Supervivencia en pacientes con cáncer de mama temprano tratadas con cirugía conservadora asociada a radioterapia en el Instituto Nacional de Cancerología

Article information

Resumen

Objetivo

Evaluar los resultados de pacientes con cáncer temprano de mama tratadas con cirugía conservadora y teleterapia en el servicio de radioterapia entre 2003 y 2004.

Métodos

Serie de casos secuencial retrospectiva. Se realizó un análisis descriptivo aplicando medidas resumen y métodos de supervivencia.

Resultados

Se incluyó a 75 pacientes con cáncer de mama temprano tratadas con cirugía conservadora asociada a teleterapia. La supervivencia global a 5 años fue del 92,9%; la supervivencia libre de recaída locorregional, del 88,4%; y la supervivencia libre de enfermedad, del 79,8%. La mayoría de las pacientes eran mayores de 50 años, posmenopáusicas, con tumores moderadamente diferenciados, de tipo ductal infiltrante y expresión de receptores hormonales. La mayoría de ellas no recibieron neoadyuvancia, y fueron tratadas con un vaciamiento axilar de más de 10 ganglios, márgenes de resección mayores a 1 cm y adyuvancia con quimioterapia y hormonoterapia. Pocas pacientes recibieron manejo radioterápico supraclavicular; la mayoría recibieron sobreimpresión. Dentro de los factores pronósticos se encontraron los receptores hormonales y la razón ganglionar.

Conclusión

El cáncer de mama es la primera causa de incidencia y la segunda causa de mortalidad por cáncer entre las mujeres colombianas. La cirugía conservadora de mama asociada a radioterapia es el estándar actual de tratamiento en pacientes con cáncer temprano. Aunque las cifras de supervivencia global y libre de enfermedad son similares a las reportadas, la supervivencia libre de recaída locorregional resulta inferior. Se recomienda considerar los receptores como factor pronóstico para recaída locorregional y garantizar márgenes de sección libres de compromiso tumoral.

Palabras clave:

Neoplasias de la mama

terapia combinada

mastectomía segmentar

radioterapia

análisis de supervivencia

Abstract

Objective

To evaluate the results of patients with early breast cancer treated with conservative surgery and teletherapy in the Department of Radiotherapy at the National Cancer Institute (NCI) between 2003 and 2004.

Methods

Research was based upon a retrospective sequential case study. Descriptive analysis included the application of summarized measurement and survival methods.

Results

Seventy-five patients with early breast cancer treated with conservative surgery in combination with teletherapy were included in the study. Overall survival at five years was 92.9%, loco-regional relapse free survival was 88.4%, and disease free survival was 79.8%. Most patients were over 50, postmenopausal, with moderately differentiated tumors of infiltrating ductal carcinoma and hormone receptor expression. The majority did not receive neoadjuvant therapy, had axilliary dissection on more than 10 lymph nodes with resection margins greater than one centimeter and adjuvant chemo and radiotherapy. A few patients underwent supraclavicular radiotherapy; the majority received overpressing. Hormone receptors and the nodal region were included among prognostic factors.

Conclusion

Although the overall survival and disease free rates were similar to those reported elsewhere; loco-regional relapse free survival turned out to be lower. We recommend considering receptors as loco-regional prognosis factors and that tumor-free margin sections be assured in surgery.

Key words:

Breast neoplasm

combined therapy

segmented mastectomy

radiotherapy

survival analysis

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