Johantgen M E, Coffey R M, Harris D R, Levy H, Clinton J J
Agency for Health Care Policy and Research, Center for General Health Services Intramural Research, Rockville, MD 20852, USA.
Am J Public Health. 1995 Oct;85(10):1432-4. doi: 10.2105/ajph.85.10.1432.
Despite growing acceptance of the fact that women with early-stage breast cancer have similar outcomes with lumpectomy plus radiation as with mastectomy, many studies have revealed the uneven adoption of such breast-conserving surgery. Discharge data from the Hospital Cost and Utilization Project, representing multiple payers, locations, and hospital types, demonstrate increasing trends in breast-conserving surgery as a proportion of breast cancer surgeries from 1981 to 1987. Women with axillary node involvement were less likely to have a lumpectomy, even though consensus recommendations do not preclude this form of treatment when local metastases are present. Non-White race, urban hospital location, and hospital teaching were associated with an increased likelihood of having breast-conserving surgery.
尽管早期乳腺癌女性接受保乳手术加放疗与乳房切除术的治疗效果相似这一事实已越来越被认可，但许多研究表明，这种保乳手术的采用情况并不均衡。来自医院成本与利用项目的出院数据涵盖了多个支付方、地点和医院类型，这些数据显示，从1981年到1987年，保乳手术在乳腺癌手术中所占比例呈上升趋势。即使存在局部转移时，共识性建议并不排除这种治疗方式，但腋窝淋巴结受累的女性接受保乳手术的可能性较小。非白人种族、城市医院所在地以及医院教学性质与接受保乳手术的可能性增加相关。
