Anatomia patológica no diagnóstico do câncer: implicações para a prevenção quaternária
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https://doi.org/10.5712/rbmfc10(35)1057Palavras-chave:
Prevenção Quaternária, Patologia Cirúrgica, Neoplasias do Colo do ÚteroResumo
A anatomia patológica é a especialidade médica responsável pelo diagnóstico de câncer. Apesar de muito importante, a partir do desenvolvimento da oncologia, sua ligação com o sobrediagnóstico e sobretratamento permanece ainda pouco estudada. Apesar de grande midiatização, a biologiamolecular não trouxe muito progresso para a classificação dos tumores. Ao contrário, a aparição silenciosa de imunohistoquímica, no final da década de 1980, foi o que melhorou significativamente as classificações tumorais, a ponto de ser possível lançar dúvidas sobre os resultados de alguns ensaios clínicos desse período. Este artigo discute como o auge e o abuso da imunohistoquímica pode ter levado ao sobrediagnóstico. Ele também destaca que a padronização ISO 15189, assim como a complexidade de classificação tumoral, podem também contribuir para a indução do sobretratamento. Em suma, a leitura crítica e a compreensão dos laudos de patologia por parte dos médicos de família são essenciais. Portanto, os médicos de família não deveriam hesitar em discutir o diagnóstico de câncer com o patologista e, em alguns casos, também questionar a decisão do oncologista. Essa abordagem pode ser considerada uma ação de prevenção quaternária que pode prevenir o sobretratamento.
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