31例原发性双侧乳腺癌患者的临床特征分析

Analysis of the clinical characteristics of 31 cases of primary bilateral breast cancer

目的研究原发性双侧乳腺癌患者的临床特征,为临床诊疗提供更多有价值的依据。方法收集原发性双侧乳腺癌患者共31例,采集患者的临床资料,如年龄、肿瘤大小、淋巴结转移数目、激素受体状态、肿瘤初诊方式等。结果原发性双侧乳腺癌第二原发癌的初诊肿瘤大小(T)较第一原发癌偏小(P<0.05),TNM分期较第一原发癌更早(P<0.05);第二原发癌的TNM分期以0期或Ⅰ期较为多见。原发性双侧乳腺癌第一原发癌与第二原发癌的激素受体状态比较,差异无统计学意义(P>0.05)。原发性双侧乳腺癌第一原发癌与第二原发癌通过自检发现的比例分别为64.5%、41.9%,由临床医师手诊、超声及钼靶X线检查发现的比例分别为35.5%、58.1%,其中有2例(6.5%)对侧乳腺癌漏诊,通过MRI检查发现。结论对于已罹患乳腺癌的患者,应定期进行对侧乳房检查并结合钼靶、超声或MRI等影像学检查,对可疑病灶予以积极处理,从而提高对侧乳腺癌的早期诊断率,进而提高双侧乳腺癌的诊疗效果。

Objective To study the clinical characteristics of patients with bilateral breast cancer and to provide more evidence for clinical diagnosis and treatment. Method A total of 31 cases diagnosed as primary bilateral breast cancer were reviewed, of which the clinical data, such as age, tumor size, the number of node metastatic sites, hormone receptor status, as well as the diagnostic methods were collected. Result Compared with the first primary carcinoma, the size of the second primary carcinoma of the bilateral breast cancer patients were smaller（P〈0.05）, the TNM stage was earlier than the first primary carcinoma（P〈0.05）; the TNM stage of second primary cancers was more common as stage 0 or stage I. There was no significant difference in receptor status between first and second primary carcinoma（P〉0.05）. The rate of the first and second primary cancers found by self-checking of patients was 64.5% and 41.9%, and that by clinical diagnosis, ultrasound and mammography accounted for 35.5% and 58.1%, and there were two cases（6.5%） found by MRI after missed diagnosis. Conclusion For patients with breast cancer, breast physical examination along with mammography, ultrasound or MRI imaging should be administered regularly, suspicious lesions should be managed actively and carefully, so as to improve the early diagnosis rate of contralateral breast cancer and improve the diagnosis and treatment effect of bilateral breast cancer.