Anatomia patológica no diagnóstico do câncer: implicações para a prevenção quaternária

  • Matthieu Yver Marne La Vallée Public Hospital
Palavras-chave: Prevenção Quaternária, Patologia Cirúrgica, Neoplasias do Colo do Útero

Resumo

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 biologia
molecular 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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Biografia do Autor

Matthieu Yver, Marne La Vallée Public Hospital

 

The author is a privileged observer. Working since 15 years as a surgical pathologist, he began his career as resident of JM Coindre, PhD, a famous international expert on sarcoma. After being assistant in the pathology department of St Louis hospital, Paris, he is now head of the pathology department of a public hospital in France. He has published several papers in Human Pathology. This article is the fruit of years of work experiences and doubts. The reading of the philosophes like Michel Foucault or Jean Baudrillard have been of high value to think about pathology more globally.

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Publicado
2015-06-24
Como Citar
Yver, M. (2015). Anatomia patológica no diagnóstico do câncer: implicações para a prevenção quaternária. Revista Brasileira De Medicina De Família E Comunidade, 10(35), 1-7. https://doi.org/10.5712/rbmfc10(35)1057