ABSTRACT
Introduction: Mammography is an excellent resource to reduce the burden of premature death associated with breast cancer; however, screening is only recommended between the ages of 50 and 69 years. General objective: To compare the frequency of suspicious and non-diagnostic mammograms for breast cancer when screening Chilean women between the ages of 40 and 50 years. Patients and methods: Cross-sectional study nested in a breast cancer screening programme in Chilean women >40 years old, conducted between 2017 and 2021. Demographic variables and risk factors are described. To establish the effect of age on screening, we calculated the number needed to screen for a Breast Imaging Reporting and Data Reporting System 4 or 5 mammogram when screening over 40 years or over 50 years. Results: We studied 137,690 women screened for breast cancer since the age of 40 years. The median age was 54 years (range 40-93 years). 64.7% of women were postmenopausal, 4.79% were nulliparous and 14% of post-menopausal women were receiving hormone replacement therapy. To find a suspicious mammogram, 170 women over 40 years and 149 women over 50 years would have to be screened. Conclusion: By changing the starting age of screening from 50 to 40 years 21 more women would have to be screened to detect a suspicious mammogram and if screened from age 50 and not from age 40 years 21% of total suspicious mammograms would remain unidentified.
ABSTRACT
The human epidermal growth factor receptor 2 (ERBB2, HER2 or HER2/neu) is a transmembrane tyrosine kinase receptor that is overexpressed in approximately 20% of breast cancers. The use of the anti-HER2 monoclonal antibodies Pertuzumab and Trastuzumab in association with chemotherapy has achieved a higher percentage of pathologic complete response (pCR) than conventional chemotherapy. The purpose of our study was to identify factors that could affect the therapeutic response of patients with breast cancer and HER2 overexpression treated with cytotoxic chemotherapy plus double HER2 blockade in neoadjuvant setting at Fundación Arturo López Pérez (FALP). A case-control study was designed to evaluate the effect of clinical and histopathological variables on the response to neoadjuvant therapy. Ninety-four women with non-metastatic breast cancer and HER2 overexpression received neoadjuvant combination chemotherapy with Trastuzumab and Pertuzumab at FALP during the period 2017-2020. Seventy percent of patients achieved pCR, and in the group of hormone receptor negative patients, 89% of patients achieved pCR. Different variables were analysed trying to look for clinicopathological predictors of complete response. This study provides us with real-world data on the efficacy of using this treatment combination in our population of HER2-overexpressing breast cancer patients.
