222例双侧原发性乳癌的预后因素

Prognostic of 222 Cases Bilateral Primary Breast Cancer

目的探讨双侧原发性乳癌（Bilateral Primary Breast Cancer，BPBC）的预后及其影响因素。方法对天津市医科大学附属肿瘤医院1972年3月-2003年12月收治的222名BPBC患者的临床资料进行预后因素分析。结果BPBC的5、10年累计生存率分别为78．73％、69．09％。sBPBC的生存率总体较mBPBC的差，但无统计学意义。第一侧淋巴结阳性结果、第二侧淋巴结阳性结果、第二侧肿瘤大小、第二侧组织学分级对生存的作用有统计学意义。结论同时性和异时性BPBC的生存率相似。第二侧肿瘤≥5cm，双侧淋巴结阳性的预后差。多因素分析表明第二侧肿瘤大小和第一侧、第二侧淋巴结阳性同是影响预后的因素。

Objective To evaluate the outcome and prognosis analyze of bilateral primary breast cancer （BPBC）. Methods The clinical data of 222 patients with BPBC, admitted to Tianjin Medical University Cancer Institute and Hospital from March 1972 to December 2003 were collected and analyzed on prognosis factors. Results 5-year and 10-year Cumulative Survival rate of BPBC were 78. 73% and 69. 09%. Cumulative Survival rate of sBPBC（Synchronous BPBC, sBPBC） is lower than mBPBC＇ s（Metachronous BPBC, mBPBC）, but there is no significant difference. The status of bilateral lymph node of and tumor size of secondary cancer affect the survival of BPBC significantly. Conclusion The survival rate of sBPBC is similar to that of mBPBC. The prognosis of patients with negative lymph node of two sides and tumor size〈5cm of secondary cancer are better than those with positive lymph node and tumor size≥ 5cm. The results of multivariate analysis showed that tumor size of secondary cancer and lymph node status of bilateral breast cancer are prognostic factors of bilateral primary breast cancer.