Impact of Treatment Type on Overall Survival in ElderlyBrazilian Women with Breast Cancer

Objective: To analyze the survival of elderly patients with breast cancer according to the type of treatment used. Methods: A cohort study of women aged 80 or over with breast cancer registered with the Brazilian National Cancer Institute (Instituto Nacional do Câncer - INCA) between 2008 and 2009 was conducted. Prognosis was analyzed according to the cancer treatment performed: surgery, radiotherapy, or hormone therapy. Analysis of the overall 5-year survival rate was performed using the Kaplan - Meier method, and comparisons of curves were undertaken using the log-rank test. For multiple regression analysis, Cox regression was used, adjusting for age and clinical stage, considering values of p < 0.05 as significant. Data were all analyzed using the statistical package SPSS version 20. Results: 70 women with a mean age of 84.0 ± 3.7 years at diagnosis participated in the study. The median follow-up time was 37.1 months (range 0.5­75.5), and 31 deaths (44.3%) occurred during this time. The median survival time was 51.2 months (95% CI, 44.9­57.4), higher in those who underwent surgery (p = 0.012) and those who had hormone therapy (p=0.001). Treatment with surgery reduced the risk of death by 61.7% (HR 0.3; 95% CI, 0.1­0.6; p = 0.001) when adjusted for clinical stage and age at diagnosis. However, there was no significant benefit from radiotherapy (HR 1.2; 95% CI, 0.5­2.5; p = 0.694). Conclusion: Treatment with surgery and hormone therapy increased the survival of our Brazilian patients with breast cancer aged 80 or over.

Consumo de bebida alcoólica como fator de risco para o desenvolvimento de complicações da ferida operatória em mulheres com câncer de mama: estudo de uma coorte hospitalar / [Alcohol consumption as a risk factor for the development of wound complications surgery in women with breast cancer: study of a hospital cohort]

Introdução: No Brasil, o câncer de mama é a neoplasia mais incidente na maioria das regiões. Apesar dos avanços no tratamento, a cirurgia é considerada um procedimento que expõe a mulher a diversas complicações, tanto físicas quanto emocionais; além disso, as complicações cicatriciais após as cirurgias para o tratamento do câncer de mama impactam ainda mais o estado emocional da mulher além de atrasarem possíveis tratamentos adjuvantes. O consumo de bebida alcoólica, apesar de interferir em vários processos orgânicos, não tem sido estudado no que diz respeito às complicações cicatriciais. Sendo assim este estudo teve como objetivo principal analisar a associação entre o consumo de bebida alcoólica e o desenvolvimento de complicações da ferida operatória em mulheres submetidas a tratamento cirúrgico para o câncer de mama. Método: Trata-se de estudo de coorte prospectiva, incluindo 486 mulheres entre 40 e 69 anos, entrevistadas no período pré-operatório para tratamento de câncer de mama entre abril de 2014 e julho de 2015. O seguimento se deu por 30 dias ou até a alta do ambulatório de curativo, por meio da evolução de enfermagem no prontuário. O projeto deste estudo foi analisado e aprovado em 16 de janeiro de 2014 pelo comitê de ética e pesquisa do Instituto Nacional de Câncer conforme a resolução CNS 466/12. Resultados: As complicações mais incidentes observadas foram seroma, seguido por necrose, infecção, deiscência, equimose e hematoma. Com relação ao consumo de bebida alcoólica, não houve associação estatisticamente significante com o desenvolvimento de nenhuma complicação estudada. No entanto, outros fatores contribuíram para o aparecimento de complicações como, tamanho do tumor, status linfonodal, estadiamento clínico, tipo histológico, receptor de estrogênio, progesterona e Her 2, tipo de cirurgia, linfadenectomia axilar, biópsia de linfonodo sentinela, quimioterapia neo-adjuvante, hormonioterapia adjuvante, quantidade de cigarros fumados por dia, diabetes, índice de comorbidade de Charlson, classificação do estado físico da Sociedade Americana de Anestesiologia (ASA) e idade. Conclusão: O consumo de bebida alcoólica nos últimos 30 dias antes da cirurgia para tratamento do câncer de mama não se mostrou associado ao desenvolvimento de complicações do sítio cirúrgico.

Introduction: In Brazil, breast cancer is the most frequent cancer in most regions. Despite advances in treatment, surgery is considered a procedure that exposes the woman to several complications, both physical and emotional. Furthermore, cicatricial complications after surgery for the treatment of breast cancer impact further the emotional state of the woman but delay of possible adjuvant treatments. Certain risk factors for surgical site complications are known, however the consumption of alcoholic drinks, despite interfering in many organic processes, have not been studied with regard to surgical site complications. Thus, this study aimed to assess the association between alcohol consumption and the development of wound complications in women undergoing surgery for breast cancer. Method: This is a prospective cohort study including 486 women between 40 and 69 years, interviewed in the preoperative treatment for breast cancer between April 2014 and July 2015. Follow-up was for 30 days or until discharge from the dressing clinic, through the nursing development in the medical record. The project of this study was analyzed and approved on 16 January 2014 by the ethics and research committee of the National Cancer Institute according to the resolution CNS 466/12. Results: The most incident complications observed were seroma, followed by necrosis, infection, dehiscence, ecchymosis and hematoma. Alcohol consumption has not a statistically significant association with the development of any complication studied. However, other factors contributed to the onset of complications such as tumor size, lymph node status, clinical stage, histology, estrogen receptor, progesterone and Her 2, type of surgery, axillary lymphadenectomy, sentinel lymph node biopsy, neoadjuvant chemotherapy, adjuvant hormone therapy, number of cigarettes smoked per day, diabetes, Charlson index, American Society of Anesthesiologists (ASA) physical status and age. Conclusion: The consumption of alcohol in the last 30 days prior to surgery for the treatment of breast cancer has not shown to contribute to the development of surgical site complications.