甘肃省基层地区乳腺癌筛查策略及结果分析

目的 探讨适合基层乳腺癌筛查的策略,调查甘肃省农村妇女乳腺癌的发病情况.方法 采用临床乳腺检查联合乳腺B超,选择性乳腺X线检查和病理活检的筛查方案,对甘肃省8 397名35～69岁妇女进行了乳腺癌筛查.结果 8 397名妇女共检出乳腺癌11例,检出率为131.0/10万（11/8 397）.11例乳腺癌患者中,导管内癌1例,浸润性导管癌9例,黏液癌1例;肿块直径＜2 cm者7例,＞2 cm者4例;0期1例,Ⅰ期4例,Ⅱ期4例,Ⅲ期1例,Ⅳ期1例.不同年龄段妇女乳腺癌检出率的差异有统计学意义（P＜0.05）,其中45～69岁妇女乳腺癌检出率明显高于35～44岁年龄段（P＜0.05）.结论 （1）应用临床乳腺检查联合乳腺B超,选择性乳腺X线检查和病理活检的筛查方案,检出率高,早期发现率高,医疗成本较低,适合基层推广;（2）本次筛查,甘肃省基层妇女乳腺癌检出率相对较高,开展乳腺癌筛查对乳腺癌的早期发现有重要意义.

Breast Cancer Screening Strategy and the Result Analysis in Primary Areas of Gansu Province

OBJECTIVE The aim of study was to find a feasible method for screening breast cancer and to understand the prevalence of breast cancer in women of Gansu. METHODS 8 379 participants, 35 to 69 years of age, received the screening with clinical exami- nations, mammography, ultrasound and pathological assessment. RESULT 11 of the 8 379 were diagnosed as breast cancer（cancer detection rate of 1.31 per 1 000 screening examinations）. 9 of the cancers in women were invasive duetal carcinoma, 1 of them was intraductal carcinoma and 1 patient was mucous carcinoma. 7 of the cancers with tumor within 2 cm in diameter and others of the 11 with tumor above 2 cm in diameter, including stage 0 intraductal cancer in 1 cases, stage I in 4, stage 11 in 4, stage rain 1 and stage 1V in 1. Our study demonstrates that the cancer detection rate appears to be different in different groups（P〈0.05）, and the group in the age of 45 - 69 had a higher detection rate than the group of 35 - 44. CONCLUSION These data suggest that the screen- ing with clinical examinations mammography, ultrasound and pathological assessment is a significant way to to enhance risk assess- ment and prevention of breast cancer.