Tratamento conservador do cancro da mama invasivo - avaliação de 11 anos

Abstract

Introduction: Breast conserving therapy involves conservative surgery – excision of the tumor mass with negative surgical margins – followed by post-operative radiation therapy. The objective of this study was to assess the clinical results of breast conserving therapy in invasive cancer. Study design: Retrospective observational study. Material and Methods: Analysis of 231 patients with invasive breast cancer treated by conservative surgery in a tertiary care University Hospital over 11 years. Results: Average age at time of diagnosis was 55.2 years (23-87). Most patients (64.5%) were post-menopausal. Almost all patients presented with a suspicious nodule at radiologic examination (61.5%). No palpable lesions were found in 40.7% of patients. Clinical stage I was the most prevalent (82.7%) and most patients were biopsed guided by radiologic methods. The majority of patients (79.2%) was treated with lumpectomy /quadrantectomy and axillary lymph node excision. The most frequent histologic type was invasive ductal carcinoma, diagnosed in 69.2% of patients. In 73.6% of cases there was no evidence of lymph node metastases. Estrogen receptors were positive in 68.8% and CerbB2 was positive in 37.2%. Surgical margins were negative in 92.2%. Adjuvant therapy consisted of radiotherapy in 95%, hormonal therapy in 69.7% and chemotherapy in 48%, either alone or in association. Average time of follow-up was 66.6 months. During this period, 11 patients had local recurrence and 16 had distant metastases. Overall survival was 93.5% at 140 months and disease-free survival was 71.3% at 140 months. Conclusion: Conservative treatment appears to be a viable therapeutic option for invasive stage I and II breast cancer.