Unité de recherche en santé des populations, Hôpital du Saint-Sacrement, Centre de recherche du Centre hospitalier affilé universitaire de Québec, 1050 chemin Sainte-Foy, Québec, QC, G1S 4L8, Canada.
Breast Cancer Res Treat. 2010 Apr;120(3):685-91. doi: 10.1007/s10549-009-0477-z. Epub 2009 Aug 4.
Ductal carcinoma in situ (DCIS) has an excellent prognosis, but its management can resemble that of early invasive breast cancer. We compared aspects of quality of life of women with DCIS to that of women with invasive disease during the first year after treatment initiation. Participants came from consecutive series of women with newly diagnosed, non-metastatic breast cancer treated in eight Quebec hospitals in 2003. Psychological distress and health-related quality of life were measured using the Psychiatric Symptom Index (PSI) and the SF-12 mental and physical component scales (MCS, PCS). Data were obtained 1, 6, and 12 months after the start of treatment. We used generalized linear models to compare mean scores and explored the possible clinical significance of between-group differences with effect size (ES). Participation and retention among eligible women were high, 86 and 97%, respectively. Among the 800 women who completed all interviews, 13.4% (n = 107) had DCIS and 86.6% (693) invasive disease. No statistically significant between-group differences were found at 1, 6, or 12 months in psychological state (PSI and MCS: P values from 0.065 to 0.904; ES from -0.01 to -0.21). Women with DCIS reported significantly higher levels of physical health, particularly when compared at 1 month to women with invasive disease who had chemotherapy (P value < 0.0001; ES = 0.82). Measured in symptoms of psychological distress, the better prognosis or less aggressive management of DCIS does not offset the general psychological effects of a cancer diagnosis to any great degree.
导管原位癌（DCIS）的预后极好，但它的治疗管理可能类似于早期浸润性乳腺癌。我们比较了患有 DCIS 和浸润性疾病的女性在治疗开始后第一年的生活质量。参与者来自 2003 年魁北克省 8 家医院连续系列的新诊断、非转移性乳腺癌女性。使用精神症状指数（PSI）和 SF-12 精神和身体成分量表（MCS、PCS）测量心理困扰和健康相关的生活质量。数据在治疗开始后 1、6 和 12 个月获得。我们使用广义线性模型比较了平均评分，并通过效应量（ES）探索了组间差异的可能临床意义。符合条件的女性的参与率和保留率分别为 86%和 97%。在完成所有访谈的 800 名女性中，13.4%（n = 107）患有 DCIS，86.6%（693）患有浸润性疾病。在 1、6 或 12 个月时，心理状态（PSI 和 MCS：P 值为 0.065 至 0.904；ES 为-0.01 至-0.21）无统计学显著差异。与患有浸润性疾病且接受化疗的女性相比，患有 DCIS 的女性报告了更高的身体健康水平，尤其是在 1 个月时（P 值 < 0.0001；ES = 0.82）。从心理困扰的症状来衡量，DCIS 的较好预后或较少的侵袭性治疗并不能在很大程度上抵消癌症诊断的一般心理影响。
