Zhao Wei-hong, Xu Bing-he, Li Qing, Zhang Pin, Sun Yan
Department of Medical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China.
Zhonghua Zhong Liu Za Zhi. 2006 May;28(5):385-8.
To investigate the clinical characteristics and prognostic factors in breast cancer patients over 70 years of age.
From 1980 to 2003, 280 female breast cancer patients over 70 years old were treated and the data were retrospectively reviewed. The clinical features including age, comorbidity, initial symptom, tumor size and location, pathological type, lymph node status, hormonal receptor status, treatment approaches and overall survival were analyzed.
These 280 patients accounted for 2.9% of all breast cancer patients registered in our institution during the same period. Presentation of breast lump as initial symptom accounted for 92.5% of the patients. The median time from the presentation of initial symptom to initial diagnosis was 4 months. Major pathological type was invasive ductal carcinoma (74.3%). Estrogen or progesterone receptor was found to be positive in 72.9% by immunohistochemical staining. 165 patients (58.9%) had comorbidity such as coronary heart disease, hypertension, diabetes, etc. 256 patients underwent surgery consisting of 162 modified mastectomies, 46 mastectomies, 38 lumpectomies, 7 lumpectomies plus lymph node dissection, 2 lymph node resection and 1 with unavailable surgery record. The cumulative 5- and 10-year overall survival was 69.9% and 40.6%, respectively. Factors affecting the prognosis were tumor size, lymph node status, pathological stage, vascular invasion and endocrine therapy by univariate analysis. The lymph node status and vascular invasion were found to be two independent prognostic factors affecting significantly the prognosis by multivariate analysis.
Female breast cancer patients over 70 years of age exhibit distinctive clinical and pathological characteristics. Surgery and endocrine therapy are important to achieve good clinical outcome. Lymph node status and vascular invasion are two independent prognostic factors.
探讨70岁以上乳腺癌患者的临床特征及预后因素。
回顾性分析1980年至2003年期间接受治疗的280例70岁以上女性乳腺癌患者的数据。分析其临床特征，包括年龄、合并症、首发症状、肿瘤大小及位置、病理类型、淋巴结状态、激素受体状态、治疗方法及总生存期。
这280例患者占同期我院登记的所有乳腺癌患者的2.9%。以乳腺肿块为首发症状的患者占92.5%。从首发症状出现到初次诊断的中位时间为4个月。主要病理类型为浸润性导管癌（74.3%）。免疫组化染色显示雌激素或孕激素受体阳性率为72.9%。165例患者（58.9%）合并冠心病、高血压、糖尿病等合并症。256例患者接受了手术，其中162例行改良根治术，46例行根治术，38例行保乳手术，7例行保乳手术加淋巴结清扫，2例行淋巴结切除术，1例手术记录不详。5年和10年总生存率分别为69.9%和40.6%。单因素分析显示影响预后的因素有肿瘤大小、淋巴结状态、病理分期、血管侵犯及内分泌治疗。多因素分析显示淋巴结状态和血管侵犯是影响预后的两个独立预后因素。
70岁以上女性乳腺癌患者具有独特的临床和病理特征。手术和内分泌治疗对取得良好的临床疗效很重要。淋巴结状态和血管侵犯是两个独立的预后因素。
