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. |
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 |
Clinicopathologic Characteristics and Treatment Patterns of Primary Breast Cancer in Elderly Women:A Retrospective Multicenter Study |
投稿时间:2016-11-02 |
DOI:10.11735/j.issn.1004-0242.2017.07.A012 |
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中文关键词: 乳腺癌 老年人 女性 临床病理学 治疗 回顾性研究 |
英文关键词:breast cancer elderly female clinicopathology treatment retrospective study |
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中文摘要: |
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、Her-2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。 |
英文摘要: |
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,Ⅰand 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),breast-conserving 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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