Trends in Racial and Age Disparities in Definitive Local Therapy of Early-Stage Breast Cancer
Trends in Racial and Age Disparities in Definitive Local Therapy of Early-Stage Breast Cancer
复制标题
DOI：
10.1200/jco.2008.17.9234
复制
发表时间：
2009-02-10
影响因子：
45.3
通讯作者：
Keating, Nancy L.
中科院分区：
文献类型：
--
作者：
Freedman, Rachel A.;He, Yulei;Keating, Nancy L.
目的指南建议采用保乳手术 (BCS) 联合放疗或乳房切除术对 I/II 期乳腺癌进行明确的局部治疗。我们按种族/民族和年龄评估了早期乳腺癌确定性局部治疗的接受情况，并检查了随时间变化的趋势。患者和方法我们利用监测、流行病学和最终结果登记数据，计算了 1988 年至 2004 年间诊断的 375,547 名 I 期或 II 期乳腺癌成年女性的确定性局部治疗（乳房切除术或 BCS 放疗）的比率。我们使用多元逻辑回归评估了确定性局部治疗的可能性和随时间变化的趋势。结果总体而言，85.8% 的女性接受了确定性局部治疗。随着乳房切除率下降（1988 年的 76.5% 降至 2004 年的 38.0%；P < .001），明确的局部治疗率也下降（1988 年的 95.2% 降至 2004 年的 79.2%；P < .001）。在调整后的分析中，黑人和西班牙裔（白人）女性的明确局部治疗率略低，而亚洲女性则较高。随着时间的推移，黑人和亚洲女性的差异保持稳定（交互作用的 P = .61 和 P = .35），但西班牙裔女性的差异有所增加 (P = .0003)。尽管年龄差异随着时间的推移而缩小，但 70 岁以上的女性和女性
PurposeGuidelines recommend breast-conserving surgery (BCS) with radiation or mastectomy for definitive local therapy of stage I/II breast cancers. We assessed receipt of definitive local therapy for early-stage breast cancer by race/ethnicity and age and examined trends over time.Patients and MethodsWe calculated rates of definitive local therapy (mastectomy or BCS with radiation) for 375,547 adult women with stage I or II breast cancer diagnosed during 1988 to 2004 using Surveillance, Epidemiology, and End Results registry data. We assessed the probability of definitive local therapy and trends over time using multivariate logistic regression.ResultsOverall, 85.8% of women had definitive local therapy. As mastectomy rates decreased (76.5% in 1988 to 38.0% in 2004; P < .001), definitive local therapy rates also decreased (95.2% in 1988 to 79.2% in 2004; P < .001). In adjusted analyses, rates of definitive local therapy were modestly lower for black and Hispanic (v white) women and higher for Asian women. Differences for black and Asian women were stable over time (P = .61 and P = .35 for interaction), but increased for Hispanic women (P = .0003). Although age differences narrowed over time, women older than 70 years and women