Surgical Treament for Early State Breast Cancer

描述（由申请人提供）：导管原位癌的发生率 乳腺癌（DCIS）在美国女性中急剧上升 从1980年代初开始。无论哪种类型，DCIS的生存率都非常高 对于组织病理学良好的患者， 肿瘤切除术后局部复发的概率很低。然而，有大量 DCIS患者手术治疗的变化。尽管许多妇女 DCIS似乎是乳房保留治疗的理想候选者， 这种特殊形式的乳腺癌的乳房切除率仍然很高。这 引起了临床医生和患者对“过度治疗”的担忧， 倡导团体一样。不幸的是，我们对这些因素了解不够 影响乳腺癌手术的选择和复杂的 作出治疗决定是为了充分了解这些辩论。而且我们 关于患者满意度等结果的信息很少， DCIS女性随后的生活质量，以及这些因素在多大程度上 重要的结果可能不同的妇女与DCIS和那些侵入性 乳腺癌 我们提出了一个多中心的人口为基础的研究，以检查一个广泛的阵列， 决定因素（外部影响、临床因素、诱发/促成因素） 患者知识和态度因素）， 对于最近被诊断患有乳腺癌的女性有三种结果：1） 手术治疗选择（乳房切除术vs乳房肿瘤切除术伴或不伴放射）; 2)患者对治疗决定的短期满意度和 治疗过程; 3）健康相关的生活质量。这项研究将 使用三个乳腺癌患者的人群样本进行 美国种族和社会经济多样化的城市地区 （底特律、洛杉矶和亚特兰大）。最近，2900名女性的初步样本 将从三个监测、流行病学和 和最终结果（SEER）集水区在15个月的时间内使用快速 案件调查过程。该样本将按疾病水平分层 (1450 DCIS女性和1450例浸润性疾病），我们将过度采样 非裔美国女性同意参加研究的合格女性将 收到一份标准化的调查问卷， 自我管理。根据我们在底特律SEER现场的试点经验，我们 预计大约75%符合研究条件的患者将 完整问卷1880份。

DESCRIPTION (provided by applicant): The incidence of ductal carcinoma in situ of the breast (DCIS) has risen dramatically among women in the United States since the early 1980's. Survival for DCIS is very high regardless of the type of surgical treatment and, for patients with favorable histopathology, the risk of local recurrence post-lumpectomy is very low. There are, however, large variations in the surgical management of DCIS patients. Although many women with DCIS appear to be ideal candidates for breast conserving therapy, mastectomy rates for this particular form of breast cancer remain high. This has led to concerns about "over treatment" among clinicians and patient advocacy groups alike. Unfortunately, we do not know enough about the factors that influence breast cancer surgery choice and the processes by which complex treatment decisions are made to fully inform these debates. Furthermore, we have little information about outcomes such as patient satisfaction or subsequent quality of life for women with DCIS, and to what extent these important outcomes may differ between women with DCIS and those with invasive breast cancer. We propose a multi-center population-based study to examine a broad array of determinants (external influences, clinical factors, predisposing/enabling factors, and patient knowledge and attitudinal factors) that are associated with three outcomes for women recently diagnosed with breast cancer: 1) surgical treatment choice (mastectomy vs lumpectomy with or without radiation); 2) short-term patient satisfaction with the treatment decision and the treatment-making process; and 3) health-related quality of life. The study will be conducted using a population-based sample of breast cancer patients in three racially and socioeconomically diverse urban areas in the United States (Detroit, Los Angeles and Atlanta). An initial sample of 2900 women recently diagnosed will be selected prospectively from three Surveillance, Epidemiology and End Results (SEER) catchment areas over a 15-month period using a rapid case ascertainment process. This sample will be stratified by level of disease (1450 women with DCIS and 1450 with invasive disease), and we will oversample African-American women. Eligible women consenting to be in the study will receive a standardized survey questionnaire in the mail for self-administration. Based on our pilot experience in the Detroit SEER site, we expect that approximately 75 percent of patients eligible for the study will complete questionnaires (N=l880).