Kotwall C, Covington D, Churchill P, Brinker C, Weintritt D, Maxwell J G
Department of Surgery, School of Medicine, University of North Carolina at Chapel Hill, USA.
Am J Surg. 1998 Dec;176(6):510-4.
This study examined trends in breast conservation surgery (BCS) at our hospital and factors associated with BCS.
We retrospectively reviewed breast cancer surgeries in patients eligible for BCS (size <4 cm, N0, N1) from 1990 through 1996 (n = 634). We calculated the yearly prevalence of BCS and used multiple logistic regression (MLR) to determine tumor, patient, and surgeon factors associated with BCS.
BCS increased from 17% in 1990 to 41% in 1996. Women with T1a and T1b tumors were 3.8 and 2.0 times, respectively, as likely to have BCS compared with those who had T2 tumors. Other factors associated with BCS included nonpalpable tumors, age <50, Medicare, Medicaid, or self-pay patients, and women whose surgeons graduated since 1961, with odds ratios of 1.8, 1.9, 2.4, and 2.3, respectively.
Women with small, nonpalpable tumors, age <50, without private insurance, operated on by younger surgeons were more likely to receive BCS.
本研究调查了我院保乳手术（BCS）的趋势以及与保乳手术相关的因素。
我们回顾性分析了1990年至1996年符合保乳手术条件（肿瘤大小<4 cm，N0，N1）的乳腺癌手术患者（n = 634）。我们计算了保乳手术的年患病率，并使用多元逻辑回归（MLR）来确定与保乳手术相关的肿瘤、患者和外科医生因素。
保乳手术率从1990年的17%上升至1996年的41%。与患有T2肿瘤的女性相比，患有T1a和T1b肿瘤的女性接受保乳手术的可能性分别为其3.8倍和2.0倍。与保乳手术相关的其他因素包括不可触及的肿瘤、年龄<50岁、享受医疗保险、医疗补助或自费的患者，以及其外科医生自1961年以来毕业的女性，比值比分别为1.8、1.9、2.4和2.3。
肿瘤小且不可触及、年龄<50岁、没有私人保险且由年轻外科医生进行手术的女性更有可能接受保乳手术。
