‒65.3%), respectively. In the multivariate analysis, the factors associated with the prognosis were: age at diagnosis, year of diagnosis, educational level, grouped clinical stage and histological type. Conclusion: Specific survival for breast cancer in the state of São Paulo is significantly associated with several characteristics. The knowledge of these characteristics can contribute to the development of public policies in the area.

scholarly journals Breast cancer in women: characterization of cases included in the hospital cancer records of the state of São Paulo and factors associated with advanced stadiums

Mastology ◽  
2020 ◽  
Vol 30 (Suppl 1) ◽  
Author(s):  
Raissa Janine de Almeida ◽  
Arthur Felipe Decker ◽  
Carolina Terra de Moraes Luizaga ◽  
Cristiane MurtaNascimento
Keyword(s):  
Breast Cancer ◽  
Clinical Stage ◽  
Sao Paulo ◽  
Age At Diagnosis ◽  
Outcome Variable ◽  
São Paulo ◽  
Female Population ◽  
Level Of Education ◽  
Factors Associated ◽  
Advanced Stages

Introduction: Breast cancer is a worldwide public health problem, being the most common malignancy in the female population. It is a potentially curable disease if diagnosed early. The advanced stage at the time of diagnosis is associated with increased morbidity and low survival of these women. Objectives: To describe the sociodemographic, clinical, and anatomopathological characteristics of breast cancer cases in women included in the São Paulo State hospital cancer database (registros hospitalares de câncer de São Paulo – RHC-SP), established in 2000 and maintained by the Fundação Oncocentro de São Paulo (FOSP) and to investigate the factors associated with the clinical stage at the time of diagnosis. Material and methods: The study design was a series of cases. The sample consisted of women with breast cancer diagnosed between 2000-2014 and included in the RHC-FOSP. The outcome variable was the clinical stage (stage 0-II versus III-IV). The explanatory variables were: age at diagnosis and education level. This study was approved by the Human Research Ethics Committee of the Botucatu Medical School, UNESP. Results: The study included 84,987 women with in situ and invasive breast cancer diagnosed between 2000-2014. The mean age of women at diagnosis was 56.7 years (95%CI 56.6–56.8 years). Sixty-five percent of the cases have complete elementary school or less and the most frequent histological type was ductal carcinoma (77.2%). During the study period, there was a small decrease in the proportion of tumors in more advanced stages, from 39.8% in 2000 to 32.6% in 2014. There was a statistically significant association between the variables age at diagnosis and level of education with the clustered clinical stage of women. Women of older age and those with a higher level of education had reduced odds ratios for tumors in more advanced stages at the time of diagnosis. Conclusion: These findings may contribute to the development of policies for the identification of breast tumors at an earlier stage.

Male breast cancer: Epidemiological evaluation and clinical outcomes.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e13619-e13619
Author(s):  
Edla Renata Cavalcante ◽  
Katia Regina Marchetti ◽  
Jamile Almeida Silva ◽  
Laura Testa
Keyword(s):  
Breast Cancer ◽  
Endocrine Therapy ◽  
Male Breast Cancer ◽  
Cox Regression ◽  
Sao Paulo ◽  
Male Breast ◽  
Rank Test ◽  
São Paulo ◽  
Male Population ◽  
Female Population

