نوع مقاله : مقاله پژوهشی

نویسندگان

1 فلوشیپ جراحی سرطان، مرکز تحقیقات بیماری های پستان، دانشگاه علوم پزشکی شیراز، شیراز، ایران

2 متخصص رادیواونکوتراپی، مرکز تحقیقات بیماری های پستان، دانشگاه علوم پزشکی شیراز، شیراز، ایران

3 پزشک عمومی، دانشکده پزشکی، دانشگاه علوم پزشکی شیراز، شیراز، ایران

4 کارشناس ارشد آمار، مرکز تحقیقات بیماری های پستان، دانشگاه علوم پزشکی شیراز، شیراز، ایران

5 متخصص پزشکی اجتماعی، مرکز تحقیقات بیماری های پستان، دانشگاه علوم پزشکی شیراز، شیراز، ایران

10.30476/smsj.2022.88772.1183

چکیده

مقدمه: سرطان سینه یکی از شایع ترین سرطان ها، همچنین مهم ترین عامل مرگ و میر زنان در سراسر جهان می باشد. اگرچه روند رو به افزایش جمعیت زنان مسن نشان دهنده پیشرفت روش های تشخیصی  و درمان این بیماری می باشد، اما با توجه به اینکه بیشتر مطالعات بر روی گروه سنی جوان انجام شده است، تقرببا می توان گفت اصول درمان در بیماران مسن به دلیل عدم شفافیت پیش آگهی بیماری در این گروه سنی نامشخص است.
روش‌ها: این مطالعه با استفاده از اطلاعات سیستم ثبت سرطان سینه دانشگاه علوم پزشکی شیراز، بزرگترین سیستم رجیستری سرطان سینه ایران، انجام شده است. حجم نمونه این مطالعه زنان مبتلای به سرطان سینه بالای 70 سال بودند. فاکتورهای پیشگویی کننده، روش های درمانی و بقای بیماران مورد بررسی قرار گرفت.
یافته‌ها: در این مطالعه 427 بیمار مورد بررسی قرار گرفتند. میانگین سنی بیماران 75±5.2 سال بود. کارسینوم داکتال مهاجم شایعترین نوع (3%/73) و گرید دو تومور (%9/56) و گروه سایز 2-5 سانتی متر (%6/50) به ترتیب بیشترین فراوانی را داشتند. %9/81 بیماران دارای گیرنده استروژن بودند. %5/47 بیماران تحت عمل کوادرانتکتومی قرار گرفتند. احتمال بقای کلی بیشتر از 5 ساله بیماران 68% و احتمال بقای بدون بیماری بیشتر از 5 ساله آنها 51% محاسبه شد.
نتیجه گیری: بر اساس توصیه های جامعه بین المللی سرطان سالمندان، برای بهبود بقای سرطان سینه در زنان مسن علاوه بر نیاز به بازبینی  و ارزیابی بیشتر مدیریت درمانی این بیماری در این گروه سنی توسط پزشکان، همکاری متخصصین طب سالمندی نیز برای ارزیابی وضعیت کلی بیماران این رده سنی به جهت تطابق با گایدلاین های درمانی نیاز است.

کلیدواژه‌ها

عنوان مقاله [English]

An evaluation of the prognosis of breast cancer in patients older than 70 years: A report of Breast Cancer Registry of Shiraz University of Medical Sciences

نویسندگان [English]

  • Majid Akrami 1
  • Sedigheh Tahmasebi 1
  • Mahdi shariat 2
  • Vahid Moradi Ranjbar 3
  • Zahra Keumarsi 4
  • Masoumeh Ghoddusi Johari 5

1 Associate professor, Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

2 Radiooncotherpy Specialist, Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

3 Medical Doctor, Shiraz University of Medical Sciences, Shiraz, Iran

4 Master in Biostatistics, Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

5 Assistant professor, Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

چکیده [English]

Introduction: Breast cancer is one of the most common invasive cancers being the leading cause of mortality among women all around the world. Although the increasing trend of the geriatric population with cancer is indicative of good advances in cancer early detection and treatment, since most studies have been conducted on  younger age group, it can be said that the principles of treatment in geriatric patients remains unclear due to the vagueness of prognostic factors in this age group.
Methods: This study was conducted using the data obtained from Shiraz Breast Cancer Registry, the largest breast cancer registry in Iran. The study population included women aged 70 years and over who had breast cancer. Prognostic factors, treatment modalities, and patients’ survival rate were reviewed and investigated.
Result: 427 patients were included in this study. The mean age of patients was 75 years old +/- 5.2yrs. Invasive ductal carcinoma  (73.3%),  Grade 2 tumor (56.9 %), and size 2-5cm (50.6%) were the most common histopathological type, respectively. 81.9% of the patients were positive for estrogen receptor. 47.5% of the patients underwent quadrantectomy. 50.8% received adjuvant chemotherapy and 41.1% received adjuvant radiotherapy. The overall survival rate for women for more than 5 years (60 months) was 68% and disease-free survival rate for more than 5 years was 51%.
Conclusion: According to ISGO recommendation to improve breast cancer survival in the elderly, in addition to the need for more critical reappraisal in breast cancer management in this age group by clinicians, the involvement of geriatricians is needed to appraise the patients’ general condition in this age group in order to meet the treatment guidelines requirements.

کلیدواژه‌ها [English]

  • Breast neoplasms
  • Survival Rate
  • Prognosis
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