Revisão bibliográfica do tratamento conservador do câncer de mama
Autor(a) principal: | |
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Data de Publicação: | 2023 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Revista Brasileira de Cancerologia (Online) |
Texto Completo: | https://rbc.inca.gov.br/index.php/revista/article/view/2977 |
Resumo: | The authors describe the Milan Trials I, II and III conducted by Istituto Nazionale per lo Studio e Ia Cura del Tumori and comparativelly analyse other trials for conservative surgical approach of breast cancer through a bibliographic review on randomized clinical trials worldwide with representativo number of patients and detailed informations on follow-up. The Milan Trial I compared radical mastectomy with quadrantectomy plus complete axiliary clearance and radiotherapy (QUART) in patients clinically TiNoMo. After sixteen years similar overall survival and disease free survival were demonstrated. There was no significant statistical difference between the two groups on local reccurrence rates and second primary tumor. From 1985 to 1987, the Milan II compared QUART versus lumpectomy plus axiliary dissection plus external radiotherapy and intersticial boost with 192Ir. After four years of follow-up, curves of overall survival were virtually superimposable with better aesthetic results and worse local reccurrence rates in the second group. The last Milan trial compared QUART with quadrantectomy plus axiliary dissection without radiotherapy ending patient’s recruitmenton 1989. Its results or conclusions are notavailable. AH the clinical trials reviewed comparing radical surgery with breast conservative treatment concluded that for stage I and II breast cancer, conservative therapy plus radiotherapy is as effective as radical mastectomy or modified mastectomy. |
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Revisão bibliográfica do tratamento conservador do câncer de mamaCâncer de Mama InicialCirurgiaEarly Breast CancerSurgeryThe authors describe the Milan Trials I, II and III conducted by Istituto Nazionale per lo Studio e Ia Cura del Tumori and comparativelly analyse other trials for conservative surgical approach of breast cancer through a bibliographic review on randomized clinical trials worldwide with representativo number of patients and detailed informations on follow-up. The Milan Trial I compared radical mastectomy with quadrantectomy plus complete axiliary clearance and radiotherapy (QUART) in patients clinically TiNoMo. After sixteen years similar overall survival and disease free survival were demonstrated. There was no significant statistical difference between the two groups on local reccurrence rates and second primary tumor. From 1985 to 1987, the Milan II compared QUART versus lumpectomy plus axiliary dissection plus external radiotherapy and intersticial boost with 192Ir. After four years of follow-up, curves of overall survival were virtually superimposable with better aesthetic results and worse local reccurrence rates in the second group. The last Milan trial compared QUART with quadrantectomy plus axiliary dissection without radiotherapy ending patient’s recruitmenton 1989. Its results or conclusions are notavailable. AH the clinical trials reviewed comparing radical surgery with breast conservative treatment concluded that for stage I and II breast cancer, conservative therapy plus radiotherapy is as effective as radical mastectomy or modified mastectomy.Os autores descrevem os Milan Trials I, II e III realizados no Istituto Nazionale per Io Studio e Ia Cura dei Tumori, em Milão, e fazem uma análise comparativa com estudos que trataram da abordagem cirúrgica conservadora do câncer de mama através de revisão bibliográfica dos estudos clínicos randomizados, prospectivos, com amostragem adequada e informações detalhadas sobre follow-up. O primeiro estudo (Milan I) comparou a cirurgia radical com a quadrantectomia associada à dissecção axilar e radioterapia (QUART) em pacientes estadiados clinicamente com TiNoMo. As conclusões finais deste estudo, após 16 anos, mostram taxas de sobrevida global e sobrevida livre de doenças semelhantes entre os grupos. A incidência de recorrência local e segundo tumor primário no braço QUART não apresentou relevância estatística. Entre 1985 e 1987, o Milan Trial II comparou o QUARTe a lumpectomia com dissecção axilar e radioterapia externa e reforço intersticial de 192Ir. Este trial apresentou, após quatro anos de seguimento, curvas de sobrevida global superponíveis. A lumpectomia apresentou maiores taxas de recorrência local, apesar do melhor resultado estético. Q último estudo de Milão concluiu o recrutamento das pacientes em 1989 e não apresentou resultados. Teve como objetivo comparar o QUART com a quadrantectomia com dissecção axilar, sem radioterapia. Os estudos clínicos comparando a cirurgia radical com o tratamento conservador mostraram que, no câncer de mama estágios I e II, a cirurgia conservadora com radioterapia é tão eficaz quanto a mastectomia radical ou radical modificada.INCA2023-06-05info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionRevisão de literaturaapplication/pdfhttps://rbc.inca.gov.br/index.php/revista/article/view/297710.32635/2176-9745.RBC.1994v40n2.2977Revista Brasileira de Cancerologia; Vol. 40 No. 2 (1994): Apr./May/June; 91-96Revista Brasileira de Cancerologia; Vol. 40 Núm. 2 (1994): abr./mayo/jun.; 91-96Revista Brasileira de Cancerologia; v. 40 n. 2 (1994): abr./maio/jun.; 91-962176-9745reponame:Revista Brasileira de Cancerologia (Online)instname:Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA)instacron:INCAporhttps://rbc.inca.gov.br/index.php/revista/article/view/2977/1851https://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessPaszternak , T.Costa , C. R. A. Nogueira, A. L L. Villela, A. C. O. 2023-06-19T13:32:18Zoai:rbc.inca.gov.br:article/2977Revistahttps://rbc.inca.gov.br/index.php/revistaPUBhttps://rbc.inca.gov.br/index.php/revista/oairbc@inca.gov.br0034-71162176-9745opendoar:2023-06-19T13:32:18Revista Brasileira de Cancerologia (Online) - Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA)false |
