Prior P, Waterhouse J A
Br J Cancer. 1978 Apr;37(4):620-34. doi: 10.1038/bjc.1978.92.
This paper gives the incidence in the Birmingham Regional Cancer Registry (England) of a second primary tumour in the contralateral breast among nearly 22,000 patients registered with a first primary in the breast between the years 1936 and 1964. The results, based on more than 90,000 women-years at risk and 399 second primary tumours, are presented with reference to 2 methods of analysis. In assessing risk, the principal factors investigated were age at first and second primary diagnoses and the interval between diagnoses. The results are discussed in terms of current aetiological hypotheses. On the basis of a method which included coincidental tumours, the overall risk of a tumour in the contraleteral breast was found to be 3.0 times that in the general population of a first primary. The corresponding risks for 3 main age-ranges (at the time of diagnosis of the first primary tumour) were 5.6 (ages 15-44 years), 3.7 (45--59 years) and 1.8 (60+ years). When coincidental tumours were excluded from the analysis, the relative risk was found to be 2.4 overall and 5.3, 3.0 and 1.0 for the 3 age-ranges, respectively. The level of risk was negatively correlated with age at first primary and the relative risk remained substantially constant over time.
本文给出了1936年至1964年间在伯明翰地区癌症登记处（英国）登记的近22,000例患有原发性乳腺癌患者中，对侧乳房出现第二原发性肿瘤的发生率。基于超过90,000人年的风险期和399例第二原发性肿瘤，采用两种分析方法给出了结果。在评估风险时，所研究的主要因素为首次和第二次原发性诊断时的年龄以及两次诊断之间的间隔。根据当前的病因假说对结果进行了讨论。基于一种包括同时性肿瘤的方法，发现对侧乳房出现肿瘤的总体风险是首次原发性肿瘤一般人群的3.0倍。在三个主要年龄范围（首次原发性肿瘤诊断时）的相应风险分别为5.6（15 - 44岁）、3.7（45 - 59岁）和1.8（60岁及以上）。当分析中排除同时性肿瘤时，总体相对风险为2.4，三个年龄范围的相对风险分别为5.3、3.0和1.0。风险水平与首次原发性肿瘤时的年龄呈负相关，且相对风险随时间基本保持恒定。
