双侧原发性乳腺癌  

Bilateral primary breast cancer

作　　者：顾禾[1] 付荣湛[1] 张丽丽[1] 郭源[1] 于学智[1] 李兆亭[1] 

机构地区：[1]山东省千佛山医院普通外科,山东济南250014

出　　处：《中国现代普通外科进展》2002年第2期110-112,共3页Chinese Journal of Current Advances in General Surgery

摘　　要：目的 :探讨双侧原发性乳腺癌临床特点及诊治。方法 :回顾性分析 1985年 11月～ 2 0 0 0年 1月行乳腺癌根治性手术 6 5 5例中双侧原发性乳腺癌 (bilateralprimarybreastcancer,BPBC) 10例的临床资料。结果 :BPBC较单侧乳腺癌发病年龄明显提前。BPBC绝经前较绝经后发病率高。BPBC好发部位多集中于腺体丰富区域和导管集中部位 ,即乳房外上象限及乳晕区域最常见。同时性癌及异时性癌的首发癌以Ⅱ、Ⅲ期较多。首发癌及时正确的治疗是影响BPBC预后的重要因素。BPBC病灶大小、腋淋巴转移数目及水平均影响预后。同时性BPBC发病较少 ,预后较差 ;异时性BPBC多见 ,预后较好。结论 :BPBC较单侧癌预后差 ,对单侧癌术前要常规做联合诊断检查 ,术后严密随访 ,要特别注意检查对侧乳腺。对高危病人有可疑病变要及时切除活检 ,以利于早期发现及时治疗。Objective:The purpose of this study is to assess the clinical characteristics and management of bilateral primary breast cancer(BPBC).Methods:Ten cases BPBC were found in 655 cases radical mastectomy from November 1985 to January 2000 by retrospective study.Results:The incidence of the BPBC was 1.53%(10/655)in our study.Patients with BPBC were significantly younger than those with unilateral cases.The incidence was higher in premenopausal period than postmenopausal period,It often occurred in upper out quadrant and areolar area.The initial cancer of BPBC was most in stage Ⅱ～Ⅲ.The early and proper therapy to initial cancer were the most important prognostic factor.The size of the second cancer,number of positive lymph nodes of the first and second cancers were also prognostic factors.The incidence of synchronous was lower compared with metachronous,but its prognosis was poorer.Conclusion:Patients with BPBC had poorer prognosis compared with unilateral breast cancer.So it is important to careful exam contralateral breast and close follow-up post-operatively.In high risk patients,excision biopsy to the suspectable contralateral breast disease is help to early diagnosis and treatment.Negtive lymph node metastasis is also a risk factor of BPBC.

关 键 词：双侧原发性乳腺癌 乳腺肿瘤 临床特点 BPBC 诊断 治疗 

分 类 号：R737.9[医药卫生—肿瘤]