Woon Y Y, Chan M Y P
Department of Surgery, Tan Tock Seng Hospital, Jalan Tan Tock Seng, Singapore 308433, Singapore.
Breast. 2005 Apr;14(2):131-5. doi: 10.1016/j.breast.2004.08.014.
Breast-conserving surgery (BCS) is a well-established treatment for early breast cancer. However, rates of BCS differ in different countries and institutions. This study attempts to find the factors affecting BCS in a local acute care hospital. To this end, 389 patients with early breast cancers treated between 2000 and 2002 were enrolled. Indications for mastectomy were more likely to be documented by breast surgeons (45%) than by other surgeons (30.6%) (P = 0.052). Univariate analysis showed that patients who had smaller tumours, were operated on in 2002 and were operated on by breast specialists were more likely to have undergone BCS. Multivariate analysis, after exclusion of patients with compelling indications for mastectomy, showed that the year of operation (p < 0.001) and the surgeon's subspecialty (p = 0.003) remained independent predictors of BCS. Thus, the surgeon has a crucial role in increasing the BCS rate in the treatment of early breast cancer.
保乳手术（BCS）是早期乳腺癌公认的治疗方法。然而，不同国家和机构的保乳手术率有所不同。本研究旨在找出影响当地一家急性护理医院保乳手术率的因素。为此，纳入了2000年至2002年间接受治疗的389例早期乳腺癌患者。与其他外科医生（30.6%）相比，乳腺外科医生记录乳房切除术指征的可能性更高（45%）（P = 0.052）。单因素分析显示，肿瘤较小、于2002年接受手术且由乳腺专科医生实施手术的患者更有可能接受保乳手术。在排除有明确乳房切除术指征的患者后进行多因素分析，结果显示手术年份（p < 0.001）和外科医生的亚专业（p = 0.003）仍然是保乳手术的独立预测因素。因此，外科医生在提高早期乳腺癌治疗中的保乳手术率方面起着关键作用。
