Braun Bettina, Kurosinski Marc-André, Khil Laura, Tio Joke, Krause-Bergmann Barbara, Hense Hans-Werner
Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany.
State Cancer Registry of North Rhine-Westphalia, Bochum, Germany.
Breast Care (Basel). 2020 Oct;15(5):498-505. doi: 10.1159/000504662. Epub 2019 Dec 19.
Apart from saving lives, mammography screening programs (MSP) are expected to reduce negative side effects of treatment by detecting cancer earlier, when it is more responsive to less aggressive treatment. This study compared quality of life (QoL) among women with breast cancers that were detected either by screening mammography, as interval cancers, or clinically among women not participating in the MSP.
Retrospective study of first-ever invasive breast cancers detected among MSP-eligible women aged 50-69 years between 2006 and 2012 in Münster, Germany. EORTC QLQ-C30 and -BR23 questionnaires were mailed to 1,399 cases still alive in 2015 (response rate 64.1%).
Women's responses were obtained on average 6.1 years after diagnosis. Mean crude and age-adjusted scores for overall QoL, breast and body image (BBI), and five functional scales (FS) were comparable between groups of detection mode. Clearly lower adjusted means for most scores were observed in women with interval cancers, if time since diagnosis was less than 5 years. Cases younger than 60 years showed lower values for some FS, particularly among interval and screen-detected cases.
DISCUSSION/CONCLUSION: In summary, cases with breast cancer showed health-related score values that were similar to the general population of the same age. There was also no indication that mode of detection markedly influenced these scores. However, after adjusting for tumor stage and other influential factors, screening participants appeared more susceptible to score declines after a diagnosis of cancer than non-participants.
除挽救生命外,乳腺钼靶筛查项目(MSP)有望通过更早发现癌症来减少治疗的负面副作用,因为癌症在早期对侵袭性较小的治疗反应更好。本研究比较了通过乳腺钼靶筛查发现的乳腺癌女性、作为间期癌发现的乳腺癌女性以及未参加MSP的临床诊断乳腺癌女性的生活质量(QoL)。
对2006年至2012年在德国明斯特年龄在50 - 69岁符合MSP条件的女性中首次诊断出的浸润性乳腺癌进行回顾性研究。向2015年仍存活的1399例患者邮寄了欧洲癌症研究与治疗组织(EORTC)QLQ - C30和 - BR23问卷(回复率64.1%)。
女性的回复平均在诊断后6.1年获得。总体生活质量、乳房和身体形象(BBI)以及五个功能量表(FS)的平均原始得分和年龄调整得分在不同检测模式组之间具有可比性。如果诊断后的时间少于5年,间期癌女性的大多数得分调整后均值明显较低。60岁以下的患者在某些功能量表上得分较低,特别是在间期癌和筛查发现的病例中。
讨论/结论:总之,乳腺癌患者的健康相关得分值与同年龄的一般人群相似。也没有迹象表明检测方式会显著影响这些得分。然而,在调整肿瘤分期和其他影响因素后,筛查参与者在被诊断患有癌症后似乎比未参与者更容易出现得分下降。