Department of Health Services Research & Policy, London School of Hygiene & Tropical Medicine, London, UK.
BMJ Open. 2013 Aug 1;3(8):e003179. doi: 10.1136/bmjopen-2013-003179.
For healthy women at high risk of developing breast cancer, a bilateral mastectomy can reduce future risk. For women who already have unilateral breast cancer, removing the contralateral healthy breast is more difficult to justify. We examined trends in the number of women who had a bilateral mastectomy in England between 2002 and 2011.
Retrospective cohort study using the Hospital Episode Statistics database.
NHS hospital trusts in England.
Women aged between 18 and 80 years who had a bilateral mastectomy (or a contralateral mastectomy within 24 months of unilateral mastectomy) with or without a diagnosis of breast cancer.
Number and incidence of women without breast cancer who had a bilateral mastectomy; number and proportion who had a bilateral mastectomy as their first breast cancer operation, and the proportion of those undergoing bilateral mastectomy who had immediate breast reconstruction.
Among women without breast cancer, the number who had a bilateral mastectomy increased from 71 in 2002 to 255 in 2011 (annual incidence rate ratio 1.16, 95% CI 1.13 to 1.18). In women with breast cancer, the number rose from 529 to 931, an increase from 2% to 3.1% of first operations (OR for annual increase 1.07, 95% CI 1.05 to 1.08). Across both groups, rates of immediate breast reconstruction roughly doubled and reached 90% among women without breast cancer in 2011.
The number of women who had a bilateral mastectomy nearly doubled over the last decade, and more than tripled among women without breast cancer. This coincided with an increase in the use of immediate breast reconstruction.
对于有罹患乳腺癌高风险的健康女性，双侧乳房切除术可降低未来的患病风险。对于已经患有单侧乳腺癌的女性，切除另一侧健康乳房则更难被证明合理。本研究旨在分析 2002 年至 2011 年期间英国行双侧乳房切除术的女性数量变化趋势。
回顾性队列研究，使用医院病例统计数据库。
英国国民保健署医院信托。
年龄在 18 岁至 80 岁之间，接受双侧乳房切除术（或单侧乳房切除术后 24 个月内行对侧乳房切除术）的女性，无论是否患有乳腺癌。
未患有乳腺癌的女性中接受双侧乳房切除术的人数和发病率；首次行乳腺癌手术时接受双侧乳房切除术的人数和比例，以及行双侧乳房切除术且接受即刻乳房重建的比例。
在未患有乳腺癌的女性中，行双侧乳房切除术的人数从 2002 年的 71 人增加到 2011 年的 255 人（年发病率比值为 1.16，95%置信区间为 1.13 至 1.18）。在患有乳腺癌的女性中，该人数从 529 人增加到 931 人，占首次手术的比例从 2%增加到 3.1%（每年增加的比值为 1.07，95%置信区间为 1.05 至 1.08）。在两组人群中，即刻乳房重建的比例大致翻了一番，2011 年在未患有乳腺癌的女性中达到 90%。
过去十年间，行双侧乳房切除术的女性人数几乎翻了一番，而在未患有乳腺癌的女性中增加了两倍多。这与即刻乳房重建使用率的增加同时发生。
