潮汕地区原发性双侧乳腺癌癌灶间相关性分析

Correlation Analysis of Primary Bilateral Breast Cancer in Chaoshan Area

目的:探讨异时性与同时性双侧乳腺癌的首侧癌灶发病风险特征的异同,为对侧肿瘤的"早期发现、诊断和治疗"提供依据。方法:回顾性分析177例双侧乳腺癌患者的临床病理资料,以6个月为界分析同时性双侧乳腺癌和异时性双侧乳腺癌。结果:双侧乳腺癌的发生率占同期乳腺癌的2.92%,其中异时性双侧乳腺癌的发生率是同时性的1.64倍。异时性双侧乳腺癌首发癌发病年龄比同时性小3岁,在低龄组(<40岁)的比重比同时性双乳癌大。异时性双侧乳腺癌在肥胖组(体质指数>28.0 kg/m2)的比重比同时性大。同时性双侧乳腺癌首侧癌的雌激素受体(ER),孕激素受体(PR)阳性率较高,异时性双乳癌首侧癌的人表皮生长因子受体-2(HER2) 3+阳性率较高。结论:单侧乳腺癌女性具备年龄较轻(<40岁),体质指数>28.0 kg/m2,肿瘤免疫组化ER、PR阴性,HER2 3+的高危因素时,应警惕对侧异时性乳腺癌的发生,单侧乳腺癌女性具备肿瘤免疫组化ER、PR阳性的高危因素时,应警惕同时性乳腺癌的发生。乳腺癌患病后应重视体重的控制,定期体检,随访时间应为10年,才能早期发现甚至降低致癌因素。

Objective: Explore the differences and similarities of risk characteristics between bilateral asynchronous breast cancer(mBBC) and bilateral synchronous breast cancer(sBBC). In the case of head cancer to provide some evidences for early detection, diagnosis and treatment of contralateral tumor. Methods: The clinicopathologic data of 177 patients with bilateral breast cancer were reviewed retrospectively. Bilateral asynchronous breast cancer and bilateral synchronous breast cancer were analyzed within 6 months. Results:The incidence of bilateral breast cancer accounted for 2.92% of the breast cancer in the same period, and the incidence of bilateral asynchronous breast cancer was 1.64 times of that of simultaneity. The age of onset of asynchronous breast cancer is 3 years less than that of synchronous breast cancer. The proportion in the younger group(age < 40 years) was higher in asynchronous breast cancer than in the synchronous breast cancer.The proportion of asynchronous bilateral breast cancer in obese group(body mass index > 28.0 kg/m2) was higher than that of simultaneous breast cancer. The positive rate of ER,PR receptor was higher in synchronous bilateral breast cancer. The HER2 receptor 3 + positive rate was higher in the asynchronous breast cancer.Conclusion: W hen women with unilateral breast cancer have high risk factors, such as at a younger age(younger than 40 years old), with a body mass index(greater than 28.0 kg/m2), with tumor immunohistochemical(ER, PR receptor) negative expression, and HER2 receptor 3+ positive expression, they should be aware of the occurrence of contralateral asynchronous breast cancer. W hen women with unilateral breast cancer have high risk factors, such as tumor immunohistochemical(ER, PR receptor) positive expression, they should be aware of the occurrence of contralateral synchronous breast cancer. Weight control and regular physical examinations should be emphasized after diagnosis of breast cancer. The duration of contralateral breast follow-up should be10 years to detect the occurrence of contralateral tumors early and even reduce the risk of contralateral cancerearly.