Aspectos clínicoepidemiológicos de pacientes con cáncer de mama del Policlínico 28 de septiembre / Clinical-Epidemiological Aspects of Patients with Breast Cancer and from the Policlínico 28 de Septiembre of Santiago de Cuba

Introducción: El cáncer de mama es considerado como un serio problema de salud pública por la alta prevalencia tanto en países desarrollados como en desarrollo. Son escasos los estudios clínico-epidemiológicos actualizados en el área de salud del Policlínico 28 de septiembre relacionados con dicha entidad clínica. Objetivo: Caracterizar desde el punto de vista clínico y epidemiológico a pacientes con cáncer de mama del área de salud perteneciente al Policlínico 28 de septiembre. Métodos: Estudio descriptivo en una serie de 35 mujeres mayores de 30 años con diagnóstico confirmado de cáncer de mama. Las variables estudiadas comprendieron edad, antecedentes familiares de cáncer de mama, factores de riesgo generales y hormonales, signos y síntomas clínicos, resultados de estudio ecográfico y diagnóstico histopatológico. Se utilizó el porcentaje como medida de resumen. Resultados: El 42,8 por ciento de la muestra objeto de estudio estuvo comprendido en el grupo de edad de 40-49 años. El 65,7 por ciento del total de mujeres tenía antecedentes familiares de cáncer de mama. La menarquía precoz (54,2 por ciento) y la nuliparidad (48,5 por ciento) representaron los factores de riesgo de mayor incidencia. El 57,1 por ciento de las lesiones diagnosticadas correspondieron a carcinomas en estadío I y IIa. Conclusiones: El cáncer de mama constituye un serio problema de salud en mujeres mayores de 30 años pertenecientes al Policlínico 28 de septiembre del municipio Santiago de Cuba(AU)

Introduction: Breast cancer is considered a serious public health concern due to its high prevalence in both developed and developing countries. There are few updated clinical-epidemiological studies carried out in the health area of the Policlínico Docente 28 de Septiembre related to this clinical entity. Objective: To characterize, from the clinical and epidemiological point of view, the patients with breast cancer and from the health area belonging to the Policlínico Docente 28 de Septiembre. Methods: A descriptive study was carried out with a series of 35 women aged more than 30 years and with a confirmed diagnosis of breast cancer. The variables studied included age, family history of breast cancer, general and hormonal risk factors, clinical signs and symptoms, ultrasound findings and histopathological diagnosis. Percentage was used as summary measure. Results: 42.8 percent of the study sample was in the age group 40-49 years old. Of the total number of women, 65.7 percent had a family history of breast cancer. Early menarche (54.2 percent) and nulliparity (48.5 percent) represented the risk factors with the highest incidence. 57.1 percent of the diagnosed lesions corresponded to stage I and IIA carcinomas. Conclusions: Breast cancer is a serious health problem in women older than 30 years and belonging to the Policlínico Docente 28 de Septiembre, of Santiago de Cuba Municipality(AU)

O uso de métodos contraceptivos hormonais em pacientes com asma: repercussões clínicas / The use of hormonal contraceptives methods in patients with asthma: clinical repercussions

Objetivo: Analisar o uso dos contraceptivos hormonais em mulheres com asma e a escolha desses métodos contraceptivos para essa população, com avaliação de eventuais repercussões sobre novos episódios de asma e sibilos. Métodos: Foram selecionados estudos longitudinais, ensaios clínicos, revisões sistemáticas e metanálises. As plataformas consultadas foram PubMed, Embase, Cochrane e SciELO, com a utilização dos descritores: "contracepção", "contracepção hormonal", "sistema intrauterino liberador de levonorgestrel" e "asma". Resultados: Dois grandes estudos demonstraram que o uso de contraceptivos hormonais esteve associado à redução do risco de novos episódios de asma. Uma revisão sistemática concluiu que os resultados para o uso de contraceptivos hormonais para mulheres com asma foram mistos, com aumento ou redução dos seguintes riscos: novo episódio de asma e aumento da frequência das crises e dos sibilos. O uso da contracepção hormonal em pacientes obesas portadoras de asma é controverso. Conclusão: Os resultados para o uso de contraceptivos hormonais em mulheres com asma são inconsistentes, com relatos de aumento ou de redução do risco de novos episódios. O uso do método contraceptivo deve ser discutido individualmente, levando-se em consideração outros fatores de risco associados e o desejo da mulher. A paciente deverá ser orientada se houver piora dos sintomas clínicos de asma na vigência do uso de qualquer método contraceptivo hormonal.

