常规乳腺钼靶检查与40岁及以上乳腺癌患者的疾病分期更早以及更适合保乳治疗相关。

Routine mammography is associated with earlier stage disease and greater eligibility for breast conservation in breast carcinoma patients age 40 years and older.

作者信息

Freedman Gary M, Anderson Penny R, Goldstein Lori J, Hanlon Alexandra L, Cianfrocca Mary E, Millenson Michael M, von Mehren Margaret, Torosian Michael H, Boraas Marsha C, Nicolaou Nicos, Patchefsky Arthur S, Evers Kathryn

机构信息

Department of Radiation Oncology, the Breast Evaluation Center, Fox Chase Cancer Center, Philadelphia, PA, USA.

出版信息

Cancer. 2003 Sep 1;98(5):918-25. doi: 10.1002/cncr.11605.

DOI:10.1002/cncr.11605

PMID:12942557

Abstract

BACKGROUND

Reduction in breast carcinoma mortality is a major benefit of screening mammography and has been demonstrated in multiple randomized clinical trials and service screening programs. Another benefit from screening is that it allows the patient a wider choice of treatment options, particularly the possibility of conservation surgery. The current study analyzed the impact of mammography in the staging and treatment of breast carcinoma.

METHODS

A total of 1591 women aged > or = 40 years were treated for breast carcinoma between July 1995 and October 2001. Three subgroups were defined and compared. Group 1 had 192 patients with no previous mammography, Group 2 was comprised of 695 patients who underwent mammography on average less often than once yearly, and Group 3 was comprised of 704 patients who on average underwent mammography once yearly or more often.

RESULTS

The difference in tumor stage was found to be statistically significant between the groups (P < 0.0001). In Group 1, 15% of the patients had ductal carcinoma in situ (DCIS) compared with 21% of patients in Group 2 and 26% of patients in Group 3. In addition, 32% of patients in Group 1 had T1 tumors, whereas 50% of patients in Group 2 and 56% of patients in Group 3 had T1 tumors. The tumor size was < or = 1 cm in 8% of the patients in Group 1 compared with 20-23% of patients in Groups 2 and 3 (P = 0.0092). Breast conservation was an option for 41% of the patients in Group 1 but mastectomy was recommended in another 41% of patients. However, in Groups 2 and 3, 61% of patients were offered breast conservation and mastectomy was recommended to 28% (P < 0.0001).

CONCLUSIONS

In the current study, women age > or = 40 years with breast carcinoma who underwent mammography at least once yearly were diagnosed with DCIS more often compared with patients who underwent mammography less frequently or those who had no prior mammography. Women who underwent mammographic screening were found to have smaller tumors, which resulted in a majority of these patients being able to consider breast conservation as an alternative to mastectomy.

摘要

背景

降低乳腺癌死亡率是乳腺钼靶筛查的一项主要益处，这已在多项随机临床试验和服务性筛查项目中得到证实。筛查的另一项益处是它能让患者有更广泛的治疗选择，尤其是保乳手术的可能性。本研究分析了乳腺钼靶对乳腺癌分期及治疗的影响。

方法

1995年7月至2001年10月期间，共有1591名年龄≥40岁的女性接受了乳腺癌治疗。定义并比较了三个亚组。第1组有192名患者之前未进行过乳腺钼靶检查，第2组由695名平均每年接受乳腺钼靶检查次数少于一次的患者组成，第3组由704名平均每年接受乳腺钼靶检查一次或更频繁的患者组成。

结果

发现各组之间肿瘤分期的差异具有统计学意义（P<0.0001）。在第1组中，15%的患者患有导管原位癌（DCIS），而第2组为21%，第3组为26%。此外，第1组中32%的患者患有T1期肿瘤，而第2组为50%，第3组为56%。第1组中8%的患者肿瘤大小≤1cm，而第2组和第3组为20%-23%（P = 0.0092）。第1组中41%的患者可选择保乳，但另有41%的患者建议行乳房切除术。然而，在第2组和第3组中，61%的患者可选择保乳，28%的患者建议行乳房切除术（P<0.0001）。