Gill Grantley, Luke Colin, Roder David
Breast and Surgical Oncology Unit, Royal Adelaide Hospital, and Department of Surgery, University of Adelaide, Adelaide, South Australia.
J Med Screen. 2006;13(2):98-101. doi: 10.1258/096914106777589560.
To determine epidemiological characteristics of palpability as a feature of asymptomatic invasive breast cancers detected through screening mammography, and to determine whether palpability is predictive of case survival after adjusting for conventional prognostic indicators such as diameter, grade and nodal status.
The University of Adelaide, South Australian Department of Health, and The Cancer Council South Australia, Adelaide, South Australia.
Sociodemographic and clinical characteristics of 2108 screen-detected invasive breast cancers were compared by tumour palpability using univariate and multiple logistic regression analysis. Survival outcomes from breast cancer were compared using Kaplan-Meier product-limit estimates. Multivariable proportional hazard regression was employed to assess the association of palpability with survival after adjusting for conventional prognostic indicators.
Palpability was associated with year of diagnosis, ductal histology type, and unfavourable prognostic indicators such as larger tumour diameter, higher grade and nodal involvement. After adjusting for these variables, no associations were found with age at diagnosis, place of residence or socioeconomic status, or with presence of multifocal disease or presence of an extensive in situ component. Palpability was predictive of death from breast cancer in an unadjusted analysis, the relative risk (95% confidence limits) being 1.75 (1.12, 2.74). After adjusting for nodal involvement and larger tumour size, the relative risk no longer was elevated, reducing to 0.99 (0.60, 1.64).
Palpability is associated with unfavourable prognostic indicators, such as larger diameter, higher grade and nodal involvement, and is not an independent indicator of survival outcome for screen-detected female-breast cancers after accounting for nodal involvement and diameter.
确定通过乳腺钼靶筛查发现的无症状浸润性乳腺癌可触及性这一特征的流行病学特征，并确定在调整诸如直径、分级和淋巴结状态等传统预后指标后，可触及性是否可预测病例生存情况。
阿德莱德大学、南澳大利亚卫生部以及南澳大利亚癌症理事会，位于南澳大利亚阿德莱德。
采用单因素和多因素逻辑回归分析，根据肿瘤可触及性比较2108例筛查发现的浸润性乳腺癌的社会人口统计学和临床特征。使用Kaplan-Meier乘积限估计法比较乳腺癌的生存结局。采用多变量比例风险回归分析，在调整传统预后指标后评估可触及性与生存的关联。
可触及性与诊断年份、导管组织学类型以及不利的预后指标相关，如肿瘤直径较大、分级较高和淋巴结受累。在调整这些变量后，未发现与诊断年龄、居住地点或社会经济地位、多灶性疾病的存在或广泛原位成分的存在有关联。在未经调整的分析中，可触及性可预测乳腺癌死亡，相对风险（95%置信区间）为1.75（1.12，2.74）。在调整淋巴结受累和肿瘤较大尺寸后，相对风险不再升高，降至0.99（0.60，1.64）。
可触及性与不利的预后指标相关，如直径较大、分级较高和淋巴结受累，在考虑淋巴结受累和直径后，对于筛查发现的女性乳腺癌，可触及性不是生存结局的独立指标
