双侧原发性乳腺癌的临床病理特征及预后分析  

Clinico-pathological features of bilateral breast cancer and related prognostic factors

作　　者：赵纹芸[1] 包家林 

机构地区：[1]上海市黄浦区中心医院乳腺科,上海200002

出　　处：《外科理论与实践》2004年第4期318-320,324,共4页Journal of Surgery Concepts & Practice

摘　　要：目的探讨双侧原发性乳腺癌的临床病理特征及其相关预后因素。方法回顾性分析45例原发性双侧乳腺癌病例资料,并运用多因素Cox比例风险回归模型筛选影响病人生存率的相关预后因素。结果45例双侧原发性乳腺癌病人占同期收治乳腺癌总病例数的2.3%。本组双侧原发性乳腺癌呈现特有的临床病理特征①发病年龄早首发癌病人的平均年龄为45岁,小于50岁者占总例数的64.4%(29/45)。②组织病理学恶性程度高本组45例共90个乳腺癌病灶中,浸润性导管癌占68.9%(62/90),其次为混合癌及单纯癌;③分期晚即使在第二原发癌中,II、III期癌肿也占73.3%(33/45)。Kaplan鄄Meier方法计算本组病例3年及5年的总体生存率分别为64.63%和60.59%。Cox回归结果提示,肿瘤TNM分期(P=0.0053)及双侧发病间隔(P=0.0059)是影响患者预后的独立指标。结论应针对具有高危因素的单侧乳腺癌病人进行筛查,早期发现和治疗第二癌,以改善双侧乳腺癌病人的预后。Objective To study the clinico-pathological features of synchronous and metachronous bilateral breast cancer, and evaluate the prognostic factors influencing the outcome of these patients. Methods The clinical data of 45 patients with bilateral breast cancer admitted during the period from January 1993 to December 2003 were retrospectively analyzed. The prognostic factors influencing the final outcome were evaluated simultaneously by the multivariate Cox proportional hazards model. Results Forty-five patients (all female) were enrolled in this study, amounting to 2.3% (45/1 926) of all patients treated for breast cancer during the same period. The characteristics of bilateral breast cancer were: ① Approximally 64.4%(29/45) of the patients whose first tumor was diagnosed before the age of 50 years; ② The majority of patients with bilateral breast cancer suffered from infiltrative tubular carcinoma(68.9% or 62/90) and/or mixed carcinoma; ③The number of patients with stage Ⅱ/Ⅲ accounted for 73.3%(33/45) of the second tumor group. The 3- and 5-year survival rates were 64.63% and 60.59% respectively. The Cox proportional hazards model revealed that the TNM stage (P=0.0053) and the interval between the occurence of the 2 cancers (P=0.0059) were independent prognostic factors. Conclusions The early diagnosis and treatment of the second primary breast cancer remain the key factor to improve the outcome of the bilateral breast cancer patients.

关 键 词：双侧乳腺癌 临床病理学 预后分析 

分 类 号：R737.9[医药卫生—肿瘤]