Breast cancer in Latin Breast cancer is a major public health problem in Latin America LA and the most common form of cancer among women. In addition, women are more likely to develop breast cancer BC at younger age and to be diagnosed Latrones latino dating an advanced stage compared to western "Latrones latino dating." While little is known about specific risk factors, changes in reproductive pattern parity, breastfeeding and lifestyle factors including sedentary behaviours, unhealthy diet, and alcohol intake may contribute to the increase of BC incidence.
In this paper we give an overview of the burden and patterns of BC, review the leading causes of BC and discuss the Latrones latino dating ways to improve BC prevention and control in LA.
Latin America LA is the fastest growing demographic population in the world, accounting for 8. BC is the most common cancer among women in LA, 4,5 and heterogeneous geographical patterns of the incidence rate are observed. Despite the lower incidence rates observed in LA countries, the mortality burden is greater compared to other developed countries. The majority of them are related to hormone and reproductive behaviour, and lifestyle including diet, obesity, physical activity, tobacco smoking and alcohol In addition, there are genetic predispositions.
LA women are more likely to develop BC at a younger age and to have an advanced stage diagnosis compared to western women. We have used two sources of data. This database presents the estimates of incidence and of mortality from 27 major cancers in countries or territories worldwide for Our core research consisted of key words related to BC combined with risk factors, outcome and LA.
Burden and patterns of incidence rates in LA. BC is the most common cancer in LA and the Caribbean, with an estimated women diagnosed every year, representing 8. The incidence rates vary considerably according to region and socioeconomic status, ranging from 15 to Uruguay and Argentina present the highest incidence rates Incidence rates increased in all LA countries for the period For example, the cumulative probability of BC incidence for women aged years in was 2.
While in it was 4. Burden and patterns of mortality rates in LA. BC is the leading cause "Latrones latino dating" cancer mortality among women in LA.
Similar to incidences rates, the highest mortality rates were observed in Uruguay, Argentina and Puerto Rico while the lowest were seen in Guatemala, and Belize. The high mortality rates observed in several of these countries may have been attributed to poor survival due to the lack of or limited access to early detection services and treatments. It has been reported that only small number of new BC diagnoses are made at stage 1. High mortality-to-incidence ratios MIRs signify poor survival, partly because of the late stage at diagnosis and poorer access to treatment.
Several studies suggested that there is delay in the diagnosis of BC. This study demonstrates that the age at diagnosis of Mexican
Latrones latino dating with BC is younger compared to those reported in other populations, with a median age at BC diagnosis 11 years younger than the average age reported in the US.
Perou and colleagues 32 were the first to describe the various molecular sub-types or molecular profiles Latrones latino dating BC. They identified subgroups of BC according to oestrogen receptor ERprogesterone receptor PR and human Latrones latino dating growth factor receptor 2 HER2 that differed by molecular features and clinical characteristics: Risk factors associated with BC in LA.
Understanding factors that contribute to the development of BC become crucial in LA, where the majority of BC cases are diagnosed at advanced stages, resources are limited, and the rate of mammography screening are very Despite the huge number of studies, the majority of BC causes remain poorly understood.
There are however few Latrones latino dating of risk factors for BC that have been consistently identified table III. Reproductive factors are one of the main factors that can affect BC risk and contribute to the heterogeneous distribution of BC. There is evidence that early menarche menstrual periods that start earlierlate first full-term pregnancy after 30 years oldnulliparity never having children and absence of breastfeeding are associated with the risk of developing BC.
Compared with parous women who had never breast-fed, women who had breast-fed for months had an age-adjusted Latrones latino dating of 0.
Others factors that may increase the risk of BC include use of contraceptives and use of menopausal hormonal therapy HRTespecially combined oestrogen and progestin therapy.
Studies have analysed the effect of behavioural and lifestyle risk factors such as dietary pattern, physical activity, tobacco smoking, and alcohol consumption on the Latrones latino dating of BC. Using the Mexican population-based case-control study, Sanchez-Zamorano and colleagues 44 have assessed the effect of four variables dietary pattern, physical activity, alcohol consumption, and tobacco smoking as components of "Healthy Lifestyle" index on the risk of BC. It was considered healthy to practice moderate and physical activity, to belong to the lowest tertile of the Western dietary pattern, Latrones latino dating have smoked less than cigarettes, or to have never smoked and to have never consumed alcohol.
