乳腺癌诊断对婚姻结局的影响，以及与离婚和分居相关的因素。
The impact of a breast cancer diagnosis on marital outcomes and factors associated with divorce and separation.
机构信息
Latin American Cooperative Oncology Group Porto AlegreRS Brazil Latin American Cooperative Oncology Group, Porto Alegre, RS, Brazil.
Pontifícia Universidade Católica do Rio Grande do Sul Porto AlegreRS Brazil Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil.
出版信息
Rev Bras Ginecol Obstet. 2024 Jun 27;46. doi: 10.61622/rbgo/2024rbgo60. eCollection 2024.
OBJECTIVE
To analyze marital outcomes, divorce or separation, and its association with demographic, socioeconomic, and clinicopathological factors among breast cancer (BC) survivors after 2-years of diagnosis.
METHODS
We performed a retrospective analysis of marital status at baseline and at years 1 and 2 of follow-up of women aged ≥ 18 years diagnosed with invasive BC participating in the AMAZONA III (GBECAM0115) study. The BC diagnosis occurred between January 2016 and March 2018 at 23 institutions in Brazil.
RESULTS
Of the 2974 women enrolled in AMAZONA III, 599 were married or living under common law at baseline. Divorce or separation occurred in 35 (5.8%) patients at 2 years of follow-up. In the multivariate analysis, public health insurance coverage was associated with a higher risk of marital status change (8.25% vs. 2.79%, RR 3.09, 95% CI 1.39 - 7.03, p = 0.007). Women who underwent mastectomy, adenomastectomy or skin-sparing mastectomy were associated with a higher risk of divorce or separation (8.1% vs. 4.49%, RR 1.97, 95 CI 1.04 - 3.72, p = 0.0366) than those who underwent breast-conserving surgery.
CONCLUSION
Women covered by the public health system and those who underwent mastectomy, adenomastectomy or skin-sparing mastectomy were associated with a higher risk of divorce or separation. This evidence further supports the idea that long-term marital stability is associated with a complex interplay between socioeconomic conditions and stressors, such as BC diagnosis and treatment. NCT02663973.
目的
分析诊断后 2 年内乳腺癌（BC）幸存者的婚姻结局、离婚或分居及其与人口统计学、社会经济学和临床病理因素的关系。
方法
我们对参与 AMAZONA III（GBECAM0115）研究的年龄≥18 岁、诊断为浸润性 BC 的女性在基线和随访 1 年和 2 年时的婚姻状况进行了回顾性分析。BC 诊断发生于 2016 年 1 月至 2018 年 3 月间，涉及巴西 23 家机构。
结果
在 AMAZONA III 中，2974 名入组女性中，599 人在基线时已婚或处于事实婚姻状态。2 年随访时，35 名（5.8%）患者离婚或分居。在多变量分析中，公共健康保险覆盖与婚姻状况改变的风险增加相关（8.25% vs. 2.79%，RR 3.09，95%CI 1.39-7.03，p=0.007）。接受乳房切除术、腺切除术或保留皮肤的乳房切除术的女性离婚或分居的风险较高（8.1% vs. 4.49%，RR 1.97，95%CI 1.04-3.72，p=0.0366），高于接受保乳手术的女性。
结论
公共卫生系统覆盖的女性和接受乳房切除术、腺切除术或保留皮肤的乳房切除术的女性离婚或分居的风险较高。这一证据进一步支持了这样一种观点，即长期婚姻稳定与社会经济状况和压力源（如 BC 诊断和治疗）之间的复杂相互作用有关。NCT02663973。
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