Objective: To analyze the use of hormonal contraceptives in women with asthma and the choice of this contraceptive method for this population, evaluating possible repercussions on new episodes of asthma and wheezing. Methods: Longitudinal studies, clinical trials, systematic reviews and meta-analyses were selected. Platforms consulted: PubMed, Embase, Cochrane, SciELO, using the descriptors: "contraception", "hormonal contraception", "levonorgestrel-releasing intrauterine system" and "asthma". Results: Two large studies demonstrated that the use of hormonal contraceptives was associated with a reduced risk of new episodes of asthma. A systematic review concluded that the results for the use of hormonal contraceptives for women with asthma were mixed, with increased or decrease in the following risks: new asthma episodes, increased frequency and wheezing. The use of hormonal contraception in obese patients with asthma is controversial. Conclusion: The results for the use of hormonal contraceptives in women with asthma are inconsistent, with reports of increased or reduced risk of new episodes. The use of the contraceptive method should be discussed individually, taking into account other associated risk factors and the woman's desire. The patient will be advised if there is a worsening of the clinical symptoms of asthma while using any hormonal contraceptive method.

Fatores associados à idade da menopausa natural na coorte Elsa-Brasil / Factors associated with age at natural menopause in the Elsa-Brasil cohort

Introdução: No Brasil, a média etária da menopausa está entre 50 a 51,2 anos. Quando precoce, a menopausa se associa ao maior risco para doenças cardiovasculares, diabetes mellitus tipo 2 e osteoporose, entre outras doenças. Características sociodemográficas, hábitos de vida e fatores reprodutivos podem interferir na idade da menopausa natural, porém existem poucos estudos sobre essas relações no contexto brasileiro. Objetivo: Analisar os fatores associados à idade da menopausa natural em mulheres participantes do Estudo Longitudinal de Saúde do Adulto ELSA ­ Brasil, na primeira (2008 ­ 2010) e segunda visita (2012 ­ 2014). Metodologia: Estudo transversal, com dados da primeira (2008-2010) e segunda (2012-2014) visita do Elsa-Brasil. Foram elegíveis para participar deste estudo todas as 3.538 mulheres com relato de menopausa natural durante a 1ª ou 2ª visita ao ELSA. O desfecho do estudo foi a idade da menopausa natural (variável contínua). Variáveis explicativas: características sociodemográficas (idade, renda, escolaridade, raça/cor), reprodutivas (idade da menarca, histórico de gestação número de partos e abortos, duração do ciclo menstrual, uso de anticoncepcional), hábitos de vida (tabagismo, uso de álcool, consumo diário de frutas e verduras, atividade física), variáveis de saúde (obesidade, diabetes, hipertensão). A associação entre essas variáveis explicativas e o desfecho foi feita por regressão linear múltipla. Resultados: A média de idade da menopausa natural foi 49,07 anos. Encontramos que, quanto menor a escolaridade, menor a média da idade da menopausa (Fundamental incompleto versus Ensino Superior: ß -1.26; IC95%-1.93; -0.59; Fundamental versus Ensino Superior: ß-1.19; IC95%-1.79; -0.60; Ensino Médio versus Ensino Superior: ß-0.81; IC95%-1.16; -0.47). Adicionalmente, encontramos menores médias da idade da menopausa entre mulheres que reportaram raça/cor da pele parda (ß:-0.43; IC95%-0.80; -0.06) e indígena (ß:-1.71; IC95% -3.12; -0.30), quando comparadas às mulheres brancas. As tabagistas também apresentaram menor média de idade da menopausa (ß:-0.84; IC95%-1.29; - 0.39), em relação às que reportaram nunca ter fumado. Observamos também que mulheres com maior número de gestações apresentaram maior média de idade da menopausa quando comparadas às mulheres com nenhuma gestação (2 gestações ß:0.46; IC95% 0.01; 0.93, 3 gestações ß:1.01; 0.53;1.50, 4 ou mais ß:0.93; IC95% 0.45;1.41 em relação a nenhuma gestação). Por fim, também encontramos que, enquanto mulheres com ciclos menstruais curtos (<25 dias) foram associadas à menor idade da menopausa (ß -0.58; IC95% -1.15; -0.02), mulheres com ciclos menstruais longos (>35 dias) foram associadas à maior idade da menopausa (ß: 2.24; IC95% 1.43; 3.04), quando comparadas às mulheres com ciclos de 25-35 dias. Conclusão: Menor escolaridade, tabagismo, cor da pele parda e indígena e menor ciclo menstrual associaram-se a menores médias de idade da menopausa natural, enquanto o maior ciclo menstrual e o maior número de gestações associaram-se positivamente ao desfecho. Este estudo soma-se a outros estudos nacionais sobre o tema e tem potencial para auxiliar a compressão acerca de fatores relacionados à idade da menopausa e, consequentemente, ser fonte de evidências para formulação de políticas mais abrangentes na saúde da mulher, com a intenção de minimizar os impactos que podem ser gerados na idade da menopausa e, consequentemente, nas comorbidades advindas de uma menopausa precoce.

