Downstaging in opportunistic breast cancer screening in Brazil: a temporal trend analysis.

BACKGROUND: Breast cancer is the most common female cancer in Brazil with an estimated 60 thousand new cases per year. Widespread use of mammography opportunistic screening has been observed in the last 20 years, including women under 50 years old. The present study aimed to analyse the trends in breast cancer stage distribution at diagnosis as a function of age in the study period. METHODS: This paper examined temporal trends of stage distribution in women with breast cancer diagnosed between 2000 and 2015 in São Paulo state, Brazil. Data from the Hospital Cancer Registry of the region were utilized. Completeness was high. The sample was described according to age, stage and date of diagnosis using absolute frequency and proportions (%). For trends, the Cochran-Armitage test was used with a 5% level of significance (P-value< 0.05). RESULTS: A total of 93,674 women were included in the analysis with a median age of 56 years old. One-third (34.4%) of the women were younger than 50 years old, and stage II was the most frequent stage (36.4%), even when analysed by age groups. Stage 0 corresponded to 7.7% (7247 women) of cases. In the study period, there was a significant trend towards an increase in Stages 0, I and IV (P < 0.01) and a trend towards a decrease in Stages IIA, IIB and IIIB (P < 0.001). Stage IIA was more prevalent until 2009, and stage I was more prevalent thereafter. The trends to increase the proportion of Stages 0 and I and to decrease the proportion of stages IIA, IIB and IIIB were significant in all age groups. CONCLUSIONS: Breast cancer cases are diagnosed mainly at early stages, and approximately one-third of cases are younger than 50 years old. Downstaging has been shown. Opportunistic screening may have supported these results. Further studies are needed to show whether these results will impact the prognosis.

Role of discoidin domain receptor 2 (DDR2) and microRNA-182 in survival of women with high-grade serous ovarian cancer.

The objective of this study is to evaluate the relationship between discoidin domain receptor 2 (DDR2) and miR-182 expression with response to platinum-based chemotherapy and survival in women with high-grade serous ovarian cancer (HGSOC). We evaluated 78 women with HGSOC stages I-IV, diagnosed between 1996 and 2013, and followed up until 2016. DDR2 expression was assessed using immunohistochemistry on tissue microarray slides. The microRNAs were evaluated by qRT-PCR. DDR2 expression was high in 11 (14.1%) women. PFS was significantly lower in women with FIGO stage I/II - versus III/IV, post-surgery residual disease and high expression of DDR2. Women with postsurgery residual disease, FIGO stage I/II - versus III/IV and DDR2 expression had worse OS, but only post-surgery residual disease remained an independent prognostic factor for worse OS in multivariable analysis. miR-182 expression levels were significantly lower in patients harboring tumors with higher expression of DDR2 (p < 0.001). In this relatively large cohort of women with HSGOC, higher DDR2 expression was associated with lower miR-182 levels and worse PFS, suggesting that these molecules may be associated with mechanisms of HGSOC progression.