老年乳腺癌的临床病理特点和治疗  

Clinical and pathological characteristics and treatment of elderly patients with breast cancer

作　　者：马传栋[1] 陈小松[1] 柳光宇[1] 狄根红[1] 吴炅[1] 陆劲松[1] 杨文涛[2] 陈佳艺[3] 韩企夏[1] 邵志敏[1] 沈镇宙[1] 沈坤炜[1] 

机构地区：[1]复旦大学上海医学院肿瘤学系复旦大学附属肿瘤医院乳腺外科,200032 [2]复旦大学上海医学院肿瘤学系复旦大学附属肿瘤医院病理科,200032 [3]复旦大学上海医学院肿瘤学系复旦大学附属肿瘤医院放疗科,200032

出　　处：《中华外科杂志》2008年第18期1397-1399,共3页Chinese Journal of Surgery

摘　　要：目的探讨老年乳腺癌的临床病理特点和治疗方式以及影响治疗的因素。方法收集2002年1月至2006年12月65岁以上乳腺癌患者647例的临床资料，将患者按年龄分成65～69岁组、70～74岁组和75岁以上组，全组患者占同期手术治疗乳腺癌患者的13．4％。本组主要病理类型为浸润性导管癌，占79．3％（513／647）。合并其他系统慢性疾病者占54．7％（354／647）。采用改良根治术者554例，占85．6％。接受术后辅助化疗者233例，占36．0％。比较三组患者的临床病理特点及治疗方式。结果较高年龄组患者的黏液腺癌和其他病理类型较多见，Her2／Neu（＋＋＋）比例较低，合并其他系统慢性疾病者较多；采用相对保守的手术方式比例较高，接受术后辅助化疗的比例较低，接受术后单纯内分泌治疗的比例较高。结论老年乳腺癌具有特殊的临床和病理生物学特点，接受的治疗方式与年龄相关。Objective To explore the clinical and pathological characteristics and treatment patterns and the factors influencing treatments of elderly patients with breast cancer. Methods From January 2001 to December 2006,647 female breast cancer patients over 65 years old were treated. The clinical records were reviewed. All patients were divided into three groups according to age, including 65 to 69 years old group, 70 to 74 years old group and 75 years or elder group. These 647 patients accounted for 13.4% of all breast cancer patients undergoing surgery during the same period. Major pathological type was invasive ductal carcinoma （79.3%）. The patients who had chronic comorbid diseases of other systems accounted for 54. 7%. Five hundred and eighty-six patients underwent modified radical mastectomy, accounting for 90. 6%. Two hundred and thirty-three patients underwent postoperative adjuvant chemotherapy, accounting for 36. 0%. The differences of clinipathological characteristics and treatment patterns between three groups were tested by Chi-square test. Results Older patients had more tumors with mucinous and other pathological types, less over-expression of Her2/Neu （ ＋ ＋ ＋ ） , higher probability to have comorbidities, higher probability to undergo relatively conservative surgery, lower probability to receive postoperative chemotherapy, and higher probability to receive postoperative endocrine therapy alone. Conclusions Breast cancer in the elderly exhibits distinctive clinical and pathological characteristics. Treatment patterns they received are related to age.

关 键 词：乳腺肿瘤 老年人 治疗 

分 类 号：R686[医药卫生—骨科学]