Factores asociados al perfil biológico para cardiotoxicidad asintomáticade los pacientes con cáncer de mama del 2013 al 2016 en el hospital SOLCA de Guayaquil.

Abstract

Background.Breast cancer is themost frequent malignancy in thefemale sex and canbe divided into biological profiles: Luminal A, Luminal B, HER-2 B, HER-2 Overexpressed and Triple negative. Cardiotoxicity is one of the main complications inthese patients; and its risk depends on the type of treatment received, the biological profile and the baseline characteristics of the patient. Objective: To determine the most significant factors for asymptomatic cardiotoxicity associated with thebiologicalprofile of patients with breast cancer treated at theSOLCA hospital between 2013 and 2016. Methodology: This is a retrospective, observational, cohort study. longitudinal,analytical, and descriptive. The population includes patients with breast cancer treatedonly in SOLCA Guayaquil during the period of 2013-2016 followed for 3 years from the date of their baseline Echocardiogram. 360 patients were studied, of which 158 were patients with more than one baseline echocardiogram where we could assess cardiotoxicity. The impact that cardiotoxicity generated in these patients was analyzedwith 3-year survival, 3-year diseasefree survival, visits to the emergency room, and hospitalization. Results: The most significant risk factors were identified: the biological profile (p = 0,009) and specific chemotherapies such as Paclitaxel (p < 0,001 ; OR 0,251), Adriamycin (p = 0,014 ; OR 0,356), Docetaxel (p = 0,018 ; OR 2,198) and Tamoxifen (p = 0,022 ; OR 0,278 ). Cardiotoxicity was shown to have a significanteffect on emergency visits (p = 0.017) and these are associated with more hospitalizations: (p = 0,005). Survival was more related to the percentage of Ki-67 (p < 0.001), and in those patients who died, their survival was significantly related to the accumulated dose of anthracyclines (p < 0.001). Conclusion: The most significant factors that had the greatest impact on the asymptomatic cardiotoxicity of the patientswas the division by immunohistochemistry within biological profiles, baseline LVEF,and specific chemotheraphy with Docetaxel, Paclitaxel , Tamoxifen ,and Adriamycin.Triple negatives had a higher risk of cardiotoxicity, mortality, and their cancer progressing with recurrences or metastases. Cardiotoxicity is associated with more visits to the ER and Hospitalizations.