關于女性乳腺疾病患者對保乳及乳房重建認同度的調查_《中國普外基礎與臨床雜志》

作者：

張欣 ^1,2 , 張蒲容 ² , 陳潔 ¹ , 鄭潔 ² ,  呂青 ¹

1.四川大學華西醫院甲狀腺乳腺外科（成都 610041）;;
2.四川省腫瘤醫院乳腺科（成都 610041）;

關鍵詞：

保乳手術乳房重建認同度問卷調查

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目的通過調查女性乳腺疾病患者對于保乳和乳房重建手術的認同度，初步探討國內保乳率和乳房重建率低下的原因，以指導乳腺外科醫生更有針對性地進行溝通和選擇治療方式。方法通過自制問卷對華西醫院乳腺外科收治的139例乳腺癌患者和224例非乳腺癌患者的年齡、職業、學歷、對于保乳手術及乳房重建手術的態度以及重建方式的選擇進行調查。結果乳腺癌組回收有效問卷117份，非乳腺癌組回收199份。乳腺癌組選擇保乳率為23.9%（28/117），選擇乳房重建率為35.9%（42/117）。非乳腺癌組選擇保乳率為53.3%（106/199），選擇乳房重建率為63.8%（127/199）。在2組中，選擇保乳率和乳房重建率均隨患者年齡增大而下降（乳腺癌組P值分別為0.002和0.000，非乳腺癌組P值分別為0.000和0.000），隨學歷增高而升高或有升高趨勢（乳腺癌組P值分別為0.029和0.296，非乳腺癌組P值分別為0.081和0.019）。乳腺癌和非乳腺癌患者中系個體經營者的選擇保乳率及乳房重建率均相對較高（P=0.013，P=0.042； P=0.032，P=0.044）。患者的年齡、職業和學歷與乳房重建方式的選擇無關（P gt;0.05）。結論年紀較輕、文化程度較高、工作條件較好的乳腺疾病患者保乳及乳房重建的愿望較強烈，應注重加強與該類患者之間進行關于保乳及乳房重建相關知識的溝通，有針對性地選擇適合患者條件的治療方式。

引用本文： 張欣,張蒲容,陳潔,鄭潔,呂青. 關于女性乳腺疾病患者對保乳及乳房重建認同度的調查. 中國普外基礎與臨床雜志, 2010, 17(12): 1240-1244. doi: 復制

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9.	Ganz PA, Kwan L, Stanton AL, et al. Quality of life at the end of primary treatment of breast cancer: first results from the moving beyond cancer randomized trial [J]. J Natl Cancer Ins, 2004； 96(5): 376-387.
10.	張疆莉, 祁富生, 白清林. 乳腺癌患者社會心理特征的研究 [J]. 中國神經精神疾病雜志, 2002； 28(5): 330-332.
11.	Tomatis L. Between the body and mind: the involvement of psychological factors in the development of multifactorial diseases [J]. Eur J Cancer, 2001； 37(Suppl 8): S148-S152.
12.	Shapiro SL, Lopez AM, Schqartz GE, et al. Quality of life and breast cancer: relationship to psychosocial variables [J]. J Clin Psychol, 2001； 57(4): 501-519.
13.	Northous LL, Caffey M, Deichelbohrer L, et al. The quality of life of African American women with breast cancer [J]. Res Nurs Health, 1999, 22(6): 449-460.
14.	Fisher B, Anderson S, Redmond CK, et al. Reanalysis and results after 12 years of follow-up in a randomized clinical trial comparing total mastectomy with lumpectomy with or without irradiation in the treatment of breast cancer [J]. N Engl J Med, 1995； 333（22）: 1456-1461.
15.	Fisher B, Anderson S, Bryant J, et al. Twenty-year follow-up of a randomized trial comparing total mastetomy, lumpectomy, and lumpectomy plus irradiction for the treatment of breast cancer [J]. N Engl J Med, 2002； 347(16): 1233-1241.
16.	Early Breast Cancer Trialists’ Collaborative Group. Effects of radiotherapy and surgery in early breast cancer -an overview of the randomized trials [J]. N Engl J Med, 1995； 333（22）: 1444-1456.
17.	張保寧. 乳腺癌保乳手術的研究進展 [J]. 中國普外基礎與臨床雜志, 2005； 12(3): 204-206.
18.	Nour A. Breast-conserving therapy in low-literacy patients in a developing country [J], Breast J， 2003； 9(2): 71-73.
19.	沈鎮宙，邵志敏. 現代乳腺腫瘤學進展 [M]. 上海：上海科學技術文獻出版社， 2002： 117-119.
20.	Dusková M, Kanková H, Tvrdek M, et al. Breast reconstruction as an integral part of a breast carcinoma therapy (a self-present final report of a reseach project IGA MZ CR) [J]. Acta Chir Plast, 2001； 43(2): 42-53.
21.	Jensen JA. Should improved mastectomy and reconstruction alter the primary management of breast cancer? [J]. Plast Reconstr Surg, 1999； 103(4): 1308-1310.
22.	Slavin SA, Schnitt SJ, Duda RB, et al. Skin-sparing mastectomy and immediate reconsruction: Oncologic risks and aesthetic results in patients with early-stage breast cancer [J]. Plast Reconstr Surg, 1998; 102(1): 49-62.
23.	Birdsell DC, Jenkins H, Berkel H. Breast cancer diagnosis and survival in women with or without breast implants [J]. Plast Reconstr Surg, 1993； 92(5): 795-800.
24.	Pusic A， Thompson TA， Kerrigan CL， et al. Surgical options options the early-stage breast cancer: factors with patient choice and postopretivequality of life [J]. Plast Reconstr Surg， 1999； 104(5): 1325-1333.
25.	栩軼，師蘭香. 原發性乳腺癌患者對改良根治術后乳腺重建認同程度的調查研究 [J]. 解放軍護理雜志， 2003； 20(3): 30-31.

