Long-term prognosis of breast cancer detected by mammography screening or other methods.
Long-term prognosis of breast cancer detected by mammography screening or other methods.
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DOI：
10.1186/bcr3080
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发表时间：
2011
期刊：
影响因子：
--
通讯作者：
Lundin J
中科院分区：
文献类型：
--
作者：
Lehtimäki T;Lundin M;Linder N;Sihto H;Holli K;Turpeenniemi-Hujanen T;Kataja V;Isola J;Joensuu H;Lundin J
以前的乳腺癌研究表明，通过乳房X光检查发现肿瘤的患者生存率更高。然而，关于筛查检测的长期预后影响知之甚少。本研究的目的是比较乳腺X线摄影筛查中检测到肿瘤的患者与通过其他方法检测到肿瘤的患者的乳腺癌特异性长期生存率。1991年和1992年在芬兰五个特定地理区域内诊断的乳腺癌患者被确定（N = 2，936）。收集了详细的临床、治疗和结局数据以及组织样本。在初步诊断时有原位癌、远处转移的女性和未接受手术治疗的女性被排除在外。在排除患有其他恶性肿瘤或对侧乳腺癌的患者后进行主要分析，然后采用不同排除标准进行敏感性分析。中位随访时间为15.4年。对乳腺癌特异性生存率进行单变量和多变量分析。在纳入主要分析的患者（n = 1，884）中，22%（n = 408）的癌症是通过筛查发现的，78%（n = 1，476）是通过其他方法发现的。乳腺癌特异性15年生存率为86%的筛查发现的癌症患者和66%的患者使用其他方法诊断（P < 0.0001，HR = 2.91）。在筛选年龄（50至69岁）的女性中以及在临床重要亚组中观察到类似的生存差异，例如小肿瘤（直径≤ 1 cm）和无淋巴结受累（N0）的患者。根据患者年龄、肿瘤大小、腋窝淋巴结状态、组织学分级和激素受体状态进行调整后，筛查性乳房X线摄影诊断的乳腺癌妇女的预后比筛查计划外诊断的乳腺癌妇女更好。根据检测方法，未观察到未来患对侧乳腺癌风险的显著差异。乳腺X线摄影筛查发现的乳腺癌是乳腺癌的独立预后因素，与更有利的生存率以及长期随访相关。
Previous studies of breast cancer have shown that patients whose tumors are detected by mammography screening have a more favorable survival. Little is known, however, about the long-term prognostic impact of screen detection. The purpose of the current study was to compare breast cancer-specific long-term survival of patients whose tumors were detected in mammography screening compared with those whose tumors were detected by other methods. Breast cancer patients diagnosed within five specified geographical areas in Finland in 1991 and 1992 were identified (N = 2,936). Detailed clinical, treatment and outcome data, as well as tissue samples, were collected. Women with in situ carcinoma, distant metastases at the time of primary diagnosis and women who were not treated surgically were excluded. The main analyses were performed after excluding patients with other malignancy or contralateral breast cancer, followed by sensitivity analyses with different exclusion criteria. Median follow-up time was 15.4 years. Univariate and multivariate analyses of breast cancer-specific survival were performed. Of patients included in the main analyses (n = 1,884), 22% (n = 408) of cancers were screen-detected and 78% (n = 1,476) were detected by other methods. Breast cancer-specific 15-year survival was 86% for patients with screen-detected cancer and 66% for patients diagnosed using other methods (P < 0.0001, HR = 2.91). Similar differences in survival were observed in women at screening age (50 to 69 years), as well as in clinically important subgroups, such as patients with small tumors (≤ 1 cm in diameter) and without nodal involvement (N0). Women with breast cancer diagnosed on the basis of screening mammography had a more favorable prognosis than those diagnosed outside screening programs, following adjustments according to patient age, tumor size, axillary lymph node status, histological grade and hormone receptor status. Significant differences in the risk of having future contralateral breast cancer according to method of detection were not observed. Breast cancer detected by mammography screening is an independent prognostic factor in breast cancer and is associated with a more favorable survival rate as well as in long-term follow-up.
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影响因子：
3.8
作者：
Anderson, William F.;Chen, Bingshu E.;Rosenberg, Philip S.
通讯作者：
Rosenberg, Philip S.
影响因子：
82.9
作者：
Kononen, J;Bubendorf, L;Kallioniemi, OP
通讯作者：
Kallioniemi, OP
影响因子：
8.8
作者：
Klemi, PJ;Toikkanen, S;Joensuu, H
通讯作者：
Joensuu, H
影响因子：
45.3
作者：
JOENSUU, H;TOIKKANEN, S
通讯作者：
TOIKKANEN, S
影响因子：
19.7
作者：
Burrell, HC;Sibbering, DM;Robertson, JFR
通讯作者：
Robertson, JFR