ISALA Breast Unit and Prevention Centre, Department of Obstetrics and Gynaecology, University Hospital Saint-Pierre, Université Libre de Bruxelles and Vrije Universiteit Brussel), Rue Haute 290, 1000, Brussels, Belgium.
Gynecology, Université Libre de Bruxelles, Brussels, Belgium.
Arch Gynecol Obstet. 2023 May;307(5):1539-1546. doi: 10.1007/s00404-022-06630-0. Epub 2022 Aug 5.
Breast cancer (BC) screening has been associated with reduced mortality and morbidity. This study compares tumor characteristics and treatment morbidity in screened versus diagnosed women.
This retrospective study, conducted between 2010 and 2013, included 666 BC screened or diagnosed patients. We compared patients and tumors characteristics and received treatments. We also analyzed the results after excluding patients at risk of BC and conducted a multivariate analysis to assess odds ratios (OR).
Screened women had smaller tumors (16,5 vs 22,6 mm, p < 0.001), of lower grade (p < 0.001) with a lower proliferation index (PI) (p < 0.001) than diagnosed women. Screened women were more frequently treated using conservative surgery (82.8% vs 59.7%, p < 0.001), needed less often axillary dissection (15.1% vs 35.4%, p < 0.001) and less often chemotherapy (20.8% vs 48.3% p < 0.001) than diagnosed women. In the multivariate analysis after adjustment for age and BC history, diagnosed women had increased (OR: 4.79, 95% IC: 3.19-7,18) risk to be administered chemotherapy and to undergo axillary dissection (OR: 4.18, 95% IC: 1.56-11.17) than screened women.
Patients should be informed about the benefits in terms of morbidity that screening confers to them.
乳腺癌（BC）筛查与降低死亡率和发病率有关。本研究比较了筛查与诊断女性的肿瘤特征和治疗发病率。
这项回顾性研究于 2010 年至 2013 年进行，包括 666 例 BC 筛查或诊断患者。我们比较了患者和肿瘤特征以及接受的治疗。我们还在排除有 BC 风险的患者后分析了结果，并进行了多变量分析以评估优势比（OR）。
筛查组女性的肿瘤较小（16.5 与 22.6 毫米，p<0.001），分级较低（p<0.001），增殖指数（PI）较低（p<0.001）。与诊断组相比，筛查组更常采用保乳手术治疗（82.8%比 59.7%，p<0.001），需要腋窝清扫术的频率较低（15.1%比 35.4%，p<0.001），化疗的频率也较低（20.8%比 48.3%，p<0.001）。在调整年龄和 BC 病史后进行多变量分析，与筛查组相比，诊断组接受化疗和腋窝清扫术的风险增加（OR：4.79，95%可信区间：3.19-7.18）（OR：4.18，95%可信区间：1.56-11.17）。
应该告知患者筛查对发病率的益处。
