Solin Lawrence J., Schultz Delray J., Kessler Howard B., Hanchak Nicholas A.
Department of Radiation Oncology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania; Department of Mathematics, Millersville University, Millersville, Pennsylvania and the University of Pennsylvania Cancer Center, Philadelphia, Pennsylvania; Department of Radiology, Fox Chase Cancer Center, Philadelphia, Pennsylvania; U.S. Quality Algorithms,(R) Inc., Aetna U.S. Healthcare,trade mark Blue Bell, Pennsylvania.
Breast J. 1999 Mar;5(2):94-100. doi: 10.1046/j.1524-4741.1999.00131.x.
The efficacy of mammographic screening for older women has not been well studied. The present study was designed to evaluate for downstaging of breast carcinomas associated with mammographic screening in older women. The study population consisted of 130 women age >/=65 years with newly diagnosed breast carcinoma in 1993-1994 and was obtained from women enrolled in a large health maintenance organization. Mammographic screening, if done, was performed by a network of predominantly community-based radiologists. Significant downstaging was found for the breast cancers detected in women who had undergone mammographic screening compared to the breast cancers detected in women who had not undergone mammographic screening. The American Joint Committee on Cancer (AJCC) clinical stage was stage 0 and stage I in 7% (8/107) and 73% (78/107), respectively, of the breast cancers detected in women who had undergone mammographic screening compared to 0% (0/23) and 22% (5/23), respectively, of the breast cancers detected in women who had not undergone mammographic screening (p < 0.0001). Clinical Tis and T1 tumors were found in 7% (8/107) and 74% (79/107), respectively, of the breast cancers detected in women who had undergone mammographic screening compared to 0% (0/23) and 22% (5/23), respectively, of the breast cancers detected in women who had not undergone mammographic screening (p < 0.0001). Of the 102 AJCC clinical stage I-II breast cancers with known pathologic axillary lymph node staging, lymph node stage was N0 for 76% (66/87) of the women who had undergone mammographic screening compared to 53% (8/15) of the women who had not undergone mammographic screening (p = 0.019). The results of downstaging reported in this study are important because earlier staged lesions are associated with an improved prognosis and an increased potential for breast-conservation treatment. These findings have shown that mammographic screening is effective in downstaging breast carcinomas found in older women.
针对老年女性的乳腺钼靶筛查效果尚未得到充分研究。本研究旨在评估乳腺钼靶筛查对老年女性乳腺癌降期的影响。研究对象为1993年至1994年新诊断为乳腺癌的130名年龄≥65岁的女性，她们来自一个大型健康维护组织的在册女性。乳腺钼靶筛查（若进行）由一个以社区放射科医生为主的网络实施。与未接受乳腺钼靶筛查的女性所患乳腺癌相比，接受过乳腺钼靶筛查的女性所患乳腺癌出现了显著降期。美国癌症联合委员会（AJCC）临床分期方面，接受过乳腺钼靶筛查的女性所患乳腺癌中，0期和I期分别占7%（8/107）和73%（78/107），而未接受乳腺钼靶筛查的女性所患乳腺癌中，0期和I期分别占0%（0/23）和22%（5/23）（p<0.0001）。接受过乳腺钼靶筛查的女性所患乳腺癌中，Tis期和T1期临床肿瘤分别占7%（8/107）和74%（79/107），而未接受乳腺钼靶筛查的女性所患乳腺癌中，Tis期和T1期临床肿瘤分别占0%（0/23）和22%（5/23）（p<0.0001）。在102例已知病理腋窝淋巴结分期的AJCC临床I-II期乳腺癌中，接受过乳腺钼靶筛查的女性中76%（66/87）的淋巴结分期为N0，而未接受乳腺钼靶筛查的女性中这一比例为53%（8/15）（p = 0.019）。本研究报告的降期结果很重要，因为分期较早的病变与预后改善及保乳治疗可能性增加相关。这些发现表明，乳腺钼靶筛查对老年女性所患乳腺癌的降期有效。
