RADIOTERAPIA NO CÂNCER DE MAMА
Keywords:
Radioterapia, Câncer de mamaAbstract
A radioterapia vem sendo empregada em conjunto com a cirurgia no manuseio dos
tumores de mama desde o final do século passado. Tem importante papel no tratamento
conservador de lesões in situ e invasoras, tumores localmente avançados e na paliação
de lesões metastáticas. A abordagem do carcinoma ductal in situ e o papel da
radioterapia em seu tratamento constituem-se em uma atual e desafiadora área de
pesquisa. A combinação de cirurgias conservadoras e radioterapia é o procedimentopadrão para a maioria das pacientes portadoras de carcinomas invasores de mama dos
estádios I e II. Um subgrupo de pacientes, em que a irradiação possa ser evitada, ainda
não foi claramente identificado, devendo, portanto, ser rotineiramente empregada após
cirurgias conservadoras. Alguns detalhes sobre a técnica ideal de tratamento e qual o
real papel da irradiação dos linfáticos periféricos permanecem controvertidos, bem
como a seqüência ideal de sua integração com a quimioterapia sistêmica.
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References
1. ARRIAGADA R, RUTQVIST LE, MATTSON A et
al. Adequate locoregional treatment for early breast
cancer may prevent secondary dissemination. J
Clin Oncol 1995; 13: 2869-2878.
2. BARON PL, MOORE MP, KINNE DW et al. Occult breast
cancer presenting with axillary metastases: uptdated
management. Arch Surg 1990; 125: 210-212.
3. BONNADONA G, VALAGUSSA P, ROSSI A et al.
Ten-year experience with CMF-based adjuvant
chemotherapy in resectable breast cancer. Breast
Cancer Res Treat 1995; 5: 95-115.
4. CARVALHO FM, BARROS ACSD, PINOTTI JA.
Carcinoma ductal in situ de mama: bases
histopatológicas e estratégias de tratamento. Rev
bras Mastol 1996; 6: 86-94.
5. DOMBERNOWSKY P, HANSEN P, MOURIDSEN H
et al. Randomized trial of CMF+RT versus CMF
alone versus TAM in the pre and pos menopausal
stage II breast cancer. Eur J Cancer 1994; 30A
(suppl 2): S28.
6. EARLY BREAST CANCER TRIALISTS
COLLABORATIVE GROUP. Effects of
radiotherapy and surgery in early breast cancer. N
Engl J Med 1995; 333: 1444-1455.7. ERNSTER VL, BARCLAY J, KERLIKOWSKE K,
GRADY D, HENDERSON C. Incidence and
treatment for ductal carcinoma in situ of the breast.
Jama 1996; 275: 913-918.
8. FAVERLY D, HOLLAND R, BURGERS L. Three
dimensional imaging of mammary ductal carcinoma
in situ: clinical implication of disease pattern and
treatment. Semin Diagn Pathol 1194; 11: 193-198.
9. FISCHER B, ANDERSON S, REDMOND C,
WOLMARK N, WICHERHAM L, CRONIN W.
Reanalysis and results after 12 years of follow-up
in a randomized clinical trial comparing total
mastectomy with lumpectomy with and without
irradiation in the treatment of breast cancer. N Engl
J Med 1995; 333: 1456-1461.
10.FISCHER B, COSTANTINO J, CAROL L et al.
Lumpectomy compared with lumpectomy and
radiation therapy for the treatment of intraductal
breast cancer. N Engl J Med 1993; 328: 1581-1586.
11. FISCHER ER, COSTANTINO J, FISCHER B et al.
Pathological findings from the National Surgical
Adjuvant Breast Project (NSABP) protocol B-17.
Cancer 1995; 75: 1310-1319.
12.FOWBLE B. The role of radiotherapy in the treatment
of ductal carcinoma in situ. To be or not to be?
The challenge of the 90s. Breast cancer: categorical
course. American Society for Therapeutic
Radiology and Oncology Congress, 1995; 37.
