Estimativa pré-operatória do tamanho do câncer mamário : correlação entre exame clínico, mamografia, ultra-sonografia e histopatológico

• Autor(a) principal: Moura, Sammya Bezerra Maia e Holanda
• Data de Publicação: 2007
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da Universidade Federal do Ceará (UFC)
• Texto Completo: http://www.repositorio.ufc.br/handle/riufc/7029
• topic: Ultrassonografia Mamária; Mamografia; Neoplasias da Mama

Objective: To establish the correlation between clinical exam, mammography and sonography, to evaluate the most accurate method of pre-operative assessment of breast cancer. Patients and metods: diagnostic technic validation study. There were selected prospectively 29 women who present suspicious palpable breast tumors in UFC from January to August 2007. There were included the confirmed palpable breast cancer proposed to primary surgery. There were excluded the multicentric cancers, that ones proposed to neo-adjuvant chemotherapy and that ones that did not appear in mammography and/or ultrasound, totalizing 20 cases. The tumors were measured for clinical exam (Tc), ultrasound (Ts) and mammography (Tm) for two different professionals. It was registered the larger measurement in each method studied it was correlated to the measurement obtained from the fresh surgical especimen (Tp). It was also estimated the interobserver variation to each method. Results: the patients were 53,6 years-old. The tumor size obtained was: Tc= 34.32 + 4.06; Ts= 30.70 + 4.91; Tm= 30.97 + 4.20 and Tp= 31.60 + 3.54. There was agreement in the staging: for Tc in 70% (k=0.471); for Tm in 75% (k = 0.598) and for Ts in 85% (k=0.758). Considering Pearson index, there was a good correlation between the observers to: clinical exam (r= 0.986), ultrasound (r= 0.984) and mammography (r = 0.991).The linear correlation between the exams and pathology were: between Tc and Tp, r = 0.882; between Ts and Tp, r = 0.916 and between Tm and Tp, r = 0.919. There was no difference among the variables correlated to the patients or to the tumor, except an inverse correlation between age and tumor size, so that as the age increased, the tumour size decreased in all groups. It was performed Bland and Altman analisys, where the smaller bias was from mammography (0.625 + 7.564). Conclusion: Besides the good correlation of all methods studied and pathology, the mamography was slightly superior to clinical exam and ultrasound in estimative of the pre-operative tumor size in the present study.