Fracchia A A, Borgen P I
Breast Service, Memorial Sloan-Kettering Cancer Center, New York, New York.
Semin Surg Oncol. 1991 Sep-Oct;7(5):300-5. doi: 10.1002/ssu.2980070513.
Bilateral breast cancer has a cumulative incidence of 7% to 20% in patients with primary operable breast cancer, and the majority of these lesions are metachronous. A consensus on the management of the contralateral breast has been elusive. Much of the confusion arises from the fact that there exist marked differences of opinion regarding the impact of a second primary breast cancer on the overall prognosis. The risk of developing a contralateral breast cancer is influenced by the age of the patient, the presence of in situ disease, lobular histology of this new lesion, multicentricity, exposure to certain types of ionizing irradiation, and, possibly, family history of breast cancer. Management options include observation (clinical and mammographic surveillance), contralateral biopsy, and, rarely, prophylactic mastectomy. It is hoped that trials of breast cancer prevention, employing drugs such as tamoxifen, will identify agents capable of abrogating the risk of contralateral breast cancer and improve the ultimate outcome.
双侧乳腺癌在原发性可手术乳腺癌患者中的累积发病率为7%至20%，且这些病变大多为异时性。对于对侧乳房的处理尚无共识。许多困惑源于这样一个事实，即对于第二原发性乳腺癌对总体预后的影响存在明显的意见分歧。发生对侧乳腺癌的风险受患者年龄、原位疾病的存在、新病变的小叶组织学、多中心性、接触某些类型的电离辐射以及可能的乳腺癌家族史影响。处理选项包括观察（临床和乳腺X线监测）、对侧活检，以及很少采用的预防性乳房切除术。希望使用他莫昔芬等药物进行的乳腺癌预防试验能够确定能够消除对侧乳腺癌风险并改善最终结局的药物。