Introduction: In Brazil, the average age of menopause is between 50 and 51.2 years. When early, menopause is associated with a higher risk for cardiovascular diseases, type 2 diabetes mellitus and osteoporosis, among others. Sociodemographic characteristics, life habits and reproductive factors can interfere with the age of natural menopause, but there are few studies on these relationships in the Brazilian context. Objective: To analyze factors associated with age at natural menopause in women participating in the ELSA Adult Health Longitudinal Study ­ Brazil, at the first (2008 ­ 2010) and second visit (2012 ­ 2014). Methodology: Cross-sectional study, with data from the first (2008-2010) and second (2012-2014) visit in Elsa-Brasil. A total of 3,538 women were studied, considering the age of natural menopause as outcome. Explanatory variables: sociodemographic characteristics (age, income, education, race/color), reproductive characteristics (age at menarche, history of pregnancy - number of deliveries and abortions, duration of the menstrual cycle, use of contraceptives), life habits (smoking, use alcohol consumption, daily consumption of fruits and vegetables, physical activity), health variables (obesity, diabetes, hypertension, symptoms of depression). The association between these variables and the outcome was analyzed by multiple linear regression. Results: The mean age of natural menopause was 49.07 years. The following variables were associated with menopause age: low schooling (High school: ß-0.81; 95%CI-1.16;-0.47, Elementary school: ß-1.19; 95%CI-1.79;-0.60, Incomplete elementary school: ß -1.26;95%CI -1.93, -0.59) in relation to higher education; brown and indigenous skin color in relation to white skin color (ß: -0.43; 95%CI-0.80;-0.06 and ß:-1.71; 95%CI -3.12;-0.30); smoking (ß:-0.84;CI95%-1.29;- 0.39) in relation to never having smoked; number of pregnancies (2 pregnancies ß:0.46; 95%CI 0.01; 0.93, 3 pregnancies ß:1.01; 0.53;1.50, 4 or more ß:0.93; 95%CI 0.45;1.41); in relation to no pregnancy; and menstrual cycle <25 days and >35 days (ß -0.58; 95%CI -1.15; -0.02, ß: 2.24; 95%CI 1.43; 3.04), compared to 25-35 days. Conclusion: Lower schooling, smoking, brown and indigenous skin color and shorter menstrual cycle were associated with lower mean age at natural menopause, while longer menstrual cycle and higher number of pregnancies were positively associated with the outcome. This study adds to other national studies on the subject and is able to help in clinical practice when health professionals have access to quality data, in the discussion and formulation of more comprehensive women's health policies that work on associated factors with the intention of minimizing the impacts that can be generated in the age of menopause and consequently in the comorbidities arising from an early menopause.

