Consenso sobre el diagnóstico y tratamiento del cáncer de mama: enfoque oncológico de la Asociación de Mastología de Antioquia

Consensus on the Diagnosis and Treatment of Breast Cancer: Oncological Approach of the Mastology Association of Antioquia

Publicado 2025-06-27

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Lema Medina M, Herazo-Maya F, Egurrola Pedraza JA, Morán D, Cuello Lopez J, Llinás Quintero N, et al. Consenso sobre el diagnóstico y tratamiento del cáncer de mama: enfoque oncológico de la Asociación de Mastología de Antioquia. Rev. colomb. hematol. oncol. [Internet]. 2025 Jun. 27 [cited 2025 Dec. 5];12(1):14-41. https://doi.org/10.51643/22562915.769

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Lema Medina M, Herazo-Maya F, Egurrola Pedraza JA, Morán D, Cuello Lopez J, Llinás Quintero N, et al. Consenso sobre el diagnóstico y tratamiento del cáncer de mama: enfoque oncológico de la Asociación de Mastología de Antioquia. Rev. colomb. hematol. oncol. [Internet]. 2025 Jun. 27 [cited 2025 Dec. 5];12(1):14-41. https://doi.org/10.51643/22562915.769
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Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-SinDerivadas 4.0.

Mauricio Lema Medina
Clínica de Oncología Astorga, Clínica SOMA, Medellín, Colombia
Roles:  
https://orcid.org/0000-0001-9346-0361
Fernando Herazo-Maya
Oncosapiens S.A.S, Fundación Colombiana de Cancerología Clínica Vida, Medellín, Colombia.
Roles:  
https://orcid.org/0000-0002-7757-0912
Jorge Armando Egurrola Pedraza
Oncosapiens S.A.S, Medellín, Universidad del Magdalena - Santa Marta
Roles:  
https://orcid.org/0000-0001-5311-4229
Diego Morán
Clínica de Oncología Astorga, Medellín, Colombia.
Roles:  
https://orcid.org/0000-0002-6035-0200
Javier Cuello Lopez
Fundación Colombiana de Cancerología Clínica Vida, Medellín, Colombia.
Roles:  
https://orcid.org/0000-0001-9741-5322
Mostrar biografía de los autores

Mauricio Lema Medina,

Medicina Interna, Hemato-oncología.

Fernando Herazo-Maya,

Cirugía General, Cirugía de Mama y Tejidos Blandos, Maestría en Epidemiología.

Jorge Armando Egurrola Pedraza,

Maestría en Ciencias Clínicas, Maestría en Oncología Molecular.

Diego Morán,

Medicina Interna, Oncología Clínica.

Javier Cuello Lopez,

Medicina Interna, Oncología Clínica, Maestría en Epidemiología, Maestría en Oncología Molecular.

Néstor Llinás Quintero,

Medicina Interna, Oncología Clínica.

Diego Mauricio Gonzáles Ramírez,

Medicina Interna, Oncología Clínica.

Andrés Yepes Perez,

Medicina Interna, Oncología Clínica.

Camilo Vallejo Yepes,

Medicina Interna, Oncología Clínica.

Marcela Bermúdez ,

Medicina Interna, Oncología Clínica.

Daniel Santa Botero,

Medicina Interna, Hemato-oncología.

Maycos Leandro Zapata Muñoz,

Medicina Interna, Oncología Clínica.

Víctor Augusto Ramos Gonzalez,

Medicina Interna, Hemato-oncología.

Laura Varela Restrepo,

Medicina Interna, Hemato-oncología.

Mauricio Luján Piedrahíta,

Medicina Interna, Oncología Clínica.

Introducción: el cáncer de mama es la neoplasia más frecuente en Colombia, con más de 17.000 casos diagnosticados anualmente. La Guía de Práctica Clínica (GPC) nacional publicada por última vez en 2017, no han sido actualizadas, lo que limita su aplicabilidad frente a los avances terapéuticos recientes. Ante la ausencia de una revisión oficial, se desarrolló un consenso regional en Antioquia que incorpora nueva evidencia y adapta las recomendaciones al contexto colombiano. Métodos: se conformó un consenso de panel de expertos (CPE) con trece médicos líderes con experiencia en el tratamiento del cáncer de mama. Las recomendaciones fueron evaluadas en dos rondas mediante la metodología Delphi. Se consideró que existía consenso cuando el nivel de acuerdo era igual o superior al 60 %. El documento se estructuró conforme a los lineamientos AGREE II y RIGHT. Resultados: se alcanzó consenso en 97 de 127 recomendaciones en la primera ronda y en 25 de 30 en la segunda. Las recomendaciones abordan aspectos clave del diagnóstico patológico, estudios de estadificación y estrategias terapéuticas según la extensión de la enfermedad (temprana, localmente avanzada, metastásica) y los subtipos histológicos (HR+/HER2−, HER2+ y triple negativo). Conclusión: la metodología del CPE ofrece un marco práctico y adaptable para actualizar el manejo del cáncer de mama en contextos donde las GPC oficiales están desactualizadas. La GPC-SGSSS de 2017 ya no es suficiente para orientar adecuadamente la atención de las pacientes con cáncer de mama en Colombia.

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