Sobrevida de cinco anos para pacientes com carcinoma ductal infiltrante de mama sem comprometimento de linfonodos axilares: coorte hospitalar, 1992-1996

Introduction: Breast cancer is the most important tumor site in Brazil with expected 41.600 new cases and 9.300 deaths in 2003. Early detection is very important to treatment and survival because node metastasis represents one of the most important prognostic factors. Nevertheless, 20 to 30% of breast cancer patients with negative nodes at diagnosis will develop the disease, showing higher death risks and thus being considered as high risk patients. Attention has been driven in current research to identify those high risk women. Objectives: To ascertain overall five years survival and the respective prognostic factors, and to build a multivariate model aiming to predict survival among breast cancer women showing negative nodes at diagnosis. Methods: Five years survival curves were obtained in a hospital cohort (Hospital do Câncer I / Instituto Nacional de Câncer) of breast cancer patients diagnosed between 01/01/1992 and 31/12/1996 in Rio de Janeiro, RJ, Brazil, using Kaplan-Meyer and Cox models. Results: Five years overall survival was 80% and mean survival 54 months (95% C.I. 53-55 yr.). Age at diagnosis, kind of treatment, surgical specimen type, skin involvement, tumor size, tubular arrangement, nuclear pleomorphism, mitosis frequency, histological grade, vascular invasion, estrogen receptors, MIB-1 and p53 were statistically significant variables in univariate models. Three different multivariate hazard models were obtained in which the following variables remained statistically significant: age (HR 1.7, 2.1, 2.3) and vascular invasion (HR: 2.5, 1.8; 1.8) in the three models; histological grade (HR 1.0-2.7-4.8; 1.0-2.6-4.3) in two models; and kind of treatment (HR 1.0-0.4-0.2-2.3), tumor size (HR 1.0-1.8-3.5), skin involvement (HR 3.8), and MIB-1 (HR 2.2) in just one model. Conclusions: Age at diagnosis, kind of treatment, tumor size, skin involvement, histological grade, vascular invasion and MIB1 were independent prognostic variables in the studied cohort.