Banco de tejido ovárico para jóvenes con cáncer de mama
Informe preliminar de los primeros casos
Resumen
Introducción: el número de pacientes jóvenes con cáncer de mama parece ser mayor en Uruguay que en los promedios internacionales. Muchas de estas jóvenes no tienen hijos y la consejería en reproducción es actualmente recomendada por las sociedades científicas de referencia. En nuestro país funciona desde 2005 un programa de Preservación de la Función Ovárica ante el Cáncer, en el ámbito del Centro Hemato-Oncológico Pediátrico del Centro Hospitalario Pereira Rossell, que realiza consejería y técnicas de criopreservación de tejido ovárico destinadas a pacientes de todos los ámbitos y en forma gratuita.
Objetivos:el objetivo principal de este trabajo es presentar los primeros casos de cáncer de mama en pacientes jóvenes que ingresaron en el protocolo de criopreservación de tejido ovárico.
El objetivo secundario es difundir y lograr incorporar en la práctica clínica la derivación de las pacientes jóvenes sin hijos que reciban este diagnóstico a una consejería en reproducción.
Material y método: en el marco del protocolo previamente aprobado por la Facultad de Medicina se tomaron los primeros cinco casos de pacientes que ingresaron con diagnóstico de cáncer de mama, sin hijos jóvenes y en estadios iniciales. La extracción de tejido ovárico se realizó luego de la cirugía oncológica y antes del tratamiento complementario mediante laparoscopía. El tejido se almacenó en el Instituto Nacional de Donación y Trasplantes de Células, Tejidos y Órganos (INDYT).
Resultados: cinco pacientes de entre 26 y 35 años ingresaron al protocolo en el período mayo de 2006 a enero de 2009. Una de las pacientes falleció, comprobándose que era un estadio superior al planteado inicialmente. Las cuatro pacientes restantes están en tratamiento complementario con buena evolución y en amenorrea. Por lo tanto, no están planteados procedimientos de reimplante al momento.
Discusión y conclusiones: Uruguay cuenta, con carácter gratuito y universal, con una de las opciones disponibles para preservar tejido ovárico indemne. Procedimiento, no obstante, de carácter experimental. Sin embargo, se reciben pocas derivaciones de pacientes con cáncer de mama. La consejería en fertilidad y la derivación correspondiente es un aspecto básico y fundamental.
Citas
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