Nissan Aviram, Spira Ram M, Hamburger Tamar, Badrriyah Mahmud, Prus Diana, Cohen Tzeela, Hubert Ayala, Freund Herbert R, Peretz Tamar
Department of Surgery, Hadassah University Hospital Mount Scopus, PO Box 24035, Jerusalem Il-91240, Israel.
Am J Surg. 2004 Jul;188(1):62-7. doi: 10.1016/j.amjsurg.2003.11.039.
The clinical profile of breast cancer may vary among different ethnic groups living in the same country and therefore affect the yield of a breast cancer screening program. The present study attempts to better characterize the breast cancer clinical profile of Arab women compared with Jewish women in the greater Jerusalem area with a future aim of establishing a comprehensive and effective screening program for this population.
Retrospective chart review was conducted and the following covariates were correlated with survival: ethnicity, age at diagnosis, and American Joint Committee on Cancer (TNM) stage at diagnosis.
A total of 312 women were operated on for breast cancer between 1994 and 1999; 51% were Ashkenazi Jews (AJ), 26% were Sephardic Jews (SJ), 21% were Palestinian Arabs (PA), and 2% patients did not fit into those ethnic groups. The mean age at diagnosis was 51.5 years for the PA group, 53.4 +/- 1.5 for the SJ group, and 55.9 years for the AJ group (P <0.03 PA versus AJ). The tumor size (mean +/- SEM) was 38.8 +/- 3.7 mm, 31.1 +/- 2.4 mm, and 24.5 +/- 1.6 mm for the PA, SJ, and AJ groups, respectively (P = 0.03 for PA versus SJ and P <0.001 for PA versus AJ). Five-year overall survival was 77 %, 72%, and 58% for the AJ, SJ, and PA groups, respectively (P = 0.02); and 5-year disease-free survival was 72%, 51%, and 50% for the AJ, SJ, and PA groups, respectively (P = 0.03, AJ versus SJ).
Our data demonstrate younger age and larger primary tumor size for the Arab patients compared with the Jewish patients. These findings were associated with lower 5-year survival and disease-free survival of the Arab patients.
在同一个国家生活的不同种族群体中，乳腺癌的临床特征可能有所不同，因此会影响乳腺癌筛查项目的效果。本研究旨在更好地描述耶路撒冷地区阿拉伯女性与犹太女性的乳腺癌临床特征，未来目标是为该人群建立一个全面有效的筛查项目。
进行回顾性病历审查，并将以下协变量与生存率相关联：种族、诊断时年龄以及美国癌症联合委员会（TNM）诊断分期。
1994年至1999年间，共有312名女性接受了乳腺癌手术；51%为阿什肯纳兹犹太人（AJ），26%为西班牙裔犹太人（SJ），21%为巴勒斯坦阿拉伯人（PA），2%的患者不属于这些种族群体。PA组诊断时的平均年龄为51.5岁，SJ组为53.4±1.5岁，AJ组为55.9岁（PA与AJ相比，P<0.03）。PA组、SJ组和AJ组的肿瘤大小（平均值±标准误）分别为38.8±3.7毫米、31.1±2.4毫米和24.5±1.6毫米（PA与SJ相比，P = 0.03；PA与AJ相比，P<0.001）。AJ组、SJ组和PA组的5年总生存率分别为77%、72%和58%（P = 0.02）；AJ组、SJ组和PA组的5年无病生存率分别为72%、51%和50%（AJ与SJ相比，P = 0.03）。
我们的数据表明，与犹太患者相比，阿拉伯患者的年龄更小，原发肿瘤更大。这些发现与阿拉伯患者较低的5年生存率和无病生存率相关。