Características clínico epidemiológicas de adolescentes femeninas con anemia / Epidemiological and clinical characteristics of female adolescents with anemia

Introducción: La adolescencia es una etapa de la vida con grandes cambios y mayor vulnerabilidad a riesgos para la salud. Entre los principales problemas de salud destacan los trastornos nutricionales, específicamente la anemia carencial. Objetivos: Determinar la prevalencia de anemia en adolescentes femeninas de un consultorio médico, describir características clínico epidemiológicas de adolescentes anémicas y la presencia de algunos factores que pudieran incidir en su ocurrencia. Métodos: Se realizó estudio descriptivo, observacional y transversal, en 76 adolescentes hembras de entre 11 a 19 años, del consultorio médico Nº 16 del Policlínico Ramón López Peña, Santiago de Cuba, desde marzo a diciembre de 2020. La muestra fue intencional, constituida por 45 adolescentes anémicas. Se estudió la edad, intensidad de la anemia, evaluación nutricional, hábitos tóxicos, edad de la menarquia, características de las menstruaciones, hábitos alimentarios, entre otros. Resultados: La prevalencia de anemia ferropénica fue de 59,2 por ciento. La edad media fue de 14,89 años; 15,6 por ciento de las adolescentes anémicas eran bajo peso y 20 por ciento tenían sobrepeso u obesidad; 73,3 por ciento tenía malos hábitos alimentarios, solo 24,4 por ciento recibió profilaxis con sales ferrosas. Además, destacó el sangrado menstrual abundante (22,3 por ciento) y la menarquia precoz (20 por ciento). Conclusiones: La anemia constituye un problema multifactorial con alta prevalencia en las adolescentes estudiadas. Se evidenció la presencia de varios factores de riesgo, como hábitos alimentarios inadecuados, malnutrición tanto por defecto como por exceso, menstruaciones abundantes y ausencia de profilaxis para la enfermedad(AU)

Introduction: Adolescence is a stage of life with many changes and greater vulnerability to health risks. Among the main health problems are nutritional disorders and, among them, deficiency anemia. Objectives: To determine the prevalence of anemia in female adolescents in a medical office, and to describe the clinical-epidemiological characteristics of anemic adolescents and the presence of some factors that could influence its occurrence. Methods: Was carried out a descriptive, observational and cross-sectional study in 76 female adolescents between 11 and 19 years old, from the Family Medical Clinic No. 16 of the Ramón López Peña Polyclinic, Santiago de Cuba, between March and December 2020. The sample was intentional, made up of 45 anemic adolescents. Were studied age, intensity of anemia, nutritional evaluation, toxic habits, age of menarche and characteristics of menstruation, eating habits, among others. Results: The prevalence of iron deficiency anemia was 59.2 percent . The mean age was 14.89 years; 15.6 percent of anemic adolescents were underweight and 20 percent were overweight or obese; 73.3 percent had bad eating habits, only 24.4 percent received prophylaxis with ferrous salts. In addition, heavy menstrual bleeding (22.3 percent ) and menarche before the age of 11 (20 percent ) stood out. Conclusions: Anemia constitutes a multifactorial problem with a high prevalence in the studied adolescents. The presence of several risk factors was evidenced, especially inadequate eating habits, malnutrition both by default and by excess, heavy menstruation and the absence of prophylaxis for the disease(AU)

Abnormal Uterine Bleeding in Adolescence: When Menarche Reveals other Surprises / Hemorragia uterina anormal na adolescência: Quando a menarca revela outras surpresas

Abstract Introduction Abnormal uterine bleeding is more frequent in adolescence. Although, most commonly, it has a non-structural etiology, it may be due to any cause described. Clinical case A 12-year-old adolescent, with no relevant personal history, menarche 1 month before, was observed in the emergency department for severemenstrual bleeding with progressive worsening, and hemodynamic repercussion in need of transfusion support. Physiological ovulatory dysfunction associated with possible previously unknown coagulopathy was considered to be the most likely diagnosis and medical treatment was initiated. Without response, the patient was submitted to sedated observation and uterine aspiration, which ultimately led to the diagnosis of a Burkitt Lymphoma. Discussion Although structural causes, and particularly malignancy, whether gynecological or not, are a rare cause of abnormal uterine bleeding in this age group, they must be considered, thus enhancing the fastest and most appropriate treatment.

