Rolul ovariectomiei celioscopice în tratamentul hormonal al cancerului mamar

Abstract

Background: It is well known that breast tumors are hormone-dependent tumors, that is why patients in reproductive and perimenopausal phases required maximum reduction possible by blocking estrogen action or by reducing circulating free estrogen. The most effective method to stop immediately the production of estrogen is represented by the ovarian ablation. Laparoscopic oophorectomy is current hormone maneuver, immediately and safely reduces circulating estrogen levels to 100% of patients, the remaining concentration being similar to that in the menopause. Laparoscopic oophorectomy can be performed with curative and prophylactic tasks. Oophorectomy was performed for the first time as a therapeutic procedure for advanced breast cancer more than 110 years ago and as adjuvant hormonal treatment in primary breast cancer – 50 years ago. The efficiency of oophorectomy remains uncertain in adjuvant treatment, so it is not surprising that prophylactic oophorectomy in women at increased risk remains controversial. Laparoscopic oophorectomy proved to be a safer method of treatment, less traumatic, with much less immunosuppressive effect, short convalescence, with fast postoperative rehabilitation (1-2 days compared to 8-10 days in laparotomy) and low price, compared to the classical ovarian ablation, or using antiestrogenic preparations. Conclusions: The choice of therapeutic agent should be individualized, based on the safety profile, associated comorbidities and biological characteristics of the tumor, the main purpose is to stop the production of estrogen and progesterone (ovarian suppression). It is a surgical technique of choice in comparison with ovarian laparotomy.