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dc.contributor.advisorVanegas Silva, Diegospa
dc.contributor.authorSáenz Ladino, Andersson Edgardo
dc.contributor.authorMoreno Reyes, Diana Carolina
dc.contributor.otherAstorquiza, María Helenaspa
dc.coverage.spatialMedicinaspa
dc.date.accessioned2019-10-22T13:37:31Z
dc.date.accessioned2019-12-30T18:58:15Z
dc.date.available2019-10-22T13:37:31Z
dc.date.available2019-12-30T18:58:15Z
dc.date.issued2019-09-20
dc.identifier.urihttp://hdl.handle.net/10654/32300
dc.description.abstractIntroducción. El cáncer de mama es en Colombia la principal causa de morbimortalidad por cáncer en la población femenina. En tumores localmente avanzados la quimioterapia neoadyuvante es parte importante del manejo y su principal objetivo es mejorar el resultado oncológico y en ocasiones también el resultado estético de la cirugía. Los cambios en la inmunohistoquímica inducidos por la quimioterapia neoadyuvante se presentan de manera variable dependiendo el subtipo molecular y se deben tener en cuenta en el momento de definir el manejo adyuvante. Materiales y métodos. Se realizó un estudio descriptivo y retrospectivo, en el que se incluyen todas las pacientes de sexo femenino con cáncer de mama ductal infiltrante diagnosticadas entre los años 2015 al 2017 llevadas a quimioterapia neoadyuvante en el Hospital Militar Central. Resultados. La respuesta patológica completa se presenta en mayor proporción en pacientes triple negativos (70%) en comparación a los demás tipos moleculares; con respecto a la variación de cada parámetro de inmunohistoquímica la principal modificación se presenta con el Ki67 (96.8%), en comparación con los demás parámetros (receptor de progestágenos 61.3%, receptor de estrógenos 48%, HER2 29%); cambios que llevan a modificación del subtipo molecular en el 35% de los pacientes, el subtipo molecular que tiene un mayor porcentaje de cambio es el Luminal B (HER2 negativo). Conclusión. En el estudio se evidencian cambios en los diferentes parámetros de inmunohistoquímica después de la quimioterapia neoadyuvante, los principales cambios se presentan a nivel del Ki 67 y del Receptor de progestágeno, los cambios de estos parámetros implican en algunos pacientes el cambio del subtipo molecular. Estos cambios se pueden deber a aspectos técnicos como la variabilidad dependiente del observador, variabilidad en el muestreo de la biopsia core por heterogeneidad tumoral y selección clonal generada por la neoadyuvancia. Siempre se debe reclasificar el subtipo molecular a las pacientes llevadas a neoadyuvancia, con el fin de redireccionar las estrategias de tratamiento en el contexto adyuvante.spa
dc.formatpdfspa
dc.format.mimetypeapplication/pdfspa
dc.language.isospaspa
dc.language.isospaspa
dc.publisherUniversidad Militar Nueva Granadaspa
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/2.5/co/spa
dc.titleExpresión de receptores hormonales, HER 2 y KI 67 antes y después de quimioterapia neoadyuvante en mujeres con cáncer de mama ductal infiltrantespa
dc.typeinfo:eu-repo/semantics/bachelorThesisspa
dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.subject.lembCANCER DE MAMAspa
dc.publisher.departmentFacultad de Medicinaspa
dc.type.localTrabajo de gradospa
dc.description.abstractenglishIntroduction. Breast cancer is the leading cause of cancer morbidity and mortality in the female population in Colombia. In locally advanced tumors, neoadjuvant chemotherapy is an important part of management and its main objective is to improve the cancer outcome and sometimes also the aesthetic outcome of the surgery. The changes in immunohistochemistry induced by neoadjuvant chemotherapy are presented variably depending on the molecular subtype and must be considered when defining adjuvant management. Materials and methods. A descriptive and retrospective study was carried out, which includes all female patients with infiltrating ductal breast cancer diagnosed between 2015 and 2017 who underwent neoadjuvant chemotherapy at the Central Military Hospital. Results. The complete pathological response occurs in greater proportion in triple-negative patients (70%) compared to the other molecular types; With respect to the variation of each immunohistochemical parameter, the main modification is presented with Ki67 (96.8%), compared to the other parameters (61.3% progestagen receptor, 48% estrogen receptor, 29% HER2); changes that lead to a modification of the molecular subtype in 35% of patients, the molecular subtype that has a higher percentage of change is Luminal B (negative HER2). Conclusion. The study shows changes in the different immunohistochemical parameters after neoadjuvant chemotherapy, the main changes are presented at the level of Ki 67 and the Progestagen Receptor, the changes of these parameters imply in some patients the change of the molecular subtype. These changes may be due to technical aspects such as observer-dependent variability, variability in core biopsy sampling by tumor heterogeneity and clonal selection generated by neoadjuvant. The molecular subtype should always be reclassified to patients taken to neoadjuvant, to redirect treatment strategies in the adjuvant context. Keywords: Breast cancer, neoadjuvant, hormonal receptors, immunohistochemistry.eng
dc.title.translatedExpression of hormonal receptors, HER 2 and KI 67 before and after neoadjuvant chemotherapy in women with infiltrating ductal breast cancerspa
dc.subject.keywordsBreast cancerspa
dc.subject.keywordsneoadjuvantspa
dc.subject.keywordshormonal receptorsspa
dc.subject.keywordsimmunohistochemistry.spa
dc.publisher.programCirugía Generalspa
dc.creator.degreenameEspecialista en Cirugía Generalspa
dc.subject.decsNEOPLASMAS
dc.subject.decsENFERMEDADES DE LA MAMA
dc.subject.decsCANCER-TRATAMIENTO
dc.description.degreelevelEspecializaciónspa
dc.publisher.facultyMedicina y Ciencias de la Salud - Cirugía Generalspa
dc.type.dcmi-type-vocabularyTextspa
dc.type.versioninfo:eu-repo/semantics/acceptedVersionspa
dc.rights.creativecommonsAtribución-NoComercial-SinDerivadasspa
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dc.subject.proposalCáncer de mamaspa
dc.subject.proposalneoadyuvanciaspa
dc.subject.proposalreceptores hormonalesspa
dc.subject.proposalinmunohistoquímicaspa


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