Institute of Diagnostic and Interventional Radiology, Friedrich Schiller University Jena, Erlanger Allee 101, 07740, Jena, Germany.
Breast Cancer Res Treat. 2010 Apr;120(2):449-59. doi: 10.1007/s10549-009-0718-1. Epub 2010 Jan 20.
Women with unilateral breast carcinoma reveal an increased risk of suffering from malignancies in the contralateral breast. There is a controversy about the existence of bilateral phenotypic similarities. The aim of this investigation was to compare histologic findings, magnetic resonance imaging (MRI) parameters, and tumor localizations of synchronous bilateral carcinomas. MRI revealed in 42 of 875 women (4.8%) with primary index carcinomas a contralateral malignancy. Twenty-two of the 42 contralateral carcinomas could only be detected by MRI, not by clinical examination, X-ray mammography, or ultrasonography. In 875 patients, MRI therefore identified 22 (2.5%) otherwise occult contralateral cancers. To evaluate bilateral MRI similarities, multiple dynamic and morphologic parameters were evaluated. Of 42 bilateral cancer pairs, histologic tumor type was identical in 54.8% (correlation analysis, P < 0.05). Estrogen receptor status was simultaneously positive or negative in 86.2% (P < 0.01), progesterone receptor status in 79.3% (P < 0.05), expression of human epidermal growth factor receptor 2 in 76.2% (P < 0.05). In 75.8%, initial signal increase, and in 63.6%, postinitial curve types were bilaterally congruent on MRI (P < 0.05). Detected masses showed bilaterally similar T2-signal intensity in 81.8% (P < 0.001). Similar shape and margin of tumor masses and occurrence of non-mass-like enhancement were also frequently observed in both breasts (P < 0.05). The main tumor quadrant was the same in 61.9%, the main localization (retromamillar, central, or dorsal) in 66.7% (P < 0.01). Contralateral carcinomas frequently present similar histologic findings, tumor localizations and MRI characteristics reflecting analogies of tumor neoangiogenesis, histopathologic components, and infiltration in the surrounding stroma. Bilateral synchronous carcinomas may represent on each site distinct, but similar biologic entities, due to analogous influences of tumor developments.
患有单侧乳腺癌的女性会增加罹患对侧乳腺癌的风险。关于双侧表型相似性是否存在存在争议。本研究旨在比较同侧双侧癌的组织学发现、磁共振成像（MRI）参数和肿瘤定位。MRI 在 875 例原发性指数癌的 42 例女性中发现了对侧恶性肿瘤。42 例对侧癌中有 22 例仅可通过 MRI 检测到，而不能通过临床检查、乳房 X 线照相术或超声检查检测到。因此，在 875 例患者中，MRI 共检出 22 例隐匿性对侧癌（2.5%）。为了评估双侧 MRI 相似性，评估了多个动态和形态学参数。在 42 对双侧癌中，组织学肿瘤类型完全相同的占 54.8%（相关分析，P < 0.05）。雌激素受体状态同时阳性或阴性的占 86.2%（P < 0.01），孕激素受体状态阳性的占 79.3%（P < 0.05），人表皮生长因子受体 2 表达阳性的占 76.2%（P < 0.05）。在 75.8%的病例中，初始信号增强，在 63.6%的病例中，MRI 上双侧初始曲线类型一致（P < 0.05）。在 81.8%的病例中，双侧肿块的 T2 信号强度相似（P < 0.001）。在双侧乳房中也经常观察到相似的肿块形状和边缘以及非肿块样增强（P < 0.05）。主要肿瘤象限相同的占 61.9%，主要定位（乳晕后、中央或背部）相同的占 66.7%（P < 0.01）。对侧癌常表现出相似的组织学发现、肿瘤定位和 MRI 特征，反映了肿瘤新生血管生成、组织病理学成分和周围基质浸润的相似性。双侧同步癌可能代表每个部位的不同但相似的生物学实体，这是由于肿瘤发展的类似影响所致。
