Baykara Meltem, Ozturk Selcuk Cemil, Buyukberber Suleyman, Helvaci Kaan, Ozdemir Nuriye, Alkis Necati, Berk Veli, Koca Dogan, Coskun Ugur, Oksuzoglu Berna, Uncu Dogan, Arpaci Erkan, Ustaalioglu Basak Oven, Demirci Umut, Kucukoner Mehmet, Dogu Gamze Gokoz, Alici Suleyman, Akman Tulay, Ozkan Metin, Aslan Ulku Yalcintas, Durnali Ayse Gok, Benekli Mustafa
Department of Medical Oncology, Gazi University Medical Faculty, Ankara, Turkey. meltembaykara@yahoo
Asian Pac J Cancer Prev. 2012;13(9):4571-5. doi: 10.7314/apjcp.2012.13.9.4571.
The frequency of bilateral breast cancer is 1.4-11.0% among all breast cancers. It can present as synchronous (SC) or metachronous (MC). Data regarding clinical course of bilateral breast cancer are scarce. In this study, we therefore evaluated demographic, pathological and clinical characteristics, treatments and responses in bilateral breast cancer cases; making distinctions between metachronous-synchronous and comparing with historic one-sided data for the same parameters.
One hundred fifty bilateral breast cancer cases from ten different centers between 2000 and 2011 were retrospectively scanned. Age of the cases, family history, menopausal status, pathological features, pathological stages, neoadjuvant, surgery, adjuvant and palliative chemotherapy/radiotherapy were examined in the context of the first and second occurrence and discussed with reference to the literature.
Metachronous and synchronous groups showed similar age, menopausal status, tumor type, HER2/neu expression; the family history tumor grade, tumor stage, ER-negativity rate, local and distant metastases rates, surgery, adjuvant chemotherapy application rates were identified as significantly different. Palliative chemotherapy response rate was greater in the metachronous group but median PFS rates did not differ between the groups.
Although bilateral breast cancer is not frequent, MC breast cancer is different from SC breast cancer by having more advanced grade, stage, less ER expression, more frequent rates of local relapse and distant metastasis and better response to chemotherapy in case of relapse/metastasis.
在所有乳腺癌中，双侧乳腺癌的发生率为1.4% - 11.0%。它可表现为同时性（SC）或异时性（MC）。关于双侧乳腺癌临床病程的数据较少。因此，在本研究中，我们评估了双侧乳腺癌病例的人口统计学、病理学和临床特征、治疗方法及反应；区分异时性和同时性，并将相同参数与既往单侧数据进行比较。
回顾性分析了2000年至2011年间来自十个不同中心的150例双侧乳腺癌病例。在首次和第二次发病的背景下，检查病例的年龄、家族史、绝经状态、病理特征、病理分期、新辅助治疗、手术、辅助治疗和姑息化疗/放疗情况，并参考文献进行讨论。
异时性和同时性组在年龄、绝经状态、肿瘤类型、HER2/neu表达方面相似；家族史、肿瘤分级、肿瘤分期、雌激素受体阴性率、局部和远处转移率、手术、辅助化疗应用率被确定为有显著差异。异时性组的姑息化疗反应率更高，但两组的中位无进展生存期无差异。
尽管双侧乳腺癌并不常见，但异时性乳腺癌与同时性乳腺癌不同，其分级、分期更晚，雌激素受体表达更少，局部复发和远处转移率更高，复发/转移时对化疗的反应更好。
