双侧原发性乳腺癌临床分析

目的 探讨影响双侧乳癌患者临床特点及预后的因素。方法 回顾性分析1975年11月～2002年1月行乳腺癌根治性手术1845例中经病理组织学证实的双侧原发性腺癌(bilateral primary breast cancer，BPBC)52例的临床资料。其中同时性双侧乳腺癌11例(21．2％)，异时性双侧乳腺腺癌41例(78．8％)，接受手术、放疗、化疗等单一或综合治疗。分析乳腺癌的多种预后因素与术后生存率的关系。结果 原发肿瘤的大小、浸润淋巴结的数目、正确治疗和两侧乳腺癌的间距时间等均影响预后。三、五、十年的生存率各为90％(19／21)、71．4％(15／21)和66．7％(14／21)。结论 正确治疗的双侧乳腺癌仍有较高的五年生存率，两侧乳腺癌之间的间隔时间是主要的预后因素，与生存率呈正相关。早期诊断和治疗第二原发癌仍是提高生存率的关键。

Clinical analysis of bilateral primary breast cancer

Objective:To study the determining prognostic factors that affect the survival of patients with bilateral breast cancer.Methods:52 BPBC cases found in 1845 cases receiving radical mastectomy from November 1975 to January 2002 were retrospectively studied.11(21.2%) presented simultaneous bilateral tumors. 41(78.8%) developed bilateral breast cancer with interval in between. Patients were treated with surgery, radiation treatment and chemotherapy. Analysis of possible relation between high risk factors for breast cancer and postoperative survival was carried out.Results:The incidence of the BPBC was 2.8%(52/1845) in our study. The size of the tumor, the number of involved axillary nodes and the adequacy of the initial treatment still remained to be the major prognostic factors, correlated with the interval between two cancers. 3-year, 5-year and 10-year survivals were recorded to be 89.8%(44/49),71.4%(35/49) and 63.3%(31/49).Conclusions:Patients with BPBC have poor prognosis compared to those with unilateral breast cancer.Interval between two breast cancers and clinical stage are the most prominent prognostic factors, correlated with the overall survival. The early diagnosis and treatment of the second primary breast cancer are still the key to longer survival rate of bilateral breast cancer.