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Federación Mexicana de Ginecología y Obstetricia, A.C.

2021, Número 06

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Ginecol Obstet Mex 2021; 89 (06)


Terapia hormonal de reemplazo y riesgo de cáncer ginecológico en mujeres en el climaterio. Revisión narrativa

Arteaga-Gómez AC, Zapata-Caballero CA, Arellano-Eguiluz A, Santoyo-Rosas SE, Robellada-Zárate CM

Idioma: Español
Referencias bibliográficas: 40
Paginas: 464-471
Archivo PDF: 213.16 Kb.


RESUMEN

Objetivo: Identificar y actualizar, mediante una revisión bibliográfica, la magnitud del riesgo que implica la terapia hormonal de reemplazo en la incidencia y recurrencia del cáncer de mama, ovario, endometrio y cuello uterino en mujeres en el climaterio. Además, evaluar la relación con el tiempo y tipo de tratamiento indicado.
Materiales y Métodos: Estudio retrospectivo, de búsqueda bibliográfica efectuada en ensayos publicados de 2010 a 2020 con desenlaces oncológicos asociados con la terapia de reemplazo hormonal. La búsqueda se llevó a cabo en las bases de datos PubMed y Google Scholar.
Resultados: Se encontraron 5848 artículos relacionados y se descartaron 3828 por haberse publicado antes del 2010. Se revisaron los resúmenes de 2020 artículos y se eliminaron 1980 por no cumplir con los criterios de inclusión. La revisión final se efectuó con 40 artículos.
Conclusiones: Con base en lo publicado, la evidencia sugiere que hay un aumento del riesgo de cáncer de mama en las usuarias de terapia hormonal de reemplazo combinada; el mayor riesgo secundario es con las progestinas. Para el endometrio el riesgo es mayor con estrógenos aislados. Para el cáncer de ovario la evidencia no es suficiente para guiar la práctica. Para el cáncer cervicouterino, la evidencia sugiere que la terapia hormonal no tiene riesgo. Los riesgos y beneficios de la terapia hormonal de reemplazo tienen variaciones considerables dependientes del régimen específico y las circunstancias individuales de cada paciente.


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