双侧原发性乳腺癌13例临床分析

摘要

目的 探讨双侧原发性乳腺癌发病因素、分子分型、手术方式等,并对其预后进行评估.方法 分析双侧原发性乳腺癌和同期单侧乳腺癌患者的发病年龄;分析双侧原发性乳腺癌临床病理资料,根据雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor,PR)和人表皮生长因子受体-2(human epidermal growth factor receptor 2,HER-2)的表达情况将双侧乳腺癌分为4种分子亚型,即Luminal A型、Luminal B型、HER-2型和三阴性乳腺癌.分析各分子亚型的临床病理特征;分析双侧原发性乳腺癌和同期单侧乳腺癌治疗方式.结果 双侧原发性乳腺癌比同期单侧乳腺癌的患者年轻.双侧原发性乳腺癌的三阴性乳腺癌组织学Ⅲ级患者明显多于其他亚型(P＜0.05),各分子亚型在淋巴结转移上差异无统计学意义(P＞0.05).双侧原发性乳腺癌保乳手术比例与同期单侧乳腺癌保乳手术比例差异有统计学意义(P＜0.01),预后生存率差异无统计学意义(P＞0.05).结论 发病年轻是双侧原发性乳腺癌发生的危险因素,双侧原发性乳腺癌各分子亚型的三阴性乳腺癌组织学Ⅲ级患者明显多于其他亚型,双侧原发性乳腺癌保乳术与同期单侧乳腺癌相比,其无瘤生存率差异无统计学意义(P＞0.05).%Objective To analyze the risk factors, molecular types, surgical methods of simultaneous bilateral primary breast cancer ( BPBC ) and assess its prognosis. Methods The age of 13 patients with simultaneous BPBC and contemporary patients with unilateral breast cancer ( UBC ) was analyzed; The clinical data of simultaneous BPBC was studied; According to the situation of the estrogen receptor ( ER ), progesterone receptor ( PR ) and human epidermal growth factor receptor - 2 ( HER - 2 ), the simultaneous BPBC was divided into four kinds - Luminal A - type, Luminal B type, HER - 2 type and triple - negative breast cancer ( TNBC ), The clinical and pathological features of the molecular subtypes and the treatment of BPBC and UBC were analyzed. Results The patients suffering from BPBC were younger than those of UBC. The patients suffering from the histological grade Ⅲ of TNBC were much more than those from other subtypes ( P <0. 05 ); There was no statistical difference about the molecular subtypes in the lymph node metastasis ( P >0. 05 ). There were significant differences in the proportion of breast - conserving surgery between patients of BPBC and UBC, and there was no obvious difference in the prognosis of survival. Conclusion Young age is the risky factor of BPBC. The patients suffering from the histological grade Ⅲ of TNBC are much more than those from other subtypes. There is no difference in the disease -free survival between the conserving surgery of simultaneous BPBC and that of UBC.