114例同时性双乳癌临床及预后的回顾性分析

Retrospective analysis of 114 cases with bilateral synchronous breast cancer

目的研究原发同时性双侧乳腺癌(以下简称同时性双乳癌)的临床病理、治疗及预后情况。方法回顾性分析中国医学科学院肿瘤医院1999年1月至2013年3月收治的114例同时性双乳癌患者的临床病理资料及随访资料。结果同时性双乳癌第一癌及第二癌病理类型以浸润性导管癌为主,原发灶手术方式以乳腺全切为主,腋窝淋巴结手术方式以清扫术为主。同时性双乳癌第一癌及第二癌激素受体阳性率高达70%,HER2阴性病例的比例(第一癌为60.5%,第二癌为64.0%)明显高于HER2阳性比例(第一癌为20.2%,第二癌为15.8%)。第一癌肿瘤大小、第一癌腋窝淋巴结分期、第一癌及第二癌TNM分期是影响同时性双乳癌预后的独立因素(均P<0.05)。结论同时性双乳癌总体发病率较低,既往文献报道的手术方式多以改良根治术为主。第一癌的肿瘤大小及腋窝淋巴结分期能够影响患者的预后,分期较早的同时性双乳癌拥有更好的预后。

Objective To analyze the clinical characteristics, treatment and prognosis for bilateral synchronous breast cancer（BSBC） Method We retrospectively analyzed the 114 cases of bilateral synchronous breast cancer registered in our hospital since 1999 to 2013 in terms of clinical and pathological features, treatment and prognosis. RRee-sult Invasive ductal cancer was the most common pathologic type in the first and second lesions. BSBC patients received mostly mastectomy and axillary lymph node dissection. The positive rate of hormone receptor was up to70%. The rate of negative HER2 is higher than the positive one. The size of first lesion, the lymph node stage of first lesion and TNM stage of first and second lesion were the independent prognostic factors. Conclusion The incidence of bilateral synchronous breast cancer is very rare. Modified radical mastectomy was the most common operation method according to past literatures. The size and lymph node stage of first lesion could influence the prognosis of patients. Early TNM stage of BSBC patients will have a better prognosis.