Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 May 10;19(1):432.
doi: 10.1186/s12885-019-5647-8.

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

Diama Bhadra Vale  1 , Cassio Cardoso Filho  2 , Julia Yoriko Shinzato  2 , Fernanda Servidoni Spreafico  2   3 , Partha Basu  4 , Luiz Carlos Zeferino  2
Affiliations

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

Diama Bhadra Vale et al. BMC Cancer. .

Abstract

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.

Keywords: Breast Neoplasms; Early Detection of Cancer; Epidemiologic Studies; Neoplasm Staging.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

No permission was needed to access the data used in the study (data was publicly available).

This study was approved by the Ethics Committee of the State University of Campinas under number CAAE 89399018.2.0000.5404. The Committee waived the need for consent.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Time trends of the proportion of breast cancer stage from 2000 to 2015, São Paulo/Brazil. Legend: Z – Cochran–Armitage test for trend; (+) trend to increase; (−) trend to decrease. P = P-value
Fig. 2
Fig. 2
Time trends of the proportion of breast cancer stage by age-groups, from 2000 to 2015, São Paulo/Brazil. Legend: Z – Cochran–Armitage test for trend; (+) trend to increase; (−) trend to decrease. P = P-value
See this image and copyright information in PMC

References

    1. Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray, F. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11. 2013. http://globocan.iarc.fr/Default.aspx. Accessed 9 Dec 2016. - PubMed
    1. International Agency for Research on Cancer. Breast Cancer Screening, IARC Handbooks of Cancer Prevention. 2016.
    1. Zuo T, Zeng H, Li H, Liu S, Yang L, Xia C, et al. The influence of stage at diagnosis and molecular subtype on breast cancer patient survival: a hospital-based multi-center study. Chin J Cancer. 2017;36:84. - PMC - PubMed
    1. American Cancer Society. Breast Cancer Survival Rates & Statistics. 2018. https://www.cancer.org/cancer/breast-cancer/understanding-a-breast-cance.... Accessed 23 Apr 2018.
    1. Sopik V, Sun P, Narod SA. Impact of microinvasion on breast cancer mortality in women with ductal carcinoma in situ. Breast Cancer Res Treat. 2018;167:787–795. - PubMed