澳大利亚浸润性乳腺癌乳房切除术后即刻乳房重建的预测因素。
Factors predictive of immediate breast reconstruction following mastectomy for invasive breast cancer in Australia.
作者信息
Roder D, Zorbas H, Kollias J, Pyke C, Walters D, Campbell I, Taylor C, Webster F
机构信息
Cancer Australia, Sydney, New South Wales, Australia; School of Population Health, University of South Australia, Adelaide, Australia.
出版信息
Breast. 2013 Dec;22(6):1220-5. doi: 10.1016/j.breast.2013.09.011. Epub 2013 Oct 13.
PURPOSE
To investigate person, cancer and treatment determinants of immediate breast reconstruction (IBR) in Australia.
METHODS
Bi-variable and multi-variable analyses of the Quality Audit database.
RESULTS
Of 12,707 invasive cancers treated by mastectomy circa 1998-2010, 8% had IBR. This proportion increased over time and reduced from 29% in women below 30 years to approximately 1% in those aged 70 years or more. Multiple regression indicated that other IBR predictors included: high socio-economic status; private health insurance; being asymptomatic; a metropolitan rather than inner regional treatment centre; higher surgeon case load; small tumour size; negative nodal status, positive progesterone receptor status; more cancer foci; multiple affected breast quadrants; synchronous bilateral cancer; not having neo-adjuvant chemotherapy, adjuvant radiotherapy or adjuvant hormone therapy; and receiving ovarian ablation.
CONCLUSIONS
Variations in access to specialty services and other possible causes of variations in IBR rates need further investigation.
目的
调查澳大利亚即刻乳房重建（IBR）的个体、癌症及治疗相关决定因素。
方法
对质量审核数据库进行双变量和多变量分析。
结果
在1998年至2010年期间接受乳房切除术治疗的12707例浸润性癌症患者中，8%进行了即刻乳房重建。这一比例随时间增加，在30岁以下女性中从29%降至70岁及以上女性中的约1%。多元回归表明，其他即刻乳房重建的预测因素包括：高社会经济地位；私人医疗保险；无症状；位于大城市而非内陆地区的治疗中心；外科医生手术量高；肿瘤体积小；淋巴结阴性状态、孕激素受体阳性状态；更多癌灶；多个乳腺象限受累；同步双侧癌症；未接受新辅助化疗、辅助放疗或辅助激素治疗；以及接受卵巢去势。
结论
获得专科服务的差异以及即刻乳房重建率差异的其他可能原因需要进一步研究。
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