Resultados oncológicos em pacientes submetidas a cirurgia oncoplastica de mama

• Autor(a) principal: Dias, Vanessa do Valle Vieira Amoroso
• Data de Publicação: 2017
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório do Centro Universitário Braz Cubas
• Texto Completo: https://repositorio.cruzeirodosul.edu.br/handle/123456789/2252
• topic: Biotecnologia; Mamoplastia; Mamas - Câncer - Cirurgia; Câncer - Cirurgia plástica; CNPQ::CIENCIAS BIOLOGICAS::BIOLOGIA GERAL

Background: Oncoplastic surgery (OP) allows bigger resections with mammoplasty techniques preserving the shape and symmetry of the breast. However, there is still the fear that it can make any necessary reoperation more difficult when it results in compromised margins because of tissue displacement. The aim of this study was to analyze the margins status, necessity for reoperation, local recurrence rates, distant metastasis, overall survival (OS) and disease free survival (DFS), in a single institution retrospective/prospective cohort. Methods: 246 patients were included with invasive or in situ breast carcinomas submitted to OP at the Nossa Senhora das Graças Hospital in Curitiba (Brazil), between the years 2004 to 2014. The follow-up began in 2008 and continued until 2016. Patients who had neoadjuvant chemotherapy or unilateral OP were excluded. A P value of less than 0.05 was considered significant Results: The median follow-up was 56 months; the reoperation rate was 6.09% with a 4% rate of mastectomy. The local recurrence rate was 5.2% and the metastasis rate was 4%. The rate of positive margins was 11.6%. Patients N0 and estrogen receptor-positive had a lower risk for local recurrence. Patients with linfovascular invasion showed increased risk for distant metastasis and a need for reoperation. Conclusion: The widespread use of OP is an approach that allows optimal oncologic resection while maintaining satisfactory cosmetic results. This study is of a large series of patients followed over the long term that showed low local recurrence rate, low positive margins and low reoperation rates, with a low mastectomy rate. More prospective randomized trials are needed to prove that OP can lower the reoperation rates in BCS.