dc.title.none.fl_str_mv |
Revisão bibliográfica do tratamento conservador do câncer de mama |
title |
Revisão bibliográfica do tratamento conservador do câncer de mama |
spellingShingle |
Revisão bibliográfica do tratamento conservador do câncer de mama Paszternak , T. Câncer de Mama Inicial Cirurgia Early Breast Cancer Surgery |
title_short |
Revisão bibliográfica do tratamento conservador do câncer de mama |
title_full |
Revisão bibliográfica do tratamento conservador do câncer de mama |
title_fullStr |
Revisão bibliográfica do tratamento conservador do câncer de mama |
title_full_unstemmed |
Revisão bibliográfica do tratamento conservador do câncer de mama |
title_sort |
Revisão bibliográfica do tratamento conservador do câncer de mama |
author |
Paszternak , T. |
author_facet |
Paszternak , T. Costa , C. R. A. Nogueira, A. L L. Villela, A. C. O. |
author_role |
author |
author2 |
Costa , C. R. A. Nogueira, A. L L. Villela, A. C. O. |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Paszternak , T. Costa , C. R. A. Nogueira, A. L L. Villela, A. C. O. |
dc.subject.por.fl_str_mv |
Câncer de Mama Inicial Cirurgia Early Breast Cancer Surgery |
topic |
Câncer de Mama Inicial Cirurgia Early Breast Cancer Surgery |
description |
The authors describe the Milan Trials I, II and III conducted by Istituto Nazionale per lo Studio e Ia Cura del Tumori and comparativelly analyse other trials for conservative surgical approach of breast cancer through a bibliographic review on randomized clinical trials worldwide with representativo number of patients and detailed informations on follow-up. The Milan Trial I compared radical mastectomy with quadrantectomy plus complete axiliary clearance and radiotherapy (QUART) in patients clinically TiNoMo. After sixteen years similar overall survival and disease free survival were demonstrated. There was no significant statistical difference between the two groups on local reccurrence rates and second primary tumor. From 1985 to 1987, the Milan II compared QUART versus lumpectomy plus axiliary dissection plus external radiotherapy and intersticial boost with 192Ir. After four years of follow-up, curves of overall survival were virtually superimposable with better aesthetic results and worse local reccurrence rates in the second group. The last Milan trial compared QUART with quadrantectomy plus axiliary dissection without radiotherapy ending patient’s recruitmenton 1989. Its results or conclusions are notavailable. AH the clinical trials reviewed comparing radical surgery with breast conservative treatment concluded that for stage I and II breast cancer, conservative therapy plus radiotherapy is as effective as radical mastectomy or modified mastectomy. |
publishDate |
2023 |
dc.date.none.fl_str_mv |
2023-06-05 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Revisão de literatura |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://rbc.inca.gov.br/index.php/revista/article/view/2977 10.32635/2176-9745.RBC.1994v40n2.2977 |
url |
https://rbc.inca.gov.br/index.php/revista/article/view/2977 |
identifier_str_mv |
10.32635/2176-9745.RBC.1994v40n2.2977 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://rbc.inca.gov.br/index.php/revista/article/view/2977/1851 |
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https://creativecommons.org/licenses/by/4.0 info:eu-repo/semantics/openAccess |
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https://creativecommons.org/licenses/by/4.0 |
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openAccess |
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application/pdf |
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INCA |
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INCA |
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Revista Brasileira de Cancerologia; Vol. 40 No. 2 (1994): Apr./May/June; 91-96 Revista Brasileira de Cancerologia; Vol. 40 Núm. 2 (1994): abr./mayo/jun.; 91-96 Revista Brasileira de Cancerologia; v. 40 n. 2 (1994): abr./maio/jun.; 91-96 2176-9745 reponame:Revista Brasileira de Cancerologia (Online) instname:Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA) instacron:INCA |
instname_str |
Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA) |
instacron_str |
INCA |
institution |
INCA |
reponame_str |
Revista Brasileira de Cancerologia (Online) |
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Revista Brasileira de Cancerologia (Online) |
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Revista Brasileira de Cancerologia (Online) - Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA) |
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rbc@inca.gov.br |
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