65岁以上中国老年女性原发性乳腺癌临床病理特征及治疗分析:多中心10年回顾性研究 |
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引用本文: | 闫 宇,任 予,范金虎. 65岁以上中国老年女性原发性乳腺癌临床病理特征及治疗分析:多中心10年回顾性研究[J]. 中国肿瘤, 2017, 26(7): 561-566. DOI: 10.11735/j.issn.1004-0242.2017.07.A012 |
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作者姓名: | 闫 宇 任 予 范金虎 |
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作者单位: | 1. 西安交通大学第一附属医院,陕西西安,710061;2. 中国癌症中心/中国医学科学院北京协和医学院肿瘤医院,北京,100021;3. 辽宁省肿瘤医院,辽宁沈阳,110046;4. 浙江省肿瘤医院,浙江杭州,310022;5. 中山大学附属肿瘤医院,广东广州,510050;6. 中南大学湘雅二院,湖南长沙,410016;7. 四川省肿瘤医院,四川成都,610047;8. 四川大学华西公共卫生学院,四川成都,610044 |
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摘 要: | [目的]研究65岁以上老年女性原发性乳腺癌的风险暴露因素、临床病理特征以及治疗特征,为老年女性乳腺癌的诊治提供依据.[方法]回顾性分析全国7个不同地区具有代表性的7家医院收集的4211例乳腺癌患者信息,将65岁以上患者作为研究对象(老年组),50~64岁年龄组作为对照组.统计学方法为卡方检验和Fisher精确检验,P<0.05具有统计学意义.[结果]65岁以上老年乳腺癌患者占同期乳腺癌患者的8.33%(351/4211).平均诊断年龄和平均绝经年龄分别为70.2岁(65~86岁)和49.59岁(32~58岁).与对照组相比,老年组具有以下特征:以体力工作、生育大于一胎、低学历、结婚早和初次生育年龄早者显著;临床病理特征方面,老年患者区域淋巴结转移少、分期早(即更多的0+Ⅰ+Ⅱ期患者)、激素受体阳性率高、Hey2低表达、Her-2亚型和三阴性亚型少.在侵袭性治疗方面,老年患者较少接受改良根治术、保乳术、放疗、化疗,更多的是接受乳腺单纯切除术.两组间内分泌治疗无显著差异.[结论]老年乳腺癌患者有较好的临床病理特征和生物学行为;接受侵袭性治疗少;内分泌治疗需要加强.
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关 键 词: | 乳腺癌 老年人 女性 临床病理学 治疗 回顾性研究 |
收稿时间: | 2016-11-02 |
Clinicopathologic Characteristics and Treatment Patterns of Primary Breast Cancer in Elderly Women:A Retrospective Multicenter Study |
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Abstract: | [Purpose] To investigate the clinicopathological characteristics and therapeutic patterns of breast cancer in elderly women.[Methods] The medical records of 4211 female patients with breast cancer were collected from 7 representative regions of China from 1999 to 2008.Data of risk factors,clinicopathological characteristics and treatment patterns were extracted and analyzed.[Results] Of 4211 patients,351 (8.33%) patients were ≥65 years of age (elderly group).In elderly group the mean age at the diagnosis was 70.2 years(65~86 years) and the mean age of menopause was 49.6 years(32~58 years).Compared to patients aged 50~64 years (control group),a larger proportion of patients in elderly group engaging in manual labors(P=0.034),having multiple birth(P<0.001),younger primiparous age(P=0.001) and less school education (P=0.018).Compare to control group,the elderly patients had axillary lymph node metastasis less frequently(P=0.001),more early-stages(stage 0,Ⅰ and Ⅱ) disease(P=0.030),less Her-2 overexpression (P=0.005),more ER/PR positivity (P=0.012);for molecular subtypes,elderly patients had less Her-2 phenotype(P<0.001) and less basal-like phenotype(P<0.001).Compared to control group,lower proportion of elderly patients received modified radical mastectomy (P<0.001),breastconserving surgery(P<0.001),chemotherapy(P<0.001) and radiotherapy(P<0.001),while the elderly patients had simple mastectomy more frequently(P<0.001),and less endocrine therapy.[Conclusion] Elderly breast cancer patients have a more favorable clinicopathologic profile and receive less aggressive therapy as compared to the younger counterparts.However,endocrine therapy needs to be strengthened. |
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Keywords: | breast cancer elderly female clinicopathology treatment retrospective study |
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