Indikacije za kirurško liječenje karcinoma dojke nakon neoadjuvantne terapije

master's thesis

• Title (english): Indications for breast cancer surgery after neoadjuvant therapy
• Author: Toni Penović
• Mentor: Srećko Budi (mentor)
• Committee member: Rado Žic (predsjednik povjerenstva)
• Committee member: Tomislav Meštrović (član povjerenstva)
• Committee member: Srećko Budi (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Surgery); Zagreb
• Defense date and country: 2019-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Oncology

Abstract

Odgovarajući kriteriji odabira pacijentica za kirurško liječenje koje uključuje poštedni operativni zahvat i mastektomiju nakon neoadjuvantne terapija slabo su definirani. Neoadjuvantna terapija zauzima sve veću ulogu u liječenju maligniteta dojke. Iako je njena primjena dosad bila indicirana većinom za lokalno uznapredovali oblik karcinoma dojke, sve se više koristi i kod tumora dojke u ranoj fazi. Kao njena glavna prednost ističe se smanjene veličine primarnog tumora nakon koje slijedi poštedni operativni zahvat dojke koji rezultira boljim terapijskim i estetskim ishodom liječenja, kao i smanjenje ili uklanjanje metastaza u pazušnim limfnim čvorovima čime se smanjuje broj pacijentica podvrgnutim disekciji pazušnih limfnih čvorova. MD Anderson prognostički indeks koristi se za identifikaciju pacijentica za kirurški zahvat nakon neoadjuvantne terapije. Četiri prognostička čimenika tumorske proširenosti koriste se u procjeni mogućnosti loko-regionalnih recidiva te povećanja veličine rezidualnog tumora, na temelju kojih se pacijentice mogu svrstati u skupinu prikladnu za poštedni operativni zahvat ili mastektomiju. Kombinacija neoadjuvantne terapije nakon koje slijedi kirurški zahvat primjer je multimodalnog liječenja tumora dojke koji zahtjeva adekvatnu komunikaciju multidisciplinarnog tima u odabiru odgovarajućih pacijentica.

Abstract (english)

Adequate selection criteria for patients for surgical treatment including breast conserving surgery and mastectomy after neoadjuvant therapy are poorly defined. Neoadjuvant therapy takes an increasingly important role in the treatment of breast malignancy. Although its use so far has been indicated for locally advanced breast cancer, it is increasingly used for breast cancer in early stage. Its main adventage is reduced size of primary tumor followed by breast conserving surgery that results in better therapeutic and aestetic outcome of the treatment, as well as reduction or removal of metastasis in axillary lymph nodes reducing the number of patients subjected to dissection of axillary lymph nodes. MD Anderson prognostic index is used to identify patients for a surgical procedure after neoadjuvant therapy. The four prognostic factors of tumor extension are used to estimate the possibility of loco-regional recurrence and increase the size of residual tumor, that provides basis of which patients can be classified into a group suitable for breast conserving surgery or mastectomy. The combination of neoadjuvant therapy followed by surgical procedure is an example of multimodal breast cancer treatment which requires adequate communication from a multidisciplinary team in the selection of appropriate patients.

• Keywords: karcinom dojke; neoadjuvatna terapija; poštedni operativni zahvat; mastektomija; MD Anderson prognostički indeks
• Keywords (english): breast cancer; neoadjuvant therapy; breast conserving therapy; mastectomy; MD Anderson prognostic index
• Language: croatian
• URN:NBN: urn:nbn:hr:105:673589
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2020-04-29 12:41:15