Cirurgia Conservadora e Radioterapia no Tratamento do Câncer da Mama
DOI:
https://doi.org/10.32635/2176-9745.RBC.1985v31n4.3358Palavras-chave:
Câncer da Mama, Tratamento Conservador, RadioterapiaResumo
No período de janeiro de 1973 a dezembro de 1983, 59 pacientes com carcinoma da mama, tratadas conservadoramente, foram encaminhadas ao serviço de radioterapia do Instituto Nacional de Câncer. A idade média do grupo foi de 53 anos (variação: 24 a 83 anos), com 50% das pacientes em pré-menopausa. O estadiamento clínico revelou 13 pacientes com tumores TI, 34 com tumores T2 e três com tumores T3. Em nove pacientes essa informação não pôde ser obtida. A axila estava clinicamente positiva em 10 casos e foi cirurgicamente estadiada em 29 pacientes com um número médio de linfonodos retirados de 14,2 (variação: 2-36). A correlação clínica/cirúrgica foi de 63%. Após tumorectomia (56% das pacientes), quadrantectomia (39%). ou biópsia (3%). As pacientes eram submetidas à irradiação de todo o parênquima mamário com dose de 5000 cGy seguida de reforço sobre o leito tumoral (1000-2000 cGy). Todas as pacientes foram tratadas com cobaltoterapia e elétrons. As cadeias linfáticas foram irradiadas em 48% dos casos. A sobrevida aos 5 anos foi de 78% com 64% das pacientes sobrevivendo livre de doença (local e a distância) ao término desse período. Quatro pacientes (7%) falharam na mama, três (5%) na axila e nove (15%) a distância. O resultado cosmético foi considerado excelente e bom em 60% dos casos e isso foi observado mais frequentemente nas pacientes tratadas com tumorectomia. O tratamento conservador do câncer da mama parece ser uma opção aceitável de tratamento para essa patologia. A não mutilação do órgão não altera os resultados e oferece à paciente um resultado cosmético extremamente satisfatório.
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