Estudio transversal: Manejo quirúrgico de Cáncer de Mama en el Hospital José Carrasco Arteaga, Enero 2017- Enero 2018 / Cross-Sectional Study: Surgical Management of Patients with Breast Cancer in José Carrasco Arteaga Hospital January 2017 ­ January 2018

INTRODUCCIÓN: El cáncer de mama ocupa el primer lugar dentro de la patología maligna que afectan a la mujer a nivel mundial, representando el 16% de los cánceres femeninos. El manejo quirúrgico del cáncer de mama ha evolucionado a lo largo de los años, disminuyendo la morbimortalidad y mejorando la calidad de vida de las pacientes. El objetivo del presente estudio es analizar el abordaje quirúrgico de las pacientes tratadas en la unidad de Cirugía Oncológica del Hospital de Especialidades José Carrasco Arteaga. MATERIALES Y MÉTODOS: Estudio observacional transversal para determinar la prevalencia de las cirugías de cáncer de mama realizadas en la Unidad de Cirugía Oncológica del Hospital de Especialidades José Carrasco Arteaga. Se incluyeron variables como edad, diagnóstico, tipo histológico, etapa, localización, tipo de cirugía y márgenes. Se analizaron los datos con estadística descriptiva utilizando el paquete estadístico SPSS versión V24.0. RESULTADOS: Se incluyeron 66 pacientes en el estudio. Los porcentajes de cirugías conservadoras y mastectomías fueron 56.06% versus 43.94% respectivamente. El tipo histológico más frecuente fue el ductal infiltrante (75.74%). Del total de pacientes diagnosticados con cáncer de mama el 46.97% fue en etapa clínica IIB; el cuadrante superior externo estuvo afectado en el 72.7% de pacientes y el lado más frecuentemente con tumor fue el izquierdo en el 50%. CONCLUSIONES: El cáncer de mama es diagnosticado con mayor frecuencia en mujeres posmenopáusicas, el tipo histológico más frecuente es el carcinoma ductal infiltrante, el porcentaje de cirugías conservadoras es mayor a las mastectomíasra de Unidad Técnica de Anatomía Patológica, Hospital de Especialidades José Carrasco Arteaga, Cuenca ­ Ecuador(AU)

BACKGROUND: Breast cancer ranks first among cancers that affect women worldwide, representing 16% of female cancers. The surgical approach to breast cancer has undergone changes over the years, reducing morbidity and mortality and improving life quality for these patients. The purpose of this study is to analyze the surgical approach in patients treated in the Oncologic Surgery unit of José Carrasco Arteaga Hospital. METHODS: Cross-sectional observational study to analyze the prevalence of breast cancer surgeries performed in the Oncologic Surgery Unit of José Carrasco Arteaga Hospital. Variables such as age, diagnosis, histological type, stage, location, type of surgical procedure and surgical margins were included. All the data was analyzed with descriptive statistics using SPSS version 24.0. RESULTS: 66 patients were included in the study. The percentages of conservative surgeries and mastectomies were 56.06% versus 43.94% respectively. The most frequent histological type was infiltrating ductal carcinoma (75.74%). Of the total of patients diagnosed with breast cancer, 46.97% were in clinical stage IIB; the upper external quadrant was affected in 72.7% of patients and the most frequent location was the left side (50%). CONCLUSIONS: Breast cancer occurs most frequently in postmenopausal women, the most frequent histological type is infiltrating ductal carcinoma, and the percentage of conservative surgeries is greater than mastectomies.(AU)

Avaliação precoce da qualidade de vida e autoestima de pacientes mastectomizadas submetidas ou não à reconstrução mamária / Assessment of the quality of life and self-esteem of mastectomized patients submitted or not to breast reconstruction

Introdução: Após o diagnóstico e tratamento do câncer de mama, algumas mulheres passam por alterações físicas, sociais e emocionais que repercutem muitas vezes na qualidade de vida e na autoestima. O objetivo é avaliar a qualidade de vida e autoestima de pacientes mastectomizadas submetidas ou não à reconstrução mamária após um mês de cirurgia. Métodos: A casuística foi composta por 89 pacientes, com idade igual ou superior a 30 anos, submetidas ou não à reconstrução mamária, e oriundas dos ambulatórios de Cirurgia Plástica e Mastologia do Hospital São Paulo e do Hospital Pérola Byington. O grupo 1 (n = 30) composto pelas pacientes mastectomizadas sem reconstrução mamária; o grupo 2 (n = 29) mastectomizadas com reconstrução mamária; e o grupo 3 (n = 30) pacientes sem alterações nas mamas. Para a avaliação da qualidade de vida, foram aplicados os instrumentos validados para uso no Brasil EORTC QLQ-C30 e Escala de Autoestima de Rosenberg UNIFESP/EPM. Resultados: Não foram observadas repercussões na qualidade de vida e autoestima das pacientes submetidas à mastectomia com ou sem a reconstrução mamária após um mês de cirurgia. Conclusão: Mulheres mastectomizadas com ou sem reconstrução mamária após um mês da cirurgia não apresentaram repercussões na qualidade de vida e na autoestima, quando comparadas entre si, bem como comparadas às mulheres sem história de câncer. É necessário que este tipo de avaliação, por meio dos questionários EORTC QLQ-C30 e QLQ-BR23, seja realizado no momento do diagnóstico do câncer de mama até o momento da pós-reconstrução mamária, com a finalidade de identificar em que fase se instalam as repercussões na qualidade de vida e autoestima.

Introduction: After diagnosis and treatment of breast cancer, some women go through physical, social, and emotional changes that often have an impact on their quality of life and self-esteem. This study aimed to assess the quality of life and self-esteem of mastectomized patients with or without breast reconstruction a month after surgery. Methods: The study consisted of 89 patients aged ≥ 30 years with or without breast reconstruction. They were recruited from the Plastic Surgery and Mastology clinic of São Paulo Hospital and Pérola Byington Hospital. Group 1 (n = 30) consisted of mastectomized patients without breast reconstruction; group 2 (n = 29) consisted of mastectomized patients with breast reconstruction; and group 3 (n = 30) consisted of patients without changes in the breasts. The EORTC QLQ-C30 and Rosenberg Self-Esteem Scale UNIFESP/EPM instruments, which are validated in Brazil, were used to assess their quality of life. Results: There were no observed effects in the quality of life and self-esteem of the patients who underwent mastectomy with or without breast reconstruction a month after surgery. Conclusion: The women with mastectomy with or without breast reconstruction a month after surgery showed no changes in their quality of life and self-esteem when compared among themselves and to women with no cancer history. It is necessary that this assessment, employing the EORTC QLQ-C30 and QLQ-BR23 questionnaires, be performed from the time of breast cancer diagnosis until after breast reconstruction to identify the stage when the quality of life and self-esteem are affected.