女性乳腺癌皮肤转移特征及其预后分析

Analysis of characteristics and prognosis factors of cutaneous metastasis in femal breast cancer

目的分析乳腺癌皮肤转移患者的临床病理特征及影响至皮肤转移时间的相关因素,总结皮肤转移后患者的生存情况。方法筛选2016-01-01-2018-12-31就诊于北京医院的乳腺癌患者,入组经病理确诊且非原发灶直接侵犯的皮肤转移患者,描述这些患者的临床、病理特征,根据随访时间及结局事件,描述乳腺癌合并皮肤转移患者的生存情况。结果共入组乳腺癌患者608例,其中女性皮肤转移者26例。平均年龄50.27岁,中位年龄49岁。乳腺癌确诊至皮肤转移中位时间29个月(3~192个月)。结节型皮肤转移患者24例,其中Luminal型17例。原发肿瘤≤5 cm者18例,其中5例在24个月以内发生皮肤转移,原发肿瘤>5 cm者8例,其中6例在24个月以内发生皮肤转移,Fisher精确概率法验证肿瘤大小与皮肤转移时间之间的关系,原发肿瘤>5 cm者早发皮肤转移率更高(P=0.038),同法证明区域淋巴结多发转移者皮肤转移发生率更高,P=0.043。中位随访26.5个月(5~123个月),乳腺癌皮肤转移生存时间>1年者23例,1年生存率为88.46%;生存时间>2年者22例,2年生存率为84.62%。结论原发肿瘤的大小、区域淋巴结转移与皮肤转移时间可能存在一定的关系,乳腺癌皮肤转移患者预后相对较好。

Objective To investigate the clinical pathological characteristics of breast cancer with cutaneous metastasis and the factors affecting time to cutaneous metastasis and summarize the survival status of these patients.Methods We screened breast cancer patients with cutaneous metastasis who were admitted to Beijing Hospital from January 1,2016 to December 31,2018, and the cutaneous foci must be pathologically confirmed and were not invaded directly by primary tumor.To describe the clinical and pathological characteristics of breast cancer patients with cutaneous metastasis.Survival of patients with skin metastasis from breast cancer was described according to the following-up time and outcome events.Results A total of 608 breast cancer patients were admitted to our hospital, and 26 female patients were pathologically confirmed with cutaneous metastases.The average age of patients was 50.27 years old, and the median age was 49 years old.Time from diagnosis of breast cancer to cutaneous metastasis ranged from 3 months to 192 months, with a median metastasis time of 29 months.There were 24 patients with nodular cutaneous metastases and 17 cases of Luminal type.There were 18 patients with primary tumor ≤5 cm, among which 5 patients had skin metastasis within 24 months and 8 patients >5 cm, among which 6 patients had skin metastasis within 24 months.Fisher’s exact test was used to verify the relationship between tumor size and the time of skin metastasis.Patients whose tumor size more than 5 cm have higher cutaneous metastasis rate in early time(P=0.038).The patients with multiple lymph nodes invasion had higer utaneous metastasis rate in early time verified by the same methods(P=0.043).The median follow-up time was 26.5 months(5-123 months),and there were 23 patients surviving one year and 22 patients for two years.The one-year and two-year survival rates after breast cancer cutaneous metastasis were 88.46% and 84.62%,respectively.Conclusions The size, regional lymph node metastasis of primary breast cancerprobably have relationship with cutaneous metastasis time.Our data show that breast cancer patients with cutaneous metastasis have a better prognosis.