摘要
目的论证指导妇女进行乳房自我检查(BSE)是否能有效降低乳腺癌患者的死亡率。方法自1989年10月起,上海26.6万名年龄在30～64岁的妇女,随机进入指导组(132979名)和对照组(133085名)。在指导组,最初先由医务人员做规范的BSE手法演示,随后的4年中,使用BSE录像带进行二次强化教育,并定期进行BSE指导和在医务人员监察下进行BSE操作。本研究进行5年,全部活动均被记录。队列人群随访到2000年7月,乳腺癌患者的生存状况随访到2001年12月。统计分析采用Kaplan-Meier方法、Logrank检验以及Cox模型。结果指导组检出乳腺癌864例,其中死于乳腺癌133例;对照组检出乳腺癌896例,其中死于乳腺癌130例。两组乳腺癌病例的肿块大小、TNM分期和累积死亡率的差异均无统计学意义(P均>0.05)。但是指导组比对照组有较多和较小的纤维腺瘤被检出(P<0.01)。结论对人群开展BSE教育和指导,未能降低人群的乳腺癌死亡率;接受BSE教育的妇女比没有接受教育的妇女可检出较多的和较小的良性乳房肿块。
Objective A randomazed trial of breast self examination (BSE) program was carried out to evaluate whether the intensive BSE can reduce the death number of women from breast cancer. Methods A total of 266 064 women (age of 30 to 64 years) associated with 519 textile factories in Shanghai had been randomly assigned to a BSE instruction group ( 132 979 women ) or a control group (133 085women ) since 1989. Initial instruction in BSE group included demonstration of proper palpation techniques. It was followed by 2 reinforcement sessions during the subsequent 4 years including video shows, BSE instruction sessions and BSE practice under medical supervision. These activities were continued for 5 years. Attendance at all events was recorded. The cohort was followed through July 2000 for development of breast diseases, and the breast cancer cases were followed up through 2001 for vital status. The data analysis methods used included Kaplan Meier plots, Log rank test and Cox modeling. Results Among women under instruction, 864 breast cancers were detected and 133 breast cancer deaths occurred, and 896 breast cancers were detected and 130 deaths recorded in the control group. The tumor size ( P =0.07), TNM stage ( P =0.39 ) and cumulative breast cancer mortality rate ( P =0.72) were not significantly different between the 2 groups. However, more and smaller fibroadenomas were detected in the instruction group than in the control group ( P <0.01). Conclusion Intensive instruction in BSE can not reduce mortality rate of breast cancer, but more and smaller benign breast lumps can be detected.
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2005年第6期350-354,共5页
Chinese Journal of Oncology
基金
美国国家癌症研究所NCI5 R01 CA46823-14
