浸润性乳腺小叶癌患者的手术治疗因体重指数而异。

IF 3 3区 医学 Q2 ONCOLOGY Breast Cancer Research and Treatment Pub Date : 2024-12-01 Epub Date: 2024-08-11 DOI:10.1007/s10549-024-07452-1
Israel O Falade, Kayla M Switalla, Molly E Baxter, Astrid Quirarte, Helena Record, Harriet T Rothschild, Elle N Clelland, Rita A Mukhtar
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引用次数: 0

摘要

目的:浸润性小叶癌(ILC)患者的边缘阳性率和乳房切除术的完成率都很高,使用肿瘤整形手术等特殊技术可以改善这一情况。然而,之前的研究表明,乳腺癌手术的类型也与患者的身体质量指数(BMI)升高等因素有关。因此,本研究调查了体重指数是否会影响 ILC 患者的手术干预类型:方法:研究人员对某机构数据库中的 705 名 I-III 期 ILC 患者进行了回顾性分析。根据体重指数(体重不足、正常体重、超重、肥胖)对患者进行分层。采用皮尔逊卡方、方差分析和多变量逻辑回归评估 BMI 与手术治疗之间的关系:结果:60%的患者最初接受的手术是保乳手术(BCS),BMI没有明显差异。在接受保乳手术的患者中,肥胖 BMI 患者接受肿瘤整形手术的几率明显更高(46.9% 对比起体重不足、正常和超重的 7.7%、37.3% 和 33.6%,P = 0.032)。与体重不足、体重正常和体重超重的患者相比,接受乳房切除术的肥胖 BMI 患者接受乳房重建的可能性较低(44.2% vs. 50%、71.1% 和 64.1%,P = 0.002):结论:与体重指数较低的患者相比,超重/肥胖体重指数(BMI)的ILC患者接受了不同的手术干预。虽然最初的乳房肿块切除率相似,但超重/肥胖患者接受乳房肿块切除术的肿瘤整形手术率较高,接受乳房切除术的乳房重建率较低。要了解BMI对ILC手术决策和结果的影响,还需要进一步的研究。
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Variation in surgical treatment by body mass index in patients with invasive lobular carcinoma of the breast.

Purpose: Patients with invasive lobular carcinoma (ILC) face high rates of positive margins and completion mastectomy, which can be improved with the use of specific techniques, such as oncoplastic surgery. However, prior studies have shown that type of breast cancer surgery performed is also associated with patient factors such as elevated body mass index (BMI). Thus, this study investigates whether BMI impacts the type of surgical interventions in patients with ILC.

Methods: A retrospective analysis of 705 patients with stage I-III ILC from an institutional database was conducted. Patients were stratified by BMI (underweight, normal weight, overweight, obese). Pearson's Chi-square, ANOVA, and multivariable logistic regression were used to evaluate the relationship between BMI and surgical procedures.

Results: Breast-conserving surgery (BCS) was the initial operation in 60% of patients, with no significant difference by BMI. Among those undergoing BCS, patients with obese BMI were significantly more likely to undergo oncoplastic surgery (46.9% vs. 7.7%, 37.3%, and 33.6% for underweight, normal, and overweight, respectively, p = 0.032). Obese BMI patients undergoing mastectomy were less likely to have reconstruction compared to those with underweight, normal weight, and overweight BMI (44.2% vs. 50%, 71.1%, and 64.1%, p = 0.002).

Conclusion: Overweight/obese BMI patients with ILC underwent different surgical interventions compared to those with lower BMI. While initial BCS rates were similar, overweight/obese patients had higher oncoplastic surgery rates in BCS and lower reconstruction rates in mastectomy. Further research is needed to understand BMI's impact on surgical decisions and outcomes in ILC.

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来源期刊
CiteScore
6.80
自引率
2.60%
发文量
342
审稿时长
1 months
期刊介绍: Breast Cancer Research and Treatment provides the surgeon, radiotherapist, medical oncologist, endocrinologist, epidemiologist, immunologist or cell biologist investigating problems in breast cancer a single forum for communication. The journal creates a "market place" for breast cancer topics which cuts across all the usual lines of disciplines, providing a site for presenting pertinent investigations, and for discussing critical questions relevant to the entire field. It seeks to develop a new focus and new perspectives for all those concerned with breast cancer.
期刊最新文献
Correction: FBLN2 is associated with basal cell markers Krt14 and ITGB1 in mouse mammary epithelial cells and has a preferential expression in molecular subtypes of human breast cancer. A randomised trial comparing 6-monthly adjuvant zoledronate with a single one-time dose in patients with early breast cancer. Alterations in the expression of homologous recombination repair (HRR) genes in breast cancer tissues considering germline BRCA1/2 mutation status. Efficacy of antiobesity medications among breast cancer survivors taking aromatase inhibitors. Cost containment analysis of superparamagnetic iron oxide (SPIO) injection in patients with ductal carcinoma in situ.
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