Fukutomi T, Akashi-Tanaka S, Nanasawa T, Matsuo K, Shimizu C
Department of Surgical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
Int J Clin Oncol. 2001 Apr;6(2):80-3. doi: 10.1007/pl00012087.
We investigated histopathological background and multicentricity in patients with familial breast cancers (FBCs) in comparison with these features in patients with sporadic breast cancers (SBCs), stratifying patients by menopausal status.
We collected a consecutive series of 469 FBC patients and 3334 SBC patients treated at our hospital between 1965 and 1995. The following criteria were used to define FBC, regardless of the presence or absence of a family history of other cancer or the patient's past history of malignancies: (1) Three or more second-degree relatives had been affected by breast cancer; (2) two first-degree relatives had been affected by breast cancer, and either one of them was under 40 years of age and/or had had bilateral breast cancers. The presence or absence of background proliferative lesions (PL; ductal/lobular hyperplasia and/or adenosis) and the multicentricity of breast carcinomas in FBCs and SBCs were analyzed for each group.
In premenopausal FBC patients, there was a non-significant trend towards a high frequency of multicentricity compared with findings in patients with SBCs overall (P = 0.087; odds ratio [OR], 1.43; 95% confidence interval [CI], 0.96-2.13). In premenopausal FBC patients, the frequency of background proliferative lesions with/or without fibroadenomas (FA) in the resected specimen was significantly higher than that in SBC patients overall (P = 0.001 for PL; OR, 1.47; 95% CI, 1.18-1.83; P < 0.001 for PL +/- FA; OR, 6.84; 95% CI, 4.93-9.49). With regard to the other clinicopathological factors examined, there were no significant differences between the two groups, except for the higher frequency of premenopausal patients among the FBC patients.
These results indicate that premenopausal patients with FBCs had more proliferative lesions in the histopathological background and more multicentric breast cancers than premenopausal patients with SBCs.
我们调查了家族性乳腺癌(FBC)患者的组织病理学背景和多中心性,并与散发性乳腺癌(SBC)患者的这些特征进行比较,同时根据绝经状态对患者进行分层。
我们收集了1965年至1995年间在我院接受治疗的469例FBC患者和3334例SBC患者的连续系列病例。无论是否存在其他癌症家族史或患者过去的恶性肿瘤病史,均采用以下标准定义FBC:(1)三个或更多二级亲属患有乳腺癌;(2)两个一级亲属患有乳腺癌,且其中一人年龄在40岁以下和/或患有双侧乳腺癌。分析每组FBC和SBC中背景增殖性病变(PL;导管/小叶增生和/或腺病)的存在与否以及乳腺癌的多中心性。
在绝经前FBC患者中,与总体SBC患者相比,多中心性频率有非显著性升高趋势(P = 0.087;比值比[OR],1.43;95%置信区间[CI],0.96 - 2.13)。在绝经前FBC患者中,切除标本中伴有或不伴有纤维腺瘤(FA)的背景增殖性病变频率显著高于总体SBC患者(PL时P = 0.001;OR,1.47;95% CI,1.18 - 1.83;PL +/- FA时P < 0.001;OR,6.84;95% CI,4.93 - 9.49)。关于所检查的其他临床病理因素,除FBC患者中绝经前患者频率较高外,两组之间无显著差异。
这些结果表明,与绝经前SBC患者相比,绝经前FBC患者在组织病理学背景中有更多的增殖性病变和更多的多中心性乳腺癌。