e13619 Background: Male breast cancer (BC) is a rare neoplasia, with a risk of 1:1.000 in USA. Data from Sao Paulo Cancer Registry has shown that BC adjusted incidence rates is about 1.21 per 100,000 at the period from 2001 to 2005, but there is no incidence data for the whole country. Methods: We conducted a unicentric retrospective cohort, with histologically proven male BC patients whose first appointment was between 2008 and 2018 at Instituto do Câncer do Estado de São Paulo in Brazil. The primary endpoint was OS according to metastatic status and initial staging. OS and RFS were analyzed by Kaplan–Meier method and the difference calculated by log-rank test; reported hazard ratios by univariate Cox Models and P-values by score test. Multivariate analysis was calculated through COX regression. Results: 89 male BC patients were accessed, average age at diagnosis was 63.3 yeas-old. 84.2% had carcinoma of no special type (88,7% estrogen positive receptor, 84,2% progesterone positive receptor). When Charlson Comorbidity Index (CCI) was calculated, most (23.5%) were ≥ 7 (10-year survival: 0%), being 17.9% stage IV. Mastectomy was performed at 73% patients, 38.2% received adjuvant chemotherapy; 44.9% received adjuvant radiotherapy and 64% received adjuvant endocrine therapy (94.7% tamoxifen). For metastatic disease, endocrine therapy was the first option in 52%. Median OS was 75 months (95% CI, 39.2-110.7) in M0 and 39 months (95% CI, 25,2–52,8) in M1 ( p = 0.001). CCI showed be an independent death factor (HR 0.37, 95% CI, 0.17-0.8, p = 0.011). Median RFS was 97 months [95% CI, 47.3–146.7]. When BMI was evaluated for patients with obesity (> 30) there was no difference in disease relapse ( p = 0.29). Conclusions: Our results are consistent with those from previous literature, regarding histology, biomarkers and later stage at diagnosis. A quarter of our patients had high CCI and this could had impacted on best treatment option choices. Treatment approaches use to be similar from those of female population. However, as disease biology and hormonal physiology are different between gender, there is a lack of specific protocols and trials in male population.

scholarly journals Survival and prognostic factors of patients with breast cancer in the state of São Paulo

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
R J Almeida ◽  
C T M Luizaga ◽  
J Eluf-Neto ◽  
E C Pessoa ◽  
A M M Chiarotti ◽  
...  
Keyword(s):  
Public Health ◽  
Breast Cancer ◽  
Prognostic Factors ◽  
Health Problem ◽  
Public Health Problem ◽  
Sao Paulo ◽  
São Paulo ◽  
Breast Cancer Specific Survival ◽  
Cancer Specific Survival

Abstract Introduction Breast cancer is a public health problem worldwide, being the most common malignant neoplasm in the female population. Objectives To estimate 5- and 10-year breast cancer-specific survival probabilities of patients included in the hospital-based cancer registry (HBCR) of the Fundação Oncocentro de São Paulo (FOSP, in Portuguese) and to assess the prognostic factors for this neoplasm. Methods Historical cohort study that included women with breast cancer included in HBCR-FOSP and diagnosed between 2002 and 2012. The event of interest was breast cancer-specific mortality. Living cases at the end of follow-up (December 31, 2017), loss to follow-up and death other than that due to breast cancer were considered censored on the date of the last contact or date of death. Descriptive analysis and survival analysis were performed using the Kaplan-Meyer method. Survival curves were compared using the log-rank test. Hazard ratios (HR) and their 95%CI were estimated using Cox's proportional hazards model. The study was approved by the Human Research Ethics Committee of the Botucatu Medical School, São Paulo State University, Brazil. Results 53,146 cases of invasive breast cancer were registered at HBCR-FOSP between 2002-2012. The median age at diagnosis was 55.9 years. By the end of the follow-up, 20,683 patients died, and 71.4% were due to breast cancer. The 5- and 10-year breast cancer-specific survival for the entire cohort was 76.1% (95%CI 75.7-76.5%) and 64.8% (95% CI 64.2-65.3%), respectively. In the multivariate analysis, the factors associated with prognosis were age at diagnosis, year of diagnosis, educational level, clinical stage, and histological type. Conclusions These findings may contribute to the development of policies for the identification of breast tumors at earlier stages. Key messages Breast cancer is an important public health problem in Brazil and worldwide. The findings of this study may contribute to the development of public policies for the control of breast cancer in the state of São Paulo.

scholarly journals Seasonal variation of femoral fractures in the state of São Paulo, Southeast Brazil

