Miura S
Gan To Kagaku Ryoho. 1986 Apr;13(4 Pt 2):1484-91.
Second malignancies were observed in 181 cases after treatment of antecedent breast cancer, among 5,302 primary breast cancer cases. The accumulated incidence of double cancer was as follows: 2.8% for 5 years, 5.2% for 10 years, 7.6% for 15 years, and 10.0% for 20 years. The observed incidence of second malignancy for all sites was 1.58 times as frequent as in the normal group. Statistically significant increased risks were observed for opposite breast cancer (O/E ratio 5.92), ovarian cancer (O/E ratio 4.47), corpus uterine cancer (O/E ratio 5.97) and thyroid cancer (O/E ratio 5.07). Among 5,302 cases, 2,431 (45.9%) underwent adjuvant chemotherapy. In chemotherapy groups, significantly increased risk of stomach cancer, thyroid cancer, leukemia and hepatoma was observed, but there were no remarkable differences between the MMC group and the CPA group. However, in the MMC + CPA combination treatment group, the risk of stomach cancer and leukemia was higher than in the single drug treatment groups. When multiple drugs were administered in large doses as long-term adjuvants, the risk of second malignancy seemed to become greater.
在5302例原发性乳腺癌病例中，181例在先行乳腺癌治疗后出现了第二原发恶性肿瘤。双癌的累积发病率如下：5年时为2.8%，10年时为5.2%，15年时为7.6%，20年时为10.0%。所有部位第二原发恶性肿瘤的观察发病率是正常组的1.58倍。观察到对侧乳腺癌（观察/预期比值5.92）、卵巢癌（观察/预期比值4.47）、子宫体癌（观察/预期比值5.97）和甲状腺癌（观察/预期比值5.07）的风险有统计学显著增加。在5302例病例中，2431例（45.9%）接受了辅助化疗。在化疗组中，观察到胃癌、甲状腺癌、白血病和肝癌的风险显著增加，但丝裂霉素组（MMC组）和环磷酰胺组（CPA组）之间没有显著差异。然而，在MMC + CPA联合治疗组中，胃癌和白血病的风险高于单药治疗组。当大剂量长期使用多种药物作为辅助剂时，第二原发恶性肿瘤的风险似乎更大。
