Carty N J, Foggitt A, Hamilton C R, Royle G T, Taylor I
Breast Unit, Royal South Hants Hospital, Southampton, UK.
Eur J Surg Oncol. 1995 Dec;21(6):607-8. doi: 10.1016/s0748-7983(95)95176-8.
Many patients diagnosed with breast cancer will develop metastases and these have diverse presentations. We have reviewed 100 consecutive patients who have died with metastatic breast cancer, to determine the frequency, sites and mode of presentation of recurrent disease. The commonest site of failure was loco-regional (n = 61), this usually presented with a mass, but a minority of patients also complained of pain. Bone metastases developed in 60 patients and produced bone pain, pathological fracture (n = 6) or cord compression (n = 5). Pulmonary metastases producing shortness of breath were diagnosed in 34 patients and were asymptomatic in a further 10. Intra-abdominal metastases were found at some time in 23 patients, most commonly in the liver (n = 20) and the majority complained of epigastric pain (n = 17). Brain metastases occurred in 23 patients and produced a wide range of symptoms including those of a space-occupying lesion (n = 10), cranial nerve palsy (n = 7), diabetes insipidus (n = 3), focal limb weakness (n = 2) and meningitis (n = 1). Three patients had choroid metastases producing reduced visual acuity. Recurrent breast carcinoma can present in a variety of ways, therefore any new symptom or sign should be considered to represent recurrence until proved otherwise.
许多被诊断为乳腺癌的患者会发生转移，且转移表现多样。我们回顾了100例死于转移性乳腺癌的连续病例，以确定复发性疾病的发生频率、部位及表现方式。最常见的复发部位是局部区域（n = 61），通常表现为肿块，但少数患者也诉说有疼痛。60例患者发生骨转移，出现骨痛、病理性骨折（n = 6）或脊髓压迫（n = 5）。34例患者被诊断为肺转移导致气短，另有10例无症状。23例患者在某些时候发现有腹腔内转移，最常见于肝脏（n = 20），大多数患者诉说有上腹部疼痛（n = 17）。23例患者发生脑转移，产生多种症状，包括占位性病变症状（n = 10）、颅神经麻痹（n = 7）、尿崩症（n = 3）、局灶性肢体无力（n = 2）和脑膜炎（n = 1）。3例患者有脉络膜转移导致视力下降。复发性乳腺癌可表现为多种形式，因此在未得到其他证实之前，任何新的症状或体征都应被视为代表复发。
