Background: Incidence rates of breast cancer continue to rise in the People's Republic of China. The purpose of this study was to describe Chinese trends in radical surgical modalities and influential imaging and demographic factors for breast malignancies.
Materials and methods: This study was a hospital-based, multicenter, 10-year (1999-2008), retrospective study. Descriptive statistical tests were used to illustrate information regarding radical surgical trends for the treatment of breast malignancies. Chi-square tests were used to assess effect of demographic factors in addition to imaging and pathological data on the specific surgical method.
Results: A total of 4,211 patients were enrolled in the survey. Among them, 3,335 patients with stage 0 to stage III disease undergoing mastectomy or breast-conserving surgery (BCS) were included in the final analysis. The rate of BCS increased from 1.53% in 1999 to 11.88% in 2008. The rate of mastectomy declined over this time period, from 98.47% in 1999 to 88.12% in 2008, with increasing use of diagnostic imaging methods and pathological biopsies. A significantly greater percentage of patients with office work, high education levels, unmarried status, younger age, and early pathological stages preferred BCS compared with mastectomy.
Conclusion: Rates of mastectomy in China remain elevated due to diagnosis at higher stages; however, because of increased use of diagnostic imaging, improvement of biopsy methods, and patient education, rates of less invasive lumpectomy are increasing and rates of mastectomy have decreased in China.
Implications for practice: In this study, 4,211 cases were collected from 1999 to 2008 through a multicenter retrospective study of varying geographic and socioeconomic areas to illustrate trends of surgeries in the People's Republic of China. The correlations between demographic and tumor characteristics and among methods of surgical treatment were explored. This study shows that the rate of breast-conserving surgery (BCS) increased and the rate of mastectomy declined over this time period with increasing use of diagnostic imaging methods and pathological biopsies. Patients with office work, high education levels, unmarried status, younger age, and early pathological stages preferred BCS compared with mastectomy in China.
摘要
背景. 中华人民共和国的乳腺癌发生率在持续升高。本研究旨在描述中国乳腺癌根治术模式的演变趋势以及相关的影像学和人口统计学影响因素。
材料与方法. 本研究为期10年(1999 – 2008年),是一项基于医院的多中心回顾性研究。我们使用描述性统计检验来说明应用根治性手术治疗乳腺癌趋势的相关信息。除影像学和病理学数据以外,人口统计学因素对特定手术方案的影响也使用卡方检验评估。
结果. 本调查共纳入4 211例患者。最终分析纳入了其中3 335例接受乳腺切除术或保乳手术(BCS)的0 ∼ III期患者。BCS率从1999年的1.53%升高到2008年的11.88%。而伴随着影像学诊断方法和病理学活检的普及,同一时期的乳腺切除术率则从1999年的98.47%降至2008年的88.12%。白领、高学历、未婚、较年轻和病理分期较早的患者选择BCS的比例显著高于乳腺切除术。
结论. 中国患者由于诊断时处于疾病较晚期,乳腺切除术率仍然偏高。但因影像学诊断的推广、活检方法的改进以及患者教育的普及,中国微创局部切除术的应用率正在升高,而乳腺切除术率已逐步下降。The Oncologist 2015;20:1036–1043
对临床实践的意义:本研究是一项多中心回顾性研究,在1999 – 2008年间收集了4 211例来自中国不同地理和社会经济区域的病例,旨在描述手术演变趋势。本研究还探讨了人口统计学与肿瘤特征及手术治疗方法之间的相关性。研究表明保乳手术(BCS)率在增加,与此同时,乳腺切除术率伴随着影像学诊断和病理学活检的普及而下降。在中国,白领、高学历、未婚、较年轻和病理分期较早的患者更多选择BCS而非乳腺切除术。
Keywords: Breast neoplasms; Diagnosis; Imaging; Surgical.
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