Mose S, Adamietz I A, Thilmann C, Saran F, Pahnke R, Böttcher H D
Abteilung für Strahlentherapie und Onkologie, Johann-Wolfgang-Goethe-Universität, Frankfurt am Main.
Strahlenther Onkol. 1995 Apr;171(4):207-13.
A review of published data does not provide a certainty whether survival rates are comparable or worse in women with bilateral breast cancer versus patients with an unilateral tumor. Therefore results of therapy in one-sided and both-sided breast cancer were retrospectively analysed.
In a period from 1977 to 1982 (follow-up 5 to 12 years) 531 breast cancer patients with T1-4 N0-3 M0 tumors were treated with mastectomy (n = 416) and breast conserving therapy (n = 115). Postoperative radiotherapy was performed in all patients (50 Gy, 2 Gy/day 5 times/weekly; chest wall/breast and regional lymph nodes). Patients with positive lymph nodes received chemotherapy. Forty patients developed bilateral breast cancer (simultaneous n = 10, metachronous n = 30) that was treated by mastectomy (n = 28) and conservative surgery (n = 12), respectively, followed by radiotherapy in 26 women.
Five- and 10-year survival was 74% and 56% in unilateral affected women. In 83% and 67% there were no metastases, respectively. Incidence of metastases was 27.9%. In bilateral breast cancer group survival rates were 85% and 59% and without evidence of metastases 87% and 60%, respectively. Distant disease was diagnosed in 35%. Differences between the 2 groups were statistically not significant. Whereas in time of follow-up 11% of unilateral cancer locally failed in bilateral cancer patients recurrences of the first and second tumor were seen in 20% and 10%, respectively.
Survival of patients with bilateral breast cancer is not significantly decreased compared with unilateral disease although in patients with both-sided carcinoma local recurrences and metastases seem to occur more frequently.
对已发表数据的回顾无法确定双侧乳腺癌女性患者的生存率与单侧肿瘤患者相比是相当还是更差。因此，对单侧和双侧乳腺癌的治疗结果进行了回顾性分析。
在1977年至1982年期间（随访5至12年），531例T1 - 4 N0 - 3 M0肿瘤的乳腺癌患者接受了乳房切除术（n = 416）和保乳治疗（n = 115）。所有患者均接受术后放疗（50 Gy，2 Gy/天，每周5次；胸壁/乳房及区域淋巴结）。淋巴结阳性的患者接受化疗。40例患者发生双侧乳腺癌（同时性n = 10，异时性n = 30），分别接受了乳房切除术（n = 28）和保守手术（n = 12），随后26例女性接受了放疗。
单侧患病女性的5年和10年生存率分别为74%和56%。分别有83%和67%的患者无转移。转移发生率为27.9%。在双侧乳腺癌组中，生存率分别为85%和59%，无转移证据的比例分别为87%和60%。远处疾病的诊断率为35%。两组之间的差异无统计学意义。在随访期间，单侧癌症局部复发率为11%，而双侧癌症患者中，第一和第二个肿瘤的复发率分别为20%和10%。
双侧乳腺癌患者的生存率与单侧疾病相比没有显著降低，尽管双侧癌患者局部复发和转移似乎更频繁发生。
