Hong Kong medical journal = Xianggang yi xue za zhi · 2007
Clinicopathological correlates in a cohort of Hong Kong breast cancer patients presenting with screen-detected or symptomatic disease.
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Leung Amy W, Mak Joyce, Cheung Polly S Y, Epstein Richard J
Аннотация
OBJECTIVES: To examine the differences in breast cancer presentation by analysing our recent experience in the diagnosis and management of breast cancer patients.
DESIGN: Retrospective study.
SETTING: Private hospital, Hong Kong.
PATIENTS: Consecutive patients (702 in all) referred to the hospital with newly diagnosed breast cancer over the 5-year period from 2001 to 2006.
MAIN OUTCOME MEASURES: Methods of detection; tumour size, lymph node involvement, and surgical treatment modalities.
RESULTS: Over 80% of these patients presented following self-discovery of a breast mass, whereas routine mammography accounted for only 8%. Screen-detected tumours were smaller than self-discovered tumours (2.02 vs 2.35 cm, P<0.03), and mastectomy rates were lower in mammogram-screened patients than in self-discovered disease (35% vs 50%; P=0.03). In addition, self-detected tumours were significantly more likely to be associated with lymph node involvement than screen-detected tumours (38% vs 20%; P=0.007), confirming a prognostic difference. These uncontrolled data should not be interpreted as proving either the efficacy or the cost-effectiveness of breast screening.
CONCLUSION: The findings suggest a disturbingly low utilisation of mammography in Hong Kong patients, and raise the possibility of a more proactive public health approach to promote such screening for susceptible target groups.
DESIGN: Retrospective study.
SETTING: Private hospital, Hong Kong.
PATIENTS: Consecutive patients (702 in all) referred to the hospital with newly diagnosed breast cancer over the 5-year period from 2001 to 2006.
MAIN OUTCOME MEASURES: Methods of detection; tumour size, lymph node involvement, and surgical treatment modalities.
RESULTS: Over 80% of these patients presented following self-discovery of a breast mass, whereas routine mammography accounted for only 8%. Screen-detected tumours were smaller than self-discovered tumours (2.02 vs 2.35 cm, P<0.03), and mastectomy rates were lower in mammogram-screened patients than in self-discovered disease (35% vs 50%; P=0.03). In addition, self-detected tumours were significantly more likely to be associated with lymph node involvement than screen-detected tumours (38% vs 20%; P=0.007), confirming a prognostic difference. These uncontrolled data should not be interpreted as proving either the efficacy or the cost-effectiveness of breast screening.
CONCLUSION: The findings suggest a disturbingly low utilisation of mammography in Hong Kong patients, and raise the possibility of a more proactive public health approach to promote such screening for susceptible target groups.