July 09, 2015
保乳崛起治疗，但禁地一些
劳拉苏斯曼
The first national review of breast-conserving therapy (BCT) shows that over the last 13 years, rates of this treatment for early-stage breast cancer have increased at a steady pace. However, the review also highlights demographic factors that impact whether or not a patient will have access to BCT. MD Anderson researchers found that disparities related to age, treatment facility type and geographic region, are declining. But they also identified several socioeconomic factors including health insurance coverage, income and travel distance to treatment centers as barriers to BCT.
发布在网上JAMA Surgery，研究人员使188bet体育网址用国家癌症数据库（NCDB）检查妇女的与1998年之间和2011年NCDB处理阶段T1或T2乳腺癌手术的选择是一个全国性的肿瘤学结果数据库，其包括所有新诊断病例的约70％of cancer in the U.S. Of the nearly 728,000 women included in the analysis, the percentage undergoing BCT increased from 54.3% in 1998 to 59.7% in 2006, and then remained relatively constant, landing at 60.1% in 2011.
然而，BCT的价格 - 也称为乳房肿瘤切除术 - 基于向变对病人的人口统计资料，包括保险的地位和收入，以及处理设施的变量，如设备类型，位置和行驶距离为病人。
“Looking at the big picture, strides have been made to reduce disparities in the use of this very effective treatment for women with early-stage breast cancer. But despite significant progress by the medical community, there are significant pockets of women where this therapy is underutilized,” said principal investigator伊莎贝尔了Bedrosian，医学博士肿瘤外科副教授和医务主任尼尔森B·康纳利乳腺中心在MD安德森。“社会经济障碍是不可能没有健康的政策变化被清除。”
Elaborating on the findings, she added that lower rates of BCT among women who live farthest from treatment facilities may be attributed to patients’ ability or willingness to travel for daily radiation therapy, a standard follow-up to lumpectomy. This may also account for lower rates of BCT in the South, where women often have disproportionately greater travel distances to treatment facilities. Income and insurance status also play a significant role in surgical choice, as a woman from a low-income family may be unable to commit to the length of time needed for the weeks of radiotherapy.
大多数妇女患乳腺癌有一些类型的手术切除肿瘤，通常为BCT或乳房切除术选择加入。与BCT，仅含有癌乳房和一些周围组织的部分被除去。美国国立卫生研究院支持BCT导致乳房中的速率和广泛接受BCT的为早期乳腺癌的适当和有效的治疗大幅下降颁发的共识声明于1990年。然而，在过去的十年中，技术进步等社会变化 - 包括BRCA1和BRCA2突变基因检测，以重建技术的进步，乳腺磁共振成像和对侧预防性乳房切除术 - 已经赢得了患者增加的兴趣。
据了Bedrosian博士，这项研究证实，大多数女性都选择BCT，一个“放心发现，患者和医生认识到，这种微创疗法是治疗早期乳腺癌的一个很好的课程。”然而，她补充说，“这些数据还表明社会经济因素需要考虑，以充分满足不同用途整个人口群体BCT的广度。”
阅读full press release在MD安德森网站。