[Evolution of breast cancer. A 5-year clinical experience at a city hospital]

In order to clarify the role that some epidemiologic factor might have on the clinical evolution of breast cancer, a retrospective study was conducted. Seventy six women diagnosed with breast cancer were selected from the population of the Hospital de Ginecobstetricia 3 del Centro Medico Nacional "La Raza" del Instituto Mexicano del Seguro Social, from 1985 to 1990. Age, medical and family history, clinical onset, diagnosis, treatment, evolution and clinical status at present were analyzed. Survival analysis and Pearson's correlation were carried out. Thirty one percent of the women were 41 to 50 years old, and thirty percent had family history of breast cancer. Other systemic condition was present in 42% of the patients and multiparity in 12%. The mean age of menopause onset was 47 +/- years. Eighty-three percent of the patients looked for medical attention due to a mammary tumor mainly in the left breast (75% of the cases). Fifty-one percent of the cases were diagnosed in advanced stages. The commonest histologic variety found was the invasive ductal carcinoma (94%). Sixty six patients underwent surgical therapy. Sixteen percent of the sample had already metastases when diagnosed; mainly at lung, bone liver or brain, in that order. Systemic therapy was administered in 63% of the cases and radiotherapy in 22 patients. About 48% of the whole sample presented recurrency and 24% progression. The overall survival at five years was 82%. Sixteen percent of these patients had tumor activity clinically apparent. In general, mortality was present in advanced stages. Survival analysis demonstrated that age and tumor persistency directly influenced survival rate in this population. Other variables' role could not be evaluated. Nevertheless variables analyzed are very helpful in actions implementation to the breast cancer management.