1] Department of Social and Preventive Medicine, Julius Centre University of Malaya, Faculty of Medicine, University of Malaya, 50603 Lembah Pantai, Kuala Lumpur, Malaysia [2] Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands.
National Clinical Research Centre, Hospital Kuala Lumpur, Level 3, Dermatology Block, Jalan Pahang, 50586 Kuala Lumpur, Malaysia.
Br J Cancer. 2014 Apr 29;110(9):2187-94. doi: 10.1038/bjc.2014.183. Epub 2014 Apr 15.
Within a setting without organised breast cancer screening, the characteristics and survival of very early breast cancer were determined.
All 4930 women diagnosed with breast cancer in University Malaya Medical Center, Malaysia from 1993 to 2011 were included. Factors associated with very early presentation (stage I) at diagnosis were identified. Tumour characteristics, management patterns, and survival of very early breast cancer were described, and where appropriate, compared with other settings.
Proportion of women presenting with stage I breast cancer significantly increased from 15.2% to 25.2% over two decades. Factors associated with very early presentation were Chinese ethnicity, positive family history of breast cancer, and recent period of diagnosis. Within stage I breast cancers, median tumour size at presentation was 1.5 cm. A majority of stage I breast cancer patients received mastectomy, which was associated with older age, Chinese ethnicity, postmenopausal status, and larger tumours. Chemotherapy was administered in 36% of patients. Five-year age-adjusted relative survival for women with stage I breast cancer was 99.1% (95% CI: 97.6-99.6%).
The proportion of women presenting with very early breast cancer in this setting without organised screening is increasing. These women seem to survive just as well as their counterparts from affluent settings.
在没有组织化乳腺癌筛查的环境下，确定了非常早期乳腺癌的特征和生存情况。
纳入了 1993 年至 2011 年在马来西亚大学医学中心诊断出的 4930 名乳腺癌患者。确定了与非常早期（I 期）诊断相关的因素。描述了非常早期乳腺癌的肿瘤特征、管理模式和生存情况，并在适当情况下与其他环境进行了比较。
在过去二十年中，I 期乳腺癌患者的比例从 15.2%显著增加到 25.2%。与非常早期表现相关的因素包括华族、乳腺癌家族史阳性和近期诊断。在 I 期乳腺癌中，就诊时的中位肿瘤大小为 1.5 厘米。大多数 I 期乳腺癌患者接受了乳房切除术，这与年龄较大、华族、绝经后状态和较大的肿瘤有关。36%的患者接受了化疗。I 期乳腺癌患者的 5 年年龄调整相对生存率为 99.1%（95%CI：97.6-99.6%）。
在这个没有组织化筛查的环境中，表现为非常早期乳腺癌的女性比例正在增加。这些女性的生存情况似乎与富裕环境中的患者一样好。