Resumo Introdução A hemorragia uterina anormal é mais frequente na adolescência. Apesar de maioritariamente de etiologia não estrutural, pode dever-se a qualquer causa descrita. Caso clínico Adolescente de 12 anos, sem antecedentes pessoais relevantes, com menarca há 1 mês, observada no serviço de urgência por hemorragia menstrual grave com agravamento progressivo e repercussão hemodinâmica com necessidade de suporte transfusional. Foi colocada a hipótese de disfunção ovulatória fisiológica associada a eventual coagulopatia desconhecida previamente e foi instituído tratamento médico. Por ausência de resposta a tratamento médico, foi submetida a observação sob sedação e aspiração uterina que evidenciou tratar-se de um Linfoma de Burkitt. Discussão Apesar de as causas estruturais, e particularmente as neoplasias, do foro ginecológico ou não, serem uma causa rara de hemorragia uterina anormal nesta faixa etária, elas devem ser levadas em consideração potenciando assim um tratamento mais célere e adequado.

Gynecological/Obstetric Background and Rheumatoid Arthritis: A Cross-sectional Study in Brazilian Patients / Antecedentes ginecológicos/obstétricos e artrite reumatoide: Um estudo transversal em pacientes brasileiros

Abstract Objective To study a sample of rheumatoid arthritis (RA) patients for their gynecological/obstetric history and compare them to controls to determine their influences on number of pregnancies, menarche, menopause and reproductive years following RA onset. Methods This is a cross-sectional study of 122 RA patients and 126 controls. Patients and controls were questioned about age of menarche, age of menopause, number of pregnancies and abortions. Reproductive years were calculated as the difference between age at menopause and age at menarche. For comparison, we used the Mann-Whitney, unpaired t, chi-squared, and Spearman tests. The adopted significance was 5%. Results In the RA patients with disease beginning in the postmenopausal years, the period of reproductive years (age at menopause - age of menarche) showed a positive correlation with age at disease onset (rho=0.46; 95% confidence interval [CI]=0.20- 0.55 with p=0.0008). The number of pregnancies was higher in patients with postmenopausal disease onset when compared with those with premenopausal disease onset (median of 3 with interquartile range [IQR]=2-4 versus median of 2 with IQR=1-3; p=0.009), and RA patients had more pregnancies than controls (p=0.0002). Conclusion The present study shows that, in our population, the duration of reproductive years and the number of pregnancies are linked to the onset of RA.

Resumo Objetivo Estudar uma amostra de pacientes com artrite reumatoide (AR), com investigação da história ginecológica e obstétrica, comparando-a com controles, visando conhecer suas influências no número de gestações, menarcas, menopausa e anos reprodutivos no início da AR. Métodos Trata-se de um estudo transversal de 122 pacientes com AR e 126 controles. Pacientes e controles foram questionados sobre idade da menarca, idade da menopausa, número de gestações e abortos. Os anos reprodutivos foram calculados com a diferença entre a idade da menopausa e a idade da menarca. Para comparação, foram utilizados Mann Whitney, Teste t não pareados, Teste qui-quadrado e teste de Spearman. A significância adotada foi de 5%. Resultados Nas pacientes comAR e início da doença na pós-menopausa, o período de anos reprodutivos (idade da menopausa - idade da menarca) apresentou correlação positiva com a idade de início da doença (rho=0,46; intervalo de confiança de 95% [IC95%]=0,20-0,55 com p=0,0008). O número de gestações foi maior nas pacientes cominício da doença no período pós-menopausa quando comparadas às pacientes em pré-menopausa (mediana de 3 comintervalo interquartil [IIQ]=2-4 versusmediana de 2 com IIQ=1-3; p=0,009). Nas pacientes com AR, foi observado ummaior número de gestações do que no grupo controle (p=0,0002). Conclusão O presente estudo mostra que, em nossa população, a diminuição dos anos reprodutivos e o alto número de gestações estão relacionados ao surgimento da AR.

