Nowikiewicz Tomasz, Zegarski Wojciech, Piątkowska Magdalena, Klag Michał
Pol Przegl Chir. 2013 Apr;85(4):204-9. doi: 10.2478/pjs-2013-0031.
The primary goal of mammography screening is to decrease mortality in patients with breast cancer.
Evaluation of the screening program results on course of implemented therapy and its results in breast carcinoma patients.
Evidence includes data on the group of 1818 patients with breast cancer that were subject to surgical treatment at the Clinic of Breast Cancer and Reconstructive Surgery of the Oncology Center in Bydgoszcz (558 patients hospitalized from January 2006 to December 2006 and 1260 patients treated from January 2011 to June 2012). Analysis included type of diagnostic procedure implemented before surgical treatment, as well as grade of cancer progression, results of pathology tests done on specimens and type of surgical procedure. Additionally, the screening group (tumor diagnosed based on screening mammography) and symptomatic group (cancer diagnosed otherwise that within the screening program) were identified.
In 2006, in 28.4% of patients included in the study, primary tumor was discover in screening process (vs 61.5% in 2011-2012). In the first period, 35.7% of changes did not exceed 2 cm--cT1 (vs 48.3% in 2011-2012), while the percentage of cT4 was 9.9% (vs 4.7% in 2011-2012). In 2006, 30.8% of patients were treated in the grade I of clinical progression (vs 44.2% in 2011-2012), 53.4% in the grade II, 14% in grade III and 0.2% in grade IV (vs 45.7%, 9.7%, and 0.4%, respectively). In 45.5% (2006) and 39.9% (in 2011-2012) of patients, metastases were found in axillary lymph nodes. Differences were similar both in screening and symptomatic group. In 2006, in 12.4% of surgical patients breast conserving therapy (BCT) was implemented (vs 49.8% in 2011-2012). In the screening group, it was applied in 15.2% of patients (in 2006) and in 63% (in 2011- 2012), while in symptomatic group the percentages were 11.8% and 41%, respectively.
In both periods of analysis, significant differences were observed as to implementation of breast cancer screening program, as well as to grade of clinical and pathological progression of the cancer. Observable increase of screening tests allowed for significantly more frequent implementation of breast conserving surgical procedures.
乳腺钼靶筛查的主要目标是降低乳腺癌患者的死亡率。
评估筛查项目对乳腺癌患者实施治疗过程及其结果的影响。
证据包括比得哥什肿瘤中心乳腺癌及重建外科诊所接受手术治疗的1818例乳腺癌患者的数据（2006年1月至2006年12月住院的558例患者以及2011年1月至2012年6月治疗的1260例患者）。分析内容包括手术治疗前实施的诊断程序类型、癌症进展程度、标本病理检查结果以及手术程序类型。此外，还确定了筛查组（基于乳腺钼靶筛查诊断出的肿瘤）和有症状组（在筛查项目之外以其他方式诊断出的癌症）。
2006年，在纳入研究的患者中，28.4%的患者在筛查过程中发现原发性肿瘤（2011 - 2012年为61.5%）。在第一阶段，35.7%的病变不超过2厘米——cT1期（2011 - 2012年为48.3%），而cT4期的比例为9.9%（2011 - 2012年为4.7%）。2006年，30.8%的患者处于临床进展I级接受治疗（2011 - 2012年为44.2%），II级为53.4%，III级为14%，IV级为0.2%（2011 - 2012年分别为45.7%、9.7%和0.4%）。45.5%（2006年）和39.9%（2011 - 2012年）的患者腋窝淋巴结发现转移。筛查组和有症状组的差异相似。2006年，12.4%的手术患者实施了保乳治疗（BCT）（2011 - 2012年为49.8%）。在筛查组中，2006年15.2%的患者接受了保乳治疗（2011 - 2012年为63%），而在有症状组中，这一比例分别为11.8%和41%。
在两个分析阶段，乳腺癌筛查项目的实施以及癌症的临床和病理进展程度均存在显著差异。筛查检测次数的明显增加使得保乳手术的实施更为频繁。
