Liang Xinrui, Li Danhua, Geng Wenwen, Cao Xuchen, Xiao Chunhua
The First Department of Breast Cancer, China Tianjin Breast Cancer Prevention, Treatment and Research center, Tianjin Medical University Cancer Institute and Hospital, West Beihuanhu Rd, Tianjin, 300060, People's Republic of China.
Tumour Biol. 2013 Apr;34(2):995-1004. doi: 10.1007/s13277-012-0636-4. Epub 2013 Jan 9.
This study was undertaken to determine the differences in the clinicopathology and survival between synchronous bilateral breast cancer (sBBC) and metachronous bilateral breast cancer (mBBC). Additionally, we analyzed the risk factors for single tumors to develop as sBBC or mBBC. Of the 190 bilateral breast cancer (BBC) cases, 84 cases were sBBC and 106 were mBBC. We defined sBBC as two tumors that developed within 12 months, while mBBC was defined as two tumors that developed over more than 12 months. The peak age of onset of the first mBBC tumors was significantly younger than that of sBBC tumors (p = 0.001). There was a higher concordance rate of ER/ER positivity and PR/PR positivity in the first and second tumors of sBBC than mBBC. The two sBBC breast cancers had relatively similar hormone conditions because of the low rate of ER and PR transformation from positive to negative or vice versa. We determined that patients who presented with extracapsular extension (p = 0.008) and ER positivity (p = 0.001) tend to have synchronous cancers, while patients with 3+ HER2 were more likely to develop metachronous tumors. The prognosis for mBBC was better than that for sBBC when the survival time of mBBC was measured from the initial observation of the first tumors.
本研究旨在确定同时性双侧乳腺癌（sBBC）和异时性双侧乳腺癌（mBBC）在临床病理及生存方面的差异。此外，我们分析了单个肿瘤发展为sBBC或mBBC的风险因素。在190例双侧乳腺癌（BBC）病例中，84例为sBBC，106例为mBBC。我们将sBBC定义为在12个月内发生的两个肿瘤，而mBBC定义为在超过12个月内发生的两个肿瘤。mBBC首个肿瘤的发病高峰年龄显著低于sBBC肿瘤（p = 0.001）。sBBC首个和第二个肿瘤中ER/ER阳性及PR/PR阳性的一致性率高于mBBC。由于ER和PR从阳性转为阴性或反之的比率较低，两个sBBC乳腺癌具有相对相似的激素状况。我们确定，出现包膜外侵犯（p = 0.008）和ER阳性（p = 0.001）的患者倾向于发生同时性癌症，而HER2为3+的患者更有可能发生异时性肿瘤。当从首个肿瘤的初始观察开始测量mBBC的生存时间时，mBBC的预后优于sBBC。
