Tidsskr Nor Laegeforen. 2020 Oct 26;140(15). doi: 10.4045/tidsskr.20.0090. Print 2020 Oct 27.
Breast-conserving surgery is recommended in Norway and internationally in cases of early-stage breast cancer. We analysed the surgical methods used for breast-cancer patients by hospital providing treatment, age at the time of diagnosis, detection method and histopathological characteristics of the tumours in the period 2003 to 2018.
Data on women of all ages diagnosed with invasive breast cancer (n = 47 004) were retrieved from the Cancer Registry of Norway's databases. We excluded women with distant metastases at the time of diagnosis (n = 1 773) and those for whom no surgical method was recorded (n = 2 638). The detection method was defined as breast cancer detected by screening, in inter-screening intervals, or outside BreastScreen Norway. The surgical methods chosen were compared by means of descriptive analyses.
Slightly over half (23 661 of 42 593, i.e. 55.6 %) of the women in whom breast cancer was detected in the study period underwent breast-conserving surgery. The percentage increased from 1 189/2 423 (49.1 %) in 2003 to 2 070/2 958 (70.0 %) in 2018. There were large differences across hospitals. In the period 2015-2018 we found the highest proportion of breast-conserving surgery, 175/187 (93.6 %) for breast cancer detected by screening to be performed at Ålesund Hospital, and the lowest proportion, 121/351 (34.5 %) among women with breast cancer detected outside BreastScreen Norway, to be performed at Radiumhospitalet. Breast-conserving surgery was used most frequently on women with small tumours without spreading to axillary lymph nodes.
We found considerable differences in the surgical methods used across hospitals and for different detection methods.
在挪威和国际上，对于早期乳腺癌，推荐采用保乳手术。我们分析了 2003 年至 2018 年期间，按治疗医院、诊断时年龄、检测方法和肿瘤组织病理学特征，对乳腺癌患者采用的手术方法。
从挪威癌症登记处的数据库中检索了所有年龄段诊断为浸润性乳腺癌的女性（n=47004）的数据。我们排除了诊断时已有远处转移的女性（n=1773）和未记录手术方法的女性（n=2638）。检测方法定义为通过筛查、筛查间期或挪威乳腺癌筛查项目以外的方式检测到的乳腺癌。通过描述性分析比较所选的手术方法。
在研究期间，略多于一半（23661/42593，即 55.6%）的女性接受了保乳手术。这一比例从 2003 年的 1189/2423（49.1%）上升至 2018 年的 2070/2958（70.0%）。不同医院之间存在较大差异。在 2015-2018 年期间，我们发现，在奥勒松医院通过筛查检测到的乳腺癌患者中，保乳手术比例最高，为 175/187（93.6%），而在挪威乳腺癌筛查项目以外的方式检测到的乳腺癌患者中，在拉德姆医院进行保乳手术的比例最低，为 121/351（34.5%）。保乳手术最常应用于肿瘤较小且未扩散至腋窝淋巴结的女性。
我们发现不同医院和不同检测方法之间的手术方法存在相当大的差异。
