CURED OF BREAST-CANCER
CURED OF BREAST-CANCER
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DOI：
10.1200/jco.1995.13.1.62
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发表时间：
1995-01-01
影响因子：
45.3
通讯作者：
TOIKKANEN, S
中科院分区：
文献类型：
--
作者：
JOENSUU, H;TOIKKANEN, S
目的：乳腺癌患者能否最终治愈一直受到质疑，因为即使在诊断出乳腺癌几十年后，也观察到晚期死亡。这项研究的目的是调查乳腺癌导致的晚期死亡率。患者和方法：利用当地医院和芬兰癌症登记处的文件，我们确定了1945-1969年间在一个明确的城区(芬兰图尔库市)所有组织学诊断为浸润性乳腺癌的患者(n=601)，其中563例(94%)可以回顾临床数据和组织学和尸检切片，这些妇女被监测的中位数为29年(范围从22到44年；结果：即使在第四个十年中也观察到了乳腺癌的死亡率，但如果排除了被诊断为对侧乳腺癌的女性(n=30)，在第27年的随访评估之后，没有发现乳腺癌死亡。PN0(结节阴性)和PN1或pN2(结节阳性)患者的30年生存率分别为62%(95%可信区间，54%~70%)、19%(95%可信区间，13%~25%)和0%。小(PT1N0M0)单侧癌(80%橄榄；95%可信区间，66~94%)、小叶癌(45%存活；95%可信区间，31%~59%)和特殊组织学类型(81%存活；95%可信区间，67%~95%)有较高的30年生存率。这些生存率是在校正了已知的并发死亡或年龄和性别匹配的普通人群中的死亡率后获得的。结论：乳腺癌，无论是结节阴性的还是结节阳性的，即使只接受局部治疗也可以永久治愈，这里列出的生存数字可以被认为是最小的价值，因为1970年到1984年在同一地区诊断的乳腺癌患者比1945年到1969年诊断的乳腺癌患者的短期(和20年)生存率显著提高。
Purpose: That patients can be ultimately cured of breast cancer has been questioned, because late deaths from the disease have been observed even several decades after the diagnosis. The purpose of this study was to investigate late mortality caused by breast cancer.Patients and Methods: Using the files of local hospitals and the Finnish Cancer Registry, we identified all patients with histologically diagnosed invasive breast cancer in a defined urban area (city of Turku, Finland) from 1945 to 1969 (n = 601), In 563 cases (94%), clinical data and histologic and autopsy slides could be reviewed, and these women had been monitored for a median of 29 years (range, 22 to 44; n = 66) or until death (n = 497).Results: Mortality from breast cancer was observed even during the fourth follow-up decade, but if women who were diagnosed with contralateral breast cancer were excluded (n = 30), no deaths from breast cancer were identified after the 27th year of follow-up evaluation. The 30-year survival rates were 62% (95% confidence interval [CI], 54% to 70%), 19% (95% CI, 13% to 25%), and 0% for women with pN0 (node-negative) and pN1 or pN2 (node-positive) disease, respectively. High 30-year survival rates were found in small (pT1N0M0) unilateral cancers (80% olive; 95% CI, 66 to 94%), and in the lobular (45% alive; 95% CI, 31% to 59%) and the special histologic types (81% alive; 95% CI, 67% to 95%). These survival rates were obtained when correcting either for known intercurrent deaths or for mortality in the age- and sex-matched general population.Conclusion: Breast cancer, node-negative and node-positive, may be permanently cured even if treated with locoregional therapy only, The survival figures listed here may be considered as minimum valves, because women with breast cancer diagnosed in the same area from 1970 to 1984 showed significantly improved shortterm (< 20 years) survival rates over those diagnosed from 1945 to 1969.