30年收治乳腺癌的发病趋势

The pathogenic trend of breast cancer treated in the past thirty years

目的总结30年来收治的乳腺癌的发病现状、诊断及预后的变化趋势。方法统计1975—2006年收治的1 092例乳腺癌患者的临床资料,共分6组(时段)进行如下对比:男女比例、年龄状况、月经状况、肿块大小、淋巴结阳性数目、病理分期、复发转移及无瘤生存率。结果患者发病年龄有增高趋势,平均年龄自第1时段的50.9岁升至第6时段的53.9岁;6个时段发病的高峰年龄均集中在40～49岁,绝经期妇女比例最高。肿瘤体积在逐步缩小,自2000年(第5时段)开始有显著下降。淋巴结阳性数目在不同的时段无统计学差异。6个时段内,病理分期均以II期居多,但0期和I期比例在逐步增多,而III期比例逐步下降,Ⅳ期比例无明显变化。6个时段内,手术方式显著变化,手术范围在逐步缩小,保乳术逐年增多。5,10年无瘤生存率逐渐提高。结论乳腺癌的早期诊断率在不断提高,患者的预后也随之不断改善。

Objective To understand the trend of occurrence, diagnosis, and prognosis of breast cancer in the cases treated in Peking Union Medical College Hospital （PUMCH） between 1975 and 2006. Methods A total of 1092 cases of breast cancer treated in the PUMCH from 1975 to 2006 were classified into six groups by time span and reviewed for a comparative study on the parameters of gender, age, menstruation status, tumor size, mumber of positive axillary nodes, pathologic stage, recurrence and metastasis and disease-free survival rate. Results The average age of breast cancer patient has risen from 50.90 to 53.92, while 40 - 49 year-old group was the largest age group of breast cancer patients, and the percentage of menopause female was the highest. Tumor size has gradually been smaller especially since 2000. The number of positive axillary nodes showed no significant change during the time periods. In all 6 groups, stage-II cases were more frequent, although the percentage of stage-0 and stage-I cases was on the rise, while the percentage of stage-Ill declined, and that of stage-IV remained stable. In all 6 groups, the 5-year and 10-year disease free survival rate had steadily increased. Conclusions The early diagnostic rate of breast cancer has been imnroving and subseuuentlv the prognosis has imoroved as well.