Hislop T G, Elwood J M, Coldman A J, Spinelli J J, Worth A J, Ellison L G
Br J Cancer. 1984 Jan;49(1):79-85. doi: 10.1038/bjc.1984.12.
Between 1946 and 1976 over 9,000 women with breast cancer were seen within one year of diagnosis at the A. Maxwell Evans Clinic (AMEC) in Vancouver, British Columbia. By 1978, 275 had a subsequent diagnosis of a second primary in the contralateral breast: 100 were diagnosed within 1 year, and 175 after 1 year of the first primary. Two separate comparison groups of AMEC patients with unilateral breast cancer were selected to identify risk factors for bilateral breast cancer and to determine the incidence. The average annual incidence rates for a second primary in the contralateral breast were 5.0, 4.1 and 3.0 per 1,000 women for women less than 45 years, 45-54 years, and over 55 years of age at diagnosis of first primary breast cancer, respectively. These rates remained stable for at least 15 years after the diagnosis of the first primary. Two risk factors were found for bilateral cancer within 1 year of the first primary, histologic diagnosis of lobular carcinoma and absence of pathologic involvement of axillary nodes; one risk factor was found for bilateral breast cancer after 1 year of the first primary, family history of breast cancer.
1946年至1976年间，不列颠哥伦比亚省温哥华市的A. 麦克斯韦·埃文斯诊所（AMEC）在乳腺癌诊断后的一年内接诊了9000多名乳腺癌患者。到1978年，有275人随后被诊断出对侧乳房出现第二原发性肿瘤：100人在第一原发性肿瘤诊断后的1年内被诊断出，175人在第一原发性肿瘤诊断1年后被诊断出。选择了两组不同的AMEC单侧乳腺癌患者作为对照，以确定双侧乳腺癌的风险因素并计算发病率。对于首次诊断为原发性乳腺癌时年龄小于45岁、45 - 54岁和55岁以上的女性，对侧乳房出现第二原发性肿瘤的年均发病率分别为每1000名女性5.0、4.1和3.0例。这些发病率在首次原发性肿瘤诊断后至少15年内保持稳定。在第一原发性肿瘤诊断后的1年内发现了双侧癌症的两个风险因素，即小叶癌的组织学诊断和腋窝淋巴结无病理累及；在第一原发性肿瘤诊断1年后发现了双侧乳腺癌的一个风险因素，即乳腺癌家族史。
