Impacto de la técnica de ganglio centinela en pacientes con cáncer de mama, Instituto Oncológico Nacional Solca 2015-2016
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2017
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
El cáncer de mama es una neoplasia que afecta cada vez más a las mujeres a nivel
mundial, ocupa el primer lugar entre todos los cánceres femeninos. Los tipos de tratamiento
quirúrgico y quimioterápico han evolucionado, consecuentemente es necesaria la correcta
evaluación del tumor primario y los ganglios linfáticos implicados por ser un importante factor
pronóstico y sobretodo de tratamiento. La técnica de ganglio centinela evalúa al primer
ganglio en recibir el drenaje linfático del tumor; el objetivo de esta investigación fue
determinar su impacto en pacientes con cáncer de mama en un estudio cuantitativo,
observacional no experimental, correlacional de recolección retrospectiva, de tipo cohorte
histórico. Se recuperó un total de 153 pacientes en dos grupos de estudio, los que se
sometieron a la técnica de ganglio centinela y los que se realizaron linfadenectomía axilar, el
tipo histológico de cáncer de mama más frecuente fue el ductal infiltrante de grado histológico
2, un 76.4% y 73.6% de pacientes tuvieron receptores de estrógeno y progesterona positivo
respectivamente mientras el receptor 2 de factor de crecimiento epidérmico humano fue
positivo en 16.9% de pacientes. La mediana del número de ganglios metastásicos fue
semejante en los dos grupos, no así el número de ganglios libres 3 vs. 14 respectivamente (p
< 0,001). En el estudio se evidenció morbilidad en 23,1% de pacientes que se realizaron la
técnica de Ganglio Centinela, en contraste con 45,5% de en quienes no se efectuó dicho
procedimiento (p = 0,025), la morbilidad más frecuentemente asociada fue el edema de la
extremidad (27%), demostrando que el vaciamiento ganglionar expone tres veces al
desarrollo de morbilidades en comparación con la técnica de ganglio centinela.
Breast cancer is a neoplasm that increasingly affects women globally, ranking first among all female cancers. The types of surgical and chemotherapy treatment have evolved, consequently it is necessary the correct evaluation of the primary tumor and the lymph nodes involved as an important prognostic factor and especially of treatment. The sentinel node technique evaluates the first lymph node to receive lymphatic drainage from the tumor; the objective of this investigation was to determine its impact in patients with breast cancer, in a quantitative, observational, non-experimental, correlational retrospective, historical cohorttype. A total of 153 patients were recovered in two study groups, who underwent sentinel node lymphadenectomy and axillary lymphadenectomy. The most common histological type of breast cancer was invasive ductal carcinoma histological grade 2, 76.4% and 73.6% of patients had positive estrogen and progesterone receptors respectively while human epidermal growth factor receptor 2 was positive in 16.9% of patients. The median number of metastatic nodes was similar in the two groups, but not the number of free nodes 3 vs. 14 respectively (p <0.001). The study showed morbidity in 23.1% of patients who underwent the Sentinel lymph node technique, in contrast to 45.5% in those who did not perform this procedure (p = 0.025), the most frequently associated morbidity was edema of the limb (27%), demonstrating that ganglionar dissection exposes three times to the development of morbidities compared to the sentinel node technique.
Breast cancer is a neoplasm that increasingly affects women globally, ranking first among all female cancers. The types of surgical and chemotherapy treatment have evolved, consequently it is necessary the correct evaluation of the primary tumor and the lymph nodes involved as an important prognostic factor and especially of treatment. The sentinel node technique evaluates the first lymph node to receive lymphatic drainage from the tumor; the objective of this investigation was to determine its impact in patients with breast cancer, in a quantitative, observational, non-experimental, correlational retrospective, historical cohorttype. A total of 153 patients were recovered in two study groups, who underwent sentinel node lymphadenectomy and axillary lymphadenectomy. The most common histological type of breast cancer was invasive ductal carcinoma histological grade 2, 76.4% and 73.6% of patients had positive estrogen and progesterone receptors respectively while human epidermal growth factor receptor 2 was positive in 16.9% of patients. The median number of metastatic nodes was similar in the two groups, but not the number of free nodes 3 vs. 14 respectively (p <0.001). The study showed morbidity in 23.1% of patients who underwent the Sentinel lymph node technique, in contrast to 45.5% in those who did not perform this procedure (p = 0.025), the most frequently associated morbidity was edema of the limb (27%), demonstrating that ganglionar dissection exposes three times to the development of morbidities compared to the sentinel node technique.
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Neoplasias de la mama, Morbilidad, Ganglio centinela, Linfadenectomía, Hospital Solca de Guayaquil, Cantón Guayaquil, Ecuador