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个人或一级家族乳腺癌病史:哪一个对乳腺癌的肿瘤检测和肿瘤大小影响更大。

Personal or first-degree family breast cancer history: which has higher impact on tumor detection and tumor size in breast cancer.

作者信息

Schwab Fabienne Dominique, Kilic Nerbil, Huang Dorothy Jane, Schmid Seraina Margaretha, Vetter Marcus, Schötzau Andreas, Güth Uwe

机构信息

Department of Gynecology and Obstetrics, University Hospital Basel (UHB), Spitalstrasse 21, 4031, Basel, Switzerland.

出版信息

Arch Gynecol Obstet. 2015 Jun;291(6):1387-94. doi: 10.1007/s00404-014-3592-y. Epub 2014 Dec 17.

Abstract

PURPOSE

A woman's risk of developing breast cancer (BC) is increased if she has a personal history (PH) or family history (FH) of the disease. We compared the impact of the two risk factors PH and FH on tumor detection and tumor size at diagnosis in a cohort of BC patients.

METHODS

The study cohort comprised 1,037 invasive BC patients (≤70 years at diagnosis). From these, 92 patients (8.5%) had a positive PH and 151 patients (13.7%) had a positive first-degree FH.

RESULTS

Compared to the tumors of patients without PH or FH, the lesions of patients who had a positive PH or a positive FH were more often found by radiologic breast examinations (RBE) (PH: 49.4%, FH: 43.4%, no PH/FH: 26.2%; both comparisons p < 0.001). In patients with a positive FH, the tumors were slightly less often found by RBE as in patients with a positive PH (p = 0.468). Patients with a positive PH or FH had smaller tumors compared with those without such a history (PH: 19.7 mm, FH: 19.6 mm, no PH/FH: 26.7 mm; p = 0.015/p < 0.001). The tumor sizes of patients with a positive PH were almost identical to those of patients with a positive FH (p = 0.999).

CONCLUSIONS

In women with a positive FH or PH of BC, the increased awareness of BC risk led to the detection of smaller tumors compared to women who have not had this experience. However, comparison of the two risk factors showed that they had a similar impact on the RBE detection rate of BC lesions and that the tumor sizes were nearly identical.

摘要

目的

如果女性有乳腺癌(BC)的个人史(PH)或家族史(FH),那么她患乳腺癌的风险会增加。我们比较了BC患者队列中PH和FH这两个风险因素对肿瘤检测及诊断时肿瘤大小的影响。

方法

研究队列包括1037例浸润性BC患者(诊断时年龄≤70岁)。其中,92例患者(8.5%)有阳性PH,151例患者(13.7%)有阳性一级FH。

结果

与无PH或FH的患者的肿瘤相比,有阳性PH或阳性FH的患者的病变更常通过乳腺放射检查(RBE)发现(PH:49.4%,FH:43.4%,无PH/FH:26.2%;两个比较均p<0.001)。在有阳性FH的患者中,RBE发现肿瘤的频率略低于有阳性PH的患者(p = 0.468)。与无此类病史的患者相比,有阳性PH或FH的患者肿瘤较小(PH:19.7mm,FH:19.6mm,无PH/FH:26.7mm;p = 0.015/p<0.001)。有阳性PH的患者的肿瘤大小与有阳性FH的患者几乎相同(p = 0.999)。

结论

与没有这种经历的女性相比,有BC阳性FH或PH的女性由于对BC风险的认识提高,导致检测出较小的肿瘤。然而,对这两个风险因素的比较表明,它们对BC病变的RBE检测率有相似的影响,且肿瘤大小几乎相同。

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