双侧原发性乳腺癌

文章编号:100929905(2002)20220110203

双侧原发性乳腺癌

顾　禾　付荣湛　张丽丽　郭　源　于学智　李兆亭山东省千佛山医院普通外科　(山东　济南　250014)

【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～2000年1月行乳腺癌根治性手术655例中双侧原发性乳腺癌(bilateral primary breast cancer ,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。无腋淋巴转移也是发生

BPBC 的危险因素。

【关键词】乳腺肿瘤;肿瘤,多原发性【中图分类号】R73719【文献标识码】A

Bil a t e r al p ri m a r y bre as t c a nce r

GU H e ,FU Rong 2zhan ,ZHANG Li 2li ,GU O Yuan ,Y U Xie 2zhi ,L I Zhao 2ting

Depa rtment of

General Surgery ,Sha ndong Provincial Qia nf osha n Hospital (J ina n ,

250014,China )

【ABS TRACT 】O b j e c t i v e :The p urp os e of t his s t udy is t o a s s e s s t he clinic al c ha r a c t e ris tic s a nd

ma na ge me nt of bila t e r al p rima ry b r e a s t c a nc e r (B PBC ).M e t h o d s :Te n c a s e s B PBC w e r e f ound in 655c a s e s r a dic al ma s t e c t omy f r om Nove mbe r 1985t o J a nua ry 2000by r e t r osp e c tive s t udy.R e s u l t s :The incide nc e of t he B PBC w a s 1.53%(10/655)in our s t udy.Pa tie nt s wit h B PBC w e r e signif ic a ntly younge r t ha n t hos e wit h unila t e r al c a s e s.The incide nc e w a s highe r in p r e me nop a us al p e riod t ha n p os t me nop a us al p e riod ,It of t e n oc c ur r e d in upp e r out qua d r a nt a nd a r e ola r a r e a.The initial c a nc e r of B PBC w a s mos t in s t a ge Ⅱ～Ⅲ.The e a rly a nd p r op e r t he r ap y t o initial c a n 2c e r w e r e t he mos t imp or t a nt p r ognos tic f a c t or.The siz e of t he s e c ond c a nc e r ,numbe r of p osi 2tive lymp h node s of t he f irs t a nd s e c ond c a nc e rs w e r e als o p r ognos tic f a c t ors.The incide nc e of s ync hr onous w a s low e r c omp a r e d wit h me t a c hr onous ,but it s p r ognosis w a s p oor e r.C o n c l u 2s i o n :Pa tie nt s wit h B PBC ha d p oor e r p r ognosis c omp a r e d wit h unila t e r al b r e a s t c a nc e r.S o it is imp or t a nt t o c a r ef ul e xa m c ont r ala t e r al b r e a s t a nd clos e f ollow 2up p os t 2op e r a tively.In high ris k p a tie nt s ,e xcision biop s y t o t he s usp e c t a ble c ont r ala t e r al b r e a s t dis e a s e is help t o e a rly dia gno 2sis a nd t r e a t me nt.Ne g tive lymp h node me t a s t a sis is als o a ris k f a c t or of B PBC.

【KEY WORDS 】Ma mma ry ne opla s ms ;Ne opla s ms ,multiplep rima ry

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011・　中国现代普通外科进展　2002年6月第5卷第2期Chin J Curr Adv G en Surg J une 2002　Vol.5　No.2