Gisladottir Lilja Dogg, Birgisson Helgi, Agnarsson Bjarni A, Jonsson Thorvaldur, Tryggvadottir Laufey, Sverrisdottir Asgerdur
Faculty of Medicine, University of Iceland, Reykjavík, Icelan.
Icelandic Cancer Registry, Reykjavík, Iceland.
Laeknabladid. 2020 Sep;106(9):397-402. doi: 10.17992/lbl.2020.09.595.
As part of the implementation of quality registration in Iceland we used retrospective data to compare diagnosis and treatment of invasive breast cancer between Iceland and Sweden.
Information on all patients diagnosed with invasive breast cancer in Iceland 2016-2017 was obtained from the Icelandic Cancer Registry. Hospital records were used to register variables in an electronic form adapted from the Swedish quality registration, and compared with data from Sweden for the same period. A chi-square test was used to compare ratios.
A total of 486 cases of breast cancer were diagnosed in Iceland and 15.325 in Sweden. A lower proportion of 40-69 year old women were diagnosed within the screening programme in Iceland (46%) compared to Sweden (60%) (p<0.01). Multidisciplinary tumor board meetings held before and after surgery were less frequent in Iceland (92% vs. 96%) compared to Sweden (98% vs. 99%) in 2016 (p<0,01) but no difference was seen in 2017. A sentinel node surgery was done in 69% of the cases in Iceland compared to 94% in Sweden (p<0,01). For cancers ≤30mm breast conserving surgery was done in 48% cases in Iceland but 80% in Sweden (p<0,01). In Iceland 87% of the cases had radiation therapy after breast conserving surgery but 94% in Sweden (p<0,01). Among mastectomy patients with lymph node metastases, 49% received radiation therapy in Iceland compared to 83% in Sweden (p<0,01).
Differences were seen in several areas of diagnosis and treatment of invasive breast cancer between Iceland and Sweden. With quality registration it will be possible to monitor and set goals for the diagnosis and treatment, with the aim of providing the best treatment to as many patients as possible.
作为冰岛质量登记实施工作的一部分，我们利用回顾性数据比较冰岛和瑞典浸润性乳腺癌的诊断和治疗情况。
从冰岛癌症登记处获取2016 - 2017年冰岛所有诊断为浸润性乳腺癌患者的信息。医院记录用于以一种改编自瑞典质量登记的电子形式记录变量，并与瑞典同期数据进行比较。采用卡方检验比较比率。
冰岛共诊断出486例乳腺癌病例，瑞典为15325例。冰岛40 - 69岁女性在筛查项目中被诊断出的比例（46%）低于瑞典（60%）（p<0.01）。2016年，冰岛手术前后多学科肿瘤委员会会议的召开频率低于瑞典（分别为92%对96%和98%对99%）（p<0.01），但2017年未发现差异。冰岛69%的病例进行了前哨淋巴结手术，而瑞典为94%（p<0.01）。对于直径≤30mm的癌症，冰岛48%的病例进行了保乳手术，而瑞典为80%（p<0.01）。在冰岛，87%的病例在保乳手术后接受了放射治疗，而瑞典为94%（p<0.01）。在有淋巴结转移的乳房切除患者中，冰岛49%接受了放射治疗，而瑞典为83%（p<0.01）。
冰岛和瑞典在浸润性乳腺癌的几个诊断和治疗领域存在差异。通过质量登记，有可能监测诊断和治疗情况并设定目标，以便为尽可能多的患者提供最佳治疗。
