双边乳房切除和乳腺癌死亡率
Vasily Giannakeas1,2,3, David W Lim1,4,5,6, Steven A Narod1,3,6
1Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.
JAMA oncology
|July 25, 2024
概括
双边乳腺切除术显著降低了单边乳腺癌妇女的逆侧乳腺癌的风险. 然而,整体乳腺癌死亡率在乳腺切除,单侧乳腺切除和双侧乳腺切除组中是相似的.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 流行病学 流行病学
背景情况:
- 双边乳房切除术对单边乳腺癌的生存益处尚不清楚.
- 了解不同手术方法对乳腺癌死亡率的长期影响对于患者护理至关重要.
研究的目的:
- 为了估计乳腺癌死亡率的20年累积风险,在妇女的阶段0-III单边乳腺癌.
- 根据最初的手术治疗来比较死亡风险:乳房切除术,单侧乳房切除术或双侧乳房切除术.
主要方法:
- 使用监测,流行病学和最终结果 (SEER) 注册表数据库 (2000-2019) 的队列研究.
- 包括患有单边乳腺癌 (侵袭性和管道癌 in situ) 的妇女.
- 1:1:1匹配创建了基于外科手术方法的三个相同大小的队列,对 contralateral 癌症和死亡率进行了20年的跟踪.
主要成果:
- 这项研究包括661,270名女性;匹配的队列分别包括36,028名.
- 双边切除乳腺切除术显著降低了逆侧乳腺癌的风险 (97例),相比切除术 (766例) 和单侧切除乳腺切除术 (728例).
- 乳腺癌20年死亡率在各组中相似:乳腺切除术 (8.54%),单侧乳腺切除术 (9.07%) 和双侧乳腺切除术 (8.50%).
结论:
- 虽然双侧乳房切除术可以降低对侧乳腺癌的风险,但与乳房切除术或单侧乳房切除术相比,它似乎不能降低整体乳腺癌死亡率.
- 发生逆侧乳腺癌后,乳腺癌死亡的风险大幅增加.
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