Utjecaj kliničkih i patohistoloških obilježja na odluku o vrsti liječenja oboljelih od luminalnog A tipa karcinoma dojke

master's thesis

• Title (english): The influence of clinical and histological features on treatment options for patients with Luminal A breast cancer
• Author: Vedran Milinković
• Mentor: Stela Bulimbašić (mentor)
• Committee member: Stela Bulimbašić (predsjednik povjerenstva)
• Committee member: Lidija Bach-Rojecky (član povjerenstva)
• Committee member: Ivica Horvatić (član povjerenstva)
• Granter: University of Zagreb; Faculty of Pharmacy and Biochemistry; Zagreb
• Defense date and country: 2023-09-14, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Pharmacy; Pharmacy

Abstract

Karcinom dojke najčešće je dijagnosticirani maligni tumor današnjice. Mortalitet karcinoma dojke u razvijenim
zemljama značajno je smanjen, zahvaljujući razvoju dijagnostike, citostatske terapije i provođenju nacionalnih
programa ranog otkrivanja. Luminalni A podtip najčešći je imunohistokemijski podtip karcinoma dojke. U radu je
ispitan patohistološki nalaz pacijentica oboljelih od luminalnog A karcinoma dojke te pristupi u liječenju. Obuhvaćene
su 72 pacijentice kojima je dijagnoza postavljena tijekom 2020. u KBC Zagreb te su ondje liječene i praćene. Od toga
su 22 pacijentice bile premenopauzalne, a 50 pacijentica postmenopauzalno. Gotovo 60% pacijentica jest u 6. i 7.
desetljeću života. Ni u jedne pacijentice nije utvrđen tumor gradusa 3. Najveća je učestalost karcinoma dojke
nespecifičnog tipa (NST), dok je učestalost lobularnog karcinoma i specijalnih tipova puno manja. Više od polovine
premenopauzalnih pacijentica imalo je bolest stadija II ili III. Većina postmenopauzalnih pacijentica imala je bolest
stadija I. Svega 2 pacijentice imale su bolest stadija IV. Od 72 pacijentice, svega 6 pacijentica nije bilo liječeno
kirurški. Poštedni zahvat nije praćen radioterapijom samo u iznimnim slučajevima, dok se nakon mastektomije
radioterapija većinom izostavlja. Pozitivan nalaz aksilarnih limfnih čvorova imalo je 12 pacijentica. Od 22
premenopauzalne pacijentice, 14 pacijentica inicijalno je propisan tamoksifen, a 8 pacijentica goserelin u kombinaciji
s inhibitorom aromataze ili tamoksifenom. Od 50 postmenopauzalnih pacijentica, 47 pacijentica propisan je inhibitor
aromataze, a 3 pacijenticama tamoksifen. Adjuvantna kemoterapija propisana je 6 pacijentica, dok se 11 pacijentica
liječilo neoadjuvantno. Adjuvantna kemoterapija i neoadjuvantno liječenje primjenjuju se kod stadija II, III i IV. Do
danas 63 pacijentice redovito dolaze na kontrolu i ne pokazuje znakove bolesti, dok je 9 pacijentica izgubljeno iz
praćenja.

Abstract (english)

Breast cancer is the most frequently diagnosed cancer today. Breast cancer mortality in high-income countries
significantly dropped, due to advances in diagnostic methods and cancer therapy, as well as implementation of national
breast cancer screening programs. Luminal A subtype is the most common immunohistochemical subtype of breast
cancer. This study examines histopathological features and treatment approaches in patients with luminal A breast
cancer. Study included 72 patients who were diagnostically evaluated in 2020, and subsequently treated in University
Hospital Centre Zagreb. Of all patients, 22 patients were premenopausal and 50 patients were postmenopausal. Patients
in the sixth and seventh decade represented almost 60% of all patients. All tumors were histologically graded as GI and
GII, with no GIII tumors. The frequency of invasive breast carcinoma of no special type (NST) was the highest, while
the frequency of lobular cancer and special types was much lower. More than half of premenopausal patients had stage
II or III disease. Most postmenopausal patients had stage I disease. Only 2 patients had stage IV disease. Of all patients,
only 6 patients were not treated surgically. Omission of radiotherapy after breast conserving surgery was appropriate
only in exceptional cases, while omitting radiotherapy after mastectomy was common. The presence of positive axillary
lymph nodes was found in 12 patients. Of 22 premenopausal patients, 14 patients were prescribed tamoxifen as initial
treatment option, while 8 patients were prescribed goserelin in combination with aromatase inhibitor or tamoxifen. Of
50 postmenopausal patients, 47 patients were prescribed aromatase inhibitors and 3 patients were prescribed tamoxifen.
Adjuvant chemotherapy was prescribed to 6 patients, while 11 patients received neoadjuvant treatment. Adjuvant
chemotherapy and neoadjuvant treatment were appropriate treatment options for stages II, III and IV. In 3-year followup, 63 patients from the analysed group are alive with no signs of relapse, while 9 patients were lost to follow-up.

• Keywords: karcinom dojke; imunofenotip; kirurško liječenje; endokrina terapija; kemoterapija; radioterapija
• Keywords (english): breast cancer; immunophenotypes; surgical therapy; endocrine therapy; chemotherapy; radiotherapy
• Language: croatian
• URN:NBN: urn:nbn:hr:163:237859
• Study programme: Title: Pharmacy; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: magistar/magistra farmacije (magistar/magistra farmacije)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-01-02 16:17:08