Resumo
Obesity is one of the main preventable risk factors in post-menopausal breast cancer. This retrospective cross-sectional study aimed to demonstrate the clinical and epidemiological profile of breast cancer patients diagnosed in the period from 2013 to 2018 in the North of Mato Grosso, Brazil and to verify the prevalence and influence of overweight and obesity in these patients. Data were collected from patient’s medical records who were diagnosed with breast carcinoma in the Department of Oncology of Santo Antônio’s Hospital, in Sinop-MT. 196 patients were included. 99.5% were women. The majority were married, ≥50 years old (57.7%) and overweight or obese. In the overweight and obesity group the percentage of patients with invasive breast carcinoma were significantly higher when compared with eutrophic group (p=0.03). In all groups the profile of estrogen and progesterone receptors positive and HER-2 negative were more prevalent, however, the frequency of triple negative profile was higher in the overweight (7.1%) and obesity (6.3%) group when compared with control (4.3%) group, as well as the presence of hypertension and diabetes. In conclusion, it was observed a high prevalence of overweight and obesity in breast cancer patients, which contributed to modify the histological type of breast cancer (high prevalence of invasive and lobular carcinomas), increase the frequency of patients in stages 3 and 4, the percentage of triple negative profile and the frequency of other comorbidities, as hypertension and diabetes. Furthermore, metformin, an antidiabetic drug, seems to be contributing to reduce tumor development and improve the clinical profile and prognosis in diabetic breast cancer patients.
Referências
- AHMAD, A. Breast Cancer Metastasis and Drug Resistance. In: AHMAD, A. (org.). Advances in Experimental Medicine and Biology. 2. ed. Mobile, AL, USA: Springer US, 2019. v. 1152, p. 413–427. Available at: https://doi.org/10.1007/978-3-030-20301-6_22
- AKRAM, M. et al. Awareness and current knowledge of breast cancer. Biological Research, [s. l.], v. 50, n. 1, p. 1–23, 2017. Available at: https://doi.org/10.1186/s40659-017-0140-9
- ANGULO, M. M. et al. Cáncer de mama. Medicine - Programa de Formación Médica Continuada Acreditado, [s. l.], v. 11, n. 27, p. 1629–1640, 2013. Available at: https://doi.org/10.1016/S0304-5412(13)70517-1
- ARGOLO, D. F.; HUDIS, C. A.; IYENGAR, N. M. The Impact of Obesity on Breast Cancer. Current Oncology Reports, [s. l.], v. 20, n. 47, p. 2–8, 2018.
- AVGERINOS, K. I. et al. Obesity and cancer risk: Emerging biological mechanisms and perspectives. Metabolism: Clinical and Experimental, [s. l.], v. 92, p. 121–135, 2019. Available at: https://doi.org/10.1016/j.metabol.2018.11.001
- BOYLE, P. et al. Diabetes and breast cancer risk: A meta-analysis. British Journal of Cancer, [s. l.], v. 107, n. 9, p. 1608–1617, 2012. Available at: https://doi.org/10.1038/bjc.2012.414
- BRAY, F. et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians, [s. l.], v. 68, n. 6, p. 394–424, 2018a. Available at: https://doi.org/10.3322/caac.21492
- BRAY, F. et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians, [s. l.], v. 68, n. 6, p. 394–424, 2018b. Available at: https://doi.org/10.3322/caac.21492
- CALLE, E. E.; KAAKS, R. Overweight, obesity and cancer: epidemiological evidence and proposed mechanisms. Nature reviews. Cancer, [s. l.], v. 4, n. 8, p. 579–591, 2004. Available at: https://doi.org/10.1038/nrc1408. Acesso em: 9 jun. 2020.
- CANCER TODAY. [S. l.], 2022. Available at: https://gco.iarc.fr/today/online-analysis-table?v=2020&mode=cancer&mode_population=continents&population=900&populations=900&key=asr&sex=0&cancer=39&type=0&statistic=5&prevalence=0&population_group=0&ages_group%5B%5D=0&ages_group%5B%5D=17&group_cancer=1&i. Acesso em: 21 nov. 2022.
- CASTANEDA, S.; CLINICS, J. S.-S. O.; 2017, undefined. Updates in the treatment of breast cancer with radiotherapy. surgonc.theclinics.com, [s. l.], [s. d.]. Available at: https://www.surgonc.theclinics.com/article/S1055-3207(17)30013-3/abstract. Acesso em: 10 ago. 2021.
- CHACÓN, R.; COSTANZO, M. Triple-negative breast cancer. Breast cancer research : BCR, [s. l.], v. 12 Suppl 2, n. Suppl 2, p. S3, 2010. Available at: https://doi.org/10.1186/BCR2574. Acesso em: 10 ago. 2021.
