Cintilografia de mamas em câncer de mama triplo negativo – Avaliação do padrão e da predição de resposta quimioterápica/ Breast scintigraphy in triple negative breast cancer - Assessment of the pattern and prediction of chemotherapy response

Katia Hiromoto Koga, Sonia Marta Moriguchi, Karina Hiromoto Oikawa, Carla Priscila Kamiya Carvalho Pessoa, Eduardo Carvalho Pessoa, Eduardo Tinóis, Heloisa Maria de Luca Vespoli, Benedito de Sousa Almeida Filho

Abstract


Com intuito de detectar a predição da resposta ao tratamento quimioterápico em carcinoma de mama triplo negativo (CMTN), assim como, um padrão específico, propusemos a cintilografia de mamas com sestamibi-99mTc como método de diagnóstico para avaliação. Foram estudadas 49 pacientes, no período de 2011 a 2016, com diagnóstico de CMTN submetidas à cintilografia de mamas pré-quimioterapia neoadjuvante e avaliação do espécime cirúrgico. Na cintilografia de mamas foram avaliadas características qualitativas como intensidade de concentração do sestamibi-99mTc na lesão da mama e presença de acúmulo do mesmo em linfonodo axilar e quantitativa pela relação da área de interesse na lesão tumoral pela mesma área em espelho em tecido mamário sem alterações na mesma mama. A análise descritiva mostrou a idade 54,24 + 11,39 anos, com variação de 26 a 79 anos e mediana de 55 anos. A mama acometida pelo tumor foi 25 (51,0%) na mama direita e 24 (49,0%) esquerda. O esquema quimioterápico empregado nas pacientes foi de 36 (73,5%) com cloridrato de doxorrubicina, ciclofosfamida e placlitaxel e 13 (26,5%) com cloridrato de doxorrubicina e ciclofosfamida. Vinte e sete pacientes (55,1%) foram submetidas a mastectomia e 22 (44,9%) a quadrantectomia. A resposta patológica completa (RPC) foi presente em 18(36,7%) e ausente 31(63,3%). Na cintilografia, a análise quantitativa mostrou índice com média e desvio padrão de 2,58 + 1,01, com mínimo de 1,17 e máximo de 5,60 e mediana de 2,29. A análise qualitativa revelou intensidade de concentração em lesões na mama: discreta em 3(6,1%), moderada em 26(53,1) e acentuada em 20(40,8%). A concentração axilar foi visualizada na cintilografia de mamas em 41 pacientes (83,7%) e ausente em 8(16,3%). As associações dos dados cintilográficos quantitativo e qualitativo não mostraram significância estatística em predizer a resposta patológica completa. Em nosso estudo observamos uma predominância de lesões com maior intensidade de concentração do sestamibi-99mTc, o que ocorre em carcinomas de mama mais agressivos. No entanto, as análises quantitativa e qualitativa da cintilografia de mamas não puderam predizer a resposta patológica completa.


Keywords


carcinoma de mama, triplo negativo, quimioterapia neoadjuvante, cintilografia de mamas, sestamibi-99mTc.

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References


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DOI: https://doi.org/10.34119/bjhrv4n3-349

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