Morris J, McNoe B, Elwood J M, Packer S
Department of Preventive and Social Medicine, University of Otago, Dunedin.
N Z Med J. 1997 Feb 28;110(1038):53-6.
To explore how patients with early breast cancer are managed surgically in New Zealand.
A questionnaire was mailed to 195 surgeons registered as general surgeons.
Replies were received from 112 of the 186 currently working surgeons (60%), of whom 76 indicated that they treated patients with breast disease. Six per cent indicated that they treated > 50 newly diagnosed breast cancer patients in 1994. A minority, 29%, had formal protocols documented for the surgical management of breast cancer patients in their unit. One-third would make the decision about treatment themselves, two-thirds would involve other specialties. Almost all would offer the patient a choice of treatment when this was appropriate. Only 9% would recommend mastectomy for a T1/2NO tumour located in the upper outer breast quadrant. There were no significant differences between surgeons when divided by regional health authority, type of hospital and numbers of patients treated annually.
There appears to be agreement amongst surgeons regarding the preferred form of surgical treatment of patients with stage I or II disease. The results indicate that the surgical treatment of early stage disease is consistent with published guidelines.
探讨新西兰早期乳腺癌患者的手术治疗方式。
向195名注册普通外科医生邮寄问卷。
186名在职医生中有112名回复(60%),其中76名表示治疗乳腺疾病患者。6%表示1994年治疗超过50例新诊断的乳腺癌患者。少数(29%)单位有记录在案的乳腺癌患者手术治疗的正式方案。三分之一的医生会自行决定治疗方案,三分之二的医生会邀请其他专科医生参与。几乎所有医生都会在合适的时候为患者提供治疗选择。只有9%的医生会推荐对位于乳腺外上象限的T1/2NO肿瘤进行乳房切除术。按地区卫生当局、医院类型和每年治疗患者数量划分,医生之间无显著差异。
外科医生对于I期或II期疾病患者首选的手术治疗方式似乎达成了共识。结果表明早期疾病的手术治疗与已发表的指南一致。