2019 ◽  
Vol 53 ◽  
pp. 55 ◽  
Author(s):  
Mônica Marin de Souza ◽  
Eniuce Menezes de Souza ◽  
Altacílio Aparecido Nunes ◽  
Edson Zangiacomi Martinez
Keyword(s):  
Hospital Admissions ◽  
Age Groups ◽  
Femoral Fractures ◽  
Sao Paulo ◽  
The State ◽  
Seasonal Effects ◽  
Seasonal Effect ◽  
Consecutive Series ◽  
São Paulo ◽  
Female Population

OBJECTIVE: To examine the effect of seasonality on femoral fracture incidence among people residing in the state of São Paulo, Brazil. METHODS: Ecological study based on a consecutive series of 216,348 reports of hospital admissions caused by femoral fractures. A Bayesian statistical model was used for time series analysis, considering the monthly average number of events of femoral fractures per day as a dependent variable. RESULTS: Among the female population, significant seasonal effects were observed only for older women, aged 60 years or more. Among younger men (aged less than 20 years) there is not a clear seasonal effect, but among the other age groups there seems to exist a higher number of cases of femoral fractures during the coldest months of the year. CONCLUSIONS: In general, more cases of fractures occur during the coldest months of the year; however, men and women have different patterns of incidence according to each age group.

Survival profile in breast cancer molecular subtypes without systemic and locoregional treatment.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 11599-11599
Author(s):  
Sherry X. Yang ◽  
Eric Polley
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Molecular Subtypes ◽  
Multivariable Analysis ◽  
Cox Proportional Hazards Model ◽  
Locoregional Therapy ◽  
Rank Test ◽  
Luminal A ◽  
Luminal B

11599 Background: It is unclear whether survival varies among breast cancer molecular subtypes without systemic and locoregional therapy. This study aims to evaluate the survival profile by molecular subtypes after surgery. Methods: In total, we evaluated 301 women with invasive breast cancer with stage I, II or III disease. Patients were classified into four major breast cancer subtypes by immunohistochemistry/FISH classifiers: luminal-A (ER+ and/or PR+/HER2-), luminal-B (ER+ and/or PR+/HER2+), HER2-enriched (HER2+/ER-/PR-) or basal-like (ER-/PR-/HER2-; triple-negative). Overall survival (OS) was analyzed by Kaplan-Meier analysis, and log-rank test for differences. Association between clinical outcome and subtype adjusting for breast cancer prognostic factors was assessed by multivariable Cox proportional hazards model. Results: All patients did not receive systemic chemotherapy and hormone therapy as well as radiation therapy. Luminal A was the most common subtype (N = 224), followed by basal-like (N = 43), luminal B (N = 21) and HER2-enriched (N = 13). Median follow-up for OS was 197 months (range: 1 – 273 months). Age at diagnosis was statistically different among the subtypes, with basal-like and luminal B having high proportions less than 50 years (P = 0.047). Patients with basal-like and HER2-enriched had more high grade tumors (P < 0.001). Notably, there was no difference in OS among the four subtypes (log-rank P = 0.983). In multivariable analysis, the adjusted hazard ratio (HR) was 1.1 for luminal A vs. luminal B (P = 0.781), 0.62 in luminal A vs. HER2-enriched (P = 0.273), or 0.67 in luminal A vs. basal-like (P = 0.158). In contrast, the adjusted HR were 2.2 in age less than 50 years (P = 0.0017), and 1.1 for number of positive nodes (P = 0.00074). Conclusions: OS, through long-term clinical follow-up, is not significantly different among molecular subtypes if not controlling for other prognostic factors in patients who only received surgery. Age and number of positive nodes are independent prognostic factors in patients with no systemic and locoregional treatments.

