原发性双侧乳腺癌的诊治

目的：探讨原发性双侧乳腺癌的临床特征、治疗和预后。方法：回顾了我院2002年1月～2006年3月经病理组织学证实的12例原发性双侧乳腺癌患者的临床资料，结合文献复习对原发性双侧乳腺癌的诊断标准、发病率、病因及危险因素、治疗方式及预后进行讨论。结果：12例均符合原发性双侧乳腺癌的诊断标准，同时性2例，异时性10例，4例（33．3％）有家族史，第一癌发病年龄较轻，绝经前9例（75％），病理类型以浸润性导管癌和特殊类型为主，有4例（33．3％）ER、HER2、p53基因表达水平有差异，首发侧病期亦较早，经综合治疗后目前生存情况良好。结论：应重视双侧乳腺癌的发生，单侧乳腺癌发生后应积极随访以早期发现对侧病变，并采取综合治疗措施。

Diagnosis and Treatment of bilateral primary breast cancer

Objective: To study the characteristics,treatment and the prognosis of bilateral primary breast cancer(BPBC).Methods: Twelve cases of BPBC patients underwent radical mastectomy from January 2002 to March 2006 in our unit were retrospectively analyzed.To evaluate diagnosis,incidence,etiology,risk factors,treatment and prognosis. Results: Twelve cases all confirmed with BPBC,induding 2 presented simultaneous bilateral tumors and 10 developed bilateral breast cancer with interval in between.Four cases belonged to kindred breast cancer.Nine cases(75%) got it before menopause as the age of patients suffering from the first breast cancer was trending younger.Pathological types of 12 cases were mostly invasive ductal carcinoma or special types.The expressions of ER,HER2,p53 in 4(33.3%) cases were different with whom the first cancer occurred earlier.All 12 Patients were in good condition after surgery,radiation treatment and chemotherapy. Conclusion: One should take more care of the patients with unilateral breast cancer and beware of the possibility of BPBC,and treat the patients with polytherapy once they are confirmed with BPBC.