This index was constructed by means of principal
Latrones latino dating analysis.
This analysis detected a protective effect among women with high Healthy Lifestyle Index. Food and nutrient factors including high intake of carbohydrates, high glycaemic load GLlow intake of folate and vitamin B12 have been suggested to increase the risk of BC, in particular postmenopausal BC. Regarding dietary GL the multivariate adjusted OR for all women comparing the highest quartile "Latrones latino dating" dietary GL with the lowest quartile was 1.
In postmenopausal women, the OR comparing the extreme quartiles was 2. High intake of folate, vitamin B 6and vitamin B 12 have been associated to lower the risk for Latrones latino dating.
Compared with women in the lowest quartile, the OR for BC for all women in the highest quartile of folate intake was 0. Studies from Uruguay have shown that the consumption of red meat could increase the risk of BC. Other nutrients such as omega 3 and 6 fatty acid, and vitamin D could play an important role on the risk of BC.
The results of the large Mexican population-based case-control study indicate an inverse association between circulating vitamin D levels and BC risk among pre- and postmenopausal Mexican women. It has been suggested that both moderate and vigorous intensity physical activity reduce the risk of BC.
However little "Latrones latino dating" known about its Latrones latino dating with BC among LA women. InBeasley and colleagues 59 supported Latrones latino dating evidence that any alcohol intake was associated with increased odds of BC among Mexican women.
Lifetime alcohol use was associated with an increased risk of BC, as women who reported ever drinking one or more drinks a month for at least 1 year had 1.
Tobacco smoking is a growing problem throughout LA countries. There are around million smokers aged 15 years or more Latrones latino dating LA. However there is no information on the effect of tobacco on BC in LA. Overweight and obesity have been associated with an increased risk of BC in postmenopausal, but with a decreased risk in pre-menopausal Caucasian women.
Despite the outstanding relevance of genetic screening of BRCA deleterious variants in patients with a history of familial cancer, this practice is less common in LA countries, probably due to the high cost of the screening and limitations in the countries health infrastructure.
BC is the most common form of cancer in women and is a heterogeneous disease. The incidence is increasing, and women with BC either present with large, advanced tumours or do not present until the disease is at an incurable stage.
Latrones latino dating are limited and the treatment cost is high. Primary prevention is one of the most-effective strategies for cancer prevention and "Latrones latino dating" focus on modifiable risk factors and early detection.
Among the important factors identified, physical activity, diet with low sugary food and drinks, low in fried meat and rich in vegetables should be promoted. In addition the consumption of alcohol should be limited. However, there is Latrones latino dating urgent need for further research to identify the distribution of specific BC phenotypes in the LA women population.
Detailed classification of tumour subtypes is necessary to refine phenotype and improve the identification of specific endogenous and exogenous risk factors. This information will be of crucial importance for the identification of susceptible women to focus prevention programs and improve BC treatment. In parallel, increased public awareness of BC and expansion of access to screening are strategies that will reduce BC mortality.
World Development IndicatorsDC, [consulted april ]. Health in the Americas, edn. Regional oulook and country profiles. Pan Health Organization, Planning cancer control in Latin America and the Caribbean.
Breast and cervical cancer in countries between and Siegel R, Naishadham D, Jemal. CA Cancer J Clin ; Breast cancer statistics, Ethnicity and breast cancer: J Natl Cancer Inst ; Oral, injected Latrones latino dating implanted contraceptives and breast cancer risk among U.
Hispanic and non-Hispanic white women. Int J Cancer ; A review of breast cancer care and outcomes in Latin America. PE Breast cancer in Brazil: Reported drop in mammography: J Womens Health Larchmt ; Identifying women at risk of delayed breast cancer diagnosis. Household catastrophic health expenditures: Salud Publica Mex ;53 suppl 2:
Latrones latino dating survival in five continents: Survival of cancer patients diagnosed in Eur J Cancer ; Strategies for increasing mammography screening in primary care in Chile: Cancer Epidemiol Biomarkers Prev ; Rev Assoc Med Bras ; Development and validation of a questionnaire to assess delay in treatment for breast cancer.
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