Influência da terapêutica hormonal prévia sobre os indicadores de prognóstico do câncer de mama em mulheres na pós-menopausa
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Data
2005-03-01
Autores
Nahás, Eliana Aguiar Petri [UNESP]
Lindsey, Susan Chow
Uemura, Gilberto [UNESP]
Nahas-Neto, Jorge [UNESP]
Dalben, Ivete [UNESP]
Vespoli, Heloísa Maria de Luca [UNESP]
De Luca, Laurival A. [UNESP]
Título da Revista
ISSN da Revista
Título de Volume
Editor
Federação Brasileira das Sociedades de Ginecologia e Obstetrícia
Resumo
OBJETIVO: avaliar a influência da terapêutica hormonal (TH) prévia sobre alguns indicadores de prognóstico do câncer de mama, em pacientes na pós-menopausa. MÉTODOS: estudo transversal por meio da aplicação de questionários e levantamento de prontuários. Foram entrevistadas 157 pacientes com diagnóstico de câncer de mama na pós-menopausa, registrando-se dados clínicos, antecedentes pessoais e familiares, uso de TH e mamografias. Nos prontuários foram obtidas informações sobre o câncer de mama quanto ao diâmetro do tumor, tipo de cirurgia e estudo imuno-histoquímico. Para a estatística empregou-se ANOVA e teste do chi2. RESULTADOS: 38,2% das pacientes eram ex-usuárias de TH e 61,8% não usuárias. O tempo médio de uso da TH foi de 3,7±3,6 anos. As ex-usuárias eram de menor faixa etária e com menor tempo de menopausa quando comparadas às não usuárias (p<0,05). Constatou-se que 26,8% das pacientes apresentavam antecedentes familiares de câncer de mama, em ambos os grupos. Entre as ex-usuárias de TH, 43,3% foram submetidas a mamografias prévias, ao passo que entre as não usuárias, apenas 11,3% (p<0,001). O diâmetro médio do tumor foi menor entre as ex-usuárias de TH (2,3±1,1 cm), com predomínio de quadrantectomias (60%), quando comparadas as não usuárias (3,3±1,5 cm e 32%, respectivamente) (p<0,001). No estudo imuno-histoquímico, observou-se correlação positiva entre a presença de receptores de estrogênio e progesterona positivos e o uso de TH (p<0,001). Não houve correlação entre TH e c-erbB-2 e p53. CONCLUSÃO: nesta casuística, as mulheres na pós-menopausa que usaram TH prévia ao diagnóstico de câncer de mama apresentaram indicadores de prognóstico mais favoráveis quando comparadas às não usuárias.
PURPOSE: to evaluate the influence of previous hormonal therapy (HT) on breast cancer prognostic markers in postmenopausal women. Methods: a cross-sectional study was carried out, applying questionnaires and medical record surveys of 157 postmenopausal patients with breast cancer diagnosis. Clinical data, personal and familiar history, HT use, and mammograms were investigated. The medical record surveys yielded information about tumor size, imunohistochemical data, and type of surgery. Statistical analysis was performed using ANOVA and the chi2 test. RESULTS: 38.2% of the patients were HT ex-users and 61.8% were non-users. Mean time of HT use was 3.7±3.6 years. HT ex-users were younger and with a shorter menopause time than non-users (p<0.05). 26.8% of the patients reported previous cases of breast cancer in their families, with no difference between the groups. of the HT ex-users, 43.3% had previous mammograms, while of the non-users, only 11.3% (p<0.001). Mean tumor size was smaller in HT ex-users (2.3±1.1 cm) than in non-users (3.3±1.5cm) (p<0.001). The conservative surgeries (quadrantectomies) were predominant in HT ex-users (60%) when compared to non-users (32%) (p<0.001). The immunohistochemical study showed, a positive correlation between the presence of positive estrogen and progesterone receptors and the HT use (p<0.001). There was no correlation between HT and c-erbB-2 and p53. CONCLUSION: postmenopausal women who used hormonal therapy previously to breast cancer diagnosis presented indication of a better prognosis when compared to non-users.
PURPOSE: to evaluate the influence of previous hormonal therapy (HT) on breast cancer prognostic markers in postmenopausal women. Methods: a cross-sectional study was carried out, applying questionnaires and medical record surveys of 157 postmenopausal patients with breast cancer diagnosis. Clinical data, personal and familiar history, HT use, and mammograms were investigated. The medical record surveys yielded information about tumor size, imunohistochemical data, and type of surgery. Statistical analysis was performed using ANOVA and the chi2 test. RESULTS: 38.2% of the patients were HT ex-users and 61.8% were non-users. Mean time of HT use was 3.7±3.6 years. HT ex-users were younger and with a shorter menopause time than non-users (p<0.05). 26.8% of the patients reported previous cases of breast cancer in their families, with no difference between the groups. of the HT ex-users, 43.3% had previous mammograms, while of the non-users, only 11.3% (p<0.001). Mean tumor size was smaller in HT ex-users (2.3±1.1 cm) than in non-users (3.3±1.5cm) (p<0.001). The conservative surgeries (quadrantectomies) were predominant in HT ex-users (60%) when compared to non-users (32%) (p<0.001). The immunohistochemical study showed, a positive correlation between the presence of positive estrogen and progesterone receptors and the HT use (p<0.001). There was no correlation between HT and c-erbB-2 and p53. CONCLUSION: postmenopausal women who used hormonal therapy previously to breast cancer diagnosis presented indication of a better prognosis when compared to non-users.
Descrição
Palavras-chave
Menopausa, Terapêutica hormonal, Neoplasias mamárias, Menopause, Hormone therapy, Breast neoplasms
Como citar
Revista Brasileira de Ginecologia e Obstetrícia. Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, v. 27, n. 3, p. 112-117, 2005.