Breast Cancer Clinical Characteristics and Outcomes in Trinidad and Tobago
Breast Cancer Clinical Characteristics and Outcomes in Trinidad and Tobago
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DOI：
10.1007/s10903-013-9930-5
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发表时间：
2015-06-01
影响因子：
1.9
通讯作者：
Taioli, Emanuela
中科院分区：
文献类型：
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作者：
Camacho-Rivera, Marlene;Ragin, Camille;Taioli, Emanuela
特立尼达和多巴哥是加勒比地区乳腺癌死亡率最高的国家。目前尚不清楚生物、行为、环境或临床因素是否在这种结果中起重要作用。对1995年至2005年期间经组织学证实并记录在TT癌症登记处的2,614例病例进行了分析，并随访至2009年。一半的病例诊断年龄在40-59岁之间，12.5%在40岁之前；45%的女性诊断为局部期，43.7%的女性激素受体阳性。诊断为远处分期的妇女比诊断为局部分期的妇女更有可能接受化疗（OR 1.39; 95% CI 1.01-1.89）。与激素受体阳性患者相比，激素受体阴性患者接受放疗或手术治疗的可能性明显降低（or分别为0.66;95% CI 0.56-0.79和or 0.67; 95% CI 0.51-0.88），但接受化疗的可能性是激素受体阳性患者的1.5倍以上。在多变量分析中，晚期疾病和负激素受体状态与较差的生存结果独立显著相关。在治疗或生存方面没有观察到种族/民族差异。虽然特立尼达和多巴哥免费提供乳腺癌筛查和治疗，但乳腺癌诊断是在晚期；综合疗法作为第一疗程的使用率很低。
Trinidad and Tobago (TT) is the country with the highest breast cancer mortality in the Caribbean. It is unknown whether biological, behavioral, environmental, or clinical factors play a significant role in such outcome. A total of 2,614 incident cases, histologically confirmed and recorded in the TT cancer registries between 1995 and 2005, with follow-up through 2009 were analyzed. Half of the cases were diagnosed between the ages of 40-59 years, 12.5 % before the age of 40 years; 45 % of women were diagnosed at localized stage and 43.7 % were hormone receptor positive. Women diagnosed with distant staging were more likely to undergo chemotherapy compared to those with localized staging (OR 1.39; 95 % CI 1.01-1.89). Hormone receptor negative cases were significantly less likely to undergo radiation or surgery therapy (OR 0.66; 95 % CI 0.56-0.79 and OR 0.67; 95 % CI 0.51-0.88 respectively) compared to those who were hormone receptor positive, but more than 1.5 times as likely to undergo chemotherapy. In multivariate analyses, advanced stage disease and negative hormone receptor status were independently significantly associated with poorer survival outcome. No racial/ethnic differences were observed with respect to treatment or survival. Although access to breast cancer screening and treatment is free in Trinidad and Tobago, breast cancer diagnosis occurs at advanced stages; use of multimodality therapy as a first course of treatment is low.