Non-standard management of breast cancer increases with age in the UK:: a population based cohort of women ≥65 years
Non-standard management of breast cancer increases with age in the UK:: a population based cohort of women ≥65 years
复制标题
DOI：
10.1038/sj.bjc.6603709
复制
发表时间：
2007-04-23
影响因子：
8.8
通讯作者：
Campbell, M.
中科院分区：
文献类型：
--
作者：
Lavelle, K.;Todd, C.;Campbell, M.
有证据表明，与年轻女性相比，老年女性接受乳腺癌标准治疗的可能性较小。在英国，对肿瘤特征的差异进行调整后，这种差异是否会持续还没有得到调查。根据西北癌症登记处的数据库，对居住在大曼彻斯特的65岁以上的浸润性乳腺癌患者进行了一项病例回顾队列研究(n=480)。通过Logistic回归分析调整与年龄相关的肿瘤特征，在所调查的所有指标中，老年女性接受标准治疗的可能性低于年轻女性。与65-69岁的女性相比，患有可手术乳腺癌(1-3a期)的80岁女性不接受三重评估(OR=5.5，95%可信区间：2.1-14.5)、不接受一次手术(OR=43.0，95%CI：9.7-191.3)、不接受腋窝淋巴结手术(OR=2 7.6，95%CI：5.6-135.9)和不接受类固醇受体检测(OR=.0，95%CI：1.7-5.5)的几率增加。与65-69岁的女性相比，75-79岁的女性在保乳手术后不接受放射治疗的几率更高(OR 11.0，95%CI：2.0-61.6)。这些结果表明，与年轻女性相比，英国老年女性接受乳腺癌标准治疗的可能性较小，这种差异不能用肿瘤特征的差异来解释。
Evidence suggests that compared to younger women, older women are less likely to receive standard management for breast cancer. Whether this disparity persists once differences in tumour characteristics have been adjusted for has not been investigated in the UK. A retrospective cohort study involving case note review was undertaken, based on the North Western Cancer Registry database of women aged >= 65 years, resident in Greater Manchester with invasive breast cancer registered over a 1-year period (n = 480). Adjusting for tumour characteristics associated with age by logistic regression analyses, older women were less likely to receive standard management than younger women for all indicators investigated. Compared to women aged 65-69 years, women aged >= 80 years with operable (stage 1-3a) breast cancer have increased odds of not receiving triple assessment (OR=5.5, 95% confidence interval (Cl): 2.1-14.5), not receiving primary surgery (OR=43.0, 95% Cl: 9.7-191.3), not undergoing axillary node surgery (OR=27.6, 95% Cl: 5.6-135.9) and not undergoing tests for steroid receptors (OR =.0, 95% Cl: 1.7-5.5). Women aged 75-79 years have increased odds of not receiving radiotherapy following breast-conserving surgery compared to women aged 65-69 years (OR 11.0, 95% Cl: 2.0-61.6). These results demonstrate that older women in the UK are less likely to receive standard management for breast cancer, compared to younger women and this disparity cannot be explained by differences in tumour characteristics.