70岁以上老年女性乳腺癌的治疗选择

Treatment options for elderly breast cancer patients over 70 years old

目的 探讨老年女性乳腺癌的临床特点及治疗选择.方法 回顾分析北京医院乳腺中心1997年9月至2011年9月收治的312例老年（≥70岁）女性乳腺癌患者的临床资料及随访结果.分析其临床特点、治疗选择及影响预后的因素.结果 全组312例老年乳腺癌占同期收治的2137例乳腺癌患者的14.6％.其中80.1％（250例）的患者以乳腺肿物就诊,90.4％（282例）的患者合并有其他疾病.主要病理类型为非特殊类型浸润性导管癌（248例,79.5％）,雌和（或）孕激素受体阳性占75.3％（235例）,Cerb-B2（＋＋＋）占15.7％（49例）.全组患者5年、10年生存率分别为75.0％和41.8％.TNM分期,脉管癌栓,手术选择和辅助综合治疗是影响预后的因素.结论 老年女性乳腺癌手术和内分泌治疗是最重要和有效的首选治疗方式.影响预后的主要因素是TNM分期、脉管癌栓和治疗方式的选择.

Objective To analyze the clinical characteristics and therapeutics of elderly patients with breast carcinomas.Methods A total of 312 patients （≥70 years old） admitted into Breast Center of Beijing Hospital from September 1997 to September 2011 were included for this retrospective study.Their clinical characteristics,treatment options and prognostic factors were analyzed.Results They accounted for 14.6％ （312/2137） of breast cancer patients treated during the same period.The predominant complaint was palpable mass （n =250,80.1％）.90.4％ （n =282） of them were complicated with other diseases.The major pathologic type was invasive ductal carcinoma of non-special type （n =248,79.5％）.The positive rate of estrogen receptor （ER） and （or） progesterone receptor （PR） was 75.3％ （n =235）,and 15.7％ （n =49） cases were Cerb-B2 （＋＋＋）.The 5,10-year overall survival were 75.0％ and 41.8％respectively.TNM stage,vascular thrombosis,operative regimen and adjuvant therapy were prognostic factors.Conclusions Surgical operation and endocrine therapy are the first choice remedies for elderly patients.And the maior prognostic factors are TNM stage,vascular thrombosis and treatment regimens.