Barco Israel, Chabrera Carol, García Font Marc, Gimenez Nuria, Fraile Manel, Lain Josep María, Piqueras Merce, Vidal M Carmen, Torras Merce, González Sonia, Pessarrodona Antoni, Barco Josep, Cassadó Jordi, García Fernández Antonio
Department of Gynaecology, Breast Unit, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Barcelona, Spain.
Department of Nursing, School of Health Science Tecnocampus Mataró-Maresme, Barcelona, Spain.
Clin Breast Cancer. 2015 Dec;15(6):482-9. doi: 10.1016/j.clbc.2015.04.007. Epub 2015 Apr 23.
Screening programs for breast cancer aim to allow early diagnosis, and thus reduce mortality. The aim of this study was to assess the effect of a population screening program in a sample of women aged between 50 and 69 years in terms of recurrence, metastasis, biological profiles, and survival, and to compare their results with those of women of a wider age range who did not participate on the screening program.
A prospective multicenter study in which 1821 patients with 1873 breast tumors who received surgery between 1999 and 2014 at MútuaTerrassa University Hospital and the Hospital of Terrassa in Barcelona were analyzed. A comparison was performed in the 50- to 69-year-old age group between those who participated on the screening program and those who did not.
The mean age of patients was 58 years. The mean follow-up was 72 months, and median follow-up 59 months. The screened group showed significantly better results in all prognostic factors and in specific mortality than all nonscreened groups. The specific mortality rate in the screened patients was 2.4% (12/496), local recurrence 2.8% (14/496), and metastasis at 10 years 3.6% (18/496). In the nonscreened group, younger women presented a higher rate of metastasis (16.4% [81/493]) and a shorter disease-free period (77.1% [380/493]). The age group older than 70 years had the highest number of T4 tumors (7.5% [30/403]) and the highest proportion of radical surgery (50.4% [203/403]).
Patients in the screening program presented improved survival. We speculate that extending breast cancer screening programs to women younger than 50 and older than 70 years could bring about mortality benefits.
乳腺癌筛查项目旨在实现早期诊断，从而降低死亡率。本研究的目的是评估一项针对年龄在50至69岁女性样本的人群筛查项目在复发、转移、生物学特征和生存率方面的效果，并将其结果与未参加筛查项目的年龄范围更广的女性的结果进行比较。
一项前瞻性多中心研究，分析了1999年至2014年期间在巴塞罗那的穆图阿·特拉萨大学医院和特拉萨医院接受手术的1821例患有1873个乳腺肿瘤的患者。对50至69岁年龄组中参加筛查项目的患者和未参加筛查项目的患者进行了比较。
患者的平均年龄为58岁。平均随访时间为72个月，中位随访时间为59个月。筛查组在所有预后因素和特定死亡率方面的结果均明显优于所有未筛查组。筛查患者的特定死亡率为2.4%（12/496），局部复发率为2.8%（14/496），10年转移率为3.6%（18/496）。在未筛查组中，年轻女性的转移率较高（16.4%[81/493]），无病期较短（77.1%[380/493]）。70岁以上年龄组的T4肿瘤数量最多（7.5%[30/403]），根治性手术比例最高（50.4%[203/403]）。
筛查项目中的患者生存率有所提高。我们推测，将乳腺癌筛查项目扩展至50岁以下和70岁以上的女性可能会带来死亡率方面的益处。
