Islam Shariful, Aziz Imran, Shah Jitendra, Oba Jacob, Harnarayan Patrick, Rampersad Arlene Jammie, Naraynsingh Vijay
San Fernando Teaching Hospital, San Fernando, Trinidad And Tobago.
Department of Clinical Surgical Science, University of the West Indies, St. Augustine, Trinidad And Tobago.
Int J Breast Cancer. 2019 Mar 7;2019:8018242. doi: 10.1155/2019/8018242. eCollection 2019.
Breast cancer is the leading form of cancer in women in Trinidad and Tobago. Traditionally the practice of mastectomy or wide local excision with or without axillary clearance was applied to most of these patients. This is often associated with significant morbidity and a poor cosmetic outcome with both negatively impacting the patients quality of life. The aim of our study was to assess the mastectomy and axillary clearance rate before and after the introduction of a specialty breast clinic in September 2012.
This is a retrospective comparative study of all female patients who underwent breast cancer surgery at our tertiary hospital 3 years prior to and 3 years after starting of breast clinic (between January 2010 and December 2015). Patients were identified from the surgical log books of our hospital. There are 5 surgical units at our hospital and in one of those units the lead surgeon had a special interest in surgical oncoplastic breast surgery. That unit formed the breast clinic in August 2012.
There were 532 women (256 before breast clinic and 276 after breast clinic era) with histologically verified breast cancer operated on between January 2010 and December 2015. The overall mastectomy rate was reduced from 62% to 51% (0.7 to 0.4) and the axillary clearance rate from 66.79% versus 37.31% (0.6 to 0.4) after the introduction of the clinic with p values of 0.007 and 0.009, respectively.
The introduction of breast clinic has significantly reduced the mastectomy and axillary clearance rate at our teaching hospital.
在特立尼达和多巴哥，乳腺癌是女性中最主要的癌症形式。传统上，大多数此类患者接受乳房切除术或广泛局部切除，无论是否进行腋窝清扫。这通常会导致显著的发病率，且美容效果不佳，两者均对患者的生活质量产生负面影响。我们研究的目的是评估2012年9月开设专科乳腺诊所前后的乳房切除术和腋窝清扫率。
这是一项回顾性比较研究，对象为在我们的三级医院于乳腺诊所开设前3年（2010年1月至2012年12月）和开设后3年（2013年1月至2015年12月）接受乳腺癌手术的所有女性患者。患者从我们医院的手术记录簿中识别。我们医院有5个手术科室，其中一个科室的主刀医生对手术肿瘤整形乳房手术有特别兴趣。该科室于2012年8月组建了乳腺诊所。
在2010年1月至2015年12月期间，共有532名经组织学证实患有乳腺癌的女性接受了手术（乳腺诊所开设前256例，开设后276例）。开设诊所以后，总体乳房切除率从62%降至51%（从概率0.7降至0.4），腋窝清扫率从66.79%降至37.31%（从概率0.6降至0.4），p值分别为0.007和0.009。
乳腺诊所的开设显著降低了我们教学医院的乳房切除术和腋窝清扫率。
