Biopsia del Ganglio Centinela tras Quimioterapia Neoadyuvante en Cáncer de Mama: Resultados de la Vida Real
DOI:
https://doi.org/10.32635/2176-9745.RBC.2024v70n3.4683Palabras clave:
Quimioterapia, Neoplasias de la Mama/cirugía, Escisión del Ganglio Linfático, Biopsia del ganglio centinela, DemografíaResumen
Introducción: El cáncer de mama (CM) es el más común entre las mujeres. La quimioterapia neoadyuvante (QTNEO) busca mejorar a las condiciones quirúrgicas en pacientes con cáncer de mama localmente avanzado. Objetivo: Comparar las características demográficas, clínicas y de tratamiento de las mujeres sometidas a QTNEO para el tratamiento de CM según si se trata de linfadenectomía axilar (LA) o biopsia del ganglio linfático centinela (BGC) y analizar los factores asociados con la indicación de SLNB en un escenario de la vida real. Método: Estudio de cohorte retrospectivo de mujeres con CM e indicación de QTNEO. Se obtuvieron diversas variables demográficas, clínicas, tumorales y de tratamiento. Se realizó regresión logística simple y múltiple para evaluar los factores independientes asociados con la indicación de BGC. Resultados: Se incluyeron 918 pacientes, de las cuales al 17,5% se le realizó BGC y al 11,4% se le realizó BGC seguida de LA. Las mujeres en el estadio III tuvieron un 95% menos de probabilidades de someterse a una BGC (OR = 0,05; IC del 95%: 0,01-0,17; p < 0,001) en comparación con aquellas en el estadio I. Las que se sometieron a una mastectomía tuvieron un 90% menos de posibilidades de someterse a una BGC que aquellas con cirugía conservadora (IC 95%: 0,06-0,17; p < 0,001). Considerando las respuestas de QTNEO, los casos sin respuesta o con avance de la enfermedad presentan un 55% menos de probabilidad de ser remitidos a la BGC en comparación con aquellos que presentan respuesta total (OR = 0,45; IC 95%: 0,24- 0,82; p = 0,009). Conclusión: La BLS se realizó en el 29% de los pacientes después de QTNEO. Las pacientes que tenían un estadio clínico más avanzado de la enfermedad, con peor respuesta a QTNEO y aquellas que se sometieron a mastectomías tenían menos probabilidades de someterse a BGC.
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