经手术治疗原发性双侧乳腺癌的临床病理分析

Clinicopathological Analysis of Primary Bilateral Breast Cancer after Surgery

目的探讨经手术治疗原发性双侧乳腺癌（bilateral breast cancer,BBC）的临床病理特点,探寻其潜在的危险因素。方法回顾性分析2004年6月至2013年5月之间在湖南省湘潭市第一人民医院和湘潭市中心医院确诊并进行手术治疗的0~Ⅲa期108例 BBC患者的临床及病理资料。同时期的2575例0~ⅢA期原发性单侧乳腺癌（unilateral primary breast cancer,UBC）患者将作为对照组。结果108例0~Ⅲa期BBC中,同时性双侧乳腺癌（synchronous bilateral breast cancer,SBBC）43例,占同期全部0~Ⅲa乳腺癌的1.6%（43/2683）。多因素回归分析发现,在 BBC 中年龄、家族史、小叶癌成分以及硬化性腺病的存在是SBBC的独立危险因素。双侧乳房全切手术是BBC患者最常见的手术治疗方式。结论对原发性 SBBC 而言,无论是临床还是病理方面,目前都无法给出明确的诊断标准,对于原发性 SBBC的诊断仍需要在临床以及影像学诊断的基础上,结合病理学检测结果。具有高危因素的患者,双侧乳房需要细致的临床及影像学检查,以及密切的常规随访。

Obj ective]To explore the clinicopathological characteristics of primary bilateral breast cancer （BBC）after surgery,and to find the potential risk factors.[Methods]Clinicopathological data of 108 patients with stage 0~Ⅲa BBC diagnosed and treated in Xiangtan first people＆#39;s hospital and Xiangtan central hospital from Jun.2004 to May 2013 were analyzed retrospectively.A total of 2,575 patients with stage 0~Ⅲa prima-ry unilateral breast cancer（UBC）during the same period were taken as control group.[Results]Among 108 patients with stage 0~Ⅲa BBC,43 patients（1.6%,43/2683）were synchronous bilateral breast cancer（SB-BC）.Multivariate regression analysis showed that age,family history,lobular carcinoma and sclerosing adeno-sis were the independent risk factors of SBBC.Bilateral mastectomy was the most common surgery for BBC patients.[Conclusion]No matter clinical or pathological aspects,the definite diagnostic criteria of primary SB-BC is unclear.The diagnosis of primary SBBC should be based on clinical and imaging diagnosis combined with pathological results.For high-risk patients,bilateral breasts should be examined by clinical and imaging exam-ination and followed up routinely and closely.