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1
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CMAJ. 1994 Apr 1;150(7):1109-15.
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1
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Breast Care (Basel). 2008;3(2):108-113. doi: 10.1159/000121732. Epub 2008 Apr 22.
2
Declining use of mastectomy for invasive breast cancer in Canada, 1981-2000.1981 - 2000年加拿大浸润性乳腺癌乳房切除术的使用情况下降。
Can J Public Health. 2004 Sep-Oct;95(5):336-40. doi: 10.1007/BF03405141.
3
We may get this horse to water, but will it drink?我们可以把马牵到水边，但它会喝水吗？
CMAJ. 1998 Feb 10;158(3):345-6.
4
Canadian atrial fibrillation anticoagulation study: were the patients subsequently treated with warfarin? Canadian Atrial Fibrillation Anticoagulation Study Group.加拿大房颤抗凝研究：这些患者随后接受华法林治疗了吗？加拿大房颤抗凝研究组。
CMAJ. 1996 Jun 1;154(11):1669-74.
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Qual Life Res. 1994 Aug;3(4):279-83. doi: 10.1007/BF00434902.

本文引用的文献

1
Comparing radical mastectomy with quadrantectomy, axillary dissection, and radiotherapy in patients with small cancers of the breast.比较乳腺癌小肿瘤患者行根治性乳房切除术与象限切除术、腋窝淋巴结清扫术及放射治疗的效果。
N Engl J Med. 1981 Jul 2;305(1):6-11. doi: 10.1056/NEJM198107023050102.
2
The 1982 national survey of carcinoma of the breast in the United States by the American College of Surgeons.1982年美国外科医师学会开展的美国全国乳腺癌调查。
Surg Gynecol Obstet. 1984 Oct;159(4):309-18.
3
Five-year results of a randomized clinical trial comparing total mastectomy and segmental mastectomy with or without radiation in the treatment of breast cancer.一项比较全乳切除术与保乳手术加或不加放疗治疗乳腺癌的随机临床试验的五年结果。
N Engl J Med. 1985 Mar 14;312(11):665-73. doi: 10.1056/NEJM198503143121101.
4
Clinical evaluation: how does it influence medical practice?
Bull Cancer. 1987;74(3):333-46.
5
Do practice guidelines guide practice? The effect of a consensus statement on the practice of physicians.实践指南能指导实践吗？一项共识声明对医生实践的影响。
N Engl J Med. 1989 Nov 9;321(19):1306-11. doi: 10.1056/NEJM198911093211906.
6
Consensus on treatment of early stage breast cancer: less surgery, more research.
J Natl Cancer Inst. 1990 Jul 18;82(14):1180-1. doi: 10.1093/jnci/82.14.1180.
7
Regional differences in surgical management of breast cancer.乳腺癌手术治疗的区域差异。
CA Cancer J Clin. 1992 Jan-Feb;42(1):39-43. doi: 10.3322/canjclin.42.1.39.
8
Geographic variation in the use of breast-conserving treatment for breast cancer.乳腺癌保乳治疗使用情况的地理差异。
N Engl J Med. 1992 Apr 23;326(17):1102-7. doi: 10.1056/NEJM199204233261702.
9
Geographic variation in the treatment of localized breast cancer.局部乳腺癌治疗的地域差异。
N Engl J Med. 1992 Apr 23;326(17):1097-101. doi: 10.1056/NEJM199204233261701.
10
Do the results of randomized clinical trials of cardiovascular drugs influence medical practice? The SAVE Investigators.心血管药物的随机临床试验结果会影响医学实践吗？心肌梗死存活研究（SAVE）调查组。
N Engl J Med. 1992 Jul 23;327(4):241-7. doi: 10.1056/NEJM199207233270405.

安大略省乳腺癌手术的时间趋势：一项随机试验能产生影响吗？

Temporal trends in breast cancer surgery in Ontario: can one randomized trial make a difference?

作者信息

Iscoe N A, Naylor C D, Williams J I, DeBoer G, Morgan M W, Fehringer G, Holowaty E

机构信息

Toronto Bayview Regional Cancer Centre, Ontario Cancer Treatment and Research Foundation.

出版信息

CMAJ. 1994 Apr 1;150(7):1109-15.

PMID:8137191
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1486399/
Abstract

OBJECTIVE

To assess the effect of a single randomized clinical trial, the National Surgical Adjuvant Breast Project (NSABP) B-06, on the surgical management of breast cancer in women.

DESIGN

Retrospective cohort study.

SETTING

All hospitals in Ontario.

PATIENTS

A consecutive sample of 37,447 women with breast cancer newly diagnosed from Jan. 1, 1980, to Dec. 31, 1989, linked to a surgical procedure record in the Ontario Cancer Registry.

MAIN OUTCOME MEASURE

The most invasive surgical procedure used within 90 days of diagnosis.

RESULTS

Unilateral breast-ablative surgery (BAS) was performed in 57.3% of the women and breast-conserving surgery (BCS) in 31.6%. The annual rate of BAS declined from 77.5% in 1980 to 44.2% in 1989 and the rate of BCS rose from 12.5% in 1980 to 43.5% in 1989. The decline was linear from 1980 to 1984 and then accelerated significantly in 1985 (p < 0.0001), after the results of the NSABP B-06 trial were published.

CONCLUSION

One randomized clinical trial can have an immediate and profound effect on medical practice.

摘要

目的

评估一项单一随机临床试验——国家乳腺癌辅助治疗项目（NSABP）B - 06对女性乳腺癌手术治疗的影响。

设计

回顾性队列研究。

地点

安大略省所有医院。

患者

选取1980年1月1日至1989年12月31日期间新诊断出乳腺癌的37447名女性的连续样本，这些样本与安大略癌症登记处的手术记录相关联。

主要观察指标

诊断后90天内采用的最具侵入性的手术方式。

结果

57.3%的女性接受了单侧乳房切除术（BAS），31.6%的女性接受了保乳手术（BCS）。BAS的年发生率从1980年的77.5%降至1989年的44.2%，BCS的发生率从1980年的12.5%升至1989年的43.5%。1980年至1984年呈线性下降，在NSABP B - 06试验结果公布后的1985年下降显著加速（p < 0.0001）。

结论

一项随机临床试验可对医疗实践产生即时且深远的影响。