Ooi Corinne W L, Campbell Ian D, Kollias James, de Silva Primali
Department of Surgery, Waikato Hospital, Hamilton.
N Z Med J. 2012 Aug 10;125(1359):7-16.
The National Breast Cancer Audit collects data on the care of early breast cancer patients in Australia and New Zealand. An overview of invasive breast cancer in New Zealand is presented with emphasis on comparing the screened population with symptomatic referrals.
All New Zealand data in the National Breast Cancer Audit with a diagnosis date of 2008 have been included in the report. Data was analysed with an aim to compare the presenting features and management of screen detected invasive cancer with symptomatic referrals in New Zealand.
There were 2371 cases of breast cancer, 52% of which were symptomatic referrals, 37% of which were BreastScreen Aotearoa referrals. Higher breast conservation rates were reported in the screening population. 3% of patients had involved margins after surgery. Almost two-thirds (62%) of BreastScreen patients underwent a sentinel node biopsy without further axillary surgery. 72% of screening patients and 86% of symptomatic patients who were high risk did not receive post mastectomy radiotherapy. A larger proportion of symptomatic patients received chemotherapy. Endocrine therapy was prescribed to 81% of hormone receptor positive patients.
Patients with early invasive breast cancer in New Zealand were managed appropriately according to audit performance indicators and clinical guidelines. The numbers of high risk patients not receiving post mastectomy radiotherapy and the lack of endocrine treatment in some patients with hormone receptor positive tumours may warrant further investigation.
澳大利亚和新西兰的国家乳腺癌审计收集早期乳腺癌患者的护理数据。本文概述了新西兰浸润性乳腺癌情况,重点是比较筛查人群和有症状转诊患者的情况。
本报告纳入了国家乳腺癌审计中所有诊断日期为2008年的新西兰数据。分析数据旨在比较新西兰筛查发现的浸润性癌与有症状转诊患者的临床表现和治疗情况。
共有2371例乳腺癌病例,其中52%为有症状转诊患者,37%为新西兰乳腺癌筛查机构转诊患者。筛查人群的保乳率更高。3%的患者术后切缘阳性。近三分之二(62%)的乳腺癌筛查患者接受了前哨淋巴结活检,未进一步进行腋窝手术。72%的筛查患者和86%的高危有症状患者未接受乳房切除术后放疗。有症状患者接受化疗的比例更高。81%的激素受体阳性患者接受了内分泌治疗。
根据审计绩效指标和临床指南,新西兰早期浸润性乳腺癌患者得到了适当治疗。高危患者未接受乳房切除术后放疗的人数以及部分激素受体阳性肿瘤患者缺乏内分泌治疗,可能值得进一步研究。