Aggressive primary treatments with favourable 5-year survival for screen-interval breast cancers
Aggressive primary treatments with favourable 5-year survival for screen-interval breast cancers
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DOI：
10.1186/s12885-018-4319-4
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发表时间：
2018-04-06
期刊：
影响因子：
3.8
通讯作者：
Ingrand, Pierre
中科院分区：
文献类型：
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作者：
Defossez, Gautier;Quillet, Alexandre;Ingrand, Pierre
工作背景：为了评估参与筛查计划的影响，根据早期诊断，治疗和特定的生存结局的妇女与乳腺癌的检测模式。方法：2008年和2009年之间在普瓦图-沙伦特地区（法国）诊断为浸润性乳腺癌的妇女被分为三组，使用癌症登记，生命统计和法国组织的筛查计划的数据链接：筛查程序（SP），间隔癌症（IC），和非筛查程序发现癌症（NSP）组。使用Kaplan-Meier方法和考克斯比例风险models.Results：在1613例患者中，65.7%（n = 1059）参加了筛选程序的特定生存率进行了分析。间期癌发生率为17.1%（n = 181）。IC组中的肿瘤在更晚期被诊断，即具有进一步的区域淋巴结转移或局部扩散，比SP组（p < 0.001），但诊断时的转移显著少于NSP组（p < 0.001）。与其他两组相比，IC接受了更积极的初步治疗，28%的根治性乳房切除术和67%的化疗。IC组的5年生存率为92.0%（95%CI，89.9-94.0%）。结论：间隔期癌症比筛查发现的癌症具有更强的侵袭性特征，但与非筛查发现的癌症相比，诊断的晚期程度较低。尽管筛查方案遗漏了一些癌症，但参加筛查过程的妇女似乎从早期治疗中受益。这些结果必须通过长期随访来证实。
Background: To assess the impact of the participation in screening programme according to the mode of detection on the early diagnosis, treatment, and specific survival outcomes in women with breast cancer.Methods: Women diagnosed with invasive breast cancer in Poitou-Charentes region (France) between 2008 and 2009 were classified into three groups, using data linkage of cancer registry, vital statistics and French organized screening programme: the screening programme (SP), interval cancer (IC), and non-screening programme detected cancer (NSP) groups. Specific survival rates were analysed using the Kaplan-Meier method and Cox proportional hazard models.Results: Among 1613 patients, 65.7% (n = 1059) participated in a screening programme. The interval cancer rate was 17.1% (n = 181). Tumours in the IC group were diagnosed at a more advanced stage, i.e. with further regional lymph node metastasis or local spread, than those in the SP group (p < 0.001), but with significantly fewer metastases at diagnosis than in the NSP group (p < 0.001). ICs underwent more aggressive primary treatments than the two other groups, with 28% of radical mastectomy and 67% undergoing chemotherapy. The five-year survival rate for IC group were 92.0% (95% CI, 89.9-94.0%).Conclusions: Interval cancers had more aggressive features than screen-detected cancers but were diagnosed at a less advanced stage compared to non-screen detected cancers. Despite having cancers missed by the screening programme, women who participate in the screening process seem to benefit from early treatment. These results must be confirmed with long-term follow-up.