İnflamatuar Meme Kanseri
Özet
Özet
İnflamatuar meme kanseri (İMK), meme derisinde kızarıklık ve ödem (peau d’orange) ile karakterize lokal ileri evre meme kanserinin agresif bir alt formudur. Tanı, biyopside invaziv karsinom varlığı ve karakteristik klinik görünümün bir arada olması ile konulur. İMK klinik bir tanı olup patogenezinde dermal lenfatiklerde tümör embolilerinin olması yer alır. Klinik semptomlar hızlı başlangıçlıdır. Enfeksiyöz mastitle karıştırılabilir. Antibiyotikle düzelmeyen mastitte akla İMK gelmelidir. İMK sıklıkla hematojen yayılım gösterir, diğer meme kanserlerine göre visseral organ metastazı daha sıktır. Agresif bir hastalık olması nedeniyle multidisipliner yaklaşımla beraber trimodal tedaviler uygulanır. Tedavi genelde neoadjuvant kemoterapi, cerrahi ve radyoterapiyi içermektedir. Sistemik tedavide antrasiklin ve taksan bazlı kemoterapiler tercih edilir. Tümörün biyobelirteçleri (her2 ve hormon reseptör durumu) tedavi seçimini yönlendirmek için kullanılır. Meme koruyucu yaklaşım ve sentinel lenf nodu biyopsisi yerine mastektomi ve aksiller lenf nodu diseksiyonu tercih edilmelidir. Mastektomi sonrası göğüs duvarı ve bölgesel lenf nodlarına radyoterapi uygulanmalıdır. Multimodal tedavilerle İMK’nın sağkalımı geçmişe göre artmıştır.
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