ABSTRACT
El cáncer de mama es el tumor de la mujer más diagnosticado en la gran mayoría de los países. Los factores no hereditarios son los principales impulsores de las diferencias internacionales e interétnicas observadas en la incidencia de este cáncer. Las tasas de incidencia del cáncer de mama han aumentado en la mayoría de los países en transición en las últimas décadas, en tanto que en la mayoría de los países más avanzados, las tasas de mortalidad por cáncer de mama han ido en descenso como resultado de la detección temprana de la enfermedad, los avances en el trata miento y mayor accesibilidad a los servicios de salud. Los principales factores de riesgo para el cáncer de mama no son fácilmente modificables porque se derivan de exposiciones hormonales endógenas prolongadas. La prevención a través de la promoción de la lactancia materna, particularmente su mayor duración, pudiera ser beneficioso. La incidencia de cáncer de mama en Panamá se comporta de manera similar a los países con índice de desarrollo Humano en transición; ha ido en aumento en las últimas décadas como resultado del aumento en la prevalencia de los factores de riesgo conocidos y la mejoría en la recolección de datos.
Breast cancer is the most diagnosed woman's tumor in the vast majority of countries. The nonhere ditary factors are the main drivers of the international and interethnic differences observed in the incidence of this cancer. Breast cancer incidence rates have increased in most countries in transition in recent decades, while in most of the more advanced countries, breast cancer death rates have been declining asa result of breast cancer. early detection of the disease, advances in treatment and greater accessibility to health services . The main risk factors for breast cancer are not easily modifiable because they are derived from prolonged endogenous hormonal exposures. Prevention through the promotion of breastfeeding, particularly its longer duration, could be beneficial. The inci dence of breast cancer in Panama behaves similarly to countries with a Human Development Index in transition; It has been increasing in recent decades as a result of the inc rease in the prevalence of k nown risk factors and the improvement in data collection.
Subject(s)
Humans , Female , Middle Aged , History, 21st Century , Breast Neoplasms/ethnology , Breast Neoplasms/mortality , Literature , Breast Neoplasms/diagnosis , Breast Neoplasms/drug therapy , Data Collection/statistics & numerical data , Development IndicatorsABSTRACT
Prognosis in patients with carcinomatous meningitis (CM) is poor, and numerous prognostic factors for response and survival have been described, but remain controversial. In general, series are small and involve a heterogeneous type of solid neoplasms. The purpose of this study was to describe a series of patients with breast cancer-associated CM to determine the clinical features and prognostic factors associated with survival. We conducted a retrospective study on 49 patients diagnosed between January 2003 and December 2007 at the Instituto Nacional de Cancerología in Mexico City. CSF cytopathology samples were re-reviewed to confirm the diagnosis. Overall survival (OS) for patients with breast cancer with CM was 7 weeks. Factors independently associated with better OS included absence of encephalopathy at diagnosis (11 weeks versus 1 week; p = .036), low CSF protein content (15 versus 5 weeks; p = .022), and nontriple-negative receptor status in the primary breast cancer tumor (13 versus 3 weeks; p = .015). According to multivariate analysis, patients were divided into favorable and poor prognostic groups, with OS of 14 weeks and 2 weeks, respectively (p < .001). These factors can identify a subgroup of patients who are candidates for an intensive management approach.
