识别"不明智的选择"风险人口:基于SEER人口的研究
Michelle J Hong1, Sharon S Lum1, Liang Ji1
1Department of Surgery, School of Medicine, Loma Linda University, Loma Linda, CA, USA.
The American surgeon
|June 1, 2023
概括
患有早期乳腺癌的老年妇女经常接受不必要的股手术,尽管指南建议不要这样做. 特定的种族,种族和社会经济群体面临过度治疗的更高风险,突出需要改善护理降级.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 自2016年以来,选择明智的运动建议不对老年患者进行常规的下手术,这些患者患有早期,激素受体阳性乳腺癌.
- 尽管有建议,但在符合条件的患者群体中,手术的发生率仍然很高.
研究的目的:
- 为了评估与手术相关的因素,老年乳腺癌患者有资格接受哨兵淋巴结活检遗漏.
- 为了确定手术利用的潜在差异.
主要方法:
- 对年龄≥70岁,具有特定早期乳腺癌特征 (2016-2019) 的女性患者的监测,流行病学和最终结果 (SEER) 数据库的分析.
- 对患者人口统计,瘤特征和与手术相关的治疗方式的多变量分析.
主要成果:
- 在31,756名符合条件的患者中,81.2%接受了手术.
- 西班牙裔种族,中等收入较低,农村治疗,晚期瘤特征和接受辐射/全身治疗与手术有关.
- 在接受手术的患者中,很少有 (2.1%) 的淋巴结呈阳性.
结论:
- 某些老年患者的种族,种族,社会经济和地理群体面临过度治疗手术的风险较高.
- 结果表明有机会进行有针对性的教育和减少不必要的程序,以减少过度治疗.
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