Are breast conservation and mastectomy equally effective in the treatment of young women with early breast cancer? Long-term results of a population-based cohort of 1,451 patients aged aparts per thousandcurrency sign40 years
Are breast conservation and mastectomy equally effective in the treatment of young women with early breast cancer? Long-term results of a population-based cohort of 1,451 patients aged aparts per thousandcurrency sign40 years
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DOI：
10.1007/s10549-010-1110-x
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发表时间：
2011-05-01
影响因子：
3.8
通讯作者：
Voogd, Adri C.
中科院分区：
文献类型：
--
作者：
van der Sangen, Maurice J. C.;van de Wiel, Fenneke M. M.;Voogd, Adri C.
为了比较保乳治疗（BCT）和乳房切除术的效果，研究人员确定了1988年至2005年间在荷兰南部接受早期乳腺癌治疗的所有年龄为千分之一（40岁）的女性。共有562名患者接受了乳房切除术，889名患者接受了BCT。在随访期间，23例接受乳房切除术的患者和135例接受BCT治疗的患者在没有既往或同时的远处疾病证据的情况下出现局部复发。乳房切除术患者5年局部复发风险为4.4%(95%可信区间（CI） 2.4-6.4)， 6年后达到平稳期，为6.0% （95% CI 3.5-8.5）。BCT后，5年、10年和15年的风险分别为8.3% （95% CI 6.3-10.5）、18.4% （95% CI 15.0-21.8）和28.2% (95% CI 23.0-33.4) （P < 0.0001）。BCT后的辅助全身治疗将15年局部复发风险从32.9% （95% CI 26.7-39.1）降低到16.1% (95% CI 9.1-23.1), （P = 0.0007）。结论：年轻早期乳腺癌患者行BCT后局部肿瘤控制较行乳腺切除术后更差。辅助全身治疗显著改善了BCT后的局部控制，因此，对于大多数患者，应考虑每千分之一的货币符号40年。强烈建议年轻患者接受BCT后进行长期随访，因为即使接受全身治疗，治疗后15年仍有1%的局部复发风险。
To compare the effectiveness of breast-conserving therapy (BCT) and mastectomy, all women aged a parts per thousand currency sign40 years, treated for early-stage breast cancer in the southern part of the Netherlands between 1988 and 2005, were identified. A total of 562 patients underwent mastectomy and 889 patients received BCT. During follow-up, 23 patients treated with mastectomy and 135 patients treated with BCT developed a local relapse without previous or simultaneous evidence of distant disease. The local relapse risk for patients treated with mastectomy was 4.4% (95% confidence interval (CI) 2.4-6.4) at 5 years and reached a plateau after 6 years at 6.0% (95% CI 3.5-8.5). After BCT, the 5-, 10- and 15-year risks were 8.3% (95% CI 6.3-10.5), 18.4% (95% CI 15.0-21.8) and 28.2% (95% CI 23.0-33.4), respectively (P < 0.0001). Adjuvant systemic therapy following BCT reduced the 15-year local relapse risk from 32.9% (95% CI 26.7-39.1) to 16.1% (95% CI 9.1-23.1), (P = 0.0007). In conclusion, local tumor control in young patients with early-stage breast cancer is worse after BCT than after mastectomy. Adjuvant systemic therapy significantly improves local control following BCT and also for that reason it should be considered for most patients a parts per thousand currency sign40 years. Long-term follow-up is highly recommended for young patients after BCT, because even with systemic treatment an annual risk of local relapse of 1% remains up to 15 years after treatment.