老年女性乳腺癌的临床病理特征和治疗方式分析  

Clinicopathological characteristics and treatment methods of breast cancer in elderly patients

作　　者：曹博[1] 朱晓萍[1] 江琴[1] CAO Bo;ZHU Xiaoping;JIANG Qin(Department of Breast Surgery,Jiaxing Maternity and Child Health Hospital,Jiaxing 314000,China)

机构地区：[1]嘉兴市妇幼保健院乳腺科,314000

出　　处：《浙江医学》2018年第12期1331-1334,1342,共5页Zhejiang Medical Journal

摘　　要：目的探讨老年女性乳腺癌的临床病理特征、治疗方式和预后情况,为老年乳腺癌的治疗提供依据。方法纳入女性乳腺癌患者739例,按年龄分为老年组(≥65岁)102例和非老年组(<65岁)637例。比较老年和非老年组患者的临床病理特征、治疗方式和预后情况。结果两组患者在家族史、首发症状、肿瘤大小、TNM分期、脉管侵犯、病理类型、组织学分级、Ki-67、分子分型、腋窝淋巴结状态、行新辅助化疗比例、乳房手术方式、腋窝手术方式和靶向治疗比例方面比较差异均无统计学意义(均P>0.05),但两组患者合并系统疾病比较差异有统计学意义(P<0.05)。老年组患者术后更多予内分泌治疗,较少予以辅助化疗及放疗,与非老年组比较差异均有统计学意义(均P<0.05)。所有患者中位随访时间23.5个月,复发25例,死亡10例。老年组和非老年组3年无病生存期(DFS)分别为85.8%和93.9%,老年组3年DFS低于非老年组,差异有统计学意义(P<0.05)。老年组和非老年组3年总生存期(OS)分别为96.3%和97.6%,两组3年OS比较差异无统计学意义(P>0.05)。结论老年与非老年乳腺癌患者临床病理特征未见明显差异,但老年患者多选择乳房单纯切除术及内分泌治疗,较少予以辅助化疗及放疗,预后差别待更长时间的随访结果。Objective To analyze the clinicopathological characteristics and treatment modalities of breast cancer in elderly patients. Methods A total of 739 female patients with breast cancer were admitted in our hospital from January 2014 to November 2017. There were 102 cases aged ≥ 65 years（elderly group） and 637 cases aged 65 years（non-elderly group）. The clinicopathological features, treatment and outcomes of patients were compared between two groups. Results There were no significant differences in terms of family history, initial symptoms, tumor size, TNM stage, vascular invasion, pathological pattern,histological grade, Ki-67, molecular subtype, lymph node status between the elderly and non-elderly group（P〈0.05）. There was a higher percentage of patients with comorbidities in the elderly group（ all P 0. 05）. There were no significant differences in axillary surgery and targeted therapy between two groups（both P〈0.05）; Elderly patients tended to receive endocrine therapy, but not chemotherapy and radiotherapy（both P〈0.05）. After a median follow up of 23.5 months, there were 25 cases of disease free survival（DFS） and 10 deaths. There was no significant difference in overall survival（ OS） between the elderly group and the non-elderly group, with 3-year OS 96.3% and of 97.6%, respectively（P〈0.05）; but there was a lower DFS rate in elderly group than that in non-elderly group with 3-year DFS of 85.8% and 93.9%, respectively（P〈0.05）. Conclusion The clinicopathological characteristics of elderly breast cancer patients are not significantly different from those of younger patients. But elderly patients tend to choose mastectomy and endocrine therapy, avoiding chemotherapy and radiotherapy.

关 键 词：老年人 乳腺癌 临床病理特征 预后 

分 类 号：R737.9[医药卫生—肿瘤]