Kato Taigo, Kakuta Yoichi, Yamanaka Kazuaki, Okumi Masayoshi, Abe Toyofumi, Imamura Ryoichi, Ichimaru Naotsugu, Takahara Shiro, Nonomura Norio
Department of Urology, Osaka University Graduate School of Medicine, 2-2 E4 Yamadaoka, Suita, Osaka, 565-0871 Japan.
Department of Urology, Tokyo Women's Medical University Graduate School of Medicine, 8-1 Kawada-cho, Shinjyuku-ku, Tokyo, 162-8666 Japan.
Springerplus. 2015 Apr 25;4:196. doi: 10.1186/s40064-015-0946-2. eCollection 2015.
The incidence of malignancies in kidney transplant recipients is increasing. Breast cancer is a common malignancy after kidney transplantation and can be more aggressive in kidney transplant recipients than in the general population. In this study, we evaluated the incidence and prognosis of breast cancer in kidney transplant recipients.
Between 1993 and 2013, 750 kidney transplant patients were followed-up at our center. Since 1999, annual physical examination, mammography, and breast ultrasonography have been performed for such patients. Diagnostic studies, including core needle or mammotome biopsy, were performed for suspected malignancies. Patients with malignant neoplasm were administered the appropriate treatment and followed-up to assess tumor response and symptoms. Nine patients were diagnosed with breast cancer during the follow-up period. The mean age at the initial detection of the breast cancer was 47.7 ± 8.4 years. The mean interval from transplantation to diagnosis was 148.7 ± 37.1 months. Of the 9 patients, 8 were detected through the screening test; 7 were treated with breast conservative surgery and 1 was treated with modified radical mastectomy. The cancer stages were 0 (n = 2), I (n = 6), and II (n = 1). The incidence of breast cancer tended to be unchanged with time between transplantation and diagnosis, inconsistent with the increase in the duration of immunosuppression.
Annual screening tests are crucial in the early diagnosis of breast cancer. Early treatment of breast cancer can result in an excellent prognosis in kidney transplant recipients.
肾移植受者中恶性肿瘤的发病率正在上升。乳腺癌是肾移植后常见的恶性肿瘤,在肾移植受者中可能比普通人群更具侵袭性。在本研究中,我们评估了肾移植受者中乳腺癌的发病率和预后。
1993年至2013年期间,我们中心对750例肾移植患者进行了随访。自1999年以来,每年对这些患者进行体格检查、乳房X线摄影和乳房超声检查。对疑似恶性肿瘤进行诊断性检查,包括粗针穿刺活检或真空辅助活检。对患有恶性肿瘤的患者给予适当治疗并进行随访,以评估肿瘤反应和症状。随访期间有9例患者被诊断为乳腺癌。乳腺癌初次检测时的平均年龄为47.7±8.4岁。从移植到诊断的平均间隔时间为148.7±37.1个月。9例患者中,8例通过筛查试验发现;7例行保乳手术,1例行改良根治性乳房切除术。癌症分期为0期(n = 2)、I期(n = 6)和II期(n = 1)。乳腺癌的发病率在移植与诊断之间随时间变化趋势不明显,这与免疫抑制时间的增加不一致。
年度筛查试验对乳腺癌的早期诊断至关重要。乳腺癌的早期治疗可使肾移植受者获得良好的预后。