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一项基于人群的有组织乳腺癌筛查项目的短期和长期(10年)结果:来自匈牙利的比较性观察研究。

Short- and Long-Term (10-year) Results of an Organized, Population-Based Breast Cancer Screening Program: Comparative, Observational Study from Hungary.

作者信息

Tóth Dezső, Varga Zsolt, Tóth Judit, Árkosy Péter, Sebő Éva

机构信息

Department of General Surgery, Kenézy Gyula University Hospital, University of Debrecen, 2-26 Bartók Street, Debrecen, 4031, Hungary.

Department of Oncology, Kenézy Gyula University Hospital, 2-26 Bartók Street, Debrecen, 4031, Hungary.

出版信息

World J Surg. 2018 May;42(5):1396-1402. doi: 10.1007/s00268-018-4486-0.

Abstract

BACKGROUND

A nationwide breast cancer screening program was introduced in Hungary in the year 2002 for women aged 45-65 years to be performed biannually.

METHODS

To investigate and report the short-term and 10-year follow-up results, we analyzed our Breast Unit's prospectively led database of screened (Group A) and age-matched symptomatic (Group B) patients from 2002 to 2007. We compared the clinicopathologic features of tumors and the impact of screening on surgical treatment, as well as the overall (OS), disease-specific (DSS) and disease-free survival (DFS) of different groups.

RESULTS

Data from 208 screen-detected and 101 symptomatic patients between 45 and 65 years of age were examined. Screen-detected women were younger (54 vs. 58.5 years; p = 0.001) had significantly smaller tumors (15.5 vs. 17 mm; p = 0.044), and more breast-conserving surgery (68.8 vs. 59.4%; p = 0.032). Survival statistics were not statistically different at the median follow-up of 123 months; however, there was a trend toward improved DFS in Group A (82.7 vs. 74.3%; p = 0.074).

CONCLUSIONS

Our study showed a significant reduction in rates of mastectomy in the screen-detected group in the short term, which does not translate into better survival rates based on initial long-term data. In order to realize the real advantage of this newly enstated screening program, a longer period of investigation is needed.

摘要

背景

2002年匈牙利推出了一项全国性乳腺癌筛查计划,针对45至65岁的女性,每两年进行一次筛查。

方法

为了调查并报告短期及10年随访结果,我们分析了本乳腺科自2002年至2007年对筛查患者(A组)和年龄匹配的有症状患者(B组)前瞻性建立的数据库。我们比较了肿瘤的临床病理特征、筛查对手术治疗的影响,以及不同组别的总生存期(OS)、疾病特异性生存期(DSS)和无病生存期(DFS)。

结果

研究了208例45至65岁经筛查发现的患者和101例有症状患者的数据。经筛查发现的女性年龄更小(54岁对58.5岁;p = 0.001),肿瘤明显更小(15.5毫米对17毫米;p = 0.044),且保乳手术比例更高(68.8%对59.4%;p = 0.032)。在123个月的中位随访期,生存统计数据无统计学差异;然而,A组的无病生存期有改善趋势(82.7%对74.3%;p = 0.074)。

结论

我们的研究表明,短期内经筛查发现的患者乳房切除术比例显著降低,但根据初步长期数据,这并未转化为更好的生存率。为了实现这项新启动的筛查计划的真正优势,需要更长时间的调查。

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