Aplicación de la cirugía oncoreconstructiva en mujeres jóvenes con cáncer de mama para ganar autoestima, Hospital Solca-Guayaquil, período 2018-2019
Fecha
2020
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Medicina
Resumen
El cáncer de mama es el tumor más frecuente en las mujeres a nivel mundial. En el instituto oncológico Instituto Oncológico Nacional “Dr. Juan Tanca Marengo” se diagnosticaron entre el año 2018 y 2019, 1671 casos nuevos de cáncer de mama de los cuales 377 casos que corresponde al 23% son mujeres jóvenes entre 20 a 44 años.
Al revisar las historias clínicas en el INTRANET de SOLCA se verifico que de las 377 pacientes solo 162 fueron operadas lo que corresponde a nuestro universo, al realizar nuestra investigación y plantear los criterios de inclusión y exclusión obtuvimos una muestra de 75 pacientes que se sometieron a cirugía onco-reconstructiva. En el actual estudio se presentaron los siguientes resultados, donde el rango de edad en el cual se presentaron mayor número de casos de cáncer de mama y procedimientos quirúrgicos onco-reconstructivos fue entre 40 a 44 años, el tipo histológico de cáncer que mayor se presento fue el carcinoma lobulillar infiltrante, teniendo mayor predominio el cáncer unilateral en la mama izquierda con el 51% que representa a 38 pacientes.
Dentro del estudio se constató que la cirugía conservadora con técnicas de oncoplastia fue la más realizada con un 68% que representa a 51 pacientes seguido de la mastectomía con reconstrucción inmediata con el 27% que representa a 20 pacientes.
Esta problemática mundial altera radicalmente el aspecto corporal y psicológico de la mujer. Los diferentes procedimientos quirúrgicos como la mastectomía cambian drásticamente el aspecto físico de las pacientes debido a la mutilación de uno o ambos senos, como resultado puede verse afectado su autoestima. Aquellas mujeres sometidas a una reconstrucción mamaria tras la mastectomía presentaron menor deterioro de su aspecto físico y autoestima que aquellas que no se sometían a la misma. Por lo tanto, la reconstrucción mamaria y la conservación de la mama mediante
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técnicas de oncoplastia se considerarían el proceso de restitución de la imagen corporal y del bienestar psicológico de las pacientes mastectomizadas. Se sostiene que la reconstrucción mamaria debe considerarse parte esencial del tratamiento y rehabilitación de las pacientes con cáncer de mama.
Metodología: Este estudio se considera de tipo descriptivo, retrospectivo y transversal. La población estudiada son las pacientes jóvenes con cáncer de mama y operadas en el Instituto Oncológico Nacional “Dr. Juan Tanca Marengo” SOLCA Guayaquil PERIODO 2018- 2019
Resultados: De la muestra estudiada de 75 pacientes se obtienen resultados donde el 68% que representa 51 pacientes del total; se sometieron a cirugía conservadora de las cuales 48 pacientes se les realizó cierre oncoplastico y 3 pacientes se les colocó prótesis mamaria, el 32% de la muestra que representa 24 pacientes se sometieron a una mastectomía más reconstrucción de las cuales 20 pacientes se realizaron reconstrucción inmediata y 4 pacientes reconstrucción diferida. Al hacer el estudio sobre resultado estético obtuvimos que el 94% presentó muy buen resultado, el 4% buen resultado, 2% un resultado regular, en cuanto al nivel de autoestima del paciente en el actual estudio se obtuvo los siguientes resultados, el 90% presentó una muy buena autoestima, el 7% una buena autoestima, el 3% una autoestima regular y ningún paciente tiene bajo nivel autoestima. De esta manera se alcanzó el objetivo del proyecto porque se pudo determinar que las pacientes a las cuales se aplicó una cirugía onco-reconstructiva presentaron una ganancia en su autoestima.
Conclusión: Se concluye que de las pacientes estudiadas a las cuales se les aplico una cirugía onco-reconstructiva presentaron ganancia en su autoestima y que este tipo de cirugía no interfiere en la sobrevida de la paciente.
