Department of Medical, Surgical, and Experimental Sciences, Unit of General Surgery 2, Clinica Chirurgica, University of Sassari, Sassari, Italy.
Unit of Medical Oncology, Azienda Ospedaliero Universitaria di Sassari, Sassari, Italy.
Clin Breast Cancer. 2019 Oct;19(5):e637-e642. doi: 10.1016/j.clbc.2019.04.013. Epub 2019 May 2.
The benefits of organized mammographic screening programs (OMSPs) in reducing breast cancer mortality have been addressed by several studies. This study was designed to specifically evaluate the advantages of OMPSs in terms of surgical management of patients with breast cancer.
Surgical treatment of 201 patients with breast cancer aged 50 to 69 years coming from OMSPs was compared with that of 532 non-OMSP patients in same age group. The likelihood of receiving BCS was analyzed through a multivariable regression model.
The mean tumor size was smaller in the OMSP patients (14 mm vs. 18 mm; P < .01). The proportion of patients having metastatic lymph nodes was higher in the non-OMSP group (33.3% vs. 17.9%; P < .01). Rates of breast-conserving surgery (BCS) were significantly higher in the OMSP group (89.1% vs. 59.1%; P < .01). Sentinel node biopsy was carried out in 84.1% and 62.5% of patients in the OMSP and non-OMSP groups, respectively (P < .01). Rates of axillary lymph node dissection were significantly different (24.9% in the OMSP group and 35.8% in the non-OMSP group; P = .02). Re-excisions for infiltrated margins after BCS were lower in the OMSP group (4.8% vs. 12.7%; P < .01). Hospital stay was shorter in the OMSP group (2.13 vs. 3.02 days; P < .01). OMPS women had a 3-fold higher probability of receiving BCS.
Patients with breast cancer belonging to OMSPs had a higher probability to receive less invasive surgery and to have shorter hospital stay. Our results support the use of campaigns aimed at increasing adhesion to mammography screening.
多项研究已经证实了有组织的乳房 X 光筛检计划（OMSPs）在降低乳腺癌死亡率方面的益处。本研究旨在专门评估 OMSPs 在乳腺癌患者手术管理方面的优势。
比较了来自 OMSPs 的 201 名 50 至 69 岁的乳腺癌患者与同年龄组的 532 名非 OMSP 患者的手术治疗。通过多变量回归模型分析接受保乳手术（BCS）的可能性。
OMSP 患者的肿瘤平均直径较小（14 毫米比 18 毫米；P<.01）。非 OMSP 组转移淋巴结患者比例较高（33.3%比 17.9%；P<.01）。BCS 的比例在 OMSP 组显著更高（89.1%比 59.1%；P<.01）。OMSP 组和非 OMSP 组分别有 84.1%和 62.5%的患者进行了前哨淋巴结活检（P<.01）。腋窝淋巴结清扫的比例有显著差异（OMSP 组为 24.9%，非 OMSP 组为 35.8%；P=.02）。BCS 后浸润边缘的再次切除率在 OMSP 组较低（4.8%比 12.7%；P<.01）。OMSP 组的住院时间较短（2.13 天比 3.02 天；P<.01）。OMSP 妇女接受 BCS 的可能性增加了 3 倍。
属于 OMSPs 的乳腺癌患者更有可能接受侵袭性较小的手术，且住院时间较短。我们的结果支持开展旨在增加乳房 X 光筛查参与度的宣传活动。
