Efecto de la quimioterapia neoadyuvante en cáncer ductal infiltrante de mama localmente avanzado con expresión de HER2-NEU 2+ indeterminado
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2024
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
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ANTECEDENTES: A nivel de salud pública mundial y particularmente en Ecuador, el
cáncer de mama (BC) es la primera causa de morbimortalidad en mujeres. El carcinoma ductal
infiltrante (CDI) es el que con más frecuencia se diagnostica y, si es un estadio localmente
avanzado, se usa quimioterapia neoadyuvante para reducir la carga tumoral y poder ser intervenido
quirúrgicamente con intención curativa. OBJETIVO: Determinar el efecto de la quimioterapia
neoadyuvante en el CDI de mama con expresión indeterminada de HER2neu en pacientes
atendidas en el Instituto Oncológico Nacional (ION) Dr. Juan Tanca Marengo – SOLCA.
METODOLOGÍA: Se realizó un estudio de corte transversal, de único centro, de tipo casos y
controles en una muestra de 112 pacientes atendidas en el lapso entre el 01 de enero de 2015 a 31
de diciembre de 2019 que recibieron quimioterapia neoadyuvante con cirugía posterior. Los
resultados se exponen en gráficos y tablas, con análisis de significación estadística según el caso.
RESULTADOS: el promedio de edad fue de 50,4 años ±11.36; 75 % de pacientes fueron
postmenopáusicas. El HER2neu indeterminado fue del 11.9 % de total de pacientes atendidas y
estuvo asociado con la presencia de receptores hormonales (OR: 2.21, IC 95 %: 1.01 – 4.84,
p=0.014). No presento asociación la expresión de HER2neu con respuesta completa (OR: 0.90, IC
95 %: 0.36 – 2.22, p=0.83), parcial (OR: 1.03, IC 95 %: 0.44 – 2.38, p=0.94) o quimio resistencia
(OR: 1.05, IC 95 %: 0.46 – 2.36, p=0.90). Tampoco se encontró asociación cuando se analizó si
esta respuesta estuvo influenciada por la expresión de receptores hormonales. CONCLUSIÓN:
No existe correlación entre la expresión indeterminada de HER2neu y la respuesta patológica
completa, parcial o quimio resistencia tras la neoadyuvancia en pacientes sometidas a mastectomía
radical o cirugía conservadora de mama.
BACKGROUND: At the global public health level and particularly in Ecuador, breast cancer (BC) is the leading cause of morbidity and mortality in women. Infiltrating ductal carcinoma (IDC) is the most frequently diagnosed and, if it is a locally advanced stage, neoadjuvant chemotherapy is used to reduce the tumor burden and allow surgical intervention with curative intent. OBJECTIVE: To determine the effect of neoadjuvant chemotherapy in breast CDI with indeterminate expression of HER2neu in patients treated at the National Oncology Institute (ION) Dr. Juan Tanca Marengo - SOLCA. METHODOLOGY: A cross-sectional, single-center, case-control study was conducted in a sample of 112 patients seen from January 1, 2015 to December 31, 2019 who received neoadjuvant chemotherapy with subsequent surgery. The results are presented in graphs and tables, with analysis of statistical significance according to the case. RESULTS: the average age was 50.4 years ±11.36; 75% of patients were postmenopausal. Indeterminate HER2neu was found in 11.9% of all patients seen and was associated with the presence of hormone receptors (OR: 2.21, 95% CI: 1.01 – 4.84, p=0.014). There was no association between HER2neu expression and complete response (OR: 0.90, 95% CI: 0.36 - 2.22, p=0.83), partial (OR: 1.03, 95% CI: 0.44 - 2.38, p=0.94) or chemo resistance ( OR: 1.05, 95% CI: 0.46 – 2.36, p=0.90). Neither was any association found when analyzing whether this response was influenced by the expression of hormone receptors. CONCLUSION: There is no correlation between indeterminate HER2neu expression and complete or partial pathological response or chemoresistance after neoadjuvant therapy in patients undergoing radical mastectomy or breast-conserving surgery.
BACKGROUND: At the global public health level and particularly in Ecuador, breast cancer (BC) is the leading cause of morbidity and mortality in women. Infiltrating ductal carcinoma (IDC) is the most frequently diagnosed and, if it is a locally advanced stage, neoadjuvant chemotherapy is used to reduce the tumor burden and allow surgical intervention with curative intent. OBJECTIVE: To determine the effect of neoadjuvant chemotherapy in breast CDI with indeterminate expression of HER2neu in patients treated at the National Oncology Institute (ION) Dr. Juan Tanca Marengo - SOLCA. METHODOLOGY: A cross-sectional, single-center, case-control study was conducted in a sample of 112 patients seen from January 1, 2015 to December 31, 2019 who received neoadjuvant chemotherapy with subsequent surgery. The results are presented in graphs and tables, with analysis of statistical significance according to the case. RESULTS: the average age was 50.4 years ±11.36; 75% of patients were postmenopausal. Indeterminate HER2neu was found in 11.9% of all patients seen and was associated with the presence of hormone receptors (OR: 2.21, 95% CI: 1.01 – 4.84, p=0.014). There was no association between HER2neu expression and complete response (OR: 0.90, 95% CI: 0.36 - 2.22, p=0.83), partial (OR: 1.03, 95% CI: 0.44 - 2.38, p=0.94) or chemo resistance ( OR: 1.05, 95% CI: 0.46 – 2.36, p=0.90). Neither was any association found when analyzing whether this response was influenced by the expression of hormone receptors. CONCLUSION: There is no correlation between indeterminate HER2neu expression and complete or partial pathological response or chemoresistance after neoadjuvant therapy in patients undergoing radical mastectomy or breast-conserving surgery.
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QUIMIOTERAPIA, MORBIMORTALIDAD, NEOPLASIAS DE LA MAMA, HOSPITAL SOLCA DE GUAYAQUIL, CANTON GUAYAQUIL, ECUADOR