Lazaro E J, Rush B F, Swaminathan A P
Surgery. 1978 Oct;84(4):441-7.
Opportunity to assess changes in the management of cancer of the breast over the past 7 years was afforded by analysis of responses to questionnaires that were part of an annual questionnaire course. Comparison of responses to questionnaires conducted in 1971 and 1977 identified important features of approaches to this disease and indicated the way in which changes have occurred. Diagnostic needle aspiration increased from 24% (1971) to 54% (1977). In both surveys surgeons reported employing mammography infrequently. Use of modified radical mastectomy increased from 15% (1971) to 60% (1977). Employment of classical radical mastectomy decreased from 83% (1971) to 37% (1977). Surgeons considering biopsy of the contralateral breast to be unnecessary decreased from 47% (1971) to 14% (1977). Skin grafting, after a mastectomy, decreased from 40% (1971) to 24% (1977). Though oophorectomy is still the preferred initial treatment for premenopausal patients with advanced disease, preference for chemotherapy in postmenopausal patients increased from 5% (1971) to 23% (1977). Surgeons approving of reconstruction with implants after mastectomy for carcinoma increased from 30% (1971) to 49% (1977). Following mastectomy in patients with positive axillary nodes, 58% of our respondents employ chemotherapy with several drugs and 34% prefer irradiation.
通过分析年度问卷调查中的问卷回复，有机会评估过去7年乳腺癌治疗管理的变化。对1971年和1977年进行的问卷调查回复进行比较，确定了这种疾病治疗方法的重要特征，并指出了变化发生的方式。诊断性针吸活检从1971年的24%增加到1977年的54%。在两项调查中，外科医生均报告很少使用乳房X线摄影。改良根治性乳房切除术的使用从1971年的15%增加到1977年的60%。经典根治性乳房切除术的使用从1971年的83%下降到1977年的37%。认为对侧乳房活检不必要的外科医生从1971年的47%下降到1977年的14%。乳房切除术后的植皮从1971年的40%下降到1977年的24%。尽管卵巢切除术仍然是绝经前晚期疾病患者的首选初始治疗方法，但绝经后患者对化疗的偏好从1971年的5%增加到1977年的23%。赞成乳腺癌乳房切除术后使用植入物重建的外科医生从1971年的30%增加到1977年的49%。在腋窝淋巴结阳性患者乳房切除术后，58%的受访者采用多种药物化疗，34%的受访者更喜欢放疗。
