É Possível Evitar a Biópsia do Linfonodo Sentinela em Pacientes com Câncer de Mama e Linfonodo Axilar Positivo com Resposta Patológica Completa à Quimioterapia Neoadjuvante?
DOI:
https://doi.org/10.32635/2176-9745.RBC.2023v69n1.2759Palavras-chave:
neoplasias da mama, biópsia de linfonodo sentinela, terapia neoadjuvanteResumo
Introdução: O câncer de mama representa 24,5% dos novos casos de neoplasias em mulheres no mundo. A quimioterapia neoadjuvante é uma importante ferramenta no tratamento dessa patologia, possibilita cirurgias menos agressivas na mama e axila, além de minimizar sequelas. Objetivo: Analisar a possibilidade de se evitar a realização da biópsia do linfonodo sentinela em pacientes com câncer de mama submetidas à quimioterapia neoadjuvante que apresentem resposta patológica completa no tumor primário e na axila, tratadas em uma instituição de referência no Nordeste brasileiro. Método: Estudo prospectivo, observacional, de coorte em pacientes com câncer de mama submetidas à quimioterapia neoadjuvante e operadas no Hospital Haroldo Juaçaba, no período de março de 2019 a julho de 2021. Resultados: Foram incluídas no estudo 45 pacientes, com média de idade de 52,6 anos, sendo todas do sexo feminino. Após quimioterapia neoadjuvante, nove pacientes (21,4%) apresentaram resposta patológica completa na mama e 17 (40,5%), resposta patológica completa nos linfonodos. Os pacientes com resposta completa na mama apresentaram uma prevalência de resposta completa em linfonodo 20,44 vezes superior aos pacientes que não tiveram a mesma resposta. Conclusão: A resposta patológica completa na mama à quimioterapia neoadjuvante mostra uma tendência em predizer uma resposta patológica nos linfonodos axilares, reforçando que, com essa condição, a biópsia do linfonodo sentinela poderia ser evitada sem causar prejuízos ao controle local do câncer de mama.
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