CONTRALATERAL BREAST-CANCER - ANNUAL INCIDENCE AND RISK PARAMETERS
CONTRALATERAL BREAST-CANCER - ANNUAL INCIDENCE AND RISK PARAMETERS
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DOI：
10.1200/jco.1995.13.7.1578
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发表时间：
1995-07-01
影响因子：
45.3
通讯作者：
ASSELAIN, B
中科院分区：
文献类型：
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作者：
BROET, P;DELAROCHEFORDIERE, A;ASSELAIN, B
目的：筛选可能预测异时性对侧乳腺癌(CBC)发生风险的因素，考虑局部或远处复发的影响，并评估CBC的年发病率。患者和方法：在1981-1987年间收治的4748例临床I期至IIIa期的浸润性单侧乳腺癌患者中，282例确诊为异时性CBC，由于CBC的发生与其他事件之间存在竞争风险，因此进行了多因素分析。结果：中位随访时间为80个月(范围1-158个月)。5年CBC累计发病率为4.1%+/-0.3%，年发病率缓慢上升，而第4年后局部复发和转移的风险降低，无论我们选择哪种模型，首次诊断时年龄小于55岁(相对风险[RR]=1.40)，以及存在小叶型癌(RR=1.50)，都与对侧乳腺肿瘤的发生风险增加相关。结论：小叶组织学和年龄小于55岁是CBC的危险因素，而辅助化疗显著降低了CBC的风险。CBC的年发病率呈递增趋势，而第一癌的临床预后因素与CBC之间缺乏联系，提示CBC可被认为是第二原发癌。
Purpose: To screen for factors that might predict the risk of developing metachronous contralateral breast cancer (CBC), taking into account the influence of local or distant recurrence, and to assess the annual incidence of CBC.Patients and Methods: Of 4,748 women with invasive unilateral breast cancer, clinical stage I to IIIa, treated between 1981 and 1987, 282 metachronous CBCs were diagnosed, Due to competing risks between the occurrence of CBC and other events, several options for multivariate analysis were considered.Results: The median follow-up rime was 80 months (range, 1 to 158). The cumulative rate of CBC was 4.1% +/- 0.3% at 5 years, and the annual incidence rate of CBC increased slowly, while the risk of local recurrence and metastases decreased after the fourth year, Whichever model we chose, age less than 55 years (relative risk [RR] = 1.40) at the time of diagnosis of the first breast cancer, as well as the presence of lobular type carcinoma (RR = 1.50), was associated with an increased risk of developing a tumor in the contrallateral breast. Adjuvant chemotherapy significantly decreased (RR = 0.54) the risk of CBC.Conclusion: Lobular histology and age less than 55 years are found to increase the risk of CBC, while adjuvant chemotherapy significantly decreased the risk of CBC. The progressive rise in the annual incidence rates of CBC, together with the absence of a link between clinical prognostic factors of the first cancer and CBC, suggested that CBC can be considered os a second primary breast cancer.