Soerjomataram I, Louwman W J, van der Sangen M J C, Roumen R M H, Coebergh J W W
Department of Public Health, Erasmus MC, PO Box 2040, Rotterdam 3000 CA, The Netherlands.
Br J Cancer. 2006 Aug 7;95(3):393-7. doi: 10.1038/sj.bjc.6603231. Epub 2006 Jun 27.
Among 1276 primary breast carcinoma in situ (BCIS) patients diagnosed in 1972-2002 in the Southern Netherlands, 11% developed a second cancer. Breast carcinoma in situ patients exhibited a two-fold increased risk of second cancer (standardised incidence ratios (SIR): 2.1, 95% confidence interval (CI): 1.7-2.5). The risk was highest for a second breast cancer (SIR: 3.4, 95% CI: 2.6-4.3; AER: 66 patients per 10,000 per year) followed by skin cancer (SIR: 1.7, 95% CI: 1.1-2.6; AER: 17 patients per 10,000 per year). The increased risk of second breast cancer was similar for the ipsilateral (SIR: 1.9, 95% CI: 1.3-2.7) and contralateral (SIR: 2.0, 95% CI: 1.4-2.8) breast. Risk of second cancer was independent of age at diagnosis, type of initial therapy, histologic type of BCIS and period of diagnosis. Standardised incidence ratios of second cancer after BCIS (SIR: 2.3, 95% CI: 1.8-2.8) resembled that after invasive breast cancer (SIR: 2.2, 95% CI: 2.1-2.4). Surveillance should be directed towards second (ipsi- and contra-lateral) breast cancer.
在1972年至2002年期间于荷兰南部诊断出的1276例原发性原位乳腺癌（BCIS）患者中，11%发生了第二种癌症。原位乳腺癌患者发生第二种癌症的风险增加了两倍（标准化发病率（SIR）：2.1，95%置信区间（CI）：1.7 - 2.5）。第二种癌症风险最高的是第二种乳腺癌（SIR：3.4，95%CI：2.6 - 4.3；每年每10000人中有66例），其次是皮肤癌（SIR：1.7，95%CI：1.1 - 2.6；每年每10000人中有17例）。同侧（SIR：1.9，95%CI：1.3 - 2.7）和对侧（SIR：2.0，95%CI：1.4 - 2.8）乳房发生第二种乳腺癌的风险增加相似。第二种癌症的风险与诊断时的年龄、初始治疗类型、BCIS的组织学类型和诊断时期无关。BCIS后第二种癌症的标准化发病率（SIR：2.3，95%CI：1.8 - 2.8）与浸润性乳腺癌后的发病率相似（SIR：2.2，95%CI：2.1 - 2.4）。监测应针对第二种（同侧和对侧）乳腺癌。
