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发展中国家乳腺癌的临床表现及管理模式。有很多工作要做。

Pattern of presentation and management of ca breast in developing countries. There is a lot to do.

作者信息

Malik Arshad Mehmood, Pathan Rafique, Shaikh Noshad Ahmed, Qureshi Jawaid Naeem, Talpur Khamiso Altaf Hussain

机构信息

Department of Surgery, Liaquat University of Medical & Health Sciences, Jamshoro, Hyderabad, Sindh.

出版信息

J Pak Med Assoc. 2010 Sep;60(9):718-21.

Abstract

OBJECTIVE

To investigate the pattern of presentation, severity, factors responsible for delayed presentation and outcome of breast cancer in patients presenting to a teaching hospital of Jamshoro.

METHODS

It's a prospective descriptive study of 103 malignant breast lumps treated at a tertiary care teaching hospital over a period of 8 years. All patients were admitted through Outpatients department and were thoroughly examined and investigated. Treatment offered was based on triple assessment and ranged from lumpectomy to toilet mastectomy depending upon the stage of disease. The variables studied were recorded on a proforma and analyzed on SPSS version 12 for measuring frequencies and using Chi square test where applicable.

RESULTS

The mean age of the study population was 39.17 +/- 6.019 years and a range of 22 to 54 years. The frequency of advanced malignancy was alarmingly high in younger patients. Intra- ductal carcinoma was the commonest tumour in 93 (90%) patients, while the remaining included lobular (07) and Paget's disease (03). The high figures of advanced disease at presentation is attributed to lack of knowledge and education, poverty and local customs of women not exposing themselves even to the physicians. In addition, there is a substantial delay in the referral of patients from under privileged, remote areas where patients continue to receive symptomatic treatment till such time that disease becomes incurable.

CONCLUSION

Advanced breast disease is common in younger patients belonging to underprivileged and remote rural areas. Great efforts are required to educate people so as to make early diagnosis possible

摘要

目的

调查在占姆肖罗一家教学医院就诊的乳腺癌患者的临床表现模式、严重程度、导致就诊延迟的因素及治疗结果。

方法

这是一项对一家三级护理教学医院在8年期间治疗的103例乳腺恶性肿块进行的前瞻性描述性研究。所有患者均通过门诊部入院,并接受了全面的检查和调查。所提供的治疗基于三重评估,根据疾病阶段从肿块切除术到乳房单纯切除术不等。所研究的变量记录在一份表格上,并在SPSS 12版本上进行分析,以测量频率,并在适用时使用卡方检验。

结果

研究人群的平均年龄为39.17±6.019岁,年龄范围为22至54岁。年轻患者中晚期恶性肿瘤的发生率高得惊人。导管内癌是93例(90%)患者中最常见的肿瘤,其余包括小叶癌(7例)和佩吉特病(3例)。就诊时晚期疾病的高比例归因于知识和教育的缺乏、贫困以及女性甚至不向医生暴露自己的当地习俗。此外,来自贫困偏远地区的患者转诊存在严重延迟,在这些地区,患者继续接受对症治疗,直到疾病无法治愈。

结论

晚期乳腺疾病在贫困偏远农村地区的年轻患者中很常见。需要付出巨大努力来教育人们,以便能够进行早期诊断。

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