预防性乳房切除术的监测：1995 年至 2005 年的使用趋势。

Surveillance of prophylactic mastectomy: trends in use from 1995 through 2005.

机构信息

Patient Safety Center, New York State Department of Health, Albany, New York, USA.

出版信息

Cancer. 2009 Dec 1;115(23):5404-12. doi: 10.1002/cncr.24623.

DOI:10.1002/cncr.24623

PMID:19787635

Abstract

BACKGROUND

Prophylactic mastectomy, prophylactic oophorectomy, and antiestrogen chemoprevention are currently the only available methods for breast cancer risk reduction. To the authors' knowledge there is little published information regarding the prevalence of prophylactic mastectomy for the primary prevention of breast cancer among high-risk women or for the prevention of subsequent tumors among women with breast cancer.

METHODS

The objective of the current study was to examine the frequency of prophylactic mastectomy in New York State between 1995 and 2005 using mandated statewide discharge data combined with data from the state cancer registry.

RESULTS

Identified were 6275 female residents of New York State receiving prophylactic mastectomy; 19% had no identifiable personal history of breast cancer (including women with lobular carcinoma in situ) and 81% had a personal history of breast cancer (84% with invasive disease and 16% with ductal carcinoma in situ). The increased use of prophylactic mastectomy over time was found to be more pronounced among women with breast cancer compared with those without. Women who underwent prophylactic mastectomies were more likely to be younger and white and to have private insurance compared with women who underwent therapeutic mastectomies and compared with all women with breast cancer. The International Classification of Diseases, Ninth Edition, Clinical Modification diagnostic code for prophylactic mastectomy introduced in 1995 was found to have low sensitivity for identifying prophylactic mastectomies in coded discharge data.

CONCLUSIONS

The results of the current analysis demonstrate that, although the discharge data alone are inadequate for surveillance purposes, combining these data with the cancer registry data allowed for the detailed examination of the prevalence of prophylactic mastectomies. Mastectomy among high-risk women for cancer prevention appears to be relatively uncommon, but the use of contralateral mastectomy in women with breast cancer is increasing.

摘要

背景

预防性乳房切除术、预防性卵巢切除术和抗雌激素化学预防是目前降低乳腺癌风险的唯一可用方法。据作者所知，关于高危女性中预防性乳房切除术用于乳腺癌的一级预防或用于预防乳腺癌女性随后发生肿瘤的情况，发表的信息很少。

方法

本研究的目的是使用强制性全州出院数据结合州癌症登记处的数据，检查 1995 年至 2005 年期间纽约州预防性乳房切除术的频率。

结果

确定了 6275 名接受预防性乳房切除术的纽约州女性居民；19%的人没有可识别的乳腺癌个人史（包括乳腺原位癌患者），81%的人有乳腺癌个人史（84%为浸润性疾病，16%为导管原位癌）。发现随着时间的推移，与无乳腺癌病史的女性相比，有乳腺癌病史的女性中预防性乳房切除术的使用率增加更为明显。与接受保乳手术的女性和所有患有乳腺癌的女性相比，接受预防性乳房切除术的女性更年轻、更白，并且更有可能拥有私人保险。1995 年引入的国际疾病分类，第九版，临床修正版预防性乳房切除术诊断代码在编码出院数据中发现其识别预防性乳房切除术的敏感性较低。