Ultrasound findings of pubertal development in girls with cystic fibrosis and their association with clinical outcomes and Tanner staging

ABSTRACT Objective: Patients with cystic fibrosis (CF) have a high incidence of pubertal and growth delay. In girls with CF, pubertal delay has an important psychological impact. Still, only a few studies have explored the occurrence of pubertal delay in girls with CF. The aims of this study were to compare the pubertal development of girls with CF compared with healthy controls regarding Tanner staging and pelvic ultrasound and, in girls with CF, correlate the findings with those of spirometry, body mass index, Shwachman-Kulczycki score (SKS), and genotyping. Subjects and methods: This was a cross-sectional, case-control study including 35 girls with CF aged 6-17 years and following up at the Pediatric Pulmonology Outpatient Clinic of a tertiary hospital. These patients were compared with 59 healthy controls who had undergone pelvic ultrasound as part of another study conducted by the same group. Girls with CF were consecutively enrolled in the study during their annual routine check-up visit. Data collected in the CF group included spirometry and anthropometric results, SKS values, bone age, occurrence of current cystic fibrosis-related diabetes (CFRD) and Pseudomonas aeruginosa colonization, history of meconium ileus, genotype, ultrasound parameters, and Tanner stage. Results: Pelvic ultrasound findings and Tanner stage reflected less pubertal development in girls with CF compared with healthy controls. Pubertal stage in patients with CF who presented CFRD (3.17 ± 1.16), had chronic colonization by Pseudomonas aeruginosa (3.10 ± 1.10), or were homozygous for the F508del mutation (1.91 ± 1.30) was more delayed than in controls (3.41 ± 1.41). Tanner stage correlated with age at menarche, bone age, and anthropometric and ultrasound data. Conclusions: Girls with CF presented a delay in pubertal development evaluated by Tanner stage and ultrasound parameters, which was more evident in the presence of comorbidities.

Importancia de las características socio-demográficas y epidemiológicas en el manejo de los tumores de ovario / Importance of the socio-demographic and epidemiological characteristics, in the management of ovary tumors

Objetivo: Describir las principales características socio-demográficas y epidemiológicas, de las pacientes con tumores de ovarios. Métodos: Estudio descriptivo, transversal, con una población de 133 pacientes que acudieron a la consulta de Ginecología Oncológica, del Servicio Oncológico Hospitalario del IVSS, entre julio de 2016 y julio de 2017,con diagnóstico de tumores de ovarios, donde solo 24cumplieron con los criterios de inclusión. Resultados: Mayor procedencia Estado Miranda con 42%. La raza mestiza 46%.El promedio de edad 48,33 años. Menarquia promedio 12,29años. Sexarquia promedio de 19,14 años. Parejas sexuales entre 1-2, 46%. Antecedentes obstétricos: 2,5 gestaciones. Anticonceptivos orales 21%. Dispositivos intrauterinos en 21%.Hábito tabáquico 29%. Síntomas en el 83% (58% aumento de volumen abdominal) con evolución de 4,05 meses. 63%tumores benignos (cistoadenoma mucinoso con 46%), 33%tumores malignos (adenocarcinoma endometroide con 37%)y 4% tumor borderline (atípicamente proliferativo), el tipo(mucinoso). Según la clasificación FIGO estadio 1C y 3C con38% respectivamente. La lateralidad predominante lado derecho(54%). El promedio del tamaño fue de 17,60 cm. Conclusión: Las características socio-demográficas, epidemiológicas y clínico-patológicas, determinan el manejo adecuado de los tumoresde ovarios, por lo que deben ser investigadas a fondo, y deesta manera, ofrecer el mejor tratamiento individualizado a laspacientes(AU)

