RESUMEN
In a retrospective survey we interviewed 53 patients with respect to side effects of adjuvant therapy for breast cancer. All of them had undergone modified mastectomy and were randomly assigned to either chemotherapy, irradiation or a combination of both. Standardized questionnaires concerning the side effects and semi-structured, focusing counseling talks were the methods used in questioning the patients. Patients named significantly more side effects of severe and extreme intensity with chemotherapy, and especially in the group given combination therapy, where chemo- and radiotherapy could be directly compared by the patient. The experience was particularly threatening when several side effects occurred simultaneously. Different psychological aspects and visualisation of systemic and local side effects are discussed with respect to the patient's ability to cope with adjuvant therapy. Consequences for routine care are: continuous explanatory talks about side effects throughout the whole process, muscle relaxation and interdisciplinary cooperation.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Neoplasias de la Mama/terapia , Traumatismos por Radiación/etiología , Adulto , Anciano , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/radioterapia , Neoplasias de la Mama/cirugía , Terapia Combinada , Ciclofosfamida/administración & dosificación , Ciclofosfamida/efectos adversos , Femenino , Fluorouracilo/administración & dosificación , Fluorouracilo/efectos adversos , Humanos , Mastectomía Radical Modificada , Metotrexato/administración & dosificación , Metotrexato/efectos adversos , Persona de Mediana Edad , Estudios RetrospectivosAsunto(s)
Muestra de la Vellosidad Coriónica/métodos , Aberraciones Cromosómicas/diagnóstico , Aberraciones Cromosómicas/genética , Trastornos de los Cromosomas , ADN/genética , Femenino , Humanos , Recién Nacido , Edad Materna , Errores Innatos del Metabolismo/diagnóstico , Embarazo , Embarazo de Alto Riesgo , Factores de RiesgoRESUMEN
100 patients were examined to evaluate the risk of abortion of chorionic villus sampling. In the 8th-10th week of pregnancy a catheter with a mandrin was introduced into the chorion frondosum under ultrasound guidance. The mandrin was then removed and trophoblast tissue obtained by aspiration. The patients agreed to postpone elective termination of pregnancy for 2 weeks. Another ultrasound was performed before suction curettage. With increasing experience, the abortion rate dropped to 4%, whereas the rate of successful biopsies and analyses rose to more than 90%. Based on these results, chorionic villi sampling was made available at the 1st Department of Obstetrics and Gynecology, University of Vienna, as an alternative method to amniocentesis. Out of 38 biopsies, 25 karyotypes were normal, two biopsies revealed pathological results (trisomy 21, 22), 11 samples showed no results (insufficient tissue or no mitoses). One patient had a spontaneous abortion (trisomy 22) and one an abortion due to infection. Chorionic villus sampling could replace amniocentesis because chromosomal anomalies may be detected already in the 1st trimester of pregnancy.
