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Article: Should young age be a contra-indication to breast conservation treatment in Chinese women? Twelve-year experience from a public cancer centre in Hong Kong

TitleShould young age be a contra-indication to breast conservation treatment in Chinese women? Twelve-year experience from a public cancer centre in Hong Kong
年輕是否患乳癌女性接受保乳治療的禁忌?香港一所公營癌症治療中心的12年經驗
Authors
KeywordsBreast neoplasms
Disease-free survival
Mastectomy
Middle aged
Neoplasm recurrence, local
Issue Date2009
PublisherHong Kong Academy of Medicine Press. The Journal's web site is located at http://www.hkmj.org.hk
Citation
Hong Kong Medical Journal, 2009, v. 15 n. 2, p. 94-99 How to Cite?
AbstractObjective: It has been proposed that young women should not be treated by breast conservation treatment because of a higher risk of local recurrences and worse survival. We therefore examined whether breast conservation treatment in young Chinese women yielded inferior clinical outcomes compared to modified radical mastectomy. Design: Retrospective study. Setting: Clinical oncology department in a public hospital in Hong Kong. Patients: A total of 258 Chinese women with invasive breast cancer, aged below 40 years, and referred between January 1994 and July 2006. Results: A total of 124 (48%) and 134 (52%) patients were treated by breast conservation treatment and modified radical mastectomy, respectively. Mastectomy patients tended to have larger primary tumours (P<0.001) and more nodal involvement (P<0.001). At a median follow-up of 6.5 years, there was no significant difference in the local failure-free survival rate (92% vs 93%, P=0.324) and loco-regional failure-free survival rate (89% vs 88%, P=0.721) in patients having breast conservation treatment and mastectomy. Probably due to their earlier presentation with disease, the former actually had better 6-year distant failure-free survival (88% vs 71%, P=0.002) and overall survival (92% vs 81%, P=0.173) rates. Multivariate analyses showed that both the resection margin status (hazard ratio=2.77, P=0.050) and the presence of peritumoural vascular invasion (hazard ratio=3.01, P=0.038) were independent predictors of local recurrence; the nodal status (hazard ratio=3.91, P<0.001) was the only predictive factor for overall survival. The choice of breast conservation treatment (vs modified radical mastectomy) had no apparent adverse impact on all the clinical outcome parameters analysed. Conclusion: Breast conservation treatment is a reasonable option for many suitably selected young Chinese women.
目的 由於較高復發率及較低生存率,過往一直認為患有乳癌的年輕女性不應接受保乳治療。本研究探討患有乳癌的年輕女性中,接受保乳治療的與接受改良根治性乳房切除術的比較,前者是否有較差的臨床結果。 設計 回顧研究。 安排 香港一所公營醫院的臨床腫瘤部門。 患者 1994年1月至2006年7月期間,獲轉介的258名患有侵犯性乳癌、40歲以下的華籍女性。 結果 124名(48%)病人接受保乳治療,另134名(52%)接受改良根治性乳房切除術。接受乳房切除術的病人通常有較大的原發性腫瘤(P< 0.001)及較多淋巴結轉移(P< 0.001)。中位數為6.5年的隨訪期間,保乳治療及乳房切除術兩組病人在無局部復發生存率(92%比93%;P=0.324)及無局部區域復發生存率方面(89%比88%;P=0.721)皆沒有顯著差別。可能由於接受保乳治療的病人大多於早期確診,她們的6年無遠處轉移生存率(88% vs 71%;P=0.002)及總生存率(92% vs 81%;P=0.173)較佳。多因素分析顯示環周切緣情況(風險比=2.77;P=0.050)和腫瘤周血管侵犯(風險比=3.01;P=0.038)是局部復發的獨立預測因素。淋巴結轉移(風險比=3.91;P< 0.001)是總生存率的唯一預測因素。與改良根治性乳房切除術比較,保乳治療於本研究的臨床結果並無負面影響。 結論 對於很多經篩選患有乳癌的年輕女性來說,保乳治療是一個適切的選擇。
Persistent Identifierhttp://hdl.handle.net/10722/180449
ISSN
2023 Impact Factor: 3.1
2023 SCImago Journal Rankings: 0.261
References

 