Breast cancer is the most common tumor in women worldwide. At the National Cancer Institute "Dr. Juan Tanca Marengo" cancer institute, 1671 new cases of breast cancer were diagnosed between 2018 and 2019, of which 377 cases corresponding to 23% are young women between 20 and 44 years old. Reviewing the medical records on SOLCA INTRANET found that of the 377 patients only 162 patients were operated on in our universe, by conducting our research and raising the criteria of inclusion and exclusion we obtained a sample of 75 patients who underwent onco-reconstructive surgery. The current study presented the following results, where the age range in which the highest number of breast cancer cases and onco-reconstructive surgical procedures were present was between 40 and 44 years, the histological type of cancer that most common was infiltrating lobular carcinoma, with unilateral cancer in the left breast having greater predominance with 51% representing 38 patients. The study found that conservative surgery with onchoplasty techniques was the most performed with 68% representing 51 patients followed by immediate reconstruction mastectomy with 27% representing 20 patients. This global problem radically alters the bodily and psychological aspect of women. Different surgical procedures such as mastectomy drastically change the physical appearance of patients due to the mutilation of one or both breasts, as a result their self-esteem may be affected. Women undergoing breast reconstruction after mastectomy had less deterioration in their physical appearance and self-esteem than those who did not have breast reconstruction. Therefore, breast reconstruction and breast conservation using onchoplasty techniques would be considered the process of restitution of the body image and XIX psychological well-being of mastectomized patients. It is argued that breast reconstruction should be considered an essential part of the treatment and rehabilitation of breast cancer patients. Methodology: This study is considered descriptive, retrospective and crosscutting. The population studied are young patients with breast cancer and operated at the National Cancer Institute "Dr. Juan Tanca Marengo" SOLCA Guayaquil PERIODO 2018- 2019. Results: Results are obtained from the sample studied from 75 patients where 68% of 51 patients out of the total underwent conservative surgery of which 48 patients had oncoplastic closures and 3 patients were given breast prostheses, 32% of the sample representing 24 patients underwent a more reconstruction mastectomy of which 20 patients had immediate reconstruction and 4 patients deferred reconstruction. In doing the study on aesthetic results we obtained that 94% had very good results, 4% good result, 2% a regular result, in terms of the level of self-esteem of the patient in the current study the following results was obtained, 90% had a very good self-esteem, 7% a good self-esteem, 3% a regular self-esteem and no patient has low self-esteem. In this way the objective of the project was achieved because it could be determined that the patients to whom onco-reconstructive surgery was applied had a gain in their self-esteem.. Conclusion: It is concluded that of the patients studied to whom onco-reconstructive surgery was applied they showed gain in their self-esteem and that this type of surgery does not interfere with the patient's survival.
Breast cancer is the most common tumor in women worldwide. At the National Cancer Institute "Dr. Juan Tanca Marengo" cancer institute, 1671 new cases of breast cancer were diagnosed between 2018 and 2019, of which 377 cases corresponding to 23% are young women between 20 and 44 years old. Reviewing the medical records on SOLCA INTRANET found that of the 377 patients only 162 patients were operated on in our universe, by conducting our research and raising the criteria of inclusion and exclusion we obtained a sample of 75 patients who underwent onco-reconstructive surgery. The current study presented the following results, where the age range in which the highest number of breast cancer cases and onco-reconstructive surgical procedures were present was between 40 and 44 years, the histological type of cancer that most common was infiltrating lobular carcinoma, with unilateral cancer in the left breast having greater predominance with 51% representing 38 patients. The study found that conservative surgery with onchoplasty techniques was the most performed with 68% representing 51 patients followed by immediate reconstruction mastectomy with 27% representing 20 patients. This global problem radically alters the bodily and psychological aspect of women. Different surgical procedures such as mastectomy drastically change the physical appearance of patients due to the mutilation of one or both breasts, as a result their self-esteem may be affected. Women undergoing breast reconstruction after mastectomy had less deterioration in their physical appearance and self-esteem than those who did not have breast reconstruction. Therefore, breast reconstruction and breast conservation using onchoplasty techniques would be considered the process of restitution of the body image and XIX psychological well-being of mastectomized patients. It is argued that breast reconstruction should be considered an essential part of the treatment and rehabilitation of breast cancer patients. Methodology: This study is considered descriptive, retrospective and crosscutting. The population studied are young patients with breast cancer and operated at the National Cancer Institute "Dr. Juan Tanca Marengo" SOLCA Guayaquil PERIODO 2018- 2019. Results: Results are obtained from the sample studied from 75 patients where 68% of 51 patients out of the total underwent conservative surgery of which 48 patients had oncoplastic closures and 3 patients were given breast prostheses, 32% of the sample representing 24 patients underwent a more reconstruction mastectomy of which 20 patients had immediate reconstruction and 4 patients deferred reconstruction. In doing the study on aesthetic results we obtained that 94% had very good results, 4% good result, 2% a regular result, in terms of the level of self-esteem of the patient in the current study the following results was obtained, 90% had a very good self-esteem, 7% a good self-esteem, 3% a regular self-esteem and no patient has low self-esteem. In this way the objective of the project was achieved because it could be determined that the patients to whom onco-reconstructive surgery was applied had a gain in their self-esteem.. Conclusion: It is concluded that of the patients studied to whom onco-reconstructive surgery was applied they showed gain in their self-esteem and that this type of surgery does not interfere with the patient's survival.
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Neoplasias de la mama, Autoimagen, Cirugía, Mamoplastia, Hospital SOLCA de Guayaquil, Cantón Guayaquil, Ecuador, Mujeres