Development of CART model for prediction of tuberculosis treatment loss to follow up in the state of São Paulo, Brazil: A case–control study

2020 ◽  
Vol 141 ◽  
pp. 104198
Author(s):  
Verena Hokino Yamaguti ◽  
Domingos Alves ◽  
Rui Pedro Charters Lopes Rijo ◽  
Newton Shydeo Brandão Miyoshi ◽  
Antônio Ruffino-Netto
Keyword(s):  
Case Control Study ◽  
Case Control ◽  
Sao Paulo ◽  
The State ◽  
Tuberculosis Treatment ◽  
São Paulo ◽  
Loss To Follow Up ◽  
Cart Model ◽  
Control Study

scholarly journals Access to colposcopy in the State of São Paulo, Brazil: probabilistic linkage study of administrative data

2022 ◽  
Vol 38 (1) ◽  
Author(s):  
Lewis Fletcher Buss ◽  
Lise Cury ◽  
Caroline Madalena Ribeiro ◽  
Gulnar Azevedo e Silva ◽  
José Eluf Neto
Keyword(s):  
Public Health ◽  
Cervical Cancer ◽  
Health System ◽  
Public Health System ◽  
Sao Paulo ◽  
The State ◽  
São Paulo ◽  
The Public ◽  
Reference Cohort

Cervical cancer screening is a multistage process, therefore access to both the primary test and subsequent diagnostic procedures is essential. Considering women undergoing screening on the public health system in the State of São Paulo, Brazil, we aimed to estimate the proportion of women accessing colposcopy within six months of an abnormal smear result. We retrieved records from two administrative databases, the Information System on Uterine Cervical Cancer (SISCOLO) that contains smear results and the Outpatient Information System of the Brazilian Unified National Health System (SIA/SUS) that records colposcopies. A reference cohort consisted of women, aged 25 years or older, with an abnormal smear result between May 1, 2014, and June 30, 2014. We excluded prevalent cases. We linked the reference cohort and records in the SIA/SUS extending to December 31, 2014. After excluding prevalent cases, 1,761 women with abnormal cytology results were left. A total of 700 (39.8%) women were linked to a colposcopy record within the follow-up period; this dropped to 671 (38.1%) women when follow-up was censored at six months. We could notice a slightly higher attendance in women living in the metropolitan region of São Paulo compared with residents of the rest of the state. We found no association between colposcopy attendance and age or cytology class. These results emphasize that access to colposcopy in the public health system in São Paulo is limited. This compromises the quality of screening, and the issue needs to be prioritized in service planning.

scholarly journals Benign breast tumors: epidemiological profile and therapeutic conduct at the escola paulista de medicina

Mastology ◽  
2020 ◽  
Vol 30 (Suppl 1) ◽  
Author(s):  
João Bueno Vitor Peixoto ◽  
Joaquim Teodoro Araújo ◽  
Simone Elias ◽  
Afonso Celso Pinto Nazário ◽  
Gil Facina
Keyword(s):  
Breast Cancer ◽  
Family History ◽  
Medical Records ◽  
Dropout Rate ◽  
Sao Paulo ◽  
São Paulo ◽  
History Of ◽  
Epidemiological Profile ◽  
Epidemiological Characteristics

Introduction: Breasts represent an important site for the development of diseases. It is known that 80% of the palpable masses of the breast are of benign origin. Benign breast diseases range from inflammatory to neoplastic processes. Objectives: to evaluate the clinical and epidemiological characteristics of patients diagnosed with benign breast tumor at the Mastology outpatient clinic of the Universidade Federal de São Paulo (UNIFESP). Methods: 1,532 medical records, available on the electronic platform PEP-HUHSP through the ICD D24 (benign breast cancer) and N63 (unspecified breast nodule), of patients referred to the service between July 2008 and July 2017 were reviewed. After applying exclusion criteria, 403 medical records were submitted to data collection and tabulation in Excel, followed by statistical analysis using the IBM SPSS Statistics 23 software. The study in question was approved by the Research Ethics Committee of UNIFESP (CEP UNIFESP), in the Teaching and Research Coordination of Hospital São Paulo – Hospital Universitário/UNIFESP (CoEP of HSP-HU/UNIFESP) and exempted from the application of the Informed Consent by the same organs. Results: In the 9-year period, the following results were obtained: mean age was 39.3 years. Comorbidities: smoking (16.4%), SAH (16.8%) and dyslipidemia (6.3%). Family history of breast and/or ovarian cancer accounted for 16.6%. Mean age of menarche and menopause, respectively, were 12.7 and 42.5 years. Causes of referral: "alteration in image examination" (38.3%), "lump in the breast" (33.3%), "follow-up due to previous nodules" (16.5%). Anatomopathological report: fibroadenoma (41%), breast cysts (16%), phylloid tumors (3%), and papilloma (1%). Mean number of consultations per patient until discharge or abandonment of follow-up: three. Choice behavior: expectant (85.2%). Conclusion: The epidemiological profile of patients referred to the UNIFESP tertiary mastology service was mainly composed of women of childbearing age and nulliparous women, whose main comorbidities were smoking and SAH, in the great majority with no family history of breast cancer. Regarding the consultation, the main reason for referral is the findings on imaging exams, and, specially, patients would bring their breast USG along, which surpassed mammography by 34.1%. The choice for biopsy was restricted, present in approximately 1/3 of the cases, but pointed out that the most prevalent nodule is fibroadenoma, followed by phylloid and papilloma tumors. Nevertheless, there was a predilection for expectant conduct. On average, there were regular follow-ups for 1.5 years, followed by a significant dropout rate.

