荷兰南部筛查时代乳腺导管原位癌患者的治疗和腋窝分期的时间趋势和医院间差异。
Time trends and inter-hospital variation in treatment and axillary staging of patients with ductal carcinoma in situ of the breast in the era of screening in Southern Netherlands.
机构信息
Eindhoven Cancer Registry, Comprehensive Cancer Centre South, PO Box 231, 5600 AE Eindhoven, The Netherlands.
Eindhoven Cancer Registry, Comprehensive Cancer Centre South, PO Box 231, 5600 AE Eindhoven, The Netherlands; Department of Epidemiology, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands.
出版信息
Breast. 2014 Feb;23(1):63-8. doi: 10.1016/j.breast.2013.11.001. Epub 2013 Dec 2.
BACKGROUND
To examine variation in time and place in axillary staging and treatment of patients with ductal carcinoma in situ (DCIS) of the breast.
METHODS
Trends in patients with DCIS recorded in the Eindhoven Cancer Registry diagnosed in 1991-2010 (n = 2449) were examined.
RESULTS
The use of breast conserving surgery (BCS) went from 17% to 67% in 1991-2010 and administration of radiotherapy after BCS increased to 89%. Axillary lymph node dissection decreased to almost 0%, while sentinel node biopsy was performed in 65% of patients in 2010. The proportion who underwent BCS varied between hospitals from 49% to 80%; the proportion without axillary staging ranged from 21% to 60%. Patients with screen-detected DCIS were more likely to receive BCS.
CONCLUSION
There was considerable variation in the use of BCS, radiotherapy, and axillary staging of DCIS over time and between hospitals. Patients with DCIS were more likely to be treated with BCS if their disease was detected by screening.
背景
本研究旨在考察乳腺导管原位癌（DCIS）患者腋窝分期和治疗的时间和地点差异。
方法
本研究回顾了 1991 年至 2010 年在埃因霍温癌症登记处诊断的 2449 例 DCIS 患者的趋势。
结果
1991 年至 2010 年间，保乳手术（BCS）的使用率从 17%上升至 67%，BCS 后放疗的使用率上升至 89%。腋窝淋巴结清扫术的使用率几乎降至 0%，而在 2010 年，65%的患者接受了前哨淋巴结活检。不同医院间 BCS 的使用率差异较大，从 49%至 80%不等；无腋窝分期的比例从 21%至 60%不等。通过筛查发现的 DCIS 患者更有可能接受 BCS。
结论
随着时间的推移和医院间的差异，BCS、放疗和腋窝分期在 DCIS 中的应用存在相当大的差异。如果疾病是通过筛查发现的，那么 DCIS 患者更有可能接受 BCS 治疗。
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