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目的调查分析唐山市社区女性乳腺癌的患病情况及危险因素。方法选取唐山市各大社区女性5 987例为研究对象,均接受临床症状、彩超、乳腺钼靶等检查,乳腺癌确诊结合病理组织学检查,分析乳腺癌危险因素。结果 5 987例女性中确诊为乳腺癌患者21例,检出率为0.35%。30~40岁女性乳腺癌检出率最低,50~60岁女性乳腺癌检出率最高。21例乳腺癌患者病理类型以浸润性导管癌最为多见,临床分期以Ⅱ期最为广泛。钼靶筛查特异度为0.97,灵敏度为0.92,约登指数0.91,阳性预测值0.17,阴性预测值0.98,阳性似然比52.36,阴性似然比0.08,一致率0.97。临床触诊特异度为0.41,灵敏度为0.72,约登指数0.16,阳性预测值0.02,阴性预测值0.99,阳性似然比1.41,阴性似然比0.60,一致率0.41。一侧乳房癌史是引起对侧乳房癌发病的危险因素;哺乳时间≥6个月是乳腺癌发病的保护因素。结论唐山市社区女性乳腺癌的患病率较高,应引起卫生部门重视。针对乳腺癌的危险因素,积极展开对社区女性的健康教育、宣传普及工作,有效降低乳腺癌发病率。
Objective To investigate the prevalence and risk factors of breast cancer in Tangshan community. Methods A total of 5 987 women from major communities in Tangshan were enrolled in this study. All patients underwent clinical examination, color Doppler ultrasound and mammography. Breast cancer was diagnosed by histopathological examination and risk factors of breast cancer were analyzed. Results Of the 5 987 women diagnosed with breast cancer in 21 cases, the detection rate was 0.35%. The detection rate of breast cancer is the lowest in women aged 30 ~ 40, and the detection rate of breast cancer in women aged 50 ~ 60 is the highest. 21 cases of breast cancer patients with invasive ductal carcinoma is the most common pathological type, stage Ⅱ to the most extensive clinical stage. Molybdenum target screening specificity was 0.97, sensitivity was 0.92, Youden index was 0.91, positive predictive value of 0.17, negative predictive value of 0.98, positive likelihood ratio of 52.36, negative likelihood ratio of 0.08, the coincidence rate of 0.97. The clinical palpation specificity was 0.41, the sensitivity was 0.72, the Youden index was 0.16, the positive predictive value was 0.02, the negative predictive value was 0.99, the positive likelihood ratio was 1.41, the negative likelihood ratio was 0.60, and the concordance rate was 0.41. Breast cancer side of the history of contralateral breast cancer risk factors; breast-feeding time ≥ 6 months is a protective factor in the incidence of breast cancer. Conclusion The prevalence of breast cancer in Tangshan community is higher, which should be paid more attention by the health department. For breast cancer risk factors, and actively carry out health education for women in the community, publicity and popularization work, effectively reduce the incidence of breast cancer.