Información del artículo
Resumen
Objetivos
Valoración de la utilidad de los programas de cribado en la disminución de la mortalidad por cáncer de mama en estadio I.
Material y métodosEstudio retrospectivo de 314 mujeres con cáncer de mama en estadio I separadas según el método de detección (lesiones diagnosticadas por palpación frente a lesiones diagnosticadas por mamografía). Estudio estadístico comparando la edad, el tamaño tumoral, la anatomía patológica, el grado de diferenciación, el tratamiento, la recurrencia y la supervivencia.
ResultadosNo encontramos diferencias estadísticamente significativas entre ambos grupos en ninguno de los factores analizados, excepto en la supervivencia, que fue mejor en el grupo de lesiones palpables (54,904 frente a 53,170 meses para las lesiones palpables).
DiscusiónEl principal factor pronóstico es el tamaño tumoral al diagnóstico, independientemente del método diagnóstico.
Palabras Clave:
Carcinoma
Mama
Supervivencia
Cribado mamográfico
Estadio I
Abstract
Objectives
To evaluate the utility of screening programs in decreasing mortality from stage I breast cancer.
Material and methodsWe performed a retrospective study of 314 women with stage I breast cancer, divided in two groups by diagnostic method (palpable vs. mammographically detected lesions). Statistical analysis was performed comparing age, tumor size, histopathology, histological grade, treatment, recurrence, and survival.
ResultsNo significant statistical differences were found between the two groups, except in survival, which was better in the group with palpable lesions (54.904 vs. 53.170 months).
DiscussionThe main prognostic factor is tumor size at diagnosis, irrespective of the diagnostic method.
Key Words:
Carcinoma
Breast
Survival
Mammographic screening
Stage I
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Bibliografía
[1.]
J. Lombardia, I. Rodríguez, M.C. Carreira.
La mama paso a paso. Guía práctica en patología mamaria, 1.a, pp. 253
[2.]
A. Soran, V.G. Vogel.
Best treatment in primary breast cancer.
Breast J, 5 (1999), pp. 81-93
[3.]
P.R. Rosen, S. Grshen, P.E. Saigo, D.W. Kinne, S.J. Hellman.
A long term follow-up study of survival in stage I (T1N0M0) and stage II (T1N1M0) breast carcinoma.
Clin Oncol, 7 (1989), pp. 355-366
[4.]
N. Ichizawa, T. Fukutomi, E. Iwamoto, S. Akashi-Tanaka.
Long term results of T1a, T1b and T1c invasive breast carcinoma in Japanese women: validation of the UICC T1 subgroup classification.
Jpn J Clin Oncol, 32 (2002), pp. 108-109
[5.]
P. Perdue, D. Page, M. Nellestein, C. Salem, C. Galbo, B. Ghosh.
Early detection of breast carcinoma: a comparison of palpable and non palpable lesions.
Surgery, 111 (1992), pp. 656-659
[6.]
E.L. Rosen, E. Sickles, D. Keating.
Capacity of mammography for showing non palpable breast cancer in women with palpable masses in breast.
AJR Am J Roentgenol, 172 (1999), pp. 309-312
[7.]
D.P. Winchester, J.D. Cox.
Standards for diagnosis and treatment in invader breast carcinoma.
CA Cancer J Clin, 48 (1998), pp. 83-107
[8.]
Protocolo n.° 101 de la SEGO. Cáncer de mama. Diagnóstico
[9.]
A. Ancona, L. Caiffa, V. Fazio.
Digital stereotactic breast mocrobiopsy with the mammotom study of 122 cases.
Radiol Med, 101 (2001), pp. 341-347
[10.]
V.J. Zannis, K.M. Aliano.
Evolución del patrón de la práctica del cirujano de mama con desaparición de la biopsia a cielo abierto en las lesiones no palpables.
Am J Surg, 176 (1998), pp. 525-528
[11.]
L. Basset, D.P. Winchester, R.B. Caplan, et al.
Punción biópsica estereotáxica de la mama: informe de la Joint Task Force del American College of Radiology,American College of Surgeons, y College of American Pathologist.
Breast J, 3 (1997), pp. 317-330
[12.]
A. Barth, P.H. Craig, M.J. Silverstein.
Predictors of axillary lymph node metastases in patients with T1 breast carcinoma.
Cancer, 79 (1997), pp. 1918-1922
[13.]
Y. Iwasaki, T. Fukutomi, S. Akashi-Tanaka, T. Nanasawa, H. Tsuda.
Axillary node metastasis from T1N0M0 breast cancer: possible avoidance of dissection in a subgroup.
Jpn J Clin Oncol, 28 (1998), pp. 601-603
[14.]
N.S. Goldstein, A. Mani, F. Vicini, J. Ingold.
Prognostic features in patients with stage T1 breast carcinoma and a 0.5-cm or less lymph node metastasis. Significance of lymph node hilar tissue invasion.
