GENETİK MUTASYON TAŞIYICILARINDA MEME KANSERİ TEDAVİSİ: CERRAHİ TEDAVİ, PROFİLAKTİK MASTEKTOMİ

Öz

Amaç: Meme kanseri kadınlar arasında en sık görülen kanser tipi olup son yıllarda genetik mutasyonların saptanmasıyla risk azaltıcı tedaviler önem kazanmıştır. Yöntem: Ocak 2018- Ocak 2023 arası genetik mutasyona sahip olduğu için kliniğimizde proflaktik mastektomi yapılan hastalar retrospektif olarak değerlendirildi. tüm hastalara yapılan cerrahi prosedürler, ameliyata ikincil gelişen komplikasyonlar, hastaların adjuvan tedaviye gönderilme zamanları, ikincil operasyon gerekliliği, hastalıksız sağ kalım süreleri değerlendirildi. Bulgular: Proflaktik mastektomi yapılmış 15 genetik mutasyonlu hastaların 4'ünde tümor oluşmadan bu ameliyat uygulanıştır. 6 hastada beklenen komplikasyonlardan kapsül kontraktürü, cilt nekrozu ve meme başı nekrozu gibi komplikasyonlar gelişmiş olup 4 hastada re-operasyon gerekliliği olmuştur. Tüm hastaların takiplerinde onkolojik prensiplere bağlı kalınmış olup hiç birinde nüks veya metastaz görülmemiştir. Sonuç : Genetik mutasyon panelinin genişlemesi ile hastalar zaman kazanmaya başlamış olup, hekim olarak bu kişilere onkolojik prensiplere uygun yol göstermemiz gerekmektedir. proflaktik mastektomi tümörsüz sağ kalım için bizim bu çalışmamızda önerdiğimiz yöntemdir.

Anahtar Kelimeler

• BRCA
• proflaktik mastektomi
• risk azaltıcı cerrahi

BREAST CANCER TREATMENT IN GENETIC MUTATION CARRIERS: SURGICAL TREATMENT, PROPHYLACTIC MASTECTOMY

Öz

Objective:Breast cancer is the most common type of cancer among women, and risk-reducing treatments have gained importance in recent years with the detection of genetic mutations. Method: Patients who underwent prophylactic mastectomy in our clinic between January 2018 and January 2023 were evaluated retrospectively. Surgical procedures performed on all patients, complications developing secondary to the surgery, the time of sending the patients to adjuvant treatment, the necessity of secondary operation, and disease-free survival were evaluated. Results: In 4 of the 15 patients with genetic mutations who underwent prophylactic mastectomy, this surgery was performed before tumor formation. Complications such as capsular contracture, skin necrosis and nipple necrosis developed in 6 patients, and reoperation was required in 4 patients. In the follow-up of all patients, oncological principles were adhered to, and no recurrence or metastasis was observed in any of them. Conclusion:With the expansion of the genetic mutation panel, patients have started to gain time, and as physicians, we need to guide these people in accordance with oncological principles. prophylactic mastectomy is the method we recommend in this study for tumor-free survival.

Anahtar Kelimeler

• Brca
• Prophylactic Mastectomy
• risk-reducing surgery

Kaynakça

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