QUIMIOTERAPIA NOS TUMORES DE MАМА AXILA-NEGATIVA
Abstract
In the period of january of 1983 to december of 1990, were diagnosed and treated 72 consecutive cases of breast cancer having a diameter of 2cm or less and histologicaly negative axillary nodes in the instituto de Ginecologia da Fundação Pioneiras Sociais - RJ.
In thirteen patients (Group 1) the tumoral diameter was less than 1cm (18%); in 27 (37,5%) it was between 1.1. to 1.5cm (Group 2) and in 32 (44.4%) it was to 1.6 to 2. cm (Group 3).
The follow-up time was 64.4 months (M = 68).
The parameters for analysis were the size of tumor, histologic grade, menopausal status and type of primary therapy. The disease-free survival rate (DFS) for the group was of 97.1% at 5 and 9 years and the overall survival (OS), 100% and 91% at 5 and 9 years
respectively.
Considering the size of the tumor, all the patients of Group 1 were alive and disease-free at 9 years; Group 2 had 96.2% of DFS and 100% of OS and 78% of Group 3 patients were alive and 96.7% disease-free in the same period.
Taking into consideration the histologic grade, 97.8% of well differentiated (GI), 100% of moderately differentiated (GII) and 87.5% of poorly differentiated tumors (GIII) were disease-free at 9 years. The OS was 92% for the GI, 100% for GII and 83.3% for GIII tumors (p = 0.657).
The menopausal status and primary treatment hasn't modified the prognosis. These data, according to the literature sugests that patients having a tumoral diameter of less than 1cm and well-differentiated are highly curable by surgical and radiotherapic therapy. The authors believe that these patients are not appropriate candidates for adjuvant chemotherapy until new prognostic factors have been well established.
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