- CHIARADIA, A. E. F. et al. Clinical and epidemiological profile of breast cancer patients diagnosed in Sinop – MT: A descriptive study. Scientific Electronic Archives, [s. l.], v. 14, n. 3, p. 84–93, 2021. Available at: https://doi.org/10.36560/14320211327. Acesso em: 10 ago. 2021.
- CLAVEL, M.; SOUKOP, M.; ONCOLOGY, Y. Improved control of emesis and quality of life with ondansetron in breast cancer. Oncology, [s. l.], v. 50, p. 180–185, 1993. Available at: https://www.karger.com/Article/Abstract/227174. Acesso em: 10 ago. 2021.
- DENG, T. et al. Obesity, Inflammation, and Cancer. [S. l.: s. n.], 2016. ISSN 1553-4006.v. 11 Available at: https://doi.org/10.1146/annurev-pathol-012615-044359
- DRÃGÃNESCU, M.; TRESTIOREANU, A.; CARMOCAN, C. Hormone Therapy in Breast Cancer. Review Article Chirurgia, [s. l.], v. 112, n. 4, p. 2017, 2017. Available at: https://doi.org/10.21614/chirurgia.112.4.413. Acesso em: 10 ago. 2021.
- FONSECA, E. A. I. et al. Metformin reduces the stimulatory effect of obesity on in vivo Walker-256 tumor development and increases the area of tumor necrosis. Life Sciences, [s. l.], v. 88, n. 19–20, p. 846–852, 2011. Available at: https://doi.org/10.1016/j.lfs.2011.03.005. Acesso em: 22 jan. 2021.
- FORTNER, R. T. et al. Obesity and Breast Cancer. Recent results in cancer research. Fortschritte der Krebsforschung. Progres dans les recherches sur le cancer, [s. l.], v. 208, p. 43–65, 2016. Available at: https://doi.org/10.1007/978-3-319-42542-9_3. Acesso em: 22 jun. 2020.
- FUJII, T. et al. Effectiveness of an Adjuvant Chemotherapy Regimen for Early-Stage Breast Cancer: A Systematic Review and Network Meta-analysis. JAMA oncology, [s. l.], v. 1, n. 9, p. 1311–1318, 2015. Available at: https://doi.org/10.1001/JAMAONCOL.2015.3062. Acesso em: 19 ago. 2021.
- HAN, H. et al. Hypertension and breast cancer risk : a systematic review and meta- analysis. Nature Publishing Group, [s. l.], v. 20, n. 7, p. 1–9, 2017. Available at: https://doi.org/10.1038/srep44877
- HARBECK, N.; GNANT, M. Breast cancer. The Lancet, [s. l.], v. 389, n. 10074, p. 1134–1150, 2017. Available at: https://doi.org/10.1016/S0140-6736(16)31891-8
- IBGE. [S. l.], 2021a. Available at: https://cidades.ibge.gov.br/brasil/mt/sinop/historico. Acesso em: 25 jan. 2021.
- IBGE. [S. l.], 2021b. Available at: https://www.ibge.gov.br/cidades-e-estados/mt/sinop.html. Acesso em: 22 jan. 2021.
- INCA. Estimativa Câncer 2020. [S. l.: s. n.], 2019a.
- INCA. [S. l.], 2019b. Available at: https://www.inca.gov.br/estimativa. Acesso em: 22 jan. 2021.
- JIRALERSPONG, S.; GOODWIN, P. J. Obesity and breast cancer prognosis: Evidence, challenges, and opportunities. Journal of Clinical Oncology, [s. l.], v. 34, n. 35, p. 4203–4216, 2016. Available at: https://doi.org/10.1200/JCO.2016.68.4480
- KOPELMAN, P. G. Obesity as a medical problem. Nature, [s. l.], v. 404, n. 6778, p. 635–643, 2000. Available at: https://doi.org/10.1038/35007508
- LEE, K. et al. Impact of obesity on breast cancer treatment. Current obesity reports, [s. l.], v. 21, n. 5, p. 41, 2019. Available at: https://doi.org/10.1016/s1359-6349(08)70405-1
- LEWANDOWSKA, A. M. et al. Environmental risk factors for cancer – review paper. Annals of Agricultural and Enviromental Medicine, [s. l.], v. 26, n. 1, p. 1–7, 2019. Available at: https://doi.org/10.26444/aaem/94299
- LIBSON, S.; LIPPMAN, M. A review of clinical aspects of breast cancer. International Review of Psychiatry, [s. l.], v. 26, n. 1, p. 4–15, 2014. Available at: https://doi.org/10.3109/09540261.2013.852971
- MARTIN, S. D.; MCGEE, S. L. Metabolic reprogramming in type 2 diabetes and the development of breast cancer. Journal of Endocrinology, [s. l.], v. 237, n. 2, p. 35–46, 2018. Available at: https://doi.org/10.1530/JOE-18-0037
- MATTIUZZI, C.; LIPPI, G. Current Cancer Epidemiology glossary. Journal of Epidemiology and Global Health, [s. l.], v. 9, n. 4, p. 217–222, 2019.