Objective: To describe the main socio-demographic and epidemiological characteristics of patients with ovarian tumors. Methods: Descriptive, cross-sectional study, with a population of 133 patients who attended the Oncology Gynecology clinic of the Hospital Oncology Service of the IVSS, between July 2016 and July 2017, with diagnosis of ovarian tumors, where only 24 complied with the inclusion criteria. Results: Of the 133 patients who attended the Oncology Gynecology clinic with a diagnosis of ovarian tumors, only 24 patients met the inclusion criteria. Highest origin Miranda State with 42%. The 46% mixed race. The average age 48.33 years. Average menarche 12.29 years. Average sexarchy of 19.14 years. Sexual couples between 1-2, 46%. Obstetric history: 2.5 pregnancies. Oral contraceptives 21%. Intrauterine devices in 21%. Smoking habit 29%. Symptoms in 83% (58% increase in abdominal volume) with evolution of 4.05 months. 63% benign tumors (mucinous cystadenoma with 46%), 33% malignant tumors (endometroid adenocarcinoma with 37%) and 4% borderline (atypically proliferative), the type (mucinous). According to the FIGO stage 1C and 3C classification with 38% respectively. The predominant laterality on the right side (54%). The average size was 17.60 cm. Conclusion: The socio-demographic, epidemiological and clinical-pathological characteristics determine the proper management of ovarian tumors, so they must be thoroughly investigated, and thus offer the best individualized treatment to patients(AU)

Factores de riesgo asociados al cáncer de mama / Risk Factors Associated with Breast Cancer

RESUMEN Introducción: El cáncer de mama es el tumor maligno más frecuente entre las mujeres de todo el mundo. Considerando los dos sexos, es el segundo en frecuencia después del cáncer de pulmón. En Cuba, sigue siendo la neoplasia maligna que más se diagnóstica en mujeres. Se estima que una de cada 9 a 12 mujeres con factores de riesgo padecerá la enfermedad a lo largo de su vida en los países del mundo occidental. Objetivo: Profundizar acerca de los factores de riesgo asociados al cáncer de mama. Métodos: Se realizó una revisión bibliográfica temática, observacional y retrospectiva de 25 artículos en el período comprendido desde septiembre 2018 a enero 2019. Se accedió a las bases de datos de Scielo. La búsqueda se hizo en artículos nacionales e internacionales, con textos completos, estos se sometieron a una lectura crítica utilizando métodos teóricos (análisis histórico-lógico y análisis-síntesis) y empíricos (análisis documental). Conclusiones: Se evidenció que el sexo femenino, la edad, el sobrepeso, la obesidad, el tabaquismo, el alcoholismo, el color de la piel, los antecedentes heredofamiliares de cáncer, la edad de la menarquía, la edad de la menopausia, los antecedentes de enfermedades benignas de la mama, el uso de tratamiento de reemplazo hormonal, la cantidad de hijos, el tiempo de lactancia materna y la actividad física, entre otros, constituyen factores de riesgo predisponentes al cáncer de mama, de ahí la importancia del reconocimiento de estos para la prevención y el diagnóstico precoz.

ABSTRACT Introduction: Breast cancer is the most frequent malignant tumor among women worldwide. Considering the two sexes, it is the second in frequency, after lung cancer. In Cuba, it is still the malignant neoplasm that is most diagnosed in women. It is estimated that one in 9 to 12 women with risk factors will suffer the disease throughout their lives in countries of the western world. Objective: To elaborate on the risk factors associated with breast cancer. Methods: A thematic, observational and retrospective bibliographic review of 25 articles was carried out in the period from September 2018 to January 2019. We accessed the Scielo databases. The search was performed in national and international articles, with full texts, which were subjected to critical reading using theoretical (historical-logical analysis and analysis-synthesis) and empirical (documentary analysis) methods. Conclusions: Evidenced showed that the female sex, age, overweight, obesity, smoking, alcoholism, skin color, hereditary family history of cancer, age of menarche, age of menopause, history of benign breast diseases, the use of hormone replacement treatment, the number of children, the time of breastfeeding, physical activity, among others, are risk factors predisposing to breast cancer; hence the importance of recognizing them for prevention and early diagnosis.