Am J Clin Pathol, 111 (1999), pp. 21-28
[15.]
P. Barillari, R. Leuzzi, A. Bassiri-Gharb, F. D’Angelo, P. Aurello, E. Naticchioni.
Ambulatory surgical treatment for breast carcinoma.
Minerva Chir, 56 (2001), pp. 55-59
[16.]
A.R. Sasson, B. Fowble, A.L. Hanlon, M.H. Torosian, G. Freedman, H. Boraas, et al.
Lobular carcinoma in situ increases the risk of local recurrence in selected patients with stages I and II breast carcinoma treated with conservative surgery and radiation.
Cancer, 91 (2001), pp. 1862-1869
[17.]
M. Morrow, J. White, J. Moughan, T. Pajack, J. Sylvester, J.F. Wilson, et al.
Factors predicting the use of breast-conserving therapy in stage I and II breast carcinoma.
J Clin Oncol, 19 (2001), pp. 2254-22562
[18.]
R. Fonseca, L.C. Hartmann, I.A. Petersen, et al.
Breast ductal carcinoma.
Ann Intern Med, 127 (1997), pp. 1013-1022
[19.]
E. Dreher, G. Berclaz.
Breast carcinoma-when is mastectomy still appropriate?.
Ther Umsch, 55 (1998), pp. 405-407
[20.]
K. Dalberg, H. Johanson, U. Johanson, L.E. Rutqvist.
A randomized trial of long term adjuvant tamoxifen plus postoperative radiation therapy versus radiation therapy alone for patients with early stage breast carcinoma treated with breast-conserving surgery. Stockholm Breast Cancer Study Group.
Cancer, 82 (1998), pp. 2204-2211
[21.]
R.K. Schmidt-Ullrich, D.e. Wazer, T. CiPetrillo, D.J. Marchant, T.J. Smith, H. Safaii, et al.
Breast conservating therapy for early stage breast carcinoma with outstanding 10-year locoregional control rates: a case for aggressive therapy to the tumor bearing quadrant.
Int J Radiat Oncol Biol Phys, 27 (1993), pp. 545-552
[22.]
P. Barillari, R. Leuzzi, A. Bassiri-Gharb, F. D’Angelo, P. Aurello, E. Naticchioni.
Results of conservative surgery in T1 breast carcinoma. Our experience in 66 treated cases.
Minerva Chir, 49 (1994), pp. 1083-1088
[23.]
J.J. Kelemen 3rd, T. Poulton, M.T. Swartz, I. Jatoi.
Surgical treatment of early-stage breast cancer in the Department of Defense Healthcare System.
J Am Coll Surg, 192 (2001), pp. 293-297
[24.]
B. Rosseel, J. Lamote, S. Van Belle, G. Storme, R. Sacre.
Breastsparing surgery in T1 breast carcinoma.
Acta Chir Belg, 87 (1987), pp. 147-151
[25.]
J. Schmolling, B. Maus, D. Rezek, R. Fimmers, T. Holler, H. Schuller, et al.
Breast preservation versus mastectomy ? recurrence and survival rates of primary breast cancer patients treated at the UFK Bonn.
Eur J Gynaecol Oncol, 18 (1997), pp. 29-33
[26.]
H. Mattig, B. Stubert, R. Schmerler.
Changes in radical surgery of breast carcinoma in the last 20 years.
Zentralbl Chir, 122 (1997), pp. 92-96
[27.]
P.P. Rosen, S. Groshen, P.E. Saigo, D.W. Kinne, S. Hellman.
Pathological prognostic factors in stage I (T1N0M0) and stage II (T1N1M0) breast carcinoma: a study of 644 patients with median follow-up of 18 years.
J Clin Oncol, 7 (1989), pp. 1239-1251
[28.]
P.C. Gotzsche, O. Olsen.
Is screening for breast cancer with mammography justifiable?.
Lancet, 355 (2000), pp. 129-134
[29.]
O. Olsen, P.C. Gotzsche.
Cochrane review on screening for breast cancer with mammography.
Lancet, 358 (2001), pp. 1340-1342
[30.]
R.J. Salmon, B. Asselain, M. Le Gal, et al.
Twelve-years of experience in breast cancer in The Institut Curie: improve of survival and value of systematic mammographic study.
Breast J, 6 (1997), pp. 202-205
[31.]
C.P. McPherson, K.K. Swenson, G. Jolitz, et al.
Survival of women 40-49 years old with breast carcinoma depend on detection method.
Cancer, 79 (1997), pp. 1923-1932
[32.]
J. Lawrence, M.D. Solin, J. Delray, P.H.D. Schultz, B. Howard, M.D. Kessler, et al.
Downstaging of breast carcinomas in older women associated with mammographic screening.
Breast J, 2 (1999), pp. 94
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