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[乳腺癌筛查研究的早期结果]

[Early results of breast cancer screening research].

作者信息

Nowicki Andrzej, Stogowska Izabela

机构信息

Zakład Pielegniarstwa Onkologicznego Wydziału Nauk o Zdrowiu, Collegium Medicum w Bydgoszczy Uniwersytetu Mikołaja Kopernika w Toruniu.

出版信息

Ginekol Pol. 2007 Jun;78(6):464-70.

Abstract

INTRODUCTION

Breast cancer is the most common malignant carcinoma among women in Poland. In the year 2000 alone, 10987 new cases were registered. Mass-screening examinations are most effective method of fighting against breast cancer. The aim of this work was to estimate a mammography screening program in population of women at the ages between 50 to 69, which has been performed during 2004-2005 in the Regional General Hospital in Elblag.

MATERIAL AND METHODS

The research was based on retrospective analysis of files from the Department of Radiology at Regional General Hospital in Elblag. Electronic database of mammography examinations and files from Oncological Outpatient Clinic and Surgery Outpatient Clinic were analyzed. Research was conducted under within the program of National Health Fund. Screening examination to detect breast cancer includes physical examination of the breast and mammography, performed in 3161 women at the ages between 50 to 69, average age being 57.8. Mammography was described according to BIRADS scale. In cases of suspected malignant lesions, patients underwent additional examinations (USG, BAC, biopsy, surgical histopathology).

RESULTS

The largest group consisted of women at the age of 50 to 55. The total number of examined women amounted to 3161. The most frequent case was glandular-fat breast structure (1720 women, 55.3% of all cases) and the least frequent one was strictly glandular structure of breast (80 women, 2.6%). The so-called typical mammography result was detected in most cases (80.4%) and malignant lesions were detected in only 2 women (0.1%). The majority of the x-ray shadows and focus-like lesions were detected in upper-outer quadrant of breast (22.1%). 6-10 millimeters lesions were the most common ones (50.8%), followed by 10-15 millimeters (21.9%) and 16-20 millimeters lesions in size (11%). Lack of size description was detected in 61 women (1.9%). 471 (14.9%) of all women were ordered to undergo further diagnostic examinations (USG, BAC, histopathologic examination) on the base of mammography results. 315 (10.8%) of women did register for those additional examinations. 53 women came for BAC examination after mammography and ultrasound examinations. Neoplastic cells were detected in materials of 22 cases. Mastectomy (according to Patey's method) was the most frequent procedure in 2004 and 2005 and it was performed in 12 women. Conservative surgery was performed in 8 patients. Furthermore, 2 women with breast cancer were not classified for surgery because of too advanced stage of cancer. Invasive ductal (72.7%) and pre-invasive cancers were most common cases of all detected breast cancers.

CONCLUSIONS

3161 mammography screening examinations were performed between 2004 and 2005. Women with detected breast cancer, mainly at the age 56-60, constituted 0.7% of the whole group. Patey's mastectomy was performed in above 50% of cases of all women, the remaining patients underwent conservative surgery. Only 10% of women have cancer at dissemination stage. Medical database of screening program contained incomplete descriptions of mammography results. Descriptions were not precise and not standardized.

摘要

引言

乳腺癌是波兰女性中最常见的恶性肿瘤。仅在2000年,就登记了10987例新病例。大规模筛查是对抗乳腺癌最有效的方法。这项工作的目的是评估2004年至2005年期间在埃尔布隆格地区总医院对50至69岁女性人群进行的乳房X线筛查项目。

材料与方法

该研究基于对埃尔布隆格地区总医院放射科档案的回顾性分析。分析了乳房X线检查的电子数据库以及肿瘤门诊和外科门诊的档案。研究在国家卫生基金项目下进行。检测乳腺癌的筛查检查包括乳房体格检查和乳房X线检查,对3161名年龄在50至69岁之间的女性进行了检查,平均年龄为57.8岁。乳房X线检查根据美国放射学会乳腺影像报告和数据系统(BIRADS)分级。在怀疑有恶性病变的情况下,患者接受了额外的检查(超声、细针穿刺活检、活检、手术组织病理学检查)。

结果

最大的群体是50至55岁的女性。接受检查的女性总数为3161人。最常见的情况是腺脂肪型乳房结构(1720名女性,占所有病例的55.3%),最不常见的是纯腺型乳房结构(80名女性,占2.6%)。大多数病例(80.4%)检测到所谓的典型乳房X线检查结果,仅2名女性(0.1%)检测到恶性病变。大多数X线阴影和类病灶性病变出现在乳房的外上象限(22.1%)。6至10毫米的病变最为常见(50.8%),其次是10至15毫米的病变(21.9%)和16至20毫米大小的病变(11%)。61名女性(1.9%)的病变未描述大小。根据乳房X线检查结果,471名(14.9%)女性被要求进行进一步的诊断检查(超声、细针穿刺活检、组织病理学检查)。315名(10.8%)女性登记参加了这些额外检查。53名女性在乳房X线检查和超声检查后前来进行细针穿刺活检。在22例病例的材料中检测到肿瘤细胞。乳房切除术(根据佩蒂法)是2004年和2005年最常见的手术,12名女性接受了该手术。8名患者接受了保乳手术。此外,2名乳腺癌女性因癌症分期太晚未被分类进行手术。浸润性导管癌(72.7%)和原位癌是所有检测到的乳腺癌中最常见的类型。

结论

2004年至2005年期间进行了3161次乳房X线筛查检查。检测出乳腺癌的女性,主要年龄在56至60岁,占整个群体的0.7%。超过50%的女性病例接受了佩蒂乳房切除术,其余患者接受了保乳手术。只有10%的女性处于癌症扩散期。筛查项目的医学数据库包含对乳房X线检查结果的不完整描述。描述不精确且未标准化。

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