Majčinstvo i dojenje nakon karcinoma dojke

Dragana Valent

doi:10.5937/opmed0-47545

Dragana Valent Dom zdravlja "Šid,Alekse antića 1 22240 Šid,infodomzdravljasid.org.rs@

DOI: https://doi.org/10.5937/opmed0-47545

Ključne reči: trudnoća, hemioterapija, hormonska terapija, anti_HEP2, cista jajnika

Sažetak

Uvod. Karcinom dojke je najučestaliji tumor u ženskoj
populaciji. Zlatni standard u dijagnostici karcinoma dojke je
mamografija u kombinaciji sa ultrazvučnim pregledom ili
magnetnom rezonancom. Terapija može da obuhvati operativno
lečenje, radioterapiju, hemioterapiju, hormonsku terapiju,
ciljanu terapiju i imunoterapiju.
Prikaz bolesnika. U radu je prikazana pacijentkinja
starosti 46 godina. Prvi put se javila na pregled 2007. godine
kada je imala 30 godina i planirala drugu trudnoću. Samopregledom
dojke napipala je čvor. Ultrazvučnim pregledom
potvrđeno je prisustvo tumora. Nakon dijagnostike i preoperativne
pripreme urađena je poštedna operacija leve dojke uz
disekciju aksile zbog pozitivnih limfnih nodusa. Patohistološki
nalaz je bio Carcinoma mixtus praecipue ductale G2
et partim mucinosum G2, dok je nalaz u limfnim nodusima
aksile bio negativan. Hormonski status tumora bio je Estrogen
1, Progesteron 1, HER2 2. Pacijentkinja je primila hemioterapiju
FAC u šest ciklusa i terapiju trastuzumabom u
16 ciklusa. Uključen je tamoksifen koji je bio u terapiji do
decembra 2009. godine kada je usled brojnih cisti uklonjen
desni jajnik i više cisti na levom jajniku. Pet godina nakon
operacije karcinoma dojke pacijentkinja je zatrudnela i rodila
devojčicu koju je dojila deset meseci iz neoperisane dojke.
Zaključak. Karcinom dojke je oboljenje koje znatno
narušava reproduktivno zdravlje kod mlađih žena, pa je
važno obratiti posebnu pažnju na želju pacijentkinje da rađa
nakon lečenja i u skladu s tim sprovesti adekvatnu terapiju i
savetovanje.

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