- MIRANDA, V. C. et al. Exploring the role of metformin in anticancer treatments: A systematic review. Drugs of Today, [s. l.], v. 50, n. 9, p. 623–640, 2014. Available at: https://doi.org/10.1358/dot.2014.50.9.2229920
- NEUHOUSER, M. L. et al. Overweight, Obesity, and Postmenopausal Invasive Breast Cancer Risk: A Secondary Analysis of the Women’s Health Initiative Randomized Clinical Trials. JAMA Oncology, [s. l.], v. 1, n. 5, p. 611–621, 2015. Available at: https://doi.org/10.1001/JAMAONCOL.2015.1546. Acesso em: 10 ago. 2021.
- PARIDA, S.; SIDDHARTH, S.; SHARMA, D. Adiponectin, obesity, and cancer: Clash of the bigwigs in health and disease. International Journal of Molecular Sciences, [s. l.], v. 20, n. 10, p. 1–27, 2019. Available at: https://doi.org/10.3390/ijms20102519
- PICON-RUIZ, M. et al. Obesity and adverse breast cancer risk and outcome: Mechanistic insights and strategies for intervention. CA: A Cancer Journal for Clinicians, [s. l.], v. 67, n. 5, p. 378–397, 2017. Available at: https://doi.org/10.3322/caac.21405
- QUEIROZ, E. et al. Metformin induces apoptosis and cell cycle arrest mediated by oxidative stress, AMPK and FOXO3a in MCF-7 breast cancer cells. PloS one, [s. l.], v. 9, n. 5, 2014. Available at: https://doi.org/10.1371/JOURNAL.PONE.0098207. Acesso em: 7 dez. 2022.
- QUEIROZ, E. A. et al. Metformin reduces the Walker-256 tumor development in obese-MSG rats via AMPK and FOXO3a. Life Sciences, [s. l.], v. 121, p. 78–87, 2015. Available at: https://doi.org/10.1016/j.lfs.2014.11.028. Acesso em: 22 jan. 2021.
- QUEIROZ, E. A. I. F. et al. Obesidade e câncer: mecanismos envolvidos e intervenções terapêuticas. Scientific Electronic Archives, [s. l.], v. 15, n. 3, 2022. Available at: https://doi.org/10.36560/15320221522. Acesso em: 18 nov. 2022.
- ROJAS, K.; STUCKEY, A. Breast Cancer Epidemiology and Risk Factors. Clinical Obstetrics and Gynecology, [s. l.], v. 59, n. 4, p. 651–672, 2016. Available at: https://doi.org/10.1097/GRF.0000000000000239. Acesso em: 22 jan. 2021.
- SAHRA, I. Ben et al. Metformin in cancer therapy: A new perspective for an old antidiabetic drug? Molecular Cancer Therapeutics, [s. l.], v. 9, n. 5, p. 1092–1099, 2010. Available at: https://doi.org/10.1158/1535-7163.MCT-09-1186
- SAMUEL, S. M. et al. Challenges and perspectives in the treatment of diabetes associated breast cancer. Cancer Treatment Reviews, [s. l.], v. 70, n. August, p. 98–111, 2018. Available at: https://doi.org/10.1016/j.ctrv.2018.08.004
- SERAVALLE, G.; GRASSI, G. Obesity and hypertension. Pharmacological Research, [s. l.], v. 122, p. 1–7, 2017. Available at: https://doi.org/10.1016/j.phrs.2017.05.013
- SOARES, P. B. M. et al. Características das mulheres com câncer de mama assistidas em serviços de referência do Norte de Minas Gerais. Revista Brasileira de Epidemiologia, [s. l.], v. 15, n. 3, p. 595–604, 2012. Available at: https://doi.org/10.1590/S1415-790X2012000300013. Acesso em: 25 jan. 2021.
- SUN, Y. S. et al. Risk factors and preventions of breast cancer. International Journal of Biological Sciences, [s. l.], v. 13, n. 11, p. 1387–1397, 2017. Available at: https://doi.org/10.7150/ijbs.21635
- VINEIS, P.; WILD, C. P. Global cancer patterns : causes and prevention. The Lancet, [s. l.], v. 383, n. 9916, p. 549–557, 2014. Available at: https://doi.org/10.1016/S0140-6736(13)62224-2
- WINTERS, S. et al. Breast Cancer Epidemiology, Prevention, and Screening. [S. l.]: Elsevier Inc., 2017. ISSN 18780814.v. 151 Available at: https://doi.org/10.1016/bs.pmbts.2017.07.002
- YEO, W. et al. NEPA efficacy and tolerability during (neo) adjuvant breast cancer chemotherapy with cyclophosphamide and doxorubicin. BMJ supportive & palliative care, [s. l.], 2020. Available at: https://doi.org/10.1136/bmjspcare-2019-002037. Acesso em: 10 ago. 2021.