Breast Diseases Division, Buenos Aires British Hospital, Buenos Aires, Argentina.
Breast J. 2010 Nov-Dec;16(6):625-32. doi: 10.1111/j.1524-4741.2010.00976.x.
The higher incidence of breast cancer, the improvements in diagnosis and treatment, together with the growing life expectancy have brought about an increase in the number of patients at risk for bilateral breast carcinoma. The aim of this study is to describe the characteristics of patients suffering from bilateral breast carcinoma who underwent surgery at the Breast Pathology Service of the Buenos Aires British Hospital and to analyze impact on survival. Between January 1970 and May 2007, 4,085 cases of breast carcinoma in 3,864 patients were treated at the Breast Diseases Division of the Buenos Aires British Hospital. A retrospective study of 194 patients with bilateral breast carcinoma was carried out: 80 synchronous and 114 metachronous. In order to compare survival, a group of 2,237 patients with unilateral breast carcinoma who had undergone surgery was analyzed. The risk of developing a contralateral breast carcinoma was 0.9% per year, with an accumulated risk at 15 years of 12.75%. The 5-year survival was 85.9% for unilateral carcinomas, 94.6% for metachronous carcinoma, and 63.3% for synchronous carcinoma. The 15-year survival was 65.5% for unilateral carcinomas, 52.3% for metachronous, and 37.2% for synchronous. The incidence of bilateral carcinomas is low. Survival was worse in patients with metachronous carcinoma diagnosed within 5 years of the first malignancy. Survival in patients with metachronous carcinoma diagnosed after 5 years is similar to those with unilateral carcinoma. Synchronous carcinoma was associated to worse survival, being an independent risk factor for mortality.
乳腺癌发病率较高，诊断和治疗水平不断提高，加之预期寿命延长，使得双侧乳腺癌高危患者人数增加。本研究旨在描述在布宜诺斯艾利斯英国医院乳腺病理科接受手术治疗的双侧乳腺癌患者的特征，并分析其对生存率的影响。1970 年 1 月至 2007 年 5 月，在布宜诺斯艾利斯英国医院乳腺疾病科治疗了 3864 例乳腺癌患者中的 4085 例。对 194 例双侧乳腺癌患者进行了回顾性研究：80 例为同时性，114 例为异时性。为了比较生存率，分析了一组 2237 例接受单侧乳腺癌手术的患者。发生对侧乳腺癌的风险为每年 0.9%，15 年累计风险为 12.75%。单侧乳腺癌的 5 年生存率为 85.9%，异时性乳腺癌为 94.6%，同时性乳腺癌为 63.3%。单侧乳腺癌的 15 年生存率为 65.5%，异时性乳腺癌为 52.3%，同时性乳腺癌为 37.2%。双侧乳腺癌的发病率较低。在首次恶性肿瘤诊断后 5 年内诊断为异时性乳腺癌的患者生存较差。在首次恶性肿瘤诊断后 5 年以上诊断为异时性乳腺癌的患者的生存与单侧乳腺癌患者相似。同时性乳腺癌与较差的生存相关，是死亡的独立危险因素。
