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ASCO 2016:局部乳腺癌选择保乳术还是乳房切除术,外科医生对决策的影响作用很大

2016-06-05 Seven L 译 MedSci原创

ASCO年会上有研究结果称,不同外科医生对局部乳腺癌进行乳房切除术的可能性变化很大。局部乳腺癌的女性可以接受乳房切除或保乳手术治疗。但最近研究都没有集中在外科医生个人的喜好程度对决策过程的影响。来自加利福尼亚大学的Isabel Boero博士和同事对44698名2000-2009年诊断为局部乳腺癌的医疗受益人进行了研究,患者进行了保乳手术或乳房切除术作为治疗方案。研究人员根据收集的数据确定手术类型

ASCO年会上有研究结果称,不同外科医生对局部乳腺癌进行乳房切除术的可能性变化很大。

局部乳腺癌的女性可以接受乳房切除或保乳手术治疗。但最近研究都没有集中在外科医生个人的喜好程度对决策过程的影响。

来自加利福尼亚大学的Isabel Boero博士和同事对44698名2000-2009年诊断为局部乳腺癌的医疗受益人进行了研究,患者进行了保乳手术或乳房切除术作为治疗方案。

研究人员根据收集的数据确定手术类型和相关外科医生。然后通过回归模型探究科医生和地理区域等与乳房切除术可能性的联系。

总体而言,10156名女性(22.7%)接受了乳房切除术。为矫正的外科医生进行乳房切除术的可能性从3.2%-47.1%不等。

相比地理因素(中位数OR=1.56),外科医生对乳房切除术决策的影响更大(OR = 2.14)。除了肿瘤大小(OR = 3.02)和淋巴结情况(OR = 2.86),其他临床和人口统计学因素对决策的影响也存在。

“我们预计到了乳房切除术率的变化,”Boero说,“毕竟某些患者由于肿瘤本身或是什么原因,并不适合保乳手术。不过我们的研究结果发现,外科医生保乳术还是乳房切除术的选择中起到了很大作用。”

男性外科医生、经验不足的外科医生、乳腺癌见得少的外科医生更有可能选择乳腺癌保乳手术(所有P值< .05)。

“我们希望这项研究可以减少医生偏见,通过多学科讨论、提高患者和医生的教育等,以及完善决策工具,”Boero说,“最终的目标是提高医师对他们的偏见的认识,以更好地尊重病人的自主权。”

原始出处:

Boero I, et al. Abstract 1008. Presented at: ASCO Annual Meeting; June 3-7, 2016; Chicago.

Surgeon preference influences likelihood of mastectomy.Healio.June 4, 2016


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    2017-02-20 quxin068
  3. 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    2016-09-10 1e10c84am36(暂无匿称)

    好文章,百姓也能从中学到好多医学知识

    0

  4. 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    2016-08-02 1dd8c52fm63(暂无匿称)

    学习学习!

    0

  5. 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    2016-06-07 chg122
  6. 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  7. 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  8. [GetPortalCommentsPageByObjectIdResponse(id=1876809, encodeId=5fcf18e680921, content=<a href='/topic/show?id=67c5319121e' target=_blank style='color:#2F92EE;'>#切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31912, encryptionId=67c5319121e, topicName=切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d8a96, createdName=doctorzheng, createdTime=Fri Aug 05 05:10:00 CST 2016, time=2016-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1938561, encodeId=3b2119385614d, content=<a href='/topic/show?id=1c292818fd' target=_blank style='color:#2F92EE;'>#ASC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2818, encryptionId=1c292818fd, topicName=ASC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Mon Feb 20 09:10:00 CST 2017, time=2017-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=119565, encodeId=e10a1195650d, content=好文章,百姓也能从中学到好多医学知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Sat Sep 10 17:08:00 CST 2016, time=2016-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=95568, encodeId=0eca955681e, content=学习学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Tue Aug 02 21:59:00 CST 2016, time=2016-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1405692, encodeId=e960140569299, content=<a href='/topic/show?id=a5404e589d7' target=_blank style='color:#2F92EE;'>#局部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47589, encryptionId=a5404e589d7, topicName=局部)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d14c2562456, createdName=chg122, createdTime=Tue Jun 07 06:10:00 CST 2016, time=2016-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1420654, encodeId=31111420654b5, content=<a href='/topic/show?id=d2514292149' target=_blank style='color:#2F92EE;'>#外科医生#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42921, encryptionId=d2514292149, topicName=外科医生)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=40a73606138, createdName=ysjykql, createdTime=Tue Jun 07 06:10:00 CST 2016, time=2016-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1541778, encodeId=433b1541e7804, content=<a href='/topic/show?id=e8ca3108823' target=_blank style='color:#2F92EE;'>#决策#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31088, encryptionId=e8ca3108823, topicName=决策)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e76e13331157, createdName=ms2999106592497887, createdTime=Tue Jun 07 06:10:00 CST 2016, time=2016-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=88753, encodeId=4e6388e5345, content=值得研究, beContent=null, objectType=article, channel=null, level=null, likeNumber=189, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7cde98330, createdName=milkshark, createdTime=Mon Jun 06 06:52:00 CST 2016, time=2016-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=88754, encodeId=927088e54b1, content=这个不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=141, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7cde98330, createdName=milkshark, createdTime=Mon Jun 06 06:52:00 CST 2016, time=2016-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=88598, encodeId=899d8859894, content=不错的文章,多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=151, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=53751677671, createdName=沉心多思, createdTime=Sun Jun 05 21:03:00 CST 2016, time=2016-06-05, status=1, ipAttribution=)]
    2016-06-06 milkshark

