Busch E, Kemeny M, Fremgen A, Osteen R T, Winchester D P, Clive R E
North Shore University Hospital, Manhasset, New York 11030, USA.
Cancer. 1996 Jul 1;78(1):101-11. doi: 10.1002/(SICI)1097-0142(19960701)78:1<101::AID-CNCR15>3.0.CO;2-3.
The elderly represent a large proportion of the women with breast cancer. However, there is a lack of information regarding breast cancer care in the elderly.
A patient care evaluation survey for breast carcinoma was conducted by the Commission on Cancer of the American College of Surgeons for 1983 and 1990. Data were obtained from hospital tumor registries from all 50 states, Puerto Rico, and Canada. Information regarding presentation, diagnostics, staging, treatment, recurrence, and survival were analyzed. Comparisons were made between women 75 years and older and those younger than 75 years.
Included were 17,029 diagnosed with breast carcinoma during 1983 and 24,004 diagnosed during 1990. In 1983 and 1990, 20.4% and 23.4% of women, respectively, were 75 years or older. Fewer cancers were detected mammographically and needle localized biopsies were performed less often in the elderly. There was no difference in tumor location or histology. Stage at diagnosis appeared more advanced in the elderly. Most women regardless of age, underwent modified radical mastectomy. Of the elderly who did undergo breast conserving surgery in 1983 and 1990, 72% and 39%, respectively, did not receive radiation therapy. No difference was found in the local recurrence rates between the elderly and younger groups. In the elderly, 20% of deaths occurred from causes other than breast cancer. Overall disease specific survival was worse in the elderly but, when analyzed by stage, was significantly different for only certain stages.
There are several differences in the detection, diagnostic methods, stage at diagnosis, treatment approaches, and outcome of breast cancer in elderly women compared with younger women.
老年女性在乳腺癌患者中占很大比例。然而，关于老年乳腺癌患者护理的信息却很匮乏。
美国外科医师学会癌症委员会于1983年和1990年开展了一项乳腺癌患者护理评估调查。数据来自美国50个州、波多黎各和加拿大的医院肿瘤登记处。对有关临床表现、诊断、分期、治疗、复发和生存的信息进行了分析。对75岁及以上女性和75岁以下女性进行了比较。
1983年有17029例被诊断为乳腺癌，1990年有24004例。1983年和1990年，分别有20.4%和23.4%的女性年龄在75岁及以上。老年女性通过乳房X线摄影检测出的癌症较少，且较少进行针吸定位活检。肿瘤位置或组织学方面没有差异。老年女性诊断时的分期似乎更晚。大多数女性，无论年龄大小，都接受了改良根治性乳房切除术。在1983年和1990年接受保乳手术的老年女性中，分别有72%和39%未接受放射治疗。老年组和年轻组的局部复发率没有差异。在老年女性中，20%的死亡是由乳腺癌以外的原因导致的。总体疾病特异性生存率在老年女性中更差，但按分期分析时，仅某些阶段存在显著差异。
与年轻女性相比，老年女性乳腺癌在检测、诊断方法、诊断分期、治疗方法和预后方面存在若干差异。
