Oncology Unit, ASST Bergamo Ovest, Treviglio, BG, Italy.
Oncology Unit, Casa di cura Igea, Milano, Italy.
Cancer Epidemiol. 2024 Aug;91:102581. doi: 10.1016/j.canep.2024.102581. Epub 2024 May 15.
There is an ongoing debate in the medical community about the association between the laterality of breast cancer (BC: whether it arises in the left or right breast) and its outcome. This study aims to assess the disparities in overall survival (OS), cardiac mortality, and cancer-specific survival (CSS) between BC affecting the left side and BC affecting the right side.
We conducted a thorough search of databases, such as PubMed, EMBASE, and the Cochrane Library, starting from their inception up until December 1, 2023. The primary outcome was OS. Additional endpoints included cardiac mortality and CSS.
The meta-analysis included 50 publications (n = 7,527,156 patients) with similar rates of left and right BCs. Patients with left-sided BC showed a marginally decreased OS (HR = 1.03, 95 %CI 1.01-1.04; P < .01) and a 10% increase in cardiac mortality (HR = 1.1, 95 %CI 1.04-1.16; P < .01). Cancer-specific survival was similar for both groups (HR = 1.01, 95 %CI 0.98-1.03; P = .32).
According to this study, there is a slight increase in mortality and a 10 % rise in cardiac-related deaths associated with left-sided breast cancer compared to right-sided breast cancer.
医学界一直在争论乳腺癌（BC：发生在左侧还是右侧乳房）的侧别与其结局之间的关系。本研究旨在评估左侧乳腺癌和右侧乳腺癌患者的总生存率（OS）、心脏死亡率和癌症特异性生存率（CSS）的差异。
我们从数据库（如 PubMed、EMBASE 和 Cochrane Library）中进行了全面检索，检索时间从数据库建立到 2023 年 12 月 1 日。主要结局为 OS。其他终点包括心脏死亡率和 CSS。
荟萃分析纳入了 50 篇文献（n=7527156 例患者），这些文献中左侧和右侧 BC 的发生率相似。左侧 BC 患者的 OS 略有降低（HR=1.03，95%CI 1.01-1.04；P<.01），心脏死亡率增加 10%（HR=1.1，95%CI 1.04-1.16；P<.01）。两组的 CSS 相似（HR=1.01，95%CI 0.98-1.03；P=0.32）。
根据本研究，与右侧乳腺癌相比，左侧乳腺癌的死亡率略高，与心脏相关的死亡风险增加 10%。
