Roder David, Zorbas Helen, Kollias James, Pyke Chris, Walters David, Campbell Ian, Taylor Corey, Webster Fleur
Cancer Australia, Sydney, Australia.
Asian Pac J Cancer Prev. 2013;14(1):547-52. doi: 10.7314/apjcp.2013.14.1.547.
To investigate patient, cancer and treatment characteristics in females with breast cancer from more remote areas of Australia, to better understand reasons for their poorer outcomes, bi-variable and multivariable analyses were undertaken using the National Breast Cancer Audit database of the Society of Breast Surgeons of Australia and New Zealand. Results indicated that patients from more remote areas were more likely to be of lower socio- economic status and be treated in earlier diagnostic epochs and at inner regional and remote rather than major city centres. They were also more likely to be treated by low case load surgeons, although this finding was only of marginal statistical significance in multivariable analysis (p=0.074). Patients from more remote areas were less likely than those from major cities to be treated by breast conserving surgery, as opposed to mastectomy, and less likely to have adjuvant radiotherapy when having breast conserving surgery. They had a higher rate of adjuvant chemotherapy. Further monitoring will be important to determine whether breast conserving surgery and adjuvant radiotherapy utilization increase in rural patients following the introduction of regional cancer centres recently funded to improve service access in these areas.
为了调查澳大利亚偏远地区乳腺癌女性患者的情况、癌症及治疗特征，以更好地理解她们预后较差的原因，我们利用澳大利亚和新西兰乳腺外科医生协会的国家乳腺癌审计数据库进行了双变量和多变量分析。结果表明，来自偏远地区的患者社会经济地位较低的可能性更大，在早期诊断阶段接受治疗，且治疗地点在内陆地区和偏远地区而非主要城市中心。他们也更有可能由低病例量的外科医生治疗，不过这一发现在多变量分析中仅具有边际统计学意义（p = 0.074）。与大城市的患者相比，偏远地区的患者接受保乳手术而非乳房切除术的可能性较小，且在接受保乳手术时接受辅助放疗的可能性也较小。他们辅助化疗的比例较高。随着最近为改善这些地区的服务可及性而资助建立了区域癌症中心，进一步监测对于确定农村患者的保乳手术和辅助放疗使用率是否增加至关重要。
