Relação entre câncer de mama e periodontite em mulheres: uma revisão narrativa da literatura

Abstract

Breast cancer (BC) is a multifactorial disease with high metastatic power. It is presented as the main cause of death by neoplasms in women. Its multidisciplinary treatment involves surgical intervention, radiotherapy and systemic approaches. In cases of BC with a positive status for hormone receptors, hormone therapy can be adopted in the pre-surgical (neoadjuvant therapy) or post-surgical (adjuvant therapy) phases, aiming to reduce the risk of disease recurrence. For this therapy, drugs from the classes of aromatase inhibitors (AIs) and selective estrogen receptor modulators (SERMs) stand out. It is known, however, that such women can experience other diseases at the same time, such as diabetes mellitus, hypertension and, at the oral level, periodontitis. Periodontitis (PD) is characterized by inflammation and intense alveolar bone resorption. Although the etiopathogenesis of CM is complex, it has in common with PD the involvement of an inflammatory response. However, there is no consensus regarding the relationship between CM and PD. The objective of this study was to review the literature regarding the periodontal repercussions in women with BC who are under hormone therapy with AIs or SERMs. Initially, articles that evidenced the condition CM and hormone therapy were freely searched, and then the search for articles in the PubMed database was adopted as a methodology, through the combination of the search delimiting terms “breast cancer” and “periodontitis ”, in the last 3 years, published in English, Portuguese or Spanish. 57 articles were found and, after reading the titles and abstracts, clinical studies on the relationship between CM and PD were included, excluding review articles, case reports and non-clinical studies, resulting in 8 articles selected to compose this review. Of the selected articles, four studies discussed the association between breast cancer and the prevalence of periodontitis based on variables such as age, systemic comorbidities, hormone receptor status and smoking; two studies evaluated the relationship between CM and PD under the influence of hormone therapy with SERMs or AIs; one article addressed non-surgical periodontal treatment prior to chemotherapy and hormone therapy and the repercussions of this on inflammatory markers of PD; and the last article sought to assess whether there was a genetic relationship between CM and PD. Currently, the evidence in the literature establishing a direct relationship between CM and PD is limited or inconclusive, knowing whether the drugs used in systemic cancer therapy can affect periodontitis in some way, showing a limitation of this review. Thus, it is suggested that more research be carried out in this context.