DC FieldValueLanguage
dc.contributor.authorYau, TKen_US
dc.contributor.authorChoi, CWen_US
dc.contributor.authorSze, Hen_US
dc.contributor.authorSoong, ISen_US
dc.contributor.authorLee, AWMen_US
dc.date.accessioned2013-01-28T01:38:13Z-
dc.date.available2013-01-28T01:38:13Z-
dc.date.issued2009en_US
dc.identifier.citationHong Kong Medical Journal, 2009, v. 15 n. 2, p. 94-99en_US
dc.identifier.issn1024-2708en_US
dc.identifier.urihttp://hdl.handle.net/10722/180449-
dc.description.abstractObjective: It has been proposed that young women should not be treated by breast conservation treatment because of a higher risk of local recurrences and worse survival. We therefore examined whether breast conservation treatment in young Chinese women yielded inferior clinical outcomes compared to modified radical mastectomy. Design: Retrospective study. Setting: Clinical oncology department in a public hospital in Hong Kong. Patients: A total of 258 Chinese women with invasive breast cancer, aged below 40 years, and referred between January 1994 and July 2006. Results: A total of 124 (48%) and 134 (52%) patients were treated by breast conservation treatment and modified radical mastectomy, respectively. Mastectomy patients tended to have larger primary tumours (P<0.001) and more nodal involvement (P<0.001). At a median follow-up of 6.5 years, there was no significant difference in the local failure-free survival rate (92% vs 93%, P=0.324) and loco-regional failure-free survival rate (89% vs 88%, P=0.721) in patients having breast conservation treatment and mastectomy. Probably due to their earlier presentation with disease, the former actually had better 6-year distant failure-free survival (88% vs 71%, P=0.002) and overall survival (92% vs 81%, P=0.173) rates. Multivariate analyses showed that both the resection margin status (hazard ratio=2.77, P=0.050) and the presence of peritumoural vascular invasion (hazard ratio=3.01, P=0.038) were independent predictors of local recurrence; the nodal status (hazard ratio=3.91, P<0.001) was the only predictive factor for overall survival. The choice of breast conservation treatment (vs modified radical mastectomy) had no apparent adverse impact on all the clinical outcome parameters analysed. Conclusion: Breast conservation treatment is a reasonable option for many suitably selected young Chinese women.en_US
dc.description.abstract目的 由於較高復發率及較低生存率,過往一直認為患有乳癌的年輕女性不應接受保乳治療。本研究探討患有乳癌的年輕女性中,接受保乳治療的與接受改良根治性乳房切除術的比較,前者是否有較差的臨床結果。 設計 回顧研究。 安排 香港一所公營醫院的臨床腫瘤部門。 患者 1994年1月至2006年7月期間,獲轉介的258名患有侵犯性乳癌、40歲以下的華籍女性。 結果 124名(48%)病人接受保乳治療,另134名(52%)接受改良根治性乳房切除術。接受乳房切除術的病人通常有較大的原發性腫瘤(P< 0.001)及較多淋巴結轉移(P< 0.001)。中位數為6.5年的隨訪期間,保乳治療及乳房切除術兩組病人在無局部復發生存率(92%比93%;P=0.324)及無局部區域復發生存率方面(89%比88%;P=0.721)皆沒有顯著差別。可能由於接受保乳治療的病人大多於早期確診,她們的6年無遠處轉移生存率(88% vs 71%;P=0.002)及總生存率(92% vs 81%;P=0.173)較佳。多因素分析顯示環周切緣情況(風險比=2.77;P=0.050)和腫瘤周血管侵犯(風險比=3.01;P=0.038)是局部復發的獨立預測因素。淋巴結轉移(風險比=3.91;P< 0.001)是總生存率的唯一預測因素。與改良根治性乳房切除術比較,保乳治療於本研究的臨床結果並無負面影響。 結論 對於很多經篩選患有乳癌的年輕女性來說,保乳治療是一個適切的選擇。-
dc.languageengen_US
dc.publisherHong Kong Academy of Medicine Press. The Journal's web site is located at http://www.hkmj.org.hken_US
dc.relation.ispartofHong Kong Medical Journalen_US
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectBreast neoplasms-
dc.subjectDisease-free survival-
dc.subjectMastectomy-
dc.subjectMiddle aged-
dc.subjectNeoplasm recurrence, local-
dc.subject.meshAdulten_US
dc.subject.meshAge Factorsen_US
dc.subject.meshAsian Continental Ancestry Groupen_US
dc.subject.meshBreast Neoplasms - Mortality - Surgeryen_US
dc.subject.meshFemaleen_US
dc.subject.meshFollow-Up Studiesen_US
dc.subject.meshHong Kongen_US
dc.subject.meshHumansen_US
dc.subject.meshMastectomy, Modified Radicalen_US
dc.subject.meshMastectomy, Segmentalen_US
dc.subject.meshNeoplasm Recurrence, Localen_US
dc.subject.meshRetrospective Studiesen_US
dc.subject.meshSurvival Rateen_US
dc.titleShould young age be a contra-indication to breast conservation treatment in Chinese women? Twelve-year experience from a public cancer centre in Hong Kongen_US
dc.title年輕是否患乳癌女性接受保乳治療的禁忌?香港一所公營癌症治療中心的12年經驗-
dc.typeArticleen_US
dc.identifier.emailSze, H: henrysze@graduate.hku.hken_US
dc.identifier.authoritySze, H=rp01697en_US
dc.description.naturepublished_or_final_versionen_US
dc.identifier.pmid19342734-
dc.identifier.scopuseid_2-s2.0-65449189510en_US
dc.identifier.hkuros266660-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-65449189510&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume15en_US
dc.identifier.issue2en_US
dc.identifier.spage94en_US
dc.identifier.epage99en_US
dc.publisher.placeHong Kongen_US
dc.identifier.scopusauthoridYau, TK=7006540678en_US
dc.identifier.scopusauthoridChoi, CW=23968827500en_US
dc.identifier.scopusauthoridSze, H=23490726900en_US
dc.identifier.scopusauthoridSoong, IS=9239786900en_US
dc.identifier.scopusauthoridLee, AWM=17035384900en_US
dc.identifier.issnl1024-2708-

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