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日本乳腺癌的临床病理特征及乳腺癌患者的治疗趋势:基于日本乳腺癌学会2004年至2011年的乳腺癌登记数据。

Clinicopathological characteristics of breast cancer and trends in the management of breast cancer patients in Japan: Based on the Breast Cancer Registry of the Japanese Breast Cancer Society between 2004 and 2011.

作者信息

Kurebayashi Junichi, Miyoshi Yasuo, Ishikawa Takashi, Saji Shigehira, Sugie Tomoharu, Suzuki Takashi, Takahashi Shunji, Nozaki Miwako, Yamashita Hiroko, Tokuda Yutaka, Nakamura Seigo

机构信息

Department of Breast and Thyroid Surgery, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan,

出版信息

Breast Cancer. 2015 May;22(3):235-44. doi: 10.1007/s12282-015-0599-6. Epub 2015 Mar 11.

Abstract

PURPOSES

We conducted a study to analyze the clinicopathological characteristics of breast cancer in Japan registered to the Japanese Breast Cancer Registry of the Japanese Breast Cancer Society (JBCS). Trends in the management of breast cancer patients in Japan were also analyzed.

PATIENTS AND METHODS

More than 250,000 breast cancer patients were registered to the JBCS registry between 2004 and 2011. Demographic and clinicopathological factors in newly diagnosed primary breast cancer patients were registered to the JBCS through the Web-based system from affiliated institutes nationwide.

RESULTS

Two distinct peaks were observed, in patients in their late 40s and early 60s, in the population-adjusted age distribution of breast cancer patients. An increased rate of screen-detected breast cancer may contribute to an earlier detection of breast cancer and increased rate of non-invasive ductal carcinoma. The positive rate of either ER or PgR appears to have increased in recent years. The annual rates of patients treated with breast-conserving surgery increased until 2006, but these increases stopped in 2007 and thereafter plateaued at approximately 60 %. The annual rates of patients treated with sentinel lymph node dissection alone have steadily increased. The annual rates of patients treated with preoperative trastuzumab plus chemotherapy have also increased, as well as those treated with postoperative aromatase inhibitors. The annual rates of patients treated with postoperative anthracycline-containing regimens have decreased, whereas those treated with postoperative taxane-containing regimens have increased. The postoperative use of trastuzumab has markedly increased since 2007.

CONCLUSION

Although this study was based on the registry database, several unique clinicopathological characteristics of breast cancer in Japan have been unveiled. Our results suggest that recent trends in the management of breast cancer patients in Japan were strongly followed by clinical evidence that originated from a number of clinical trials worldwide.

摘要

目的

我们开展了一项研究,以分析在日本乳腺癌学会(JBCS)的日本乳腺癌登记处登记的日本乳腺癌的临床病理特征。同时还分析了日本乳腺癌患者的治疗趋势。

患者与方法

2004年至2011年间,超过250,000例乳腺癌患者被登记到JBCS登记处。新诊断的原发性乳腺癌患者的人口统计学和临床病理因素通过基于网络的系统从全国附属机构登记到JBCS。

结果

在乳腺癌患者的人群校正年龄分布中,观察到两个明显的高峰,分别在40多岁后期和60岁初期的患者中。筛查发现的乳腺癌发病率增加可能有助于乳腺癌的早期发现以及非浸润性导管癌发病率的增加。近年来,雌激素受体(ER)或孕激素受体(PgR)的阳性率似乎有所上升。保乳手术治疗患者的年发生率在2006年之前一直上升,但在2007年停止上升,此后稳定在约60%。仅接受前哨淋巴结清扫术治疗患者的年发生率稳步上升。术前使用曲妥珠单抗加化疗治疗患者的年发生率以及术后使用芳香化酶抑制剂治疗患者的年发生率也有所上升。含蒽环类方案术后治疗患者的年发生率下降,而含紫杉类方案术后治疗患者的年发生率上升。自2007年以来,曲妥珠单抗的术后使用显著增加。

结论

尽管本研究基于登记数据库,但已揭示了日本乳腺癌的一些独特临床病理特征。我们的结果表明,日本乳腺癌患者近期的治疗趋势在很大程度上受到了来自全球多项临床试验的临床证据的影响。

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