Aspectos clínicos, anatomopatológicos, recidiva local e sobrevida de pacientes com carcinoma de mama tratadas pela cirurgia conservadora / Clinical aspects, histologic findings, local recurrence and survival rates in patients with breast cancer treated with breast conservation surgery

RESUMO

Objetivos: Avaliar a idade, o diâmetro do tumor primário, o estadiamento clínico, o tipo histológico,as porcentagens de recidiva local e a sobrevida de pacientes submetidas a tratamento conservadordo carcinoma invasivo inicial de mama na Universidade Federal de São Paulo (Unifesp).Métodos: Estudou-se, retrospectivamente, o prontuário de pacientes com câncer de mama submetidasa tratamento conservador, isto é, quadrantectomia com dissecção axilar e radioterapia, noperíodo de 1990 a 2002 na disciplina de Mastologia do Departamento de Ginecologia da Unifesp.Avaliou-se a idade, o diâmetro tumoral, o estadiamento clínico e as taxas de sobrevida e recidivalocal. Resultados: A idade variou de 23 a 88 anos, sendo a média de 53,7 anos. O diâmetro dotumor primário variou de 0,5 a 4 cm, sendo a média de 1,9 cm; 60,1% das pacientes estavamno estádio clínico I; 34,4% no estádio IIA; 4,9% no IIB e 0,6% no III. O tipo histológico maisfreqüente foi o ductal infiltrativo (83,1%), seguido do lobular (7,1%). A recidiva local foi diagnosticadaem 3,9% das pacientes e a sobrevida global no período médio de 44,5 meses foi de 97,3%.Conclusões: A cirurgia conservadora no câncer de mama inicial apresenta resultados semelhantesaos da cirurgia radical e os resultados do presente estudo foram comparáveis aos da literatura.

ABSTRACT

Purpose: To evaluate the age, the tumor size, the clinical stage, the histologic feature, survival and localrecurrence rates of the patients treated with breast conservation therapy in early breast cancer at FederalUniversity of Sao Paulo (Unifesp). Methods: A retrospective study of the patient’s medical records wasconducted. The patients selected for the study were those who had undergone breast conservation therapyfor early stage breast cancer, such as quadrantectomy with axillary dissection and radiotherapy, between1990 and 2002 at Mastology Discipline of Gynecology Department of Unifesp. The age, tumor size, clinicalstage, histologic type, survival and local recurrence rates were assessed and compared with data fromthe current literature. Results: The patients aged 23 to 88 years (median = 53.7). The tumor size was 0.5to 4.0 cm (median 1.9 cm); 60.1 percent of women were in stage I, 34.4% in stage IIA, 4.9% in IIB and0.6% in III. Concerning histologic feature, 83.1% were invasive ductal carcinoma and 7.1% lobularcarcinoma. The survival rate of 97.3 % and local recurrence rate of 3.9 in a 44.5 months of follow-up.Conclusions: The breast conservation therapy has become the method of choice for the treatment of earlystage breast carcinoma and our results were comparable with the literature.