Mandelblatt Jeanne, Figueiredo Melissa, Cullen Jennifer
Department of Oncology and Lombardi Cancer Center, Georgetown University, Washington, DC, USA.
Health Qual Life Outcomes. 2003 Sep 17;1:45. doi: 10.1186/1477-7525-1-45.
There are few comprehensive reviews of breast cancer outcomes in older women. We synthesize data to describe key findings and gaps in knowledge about the outcomes of breast cancer in this population.
We reviewed research published between 1995 and June 2003 on breast cancer quality of life and outcomes among women aged 65 and older treated for breast cancer. Outcomes included communication, satisfaction, and multiple quality of life domains.
Few randomized trials or cohort studies that measured quality of life after treatment focused exclusively on older women. Studies from older women generally noted that, with the exception of axillary dissection, type of surgical treatment generally had no effect on long-term outcomes. In contrast, the processes of care, such as choosing therapy, good patient-physician communication, receiving treatment concordant with preferences about body image, and low perceptions of bias, were associated with better quality of life and satisfaction.
With the exception of axillary dissection, the processes of care, and not the therapy itself, seem to be the most important determinants of long-term quality of life in older women.
针对老年女性乳腺癌治疗结果的全面综述较少。我们综合数据以描述该人群乳腺癌治疗结果的关键发现及知识空白。
我们回顾了1995年至2003年6月间发表的关于65岁及以上接受乳腺癌治疗女性的乳腺癌生活质量及治疗结果的研究。治疗结果包括沟通、满意度及多个生活质量领域。
很少有专门针对老年女性治疗后生活质量的随机试验或队列研究。老年女性的研究普遍指出，除腋窝清扫术外，手术治疗方式一般对长期治疗结果没有影响。相比之下，护理过程，如选择治疗方案、良好的医患沟通、接受符合身体形象偏好的治疗以及较低的偏见感，与更好的生活质量和满意度相关。
除腋窝清扫术外，护理过程而非治疗本身似乎是老年女性长期生活质量的最重要决定因素。
