同时性原发性双侧乳腺癌1例及文献复习  

A case report of simultaneous primary bilateral breast cancer and literature review

作　　者：尹美凤 张旭东[1] 朱利楠[1] 牛松涛[1] 陈清江[1] YIN Mei-feng;ZHANG Xu-dong;ZHU Li-nan;NIU Song-tao;CHEN Qing-jiang(Department of Oncology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan Province,China)

机构地区：[1]郑州大学第一附属医院肿瘤科,河南郑州450052

出　　处：《新乡医学院学报》2018年第7期623-625,共3页Journal of Xinxiang Medical University

摘　　要：目的通过分析1例同时性原发性双侧乳腺癌患者的临床资料及文献复习,总结同时性原发性双侧乳腺癌的诊疗方案,以提高对该病的认识。方法分析2017年12月郑州大学第一附属医院肿瘤科诊治的1例同时性原发性双侧乳腺癌患者的临床资料,采取病例报告和文献综述的方式对同时性原发性双侧乳腺癌的诊断及治疗进行总结。结果此患者经术后病理确诊为左乳高级别原位导管癌伴局部浸润,右乳恶性叶状肿瘤;给予表柔比星联合环磷酰胺序贯多西紫杉醇化学治疗方案治疗,8周期化学治疗后达到完全缓解。文献综述分析提示,此类疾病尚无统一诊断标准,治疗方案根据恶性程度较高一侧的乳腺癌类型确定。肿瘤分期早、双侧乳腺癌间隔时间长、雌激素受体及孕激素受体阳性、人表皮生长因子受体-2(HER-2)阳性的患者预后好。结论同时性原发性双侧乳腺癌诊断明确后,应针对病理类型恶性程度高的一侧乳腺癌进行化学治疗、内分泌治疗及放射治疗等个体化综合治疗。肿瘤分期、双侧乳腺癌间隔时间、激素相关受体、HER-2表达是影响双侧原发性乳腺癌患者预后的主要因素。Objective To summarize therapeutic schedule of simultaneous primary bilateral breast cancer(SPBPC)by reporting a case and reviewing the relevant literature,which might help to promote the perception of the SPBPC.Methods The chinical data of one patient with SPBPC in the First Affiliated Hospital of Zhengzhou University in December 2017 was analysed.The diagnosis and therapy of SPBPC were summarized by relevant case report and literature review.Results The patient was diagnosed as high-grade ductal carcinoma in situ with local invasion in left breast and malignant phyllodes tumor in right breast by biopsy after surgery.The patient achieved complete response after the 8-cycle chemotherapy of pharmorubicin combined with cyclophosphamide sequential docetaxel.The results of literature review showed that,uniform diagnostic criteria for SBPBC was not found,but the therapeutic schedule was usually determined based on the type of breast carcinoma on one side which was higher malignancy.The patients would have a good prognosis,who were in the early disease stage,had a long bilateral breast cancer interval,positive sex hormone-related receptors and positive human epidermalgrowth factor receptor-2(HER-2)gene expression.Conclusion Once the diagnosis of SPBPC is definite,the comprehensive individualized therapy should be implemented such as chemotherapy,endocrine treatment and radiotherapy on one side of breast cancer with higher malignancy.Tumor staging,bilateral breast cancer interval,hormone-related receptor and HER-2 gene expression are the major factors affecting the prognosis of patient with SPBPC.

关 键 词：同时性双侧乳腺癌 诊断 治疗 

分 类 号：R737.9[医药卫生—肿瘤]