IMPACT OF DISPERSANT USE DURING THE BRAZILIAN MARINA INCIDENT

1979 ◽  
Vol 1979 (1) ◽  
pp. 269-276
Author(s):  
Richard T. Dewling ◽  
Carlos Celso Do Amaral E. Silva
Keyword(s):  
Environmental Samples ◽  
Rio De Janeiro ◽  
Sao Paulo ◽  
The State ◽  
Beach Sand ◽  
São Paulo ◽  
Follow Up Studies ◽  
Coastal Embayments ◽  
Spill Site

ABSTRACT In January 1978, the tanker Brazilian Marina, while under tow, struck rock in São Sebastiao Channel, Sao Paulo, Brazil, and spilled approximately 10,000 tons (3,000,000 gallons) of 31.4 API gravity Kuwait crude. Prevailing winds and currents carried the oil in a northeasterly direction, causing pollution of the coastal embayments and beach areas in the States of São Paulo and Rio de Janeiro. The most severely impacted areas were those in Ubatuba, Sao Paulo, and the coastline along the southwestern shore of the State of Rio de Janeiro. In an attempt to protect recreational and other public use areas, particularly the popular beaches of Ubatuba, undiluted dispersants were applied to remove oil accumulations from the shoreline. This response action, while it cosmetically removed oil from the surface of the beaches, caused the oil to penetrate more deeply into the underlying sand, thus compounding the pollution and aesthetic problems attributable to the spill incident. Chemical analysis of detergent-treated and oil-contaminated sand samples from Ubatuba beaches, as well as samples from a beach area in the State of Rio de Janeiro, located approximately 200 kilometers (124 miles) from the spill site, found similarities between the environmental samples and the suspected source, the Brazilian Marina. Preliminary follow-up studies, conducted seven months after the incident, verified the persistence of the detergent-treated oil in the beach sand.

The Daily Routine of Students in the Classroom

2020 ◽  
Vol 8 (3) ◽  
pp. 157-163
Author(s):  
Lilian Marques Silva
Keyword(s):  
Elementary School ◽  
Public School ◽  
Data Collection ◽  
New Technologies ◽  
Sao Paulo ◽  
The State ◽  
Daily Routine ◽  
São Paulo ◽  
Access To Information ◽  
Technological Advances

The almost instantaneous access to information provided by technological advances has revolutionized the behavior of people and of the classrooms too. Teachers had to adapt themselves to new technologies to maintain students interested and attentive to the discipline being taught. In this work, the behavior of the students of the 6th grade of elementary school II during class was observed. The school chosen is a public school in the State of São Paulo (Brazil). The research was based on data collection. The students were observed by being filmed during six months. The results showed that the students were interested in the classes and committed to the activities. The place that the student chooses to sit in the classroom influences the behavior of the teacher, because the more distant the teacher, the less he participates in the class.

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