Hagemeister F B, Buzdar A U, Luna M A, Blumenschein G R
Cancer. 1980 Jul 1;46(1):162-7. doi: 10.1002/1097-0142(19800701)46:1<162::aid-cncr2820460127>3.0.co;2-b.
Between January 1973 and October 1977, 166 patients who died of breast cancer were autopsied. The examination revealed consistently more tumor involvement than had been clinically suspected. Unsuspected areas of tumor involvement included the endocrine organs (40%), lungs (28%), cardiovascular system (21%), and the genitourinary system (21%). The error in diagnosis was smaller with metastasis to the bones (10%) and central nervous system (14%). The major causes of death included pulmonary insufficiency (26%), infection (24%), cardiac disease (15%), hepatic insufficiency (14%), hemorrhage (9%), central nervous system disease (9%), and hypercalcemia (3%). The most common cause of death was metastatic disease to various organs, accounting for 42% of all deaths. Infection was the second most common cause of death; however, only 27% of the patients with infection had significant neutropenia. In patients dying of hemorrhage, only 9% were thrombocytopenic. In conclusion, although many clinicians have expressed concern that chemotherapy would add to early mortality in cancer, our study shows that this is not the case for patients with breast cancer. Deaths due to chemotherapy were rare and the rise in the infection rate did not correlate with the advent of chemotherapy.
1973年1月至1977年10月期间，对166例死于乳腺癌的患者进行了尸检。检查发现肿瘤累及范围始终比临床怀疑的要多。未被怀疑的肿瘤累及部位包括内分泌器官（40%）、肺（28%）、心血管系统（21%）和泌尿生殖系统（21%）。骨转移（10%）和中枢神经系统转移（14%）时诊断误差较小。主要死亡原因包括肺功能不全（26%）、感染（24%）、心脏病（15%）、肝功能不全（14%）、出血（9%）、中枢神经系统疾病（9%）和高钙血症（3%）。最常见的死亡原因是各器官的转移性疾病，占所有死亡人数的42%。感染是第二常见的死亡原因；然而，只有27%的感染患者有明显的中性粒细胞减少。在死于出血的患者中，只有9%有血小板减少。总之，尽管许多临床医生担心化疗会增加癌症患者的早期死亡率，但我们的研究表明乳腺癌患者并非如此。化疗导致的死亡很少见，感染率的上升与化疗的出现无关。
