降低风险的乳房切除术：10个欧洲中心的结果
Risk reducing mastectomy: outcomes in 10 European centres.
作者信息
Evans D G R, Baildam A D, Anderson E, Brain A, Shenton A, Vasen H F A, Eccles D, Lucassen A, Pichert G, Hamed H, Moller P, Maehle L, Morrison P J, Stoppat-Lyonnet D, Gregory H, Smyth E, Niederacher D, Nestle-Krämling C, Campbell J, Hopwood P, Lalloo F, Howell A
机构信息
Central Manchester and Manchester Children's University Hospitals NHS Trust, St Mary's Hospital, Manchester, M13 0JH, UK.
出版信息
J Med Genet. 2009 Apr;46(4):254-8. doi: 10.1136/jmg.2008.062232. Epub 2008 Nov 7.
BACKGROUND
Increasingly women at high risk of breast cancer are opting for risk reducing surgery. The aim of this study was to assess the effectiveness of this approach in women at high risk in both carriers and non-carriers of BRCA1/2.
METHODS
Data from 10 European centres that offer a genetic counselling and screening service to women at risk were obtained prospectively from 1995. Breast cancer risks were estimated from life tables and a control group of women at risk who did not undergo surgery.
RESULTS
The combined centres have data on 550 women who have undergone risk reducing mastectomy with greater than 3334 women years of follow-up. Operations were carried out on women with lifetime risks of 25-80%, with an average expected incidence rate of 1% per year. No breast cancers have occurred in this cohort in the "at risk" unaffected breast, whereas >34 would have been expected. A high rate (2-3.6%) of occult disease was identified in the at risk breast at the time of surgery.
INTERPRETATION
We conclude that risk reducing surgery is highly effective.
背景
越来越多患乳腺癌高风险的女性选择进行降低风险的手术。本研究的目的是评估这种方法对BRCA1/2基因携带者和非携带者中高风险女性的有效性。
方法
自1995年起前瞻性地获取了来自10个为有风险女性提供遗传咨询和筛查服务的欧洲中心的数据。根据生命表估计乳腺癌风险，并设立了未接受手术的有风险女性对照组。
结果
各中心汇总后有550名接受了降低风险乳房切除术的女性的数据，随访时间超过3334人年。对终生风险为25%至80%的女性进行了手术，平均预期发病率为每年1%。在该队列中，处于“有风险”的未受影响乳房未发生乳腺癌，而预期会有超过34例。手术时在有风险乳房中发现了较高比例（2% - 3.6%）的隐匿性疾病。
解读
我们得出结论，降低风险的手术非常有效。
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