将接受乳腺保护疗法的患者与整体乳房切除术作为早期乳腺癌的首次治疗方法之间的生存差异进行比较
Min Yi1, Mariana Chavez-MacGregor2,3, Benjamin D Smith4
1Unit 1434, Breast Surgical Oncology Department, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Annals of surgical oncology
|August 11, 2025
概括
年轻女性的整体乳房切除 (TM) 率增加. 乳腺保护疗法 (BCT) 和TM显示早期乳腺癌的生存结果相当,有助于临床决策.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 乳腺癌研究研究 乳腺癌研究
背景情况:
- 评估早期乳腺癌 (BC) 总乳房切除 (TM) 率的趋势.
- 将乳腺保护疗法 (BCT) 和TM之间的生存结果进行比较.
- 评估早期BC的外科治疗趋势.
研究的目的:
- 评估早期乳腺癌 (BC) 患者的整体乳房切除 (TM) 率的趋势.
- 在BCT和TM之间比较总生存率 (OS),远程转移无生存率 (DMFS),局部区域复发率 (LRR) 和乳腺癌特异性生存率 (BCSS).
- 分析基于手术方法和患者特征的生存差异.
主要方法:
- 对8967名患有早期BC的妇女进行了前期手术 (2000-2014) 的回顾性分析.
- 用逆概率加权 (IPW) 进行混调整来评估TM率和生存结果.
- 基于疾病阶段和激素受体状态的子组分析.
主要成果:
- 在年龄 ≤50岁的患者中,TM发病率增加 (39.7%至59.9%).
- 在IPW调整后,与辐射的BCT显示了类似的OS,DMFS和LRR,但与单独的TM相比,BCSS略差一些.
- 在亚群分析中,在没有辐射的TM和BCT之间没有观察到显著的生存差异. 在三重阴性,I期BC中,BCT显示较低的LRR.
结论:
- 乳腺保护疗法 (BCT) 和全乳切除术 (TM) 是早期乳腺癌的初始手术策略.
- 这些发现支持医生和患者之间关于手术选择的共享决策.
- 该研究提供了证据,以指导符合条件的乳腺癌患者的治疗选择.
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