Chart P L, Franssen E
Preventive Oncology Program, Toronto-Sunnybrook Regional Cancer Centre, Ont.
CMAJ. 1997 Nov 1;157(9):1235-42.
To examine the characteristics of malignant tumours that develop in women undergoing surveillance for increased risk for breast cancer and to identify presentation patterns in order to determine the respective roles of mammography, clinical breast examination (CBE) and breast self-examination (BSE).
Breast Diagnostic Clinic and Familial Breast Cancer Clinic at Toronto-Sunnybrook Regional Cancer Centre.
A total of 1044 women evaluated for breast cancer risk from Oct. 1, 1990, to Dec. 31, 1996, of whom 381 were categorized as being at high risk, 204 as being at moderate risk, 401 as being at slightly increased risk and 58 as being at no appreciably increased risk.
Comprehensive review and discussion of risk factors, clinical assessment, surveillance recommendations that include mammography, CBE and BSE, genetics consultation (Familial Breast Cancer Clinic) and psychosocial support. Data are captured prospectively, updated at each visit and audited every 3 to 6 months.
During the study period breast cancer was diagnosed in 24 patients, 12 in the high-risk group, 4 in the moderate-risk group and 8 in the group at slightly increased risk. The mean age at diagnosis was 47 (range 32 to 82) years. Ten cases of cancer were diagnosed during surveillance (incident cancer), 5 in women under age 50. The mean length of time from initial assessment to diagnosis was 28.6 (range 12 to 51) months. Of the 24 women, 17 reported a family history of breast cancer. The mean age at diagnosis in this cohort was 45.5 years, and the diagnosis was made under age 50 in 10 patients (59%). The mean earliest age at which breast cancer was diagnosed in a family member was 42.5 years.
These preliminary results suggest that surveillance of women at increased risk for breast cancer may be useful in detecting disease at an early stage. The regular performance of mammography, CBE and BSE appears necessary to achieve these results.
研究接受乳腺癌风险增加监测的女性所患恶性肿瘤的特征，并确定其表现模式，以明确乳房X线摄影、临床乳腺检查（CBE）和乳腺自我检查（BSE）各自的作用。
多伦多-桑尼布鲁克地区癌症中心的乳腺诊断诊所和家族性乳腺癌诊所。
1990年10月1日至1996年12月31日期间，共有1044名女性接受了乳腺癌风险评估，其中381人被归类为高风险，204人被归类为中度风险，401人被归类为风险略有增加，58人被归类为无明显风险增加。
对风险因素进行全面审查和讨论、临床评估、包括乳房X线摄影、CBE和BSE的监测建议、遗传咨询（家族性乳腺癌诊所）以及心理社会支持。前瞻性收集数据，每次就诊时更新，并每3至6个月进行一次审核。
在研究期间，24名患者被诊断出患有乳腺癌，其中高风险组12人，中度风险组4人，风险略有增加组8人。诊断时的平均年龄为47岁（范围32至82岁）。10例癌症在监测期间被诊断出来（新发癌症），5例发生在50岁以下女性中。从初次评估到诊断的平均时间为28.6个月（范围12至51个月）。在这24名女性中，17人报告有乳腺癌家族史。该队列中诊断时的平均年龄为45.5岁，10名患者（59%）在50岁以下被诊断出。家族成员中最早被诊断出乳腺癌的平均年龄为42.5岁。
这些初步结果表明，对乳腺癌风险增加的女性进行监测可能有助于早期发现疾病。定期进行乳房X线摄影、CBE和BSE似乎是取得这些结果所必需的。
