Richards M, Sainsbury R, Kerr D
Guy's and St Thomas's NHS Trust, London, UK.
Br J Cancer. 1997;76(5):634-8. doi: 10.1038/bjc.1997.437.
Comparisons across Europe suggest that survival from breast cancer is less good in the United Kingdom than in many countries. The care given in some UK breast cancer units is exemplary. However, it is difficult to escape the conclusion that a substantial number of women who present with breast cancer receive suboptimal care. Cancer registry-based studies have clearly demonstrated variations between surgeons and between hospitals in the management of early breast cancer. Although variations in surgical practice per se may have little impact on survival, there is evidence that differences in the use of systemic adjuvant therapy influence outcome. Five-year survival seems to be greater in women treated by surgeons seeing more than 30-50 new cases of breast cancer each year. This may be because such patients are more likely to be treated by a multidisciplinary team and to receive adjuvant therapy. Proposals that would increase the overall quality of breast cancer care and remove current inequalities must be carefully considered and should then be implemented.
欧洲范围内的比较表明，英国乳腺癌患者的生存率低于许多国家。英国一些乳腺癌治疗单位提供的护理堪称典范。然而，很难不得出这样的结论：大量罹患乳腺癌的女性接受的护理并不理想。基于癌症登记处的研究清楚地表明，早期乳腺癌的治疗在外科医生之间以及医院之间存在差异。虽然手术操作本身的差异可能对生存率影响不大，但有证据表明，全身辅助治疗的使用差异会影响治疗结果。每年诊治30 - 50例以上新乳腺癌病例的外科医生所治疗的女性，其五年生存率似乎更高。这可能是因为这类患者更有可能由多学科团队进行治疗并接受辅助治疗。必须认真考虑那些能够提高乳腺癌护理整体质量并消除当前不平等现象的提议，然后予以实施。
