Sun Bei, Jing Yaoyao, Wang Yang, Wang Haiyan, Zhang Xinyue, Zhang Jin, He Feng
Institute of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China.
Department of Day Ward, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China.
Discov Oncol. 2025 May 21;16(1):845. doi: 10.1007/s12672-025-02162-6.
The rise of multiple primary malignant neoplasms (MPMNs) necessitates exploration. MPMNs represent 18% of U.S. cancers. Breast cancer is the predominant malignancy among female Americans. However, most studies on breast cancer with MPMNs are confined to case reports with small sample sizes. Hence, this article scrutinizes 280 patients diagnosed with breast cancer and extramammary primary malignancies via long-term follow-up.
We reviewed 280 breast cancer cases with extramammary primary malignancies from January 2000 to December 2022 at our institute, excluding those diagnosed with stage IV breast cancer. The double primary malignant neoplasms (DPMNs) were used as focal points and segregated into the first primary breast cancer (FPBC) and second primary breast cancer (SPBC) subgroups. With a median follow-up period of 107 months (8.9 years), we examined the characteristics of these diseases in various patients.
Concerning breast cancer patients with extramammary primary malignancies, DPMNs were predominant, comprising 77.1% (216/280). Among these DPNMs, gynecology, thyroid, and lung were the primary site of extramammary tumors, predominantly. Nearly all (93.9%) of FPBC patients exhibited metachronous cancer whereas 55.9% of SPBC patients experienced this. The median interval between the onset of breast cancer and extramammary malignancy in metachronous FPBC and metachronous SPBC patients was 60 months and 48 months, respectively. Over time, both metachronous FPBC and metachronous SPBC patients demonstrated a diminishing prevalence of second tumors. The distinction lay in that in the metachronous FPBC group, second tumors ceased to occur after 300 months, whereas in the metachronous SPBC group, their emergence persisted. Synchronous cancer, negative ER/PR status, and advanced extramammary malignancy stage portend poor prognosis among patients with DPMNs.
Careful monitoring of MPMNs necessitates precise guidelines, differing amongst FPBC and SPBC patients. Synchronous cancer, ER/PR-negative, and advanced extramammary malignancy stage indicate poor prognosis in DPMNs patients.
多重原发性恶性肿瘤（MPMNs）的增多需要进行探索。MPMNs占美国癌症的18%。乳腺癌是美国女性中最主要的恶性肿瘤。然而，大多数关于乳腺癌合并MPMNs的研究仅限于小样本量的病例报告。因此，本文通过长期随访对280例诊断为乳腺癌和乳腺外原发性恶性肿瘤的患者进行了详细分析。
我们回顾了2000年1月至2022年12月在我院诊断为乳腺癌合并乳腺外原发性恶性肿瘤的280例病例，排除诊断为IV期乳腺癌的患者。以双原发性恶性肿瘤（DPMNs）为重点，分为第一原发性乳腺癌（FPBC）和第二原发性乳腺癌（SPBC）亚组。中位随访期为107个月（8.9年），我们研究了不同患者中这些疾病的特征。
在患有乳腺外原发性恶性肿瘤的乳腺癌患者中，DPMNs占主导，占77.1%（216/280）。在这些DPMNs中，妇科、甲状腺和肺是乳腺外肿瘤的主要原发部位。几乎所有（93.9%）的FPBC患者表现为异时性癌症，而55.9%的SPBC患者出现这种情况。异时性FPBC和异时性SPBC患者中乳腺癌发病与乳腺外恶性肿瘤发病的中位间隔分别为60个月和48个月。随着时间的推移，异时性FPBC和异时性SPBC患者的第二肿瘤患病率均呈下降趋势。不同之处在于，在异时性FPBC组中，300个月后不再出现第二肿瘤，而在异时性SPBC组中，第二肿瘤仍持续出现。同步性癌症、ER/PR阴性状态和晚期乳腺外恶性肿瘤分期预示着DPMNs患者预后不良。
对MPMNs进行仔细监测需要精确的指导方针，FPBC和SPBC患者有所不同。同步性癌症、ER/PR阴性和晚期乳腺外恶性肿瘤分期表明DPMNs患者预后不良。
