Cancer Council South Australia, PO Box 929, Adelaide, Unley, South Australia 5061, Australia.
Breast. 2011 Apr;20(2):158-64. doi: 10.1016/j.breast.2010.10.004. Epub 2010 Nov 18.
Uncertainty remains about the impact of bilateral breast cancer. Characteristics and outcomes of unilateral and bilateral breast cancer were compared within an Australian multi-institutional cohort.
Demographic, tumour and treatment characteristics were compared among unilateral (n = 2336) and bilateral cases (52 synchronous, 35 metachronous) using descriptive analyses. Disease-specific outcomes were investigated using Cox regression modelling to adjust for prognostic and treatment factors.
Factors associated with increased risk of bilateral breast cancer included lobular histology (p = 0.046), family history (p = 0.025) and metropolitan residence (p = 0.006). Mastectomy was more common for bilateral cases (p = 0.001) while radiotherapy was less common (p = 0.015). Index metachronous cases were less likely to receive hormonal therapy (p = 0.001). Five-year survivals for metachronous, synchronous and unilateral cases were 79%, 88% and 94%, respectively. Poorer outcomes remained after adjusting for prognostic factors [HR = 2.26, 1.21-4.21].
Our results confirm international findings indicating worse outcomes from bilateral compared with unilateral breast cancer.
双侧乳腺癌的影响仍存在不确定性。本研究比较了澳大利亚多机构队列中单侧和双侧乳腺癌的特征和结局。
采用描述性分析比较单侧（n=2336）和双侧（52 例同步，35 例异时）病例的人口统计学、肿瘤和治疗特征。使用 Cox 回归模型研究疾病特异性结局，以调整预后和治疗因素。
与双侧乳腺癌风险增加相关的因素包括小叶状组织学（p=0.046）、家族史（p=0.025）和大都市居住（p=0.006）。双侧病例更常行乳房切除术（p=0.001），而放疗较少（p=0.015）。指数异时病例更不可能接受激素治疗（p=0.001）。异时、同步和单侧病例的 5 年生存率分别为 79%、88%和 94%。调整预后因素后，结果仍较差[HR=2.26，1.21-4.21]。
我们的结果证实了国际研究结果，即与单侧乳腺癌相比，双侧乳腺癌的结局更差。