13.GLICK JH, GELBER RD, GOLDHIRSCH A, SENN
HJ. Commentary: adjuvant therapy of primary
breast cancer. 4th International Conference of
adjuvant therapy for breast cancer. Sem Oncol
1992; 19: 263-77.
14.GOLDHIRSCH A. National Institute of Health
Consensus Development Panel. American J Natl
Cancer Inst 1995; 87: 1441.
15.HOLLAND R, HENDRIKS JH. Microcalcifications
associated with ductal carcinoma in situ:
mammographic-phatologic correlation. Semin
Diagn Pathol 1994; 11: 181-92.
16.KUSKE RR, SCHUSTER R, KLEIN E, YOUNG L,
PEREZ CA, FINENBERG B. Radiotherapy and
breast reconstruction: clinical results and
dosimetry. Int J Radiat Oncol Bioł Phys 1991; 21:
339-346.
17.LEITE MTT. Radioterapia no tratamento do carcinoma
ductal in situ. Oncologia Atual 1994; 4: 33-36.
18.LEITE MTT PINTO AC. Radioterapia no câncer de
mama. In: Dias EN, Caleffi M, Silva HMS, Figueira
ASS. Mastologia Atual. Rio de Janeiro: Revinter.
1995; 191-201.
19.LEITE MTT, SCHMIDT, ANDRADE W. Aspectos
biopsicossociais do câncer de mama. Rev bras
Mastol 1996; 6: 15-20.
20.MARTELA E, CASTRO EM, CAMARGO RS. A
biologia molecular e a radioterapia. Cancerologia
1996; 19: 26-30.
21.MORROW M, E SCHNITT SJ. Carcinoma in situ.
In: Harris JR, Lippman ME, Morrow M, Hellman
S. Diseases of the breast Philadelphya: Lippincot
Company. 1966; 355-369.
22.RETCH A, HARRIS JR, COME S, GELMAN R et al.
Integration of conservative surgery, radiotherapy,
and chemotherapy for the treatment of early stage,
node-positive breast cancer: sequencing, timing and
outcome. J Clin Oncol 1991; 9: 1662-1667.
23.REUNIÃO NACIONAL DE CONSENSO EM
MASTOLOGIA. Tratamento cirúrgico do câncer
de mama. Rio de Janeiro: Sociedade Brasileira de
Mastologia. 1995.
24.ROBERT N, WAZER DE, SMITH TS, HOMER MJ,
SAFALL H, MARCHANT DJ. In situ breast cancer:
a multidisciplinary approach. Hosp Pract 1989; 24:
169-185.
25.RUTQVIST LE, LAX I, FORNANDER Т,
JOHANSSON H. Cardiovascular mortality in a
randomized trial of adjuvant radiation therapy versus
surgery alone in a primary breast cancer. Int J
Radiat Biol Oncol Phys 1992; 22: 887-896.
26. RUTQVIST LE, PETERSON D, JOHANSSON M.
Adjuvant radiation therapy versus surgery alone in
operable breast cancer: long term follow up in a large
randomized trial. Radiot Oncol 1993; 26: 104-109.
27.SILVERSTEIN MJ, LAGIOS MD, GRAIG PH et al.
The Van Nuys prognostic index for ductal
carcinoma in situ. Breast J 1996; 2: 38-40.
28. SOLIN LJ, FOWBLE B, YEH T et col. Microinvasive
ductal carcinoma of the breast treated with breastconserving surgery and definitive irradiation. Int J
Radiation Oncol Biol Phys 1992; 23: 961-968.
29. VERONESI U, MARUBINI E, DEL VECHIO M et al.
Local recurrences and distant metastases after
conservative breast cancer treatment. J Nat Cancer
Inst 1995; 87:19-27.
30. VERONESI U, ZURRIDA S, FARANTE G, GRECO
M. Reflexiones sobre el tratamiento conservador
del cancer de mama. Avances en Oncologia 1996;
IV: 88-104.
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