Mueller C B, Ames F
Can J Surg. 1978 Sep;21(5):459-65.
Of 3558 women with cancer of the breast, 129 were found to have bilateral primary cancers. In approximately one quarter (33) of these women the two cancers developed synchronously; in the remainder (96) the second cancer developed metachronously, more than 6 months after the appearance of the first primary tumour. In two thirds (64) of the women in the latter group the second cancer made its appearance within 4 years after the first was detected. The 15-year survival curve for the 129 patients shows a 50% mortality at approximately 10 years, slightly better than that for the total group of 3558. At the time of our study (April 1975) 70 were alive and 59 were dead; 53 died as a result of their breast cancer and 6 from other causes. Only 3 of the 48 women in whom the first cancer developed before the age of 70 years died of causes other than breast cancer, giving a mortality due to breast cancer of 90%. The clinical stage, the recorded histopathology, the type of operation and the duration of time at risk after the first diagnosis did not differ significantly between those who lived and those who died. The authors conclude that age, stage or type of growth, operative therapy or time at risk do not determine the time of death or alter the 90% certainty that death will be due to carcinoma of the breast.
在3558例乳腺癌女性患者中，发现129例患有双侧原发性癌症。在这些女性患者中，约四分之一（33例）的双侧癌症是同时发生的；其余（96例）的第二处癌症是异时发生的，在第一处原发性肿瘤出现6个月以后。在后一组患者中，三分之二（64例）的第二处癌症在第一处被发现后的4年内出现。129例患者的15年生存曲线显示，大约在10年时死亡率为50%，略优于3558例患者的总体情况。在我们的研究期间（1975年4月），70例存活，59例死亡；53例死于乳腺癌，6例死于其他原因。在48例第一处癌症发生在70岁之前的女性患者中，只有3例死于乳腺癌以外的原因，乳腺癌导致的死亡率为90%。存活者和死亡者在临床分期、记录的组织病理学、手术类型以及首次诊断后的风险持续时间方面没有显著差异。作者得出结论，年龄、生长阶段或类型、手术治疗或风险持续时间并不能决定死亡时间，也不能改变死亡将由乳腺癌导致的90%的确定性。