    值得研究

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1876809, encodeId=5fcf18e680921, content=<a href='/topic/show?id=67c5319121e' target=_blank style='color:#2F92EE;'>#切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31912, encryptionId=67c5319121e, topicName=切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d8a96, createdName=doctorzheng, createdTime=Fri Aug 05 05:10:00 CST 2016, time=2016-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1938561, encodeId=3b2119385614d, content=<a href='/topic/show?id=1c292818fd' target=_blank style='color:#2F92EE;'>#ASC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2818, encryptionId=1c292818fd, topicName=ASC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Mon Feb 20 09:10:00 CST 2017, time=2017-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=119565, encodeId=e10a1195650d, content=好文章,百姓也能从中学到好多医学知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Sat Sep 10 17:08:00 CST 2016, time=2016-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=95568, encodeId=0eca955681e, content=学习学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Tue Aug 02 21:59:00 CST 2016, time=2016-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1405692, encodeId=e960140569299, content=<a href='/topic/show?id=a5404e589d7' target=_blank style='color:#2F92EE;'>#局部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47589, encryptionId=a5404e589d7, topicName=局部)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d14c2562456, createdName=chg122, createdTime=Tue Jun 07 06:10:00 CST 2016, time=2016-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1420654, encodeId=31111420654b5, content=<a href='/topic/show?id=d2514292149' target=_blank style='color:#2F92EE;'>#外科医生#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42921, encryptionId=d2514292149, topicName=外科医生)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=40a73606138, createdName=ysjykql, createdTime=Tue Jun 07 06:10:00 CST 2016, time=2016-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1541778, encodeId=433b1541e7804, content=<a href='/topic/show?id=e8ca3108823' target=_blank style='color:#2F92EE;'>#决策#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31088, encryptionId=e8ca3108823, topicName=决策)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e76e13331157, createdName=ms2999106592497887, createdTime=Tue Jun 07 06:10:00 CST 2016, time=2016-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=88753, encodeId=4e6388e5345, content=值得研究, beContent=null, objectType=article, channel=null, level=null, likeNumber=189, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7cde98330, createdName=milkshark, createdTime=Mon Jun 06 06:52:00 CST 2016, time=2016-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=88754, encodeId=927088e54b1, content=这个不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=141, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7cde98330, createdName=milkshark, createdTime=Mon Jun 06 06:52:00 CST 2016, time=2016-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=88598, encodeId=899d8859894, content=不错的文章,多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=151, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=53751677671, createdName=沉心多思, createdTime=Sun Jun 05 21:03:00 CST 2016, time=2016-06-05, status=1, ipAttribution=)]
    2016-06-06 milkshark

    这个不错

    0

  10. 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    2016-06-05 沉心多思

    不错的文章,多学习

    0

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法国里昂癌症研究机构(IARC)的Kevin D. Shield博士和同事指出,少量饮酒增加女性患乳腺癌的风险,研究结果发表在Alcoholism: Clinical and Experimental Research。这一研究结论解决了关于少量饮酒与乳腺癌风险的长期争论。1987年IARC正式宣布口腔、咽部、喉部、食道等位置的肿瘤与肝癌的发生与饮酒有直接关系。自那时以来,许多研究发现饮酒与乳腺癌

Breast Cancer Res:福音!他汀类药物或可有效治疗雌激素受体阳性的乳腺癌女性

近日,来自伦敦大学癌症研究学院的研究人员发现,乳腺癌细胞产生一种模仿雌激素的分子,因此他们呼吁进行临床试验以探究他汀类药物对复发性乳腺癌患者的治疗效果,该研究成果已发表于Breast Cancer Research。在英国,每年有多达4万名女性诊断为雌激素受体(ER)阳性乳腺癌,很多患者术后服用他莫昔芬或芳香酶抑制剂来阻断雌激素的作用,并降低疾病的复发风险。但是,即使是经过内分泌治疗仍有约1.2 

Cell Res:RANKL抑制剂有望预防乳腺癌的发生

大约8名女性中就有一人将在她的一生当中患上浸润性乳腺癌。这可能是使用人工合成性激素和其他环境因子导致的,也可能是BRCA1基因等发生突变导致的。平均而言,BRCA1基因发生突变的女性有高达87%的风险患上乳腺癌。截至目前,预防性手术切除是显著降低乳腺癌风险的唯一方法,但是这也经常伴随着术后并发症。 2010年,奥地利科学院分子生物技术研究所(IMBA)科学主任Josef Penninge

ASCO 2016 :糖尿病药物二甲双胍或可有效预防并治疗乳腺癌

近日,一项发表于美国临床肿瘤学会年会上的研究报告中,来自宾夕法尼亚大学的研究人员通过研究发现,常用作2型糖尿病一线疗法的药物二甲双胍或可改善某些乳腺癌患者的生存,同时其还可作为治疗子宫内膜增生症患者的潜在疗法。 在其中一项研究中,研究人员首先检测了二甲双胍的治疗对乳腺癌患者生存率的影响,研究者对在1997年至2013年间诊断为乳腺癌或者进行手术疗法的1215名患者进行了相应的临床试验并且检测

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