RESUMO
BACKGROUND: The chemotherapy commonly used for the treatment of breast cancer affect the fertility and could cause premature ovarian failure. The subsequent pregnancy to the breast cancer therefore it is not habitual. OBJECTIVE: The purpose of this study was to identify the effects of the chemotherapy in the women reproductive life; to evaluate the frequency of the women that experienced a later pregnancy after treatment of cancer, as well as the effects of the subsequent pregnancy on the breast cancer. We report our experience in the 14 year period. MATERIAL AND METHOD: As retrospective design, of 14 cases with breast cancer and subsequent pregnancy, from March 1994 to June 2008; demographic variables, clinical presentation, histopathological data, diagnostic procedures, treatments and results of the pregnancy were identified. RESULTS: The mean (M +/- SD) age of gestational women was of 31.5 +/- 5.2 years; the 83.3% women received adyuvant chemotherapy with antraciclines; the patients with regional illness (> 4 N+) and advanced illness had an adverse presage; the systemic relapse and progression showed in 42.8% of the cases. The pregnancy to term was presented in half of the cases in the first two years and in a third part, later to the 2 years of having concluded the oncological treatment; of the fourteen patients with breast cancer presented a total of 16 pregnancies: 9 were of term, 3 of preterm and 4 abortions. CONCLUSIONS: The study founds are based on a series of cases, which do not suggest that the pregnancy after the diagnosis and treatment of breast cancer has some adverse effect in the patients survival, for what the patients can conceive later to the oncological treatment. However, in this study it was observed that the effect of the advanced stage and positive axillary ganglion (> 4) influence in the relapses.
Assuntos
Neoplasias da Mama/tratamento farmacológico , Carcinoma Ductal de Mama/tratamento farmacológico , Quimioterapia Adjuvante/efeitos adversos , Infertilidade Feminina/epidemiologia , Resultado da Gravidez , Sobreviventes , Aborto Espontâneo/epidemiologia , Aborto Espontâneo/etiologia , Adulto , Neoplasias da Mama/mortalidade , Neoplasias da Mama/patologia , Carcinoma/tratamento farmacológico , Carcinoma/mortalidade , Carcinoma/patologia , Carcinoma Ductal de Mama/mortalidade , Carcinoma Ductal de Mama/patologia , Feminino , Idade Gestacional , Humanos , Infertilidade Feminina/induzido quimicamente , Metástase Linfática , Mortalidade Materna , México/epidemiologia , Gravidez , Insuficiência Ovariana Primária/induzido quimicamente , Recidiva , Estudos Retrospectivos , Risco , Natimorto/epidemiologia , Adulto JovemRESUMO
La colecistectomía laparoscópica es actualmente el tratamiento de elección para la litiasis biliar sintomática. El hallazgo incidental de un cáncer no sospechado durante la colecistectomía laparoscópica y los implantes en la pared abdominal es un evento poco común que puede alterar la conducta biológica del tumor y empeorar su pronóstico. La frecuencia real de esta complicación no se conoce y sólo se han documentado casos aislados. Se deben examinar las piezas quirúrgicas y realizar estudios transoperatorios de cualquier zona sospechosa. En caso de encontrar un carcinoma de manera incidental, se recomienda reintervenir al paciente y realizar resección amplia de los puertos y del lecho vesicular con linfadenectomía en un intento de mejorar la posibilidad de curación. Presentamos dos casos de pacientes sometidas a colecistectomía laparoscópica quienes desarrollaron metástasis en los puertos por adenocarcinoma de vesícula biliar no sospechado y su evolución