Lucas Donald J, Sabino Jennifer, Shriver Craig D, Pawlik Timothy M, Singh Devinder P, Vertrees Amy E
Walter Reed National Military Medical Center, Bethesda, Maryland, USA.
Am Surg. 2015 Jan;81(1):74-80.
An increasing number of women may be choosing mastectomy over breast-conserving surgery for breast cancer as well as undergoing more bilateral resection, immediate reconstruction, and prophylactic operations. Women who had breast cancer operations between 2005 and 2011 were selected from the National Surgical Quality Improvement Program database. Annual trends were explored using robust Poisson multivariable regression as were predictors for mastectomy versus breast-conserving surgery. A total of 85,401 women were identified. Mastectomy increased from 2005 to 2011, starting at 40 per cent in 2005 and peaking at 51 per cent in 2008 (P < 0.001). Bilateral resection, immediate reconstruction, and prophylactic mastectomy also increased (all P < 0.001). Independent predictors of mastectomy included young age, Asian race, invasive cancer (vs carcinoma in situ), bilateral resection, axillary dissection, higher American Society of Anesthesiologists class, and lower body mass index (all P < 0.001). There was an increase in mastectomy, bilateral resection, immediate reconstruction, and prophylactic mastectomy from 2005 to 2011.
越来越多的女性在乳腺癌治疗中可能选择乳房切除术而非保乳手术，并且接受更多的双侧切除术、即刻乳房重建术和预防性手术。从国家外科质量改进计划数据库中选取了2005年至2011年间接受乳腺癌手术的女性。使用稳健泊松多变量回归分析年度趋势以及乳房切除术与保乳手术的预测因素。共识别出85401名女性。乳房切除术从2005年到2011年有所增加，2005年为40%，2008年达到峰值51%（P<0.001）。双侧切除术、即刻乳房重建术和预防性乳房切除术也有所增加（均P<0.001）。乳房切除术的独立预测因素包括年轻、亚洲种族、浸润性癌（与原位癌相比）、双侧切除术、腋窝清扫术、美国麻醉医师协会分级较高以及体重指数较低（均P<0.001）。2005年至2011年间，乳房切除术、双侧切除术、即刻乳房重建术和预防性乳房切除术均有所增加。
