乳腺癌术后非乳腺部位多原发恶性肿瘤临床分析

Non-breast parts multiple primary malignant neoplasms in breast cancer patients

目的:探讨乳腺癌术后发生在非乳腺部位的多原发恶性肿瘤(MPMN)临床特点、发生原因及预后。方法:回顾性分析了2009年1月至2011年11月治疗的15例经病理证实的乳腺癌术后非乳腺部位发生的MPMN。结果:①乳腺癌与发生第二原发肿瘤中位间隔时间为30个月,同时性(间隔≤6个月)发生4例,异时性(间隔>6个月)发生11例。②第二原发恶性肿瘤部位依次为:肺、子宫内膜、胸壁、卵巢、食管、胰腺和甲状腺。③13例乳腺癌无复发和转移,双侧胸水和单侧进展各1例,第二原发肿瘤治疗中采用手术方法7例,15例病人中9例死亡,8例死亡原因为MPMN。结论:①乳腺癌术后易发生MPMN;②MPMN的发生与乳腺癌治疗有关;③MPMN的预后比乳腺癌转移复发的预后好。

Objective To investigate the clinical feature, causes and prognosis of multiple primary malignant neoplasm （MPMN） at the non-breast parts in patients after breast cancer. Methods Fifteen cases with pathologically confirmed MPMN at non-breast parts after the operation of breast cancer were analyzed retrospectively from Jan 2009 to Nov 2011. Results （1） The median interval between occurrence of breast cancer and second primary malignant neoplasm was 30 months, synchronous occurrence in 4 cases, metachronous occurrence in 11 cases. （2） The sites of second primary malignant neoplasm were： lung, endometrial, chest wall, ovary, esophagus, pancreas and thyroid. （3） Thirteen cases with breast cases had no recurrence and metastasis. Bilateral pleural effusion occurred in one case, and unilateral progress occurred in one case. Second primary malignant neoplasm was treated with surgical methods in 7 cases, 9 in 15 patients died. Eight patients died of MPMN. Conclusions （1） Patients with breast cancer were prone to MPMN. （2） The occurrence of MPMN related with the therapy of breast cancer. （3） The prognosis of the patients with MPMN was better than that of breast cancer patients with recurrence and metastasis.