Anvari Kazem, Fanipakdel Azar, Davoudi Yasmin
Cancer Research Center, Omid Hospital ,Faculty of Medicine, Mashad University of Medical Sciences, Mashad, Iran.
Dept. of Radiology, Imam Reza Hospital, Mashad University of Medical Sciences, Mashad, Iran.
Iran J Cancer Prev. 2013 Winter;6(1):17-24.
The beginning of metastasis poorly affects the prognosis of breastcancer patients. Lung is the most frequent site of visceral metastasis, and the rate of recurrence is 10-30%. We have tried to find out if the routine Chest X Ray (CXR) could play a role for early detection of lung metastasis, during the prognosis of these patients.
The files of the breast cancer patients between 1996 to 2006 (1739 patients) have reviewed. Clinical characteristics of patients with pulmonary metastasis have recorded. Patients, who lacked imaging files or lacked an appropriate follow-up, have excluded. Data have analyzed by SPSS 11.5. The survival analyses have performed by using the Kaplan-Meier method.
Fifty-six patients, median age 46, have entered into this retrospective study. Median tumor size was 4cm; median number of Lymphadenopathy (LAP) was 4. The intermediate grade has detected in 74% of patients. All patients have received adjuvant treatment. Median time from cancer diagnosis to pulmonary metastasis was 22 months. Pulmonary metastasis has detected by control CXR in77.4% and patients' symptoms in 22.6%. Forty eight patients have received chemotherapy in metastatic phase. In 28 patients (50%), other sites of metastasis (bone, liver, and brain) have discovered.The most frequent pattern of lung recurrence was pulmonary nodule (44.6%), followed by pleural effusion (28.6%). Median survival was 27.5; median survival from pulmonary metastasis was 8 m.
Early detection of pulmonary metastasis by CXR did not affect patients' endpoints. None of the probable prognostic factors have shown a significant effect on patients' outcome. Despite systemic treatment, survival after metastasis is low.
转移的发生对乳腺癌患者的预后影响较差。肺是内脏转移最常见的部位，复发率为10% - 30%。我们试图探究在这些患者的预后过程中，常规胸部X线检查（CXR）能否在早期发现肺转移方面发挥作用。
回顾了1996年至2006年间乳腺癌患者的病历（共1739例患者）。记录了肺转移患者的临床特征。排除了缺乏影像资料或缺乏适当随访的患者。数据采用SPSS 11.5进行分析。生存分析采用Kaplan - Meier方法进行。
56例患者进入这项回顾性研究，中位年龄46岁。肿瘤中位大小为4cm；淋巴结病（LAP）中位数量为4个。74%的患者检测为中级。所有患者均接受了辅助治疗。从癌症诊断到肺转移的中位时间为22个月。通过对照CXR检测到肺转移的患者占77.4%，通过患者症状检测到的占22.6%。48例患者在转移期接受了化疗。在28例患者（50%）中，发现了其他转移部位（骨、肝和脑）。最常见的肺复发模式是肺结节（44.6%），其次是胸腔积液（28.6%）。中位生存期为27.5个月；从肺转移开始的中位生存期为8个月。
通过CXR早期发现肺转移并未影响患者的终点指标。没有一个可能的预后因素对患者的结局显示出显著影响。尽管进行了全身治疗，但转移后的生存率较低。
