Nemoto T, Vana J, Bedwani R N, Baker H W, McGregor F H, Murphy G P
Cancer. 1980 Jun 15;45(12):2917-24. doi: 10.1002/1097-0142(19800615)45:12<2917::aid-cncr2820451203>3.0.co;2-m.
This is a resume of a Breast Cancer Survey carried out by the American College of Surgeons in 1978. Four hundred and ninety-eight hospitals in 47 states, Washington, D.C., and Puerto Rico participated, contributing a total of 24,136 female patients with histologically confirmed breast cancer. In these patients, five-year cure rates were 60.5% for clinically localized disease and 33.9% for regional disease. Five-year survival rates were 72.8% for localized disease and 49.1% for regional disease. From the 1960's into the early 1970's, there was a gradual shift away from radical mastectomy towards so-called modified radical mastectomy. In a group of patients treated by either radical or modified mastectomies, the axillary nodal status, size of the tumor, and location of the tumor were examined in relation to the prognosis. In the study of number of metastatic nodes in the axilla, there were reduced cure and survival rates in patients with one or more positive nodes as compared to those with negative axillary nodes. With the increase in the number of positive nodes, there was a continuing associated decline in survival and cure. The clinical size of the tumor also correlated well to the prognosis. With the increase in the size of the tumor, there was a gradual increase in the probability of axillary nodal involvement. However, in the group of patients with tumor size smaller than 1 cm, axillary metastasis occurred in 25%. When the axillary nodes were involved, the cure rate in those patients was not significantly better than the rates for those with larger primary tumors in this study. Tumors located in the medial half of the breast were associated with a slightly lower cure rate than those in the lateral half. Young women under 35 years of age had poorer survival and cure rates, although in women 35-44 years of age, the five-year results were comparable to the older group of patients. In blacks, breast cancer was diagnosed in a relatively more advanced stage than in whites. Survival and cure rates were generally lower for blacks, and such lower rates seem to be associated with the relatively advanced stage of the disease.
这是美国外科医师学会于1978年开展的一项乳腺癌调查的总结。来自47个州、华盛顿特区和波多黎各的498家医院参与其中，共提供了24136例经组织学确诊的女性乳腺癌患者。在这些患者中，临床局限期疾病的五年治愈率为60.5%，区域期疾病的五年治愈率为33.9%。局限期疾病的五年生存率为72.8%，区域期疾病的五年生存率为49.1%。从20世纪60年代到70年代初，存在从根治性乳房切除术逐渐转向所谓改良根治性乳房切除术的趋势。在一组接受根治性或改良乳房切除术治疗的患者中，研究了腋窝淋巴结状态、肿瘤大小和肿瘤位置与预后的关系。在腋窝转移性淋巴结数量的研究中，与腋窝淋巴结阴性的患者相比，有一个或多个阳性淋巴结的患者治愈率和生存率降低。随着阳性淋巴结数量的增加，生存率和治愈率持续下降。肿瘤的临床大小也与预后密切相关。随着肿瘤大小的增加，腋窝淋巴结受累的可能性逐渐增加。然而，在肿瘤大小小于1厘米的患者组中，25%发生了腋窝转移。在本研究中，当腋窝淋巴结受累时，这些患者的治愈率并不显著高于原发性肿瘤较大的患者。位于乳房内侧半部的肿瘤治愈率略低于外侧半部的肿瘤。35岁以下的年轻女性生存率和治愈率较差，尽管35 - 44岁女性的五年结果与老年患者组相当。在黑人中，乳腺癌的诊断阶段相对比白人更晚。黑人的生存率和治愈率总体较低，而且这种较低的比率似乎与疾病相对较晚的阶段有关。
