Breast carcinoma in patients with dermatomyositis: a retrospective analysis of eight cases.
Breast carcinoma in patients with dermatomyositis: a retrospective analysis of eight cases.
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发表时间：
2002-06
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通讯作者：
C. Yeh;Shin-Cheh Chen;T. Hwang;Miin‐Fu Chen;C. Liaw;H. Chan
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作者：
C. Yeh;Shin-Cheh Chen;T. Hwang;Miin‐Fu Chen;C. Liaw;H. Chan
背景皮肌炎与乳腺癌之间的关系尚未得到充分评价。这项研究的目的是阐明这两种疾病之间的关联特征。方法回顾性分析1990 ~ 1998年我院收治的128例皮肌炎或多发性肌炎患者的临床资料。8名患者（6.3%）被确定为皮肌炎，并伴有潜在的乳腺癌。评估这些患者的临床特征、实验室数据、肌电图、肌肉活检和预后。结果8例乳腺癌合并皮肌炎患者的平均年龄（62.1 +/- 6.7岁）大于不伴有皮肌炎的乳腺癌患者（48.5 +/- 11.8岁）。皮肌炎伴发乳腺癌2例，并发乳腺癌5例，伴发乳腺癌1例。这8例患者中，4例为TNM分期IV期（M1）乳腺癌，1例为IIIA （T2N2M0）乳腺癌，3例为IIB （T2N1M0）乳腺癌。随访时间为2 ~ 79个月（中位21个月）。5例患者因复发或远处转移死亡，其余3例患者无病生存，随访时间11 ~ 28个月，中位20个月。5例患者中有4例在乳腺癌手术治疗后皮肌炎有平行改善。结论在台湾，皮肌炎与乳癌的发生率增加有关。8例乳腺癌合并皮肌炎患者的平均年龄明显大于无皮肌炎的乳腺癌患者。如果存在，乳腺癌可以在皮肌炎的诊断之前，同时发生，或之后。乳腺癌的手术治疗可以缓解皮肌炎的病程，在某些情况下可以消除对类固醇的需要。
BACKGROUND The association between dermatomyositis and breast carcinoma has not been fully evaluated yet. The aim of the study was to clarify characteristics of the association between these two diseases. METHODS The medical records of 128 patients with dermatomyositis or polymyositis from 1990 to 1998 were retrospectively reviewed. Eight patients (6.3%) were identified with dermatomyositis which was associated with an underlying breast carcinoma. Clinical features, laboratory data, electromyograms, muscle biopsies, and the prognoses of these patients were assessed. RESULTS The mean age of the 8 patients with breast carcinoma and dermatomyositis (62.1 +/- 6.7 years) was larger than that of patients with breast carcinoma without dermatomyositis (48.5 +/- 11.8 years). Dermatomyositis preceded breast carcinoma in 2 patients, was concurrent with breast carcinoma in 5 patients, and followed breast carcinoma in 1 patient. Of these 8 patients, 4 had TNM classification stage IV (M1) breast cancer, 1 had IIIA (T2N2M0) breast cancer, and 3 had IIB (T2N1M0) breast cancer. The follow-up period ranged from 2 to 79 (median, 21) months. Five patients died of recurrence or distant metastasis, and the remaining 3 patients had disease-free survival, with a follow-up period ranging from 11 to 28 (median, 20) months. Four of 5 patients had parallel improvement in dermatomyositis after surgical treatment of breast carcinoma. CONCLUSION In Taiwan, dermatomyositis is associated with an increased incidence of breast carcinoma. The mean age of the 8 patients with breast carcinoma and dermatomyositis was significantly larger than that of patients with breast carcinoma without dermatomyositis. If present, breast carcinoma can precede, occur concurrently with, or follow the diagnosis of dermatomyositis. Surgical treatment of breast carcinoma may alleviate the course of dermatomyositis and eliminate the need for steroids in some cases.