John P. Murtha Cancer Center, Bethesda, MD, USA.
Am J Surg. 2013 Sep;206(3):393-9. doi: 10.1016/j.amjsurg.2013.01.034. Epub 2013 Jul 16.
Studies on the effect of comorbidities on breast cancer operation have been limited and inconsistent. This study investigated whether pre-existing comorbidities influenced breast cancer surgical operation in an equal access health care system.
This study was based on linked Department of Defense cancer registry and medical claims data. The study subjects were patients diagnosed with stage I to III breast cancer during 2001 to 2007. Logistic regression was used to determine if comorbidity was associated with operation type and time between diagnosis and operation.
Breast cancer patients with comorbidities were more likely to receive mastectomy (odds ratio [OR] = 1.27; 95% confidence interval [CI], 1.14 to 1.42) than breast conserving surgery plus radiation. Patients with comorbidities were also more likely to delay having operation than those without comorbidities (OR = 1.27; 95% CI, 1.14 to 1.41).
In an equal access health care system, comorbidity was associated with having a mastectomy and with a delay in undergoing operation.
关于合并症对乳腺癌手术影响的研究有限且结果不一致。本研究旨在调查在公平获得医疗保健的体系中，是否存在合并症会影响乳腺癌的手术治疗。
本研究基于美国国防部癌症登记处和医疗记录数据进行。研究对象为 2001 年至 2007 年间被诊断患有 I 期至 III 期乳腺癌的患者。采用 logistic 回归分析确定合并症是否与手术类型和诊断与手术之间的时间有关。
患有合并症的乳腺癌患者更倾向于接受乳房切除术（比值比 [OR] = 1.27；95%置信区间 [CI]，1.14 至 1.42），而非保乳手术加放疗。与无合并症的患者相比，有合并症的患者更有可能延迟手术（OR = 1.27；95% CI，1.14 至 1.41）。
在公平获得医疗保健的体系中，合并症与接受乳房切除术和延迟手术有关。
