中国年轻女性乳腺癌的临床病理特征及治疗：一项全国多中心10年回顾性研究
Clinicopathological characteristics and treatment of young women with breast cancer in China: a nationwide multicenter 10-year retrospective study.
作者信息
Zhang Wei, Zhang Bai-Lin, He Jian-Jun, Fan Jin-Hu, Li Jing, Zhang Bin, Yang Hong-Jian, Xie Xiao-Ming, Tang Zhong-Hua, Li Hui, Li Jia-Yuan, Wang Shu-Lian, Qiao You-Lin, Huang Rong, Zhang Pin
机构信息
Department of Breast Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Department of Breast Cancer, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union of Medical College, Beijing, China.
出版信息
Gland Surg. 2021 Jan;10(1):175-185. doi: 10.21037/gs-20-574.
BACKGROUND
Breast cancer is currently the most common female malignancy in China. However, the clinical features and overall prognosis of young women diagnosed with this malignancy remain unclear. This study aimed to describe the clinicopathological characteristics of young patients (≤34 years of age) with breast cancer and explore the current treatment approaches used in China.
METHODS
This was a hospital-based, multicenter, retrospective study of women with breast cancer across seven Chinese hospitals from 1999 to 2008. A total of 295 young (≤34 years of age) patients (research group) and 2,119 women aged 35 to 49 years (control group) were included in the study. Patient epidemiology, pre-operative examinations, clinical pathology, and treatment were analyzed.
RESULTS
The percentage of young patients with breast cancer in the study group was 7.01%. These young women had a lower body mass index (BMI), a higher level of education, a lower number of previous births, and a lower history of breastfeeding than the control group (P<0.05). Increasingly, pre-operative use of ultrasound and magnetic resonance imaging are being used to diagnose breast cancer in young women in China. In young women with breast cancer, breast cancer not otherwise specified (NOS) was the primary pathology. The carcinoma in young women was more prone to lymph node metastasis, showed less progesterone receptor (PR) expression, and was more advanced than observed in the control group (P<0.05). We found that the number of young breast cancer patients undergoing breast-conserving surgery in China is increasing.
CONCLUSIONS
Young breast cancer patients display unique clinicopathological features, including tumors of a higher grade than those aged 35 years or older. As breast cancer is more aggressive in younger women, prevention and early diagnosis are critical, and new policies should be developed in line with these findings.
背景
乳腺癌是目前中国最常见的女性恶性肿瘤。然而，被诊断患有这种恶性肿瘤的年轻女性的临床特征和总体预后仍不明确。本研究旨在描述年轻（≤34岁）乳腺癌患者的临床病理特征，并探讨中国目前使用的治疗方法。
方法
这是一项基于医院的多中心回顾性研究，研究对象为1999年至2008年期间中国七家医院的乳腺癌女性患者。共纳入295例年轻（≤34岁）患者（研究组）和2119例年龄在35至49岁之间的女性（对照组）。对患者的流行病学、术前检查、临床病理和治疗情况进行了分析。
结果
研究组中年轻乳腺癌患者的比例为7.01%。与对照组相比，这些年轻女性的体重指数（BMI）较低、受教育程度较高、既往生育次数较少且母乳喂养史较少（P<0.05）。在中国，越来越多的年轻女性乳腺癌术前使用超声和磁共振成像进行诊断。在年轻乳腺癌女性中，非特殊类型乳腺癌（NOS）是主要病理类型。年轻女性的癌更容易发生淋巴结转移，孕激素受体（PR）表达较少，且比对照组更晚期（P<0.05）。我们发现，中国接受保乳手术的年轻乳腺癌患者数量正在增加。
结论
年轻乳腺癌患者表现出独特的临床病理特征，包括肿瘤分级高于35岁及以上的患者。由于年轻女性的乳腺癌侵袭性更强，预防和早期诊断至关重要，应根据这些发现制定新的政策。
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