1. Veronesi U, Salvadori B, Luini A, et al. Breast conservation is a safe method in patients with small cancer of the breast. Long-term results of three randomised trials on 1 973 patients [J]. Eur J Cancer, 1995； 31A(10): 1567-1569.
2. Caffo O, Amichetti M, Ferro A, et al. Pain and quality of life after surgery for breast cancer [J]. Breast Cancer Res Treat, 2003； 80(1): 39-48.
3. Bergen PI, Heerdt AS, Moore MP, et al. Breast conservation therapy for invasive carcinoma of the breast [J]. Curr Prold Surg, 1995; 32（3）: 191-248.
4. 林本耀. 乳腺癌保乳治療學 [M]. 北京: 清華大學出版社, 2004: 113-116.
5. 張保寧. 早期乳腺癌保乳手術的相關問題 [J]. 中國腫瘤, 2007； 16（10）： 758-760.
6. Lam WW, Fielding R, Ho EY. Predicting psychological morbidity in Chinese women after surgery for breast carcinoma [J]. Cancer, 2005； 103(3): 637-646.
7. Engel J, Kerr J, Schlesinger-Raab A, et al. Quality of life following breast-conserving therapy or mastectomy: results of 5-year prospective study [J]. Breast J, 2004； 10(3): 223-231.
8. 孫強，陳凜，陳杰，等. 乳腺癌術后乳房缺損患者的心理調查 [J]. 中華整形外科雜志， 2003； 19(4)： 294-296.
9. Ganz PA, Kwan L, Stanton AL, et al. Quality of life at the end of primary treatment of breast cancer: first results from the moving beyond cancer randomized trial [J]. J Natl Cancer Ins, 2004； 96(5): 376-387.
10. 張疆莉, 祁富生, 白清林. 乳腺癌患者社會心理特征的研究 [J]. 中國神經精神疾病雜志, 2002； 28(5): 330-332.
11. Tomatis L. Between the body and mind: the involvement of psychological factors in the development of multifactorial diseases [J]. Eur J Cancer, 2001； 37(Suppl 8): S148-S152.
12. Shapiro SL, Lopez AM, Schqartz GE, et al. Quality of life and breast cancer: relationship to psychosocial variables [J]. J Clin Psychol, 2001； 57(4): 501-519.
13. Northous LL, Caffey M, Deichelbohrer L, et al. The quality of life of African American women with breast cancer [J]. Res Nurs Health, 1999, 22(6): 449-460.
14. Fisher B, Anderson S, Redmond CK, et al. Reanalysis and results after 12 years of follow-up in a randomized clinical trial comparing total mastectomy with lumpectomy with or without irradiation in the treatment of breast cancer [J]. N Engl J Med, 1995； 333（22）: 1456-1461.
15. Fisher B, Anderson S, Bryant J, et al. Twenty-year follow-up of a randomized trial comparing total mastetomy, lumpectomy, and lumpectomy plus irradiction for the treatment of breast cancer [J]. N Engl J Med, 2002； 347(16): 1233-1241.
16. Early Breast Cancer Trialists’ Collaborative Group. Effects of radiotherapy and surgery in early breast cancer -an overview of the randomized trials [J]. N Engl J Med, 1995； 333（22）: 1444-1456.
17. 張保寧. 乳腺癌保乳手術的研究進展 [J]. 中國普外基礎與臨床雜志, 2005； 12(3): 204-206.
18. Nour A. Breast-conserving therapy in low-literacy patients in a developing country [J], Breast J， 2003； 9(2): 71-73.
19. 沈鎮宙，邵志敏. 現代乳腺腫瘤學進展 [M]. 上海：上海科學技術文獻出版社， 2002： 117-119.
20. Dusková M, Kanková H, Tvrdek M, et al. Breast reconstruction as an integral part of a breast carcinoma therapy (a self-present final report of a reseach project IGA MZ CR) [J]. Acta Chir Plast, 2001； 43(2): 42-53.
21. Jensen JA. Should improved mastectomy and reconstruction alter the primary management of breast cancer? [J]. Plast Reconstr Surg, 1999； 103(4): 1308-1310.
22. Slavin SA, Schnitt SJ, Duda RB, et al. Skin-sparing mastectomy and immediate reconsruction: Oncologic risks and aesthetic results in patients with early-stage breast cancer [J]. Plast Reconstr Surg, 1998; 102(1): 49-62.
23. Birdsell DC, Jenkins H, Berkel H. Breast cancer diagnosis and survival in women with or without breast implants [J]. Plast Reconstr Surg, 1993； 92(5): 795-800.
24. Pusic A， Thompson TA， Kerrigan CL， et al. Surgical options options the early-stage breast cancer: factors with patient choice and postopretivequality of life [J]. Plast Reconstr Surg， 1999； 104(5): 1325-1333.
25. 栩軼，師蘭香. 原發性乳腺癌患者對改良根治術后乳腺重建認同程度的調查研究 [J]. 解放軍護理雜志， 2003； 20(3): 30-31.

《中國普外基礎與臨床雜志》

關于女性乳腺疾病患者對保乳及乳房重建認同度的調查

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《中國普外基礎與臨床雜志》

關于女性乳腺疾病患者對保乳及乳房重建認同度的調查

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料