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segunda-feira, julho 03, 2006

Carcinoma Inflamatório da mama

Excepção feita aos profissionais de saúde, pouco se sabe sobre este cancro da mama tão grave.

O carcinoma inflamatório da mama constitui menos de 5% das ocorrências, e são as que apresentam pior prognóstico, requerendo sempre terapia agressiva, especialmente quimioterapia.

A maioria das pacientes com carcinoma inflamatório de mama, tratadas somente com terapias locais, morreu 18 a 24 meses depois do diagnóstico.O uso do tratamento combinado, com quimioterapia, cirurgia e radioterapia, melhorou as taxas de período livre de doença e de sobrevida total, nos casos de carcinoma inflamatório. Aproximadamente 35% a 55% das pacientes tratadas com os regimes combinados permanecem livres de doenças e estão vivas cinco anos após tratamento.

A sua similitude com as mastites pode atrasar o diagnóstico, diminuindo assim as hipóteses de sobrevivência.

Resumo dos sintomas:

Mama vermelha e quente
Inchaço, tumefacção
Pele “casca de laranja”
Alteração do tamanho e formato da mama
Mamilo “invertido” ou purgando
Gânglios inchados

As pesquisas efectuadas para encontrar textos em português sobre o tema foram infrutíferas. Fez-se aqui um brevíssimo resumo e remete-se para um texto em inglês e um video que poderão ver no lado direito do ecran. Assim que houver mais informação sobre esta forma de cancro, será publicada aqui.

“What is Inflammatory Breast Cancer?

Inflammatory breast cancer is an uncommon form of rapidly advancing breast cancer that usually accounts for approximately 1% to 3% of all breast cancer diagnoses. Inflammatory breast cancer is a form of invasive breast cancer that progresses quickly and should be differentiated by physicians from other forms of advanced breast cancer with similar characteristics. Inflammatory breast cancer causes the breast to appear swollen and inflamed. This appearance is often caused when cancer cells block the lymphatic vessels in the skin of the breast, preventing the normal flow of lymph fluid and leading to reddened, swollen and infect-looking breast skin—hence the designation "inflammatory" breast cancer. Inflammatory breast cancer is not caused by infection or inflammation as was once believed.

With inflammatory breast cancer, the breast skin has a thick, pitted appearance that is classically described as peau d’orange (resembling an orange peel). Sometimes the skin develops ridges and small bumps that resemble hives.

How is Inflammatory Breast Cancer Diagnosed?

The symptoms associated with inflammatory breast cancer are usually the first cause of concern. These symptoms may include:

breast redness
swelling
warmth
ridges or pits in the breast skin (a condition referred to as peau d’orange; resembling an orange peel)
a change in the size or shape of the breast
nipple discharge or an inverted (pulled back) nipple
swollen
lymph nodes

Inflammatory breast cancer can sometimes be mistaken by patients and physicians as a breast infection (or mastitis) because its symptoms , and the rapidity with which they appear (sometimes within weeks) resemble those associated with infections. However, while most breast infections will respond to antibiotics, inflammatory breast cancer will not. In fact, symptoms of inflammatory breast cancer do not usually get better or worse as infections do. If symptoms persist more than two or three weeks despite treatment, further testing and a breast biopsy should be performed to determine whether cancer is present.

Inflammatory breast cancer is typically classified as Stage III cancer, unless it has spread to the lymph nodes or other body organs. In these cases, it is classified as Stage IV breast cancer, or advanced breast cancer. Click here for more information on breast cancer stages.

How is Inflammatory Breast Cancer Treated?

Inflammatory breast cancer is an aggressive cancer that can grow and spread quickly. If the inflammatory cancer has not spread beyond the breast, a mastectomy (removal of the entire breast) may be performed to remove the tumor. However, because inflammatory breast cancer involves lymphatic vessels of the skin, mastectomy can increase the chances for the cancer to recur (since the skin is stitched together after mastectomy). Therefore, other treatment options (most commonly, chemotherapy) are usually considered before surgery.

Chemotherapy is treatment with anti-cancer drugs. Chemotherapy is often administered to inflammatory breast cancer patients before local treatment (such as mastectomy or radiation). One common regimen of chemotherapy used to treat inflammatory breast cancer patients is CAF (cyclophosphamide, doxorubicin, and fluorouracil). Researchers are also investigating whether high-dose chemotherapy is effective for treating inflammatory breast cancer. Because high dose chemotherapy causes damage to bone marrow cells, a bone marrow transplant or blood stem cell transplantation may be necessary. After surgery, patients with inflammatory breast cancer are usually treated with additional chemotherapy followed by radiation therapy to the chest wall.

What is the Prognosis for Inflammatory Breast Cancer?

Because inflammatory breast cancer is an advanced cancer, it has been associated with a poor prognosis (expected outcome). Past statistics have shown the average survival rate of inflammatory breast cancer to be approximately 18 months. However, recent studies have shown that advancements in treatment may help to extend the survival time for women with inflammatory breast cancer. Using chemotherapy, surgery (mastectomy), and radiation, the average five-year survival rate is currently 40%. Physicians are hopeful that advances in treatment will continue to improve the prognosis for women diagnosed with inflammatory breast cancer.” - http://imaginis.com/breasthealth/nipple.asp