Factores pronósticos de cáncer de seno: Hospital Militar Central enero 2003 a diciembre 2008

Introducción: el riesgo de desarrollar cáncer de seno durante la vida es del 13,4% (1 de cada 7 mujeres) y la posibilidad de morir por la enfermedad después del diagnostico es cercana al 30%. Pacientes y Métodos: es un estudio de cohorte abierta retrospectiva en el que se analizó la sobrevida según los factores pronósticos de las pacientes con cáncer de seno del hospital militar central en el periodo de enero de 2003 a diciembre de 2008. Los factores pronósticos son: Edad, estadío del tumor al momento del diagnóstico, Grado de diferenciación del tumor, presencia de metástasis al momento del diagnóstico, presencia de metástasis, número de sitios de metástasis, erb2, presencia de ganglios afectados, número de ganglios positivos, receptores estrogénicos, receptores de progestágeno, tratamiento con trastuzumab, tratamiento con hormonoterapia; el análisis estadístico se realizó a partir de la herramienta de recolección de datos, esta base de datos fue trasladada al programa SPSS. Resultados: participaron 171 mujeres. La presencia de receptores para estrógenos positivos se correlaciona con una mayor sobrevida con una diferencia estadísticamente significativa (p=0.015). Durante el periodo de tiempo del estudio fallecieron 23 pacientes (13.4%), de las cuales 20 (86%) presentaban Carcinoma Canalicular Infiltrante y 21 (91%) presentaban estadios avanzados del carcinoma. Conclusiones: las características demográficas de nuestra población son similares a lo publicado en la literatura, sin variantes estadísticamente significativas frente a los hallazgos internacionales. En nuestro análisis hubo una fuerte correlación de la presencia de estrógenos positivos en relación al tiempo de sobrevida.

Background: In Colombia BC constitutes, after cervix, the second most prevalent cancer location in women and is the first cause of death from cancer in women. There is no local data on the 5-year survival of BC patients in Colombia. It is necessary to define the prognostic factors that have an impact in survival. Methods: Open retrospective cohort study with survival analysis that includes the prognostic factors age, stage at diagnosis, tumor differentiation, metastasis at diagnosis (MaD), metastasis during study period, number of metastasis sites, HER2, axillary nodes, number of affected nodes, estrogenic (ER) and progesterone receptors, treatment with trastuzumab, and hormone therapy. The statistical analysis included Kaplan-Meier test, evaluating survival in relationship with the prognosis variables. Survival distribution was measured by quartiles, and multivariate analyses were performed using the Cox regression. Results: 171 clinical records of the women diagnosed with BC between 2003 and 2008 were reviewed. 50 subjects were <50 years old (29.8%) and 129 (70.2%) were =50 years old. The most frequent type of cancer (84.2%) was infiltrative ductal carcinoma, the most frequent stage was IIA (22.8%), 57.9% of patients were in advanced stage (IIB, IIIA, IIIB, IV), 4.7% had MaD, 12.9% positive for HER2, 56.1% had ER+, 63% had hormone therapy, and 9.9% trastuzumab. During the time of study 23 patients died (13.4%). The presence of estrogen receptors correlates with a longer survival (p=0.015). Patients with affected axillary lymph nodes had a lower survival than those with negative nodes (p= 0.012); Patients with MaD had a significantly shorter survival than those without (p=0.000). Survival was also longer for patients who did not develop metastases (p=0.000). On multivariate analyses, the risk factor most strongly associated to the outcome (death) was the presence of MaD. Conclusions: The factors related with most risk of mortality in our study were the presence of MaD as risk factor and the ER+ as a protective factor.