Bilateral primary breast cancers. A prospective clinicopathological study
Bilateral primary breast cancers. A prospective clinicopathological study
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双侧原发性乳腺癌。
DOI：
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发表时间：
1964
期刊：
影响因子：
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通讯作者：
J. Berg
中科院分区：
文献类型：
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作者：
G. Robbins;J. Berg
一项前瞻性的20年研究双侧乳腺癌的发生提出。在1940-1943年在纽约纪念医院接受治疗的1458名患者中，随访证实91名患者双乳原发癌。发病率平均为每年每1000名高危患者中有7名患者。据认为，总体频率可能比记录的要高。第一次乳房切除术时年龄小于50岁的女性患乳腺癌的风险是60岁以上女性的两倍。在一般女性人群中，患第二种癌症的总体风险是患乳腺癌的5倍。50岁以下的女性是正常的10倍，但70岁以后不到正常的2倍。第一次癌症存活的妇女（5年生存率）目前还活着，平均预期寿命再延长15年。对许多人来说，这个故事只讲了一半，但随着年龄的增长，这种风险往往会降低。每有8人死于第一种癌症，或每3人死于其他原因，就有1人患第二种乳腺癌。尽管第一次癌症复发和其他原因导致死亡，但在最初的系列中，大约十分之一的人会受到影响。发病率最高的是第一个乳房有多个癌症的患者。当第一次肿瘤为低级别导管癌时，第二次肿瘤的发生率最低。以粉刺癌或胶体癌为首发肿瘤时发病率最高。混合模式包括混合等级是常见的。双侧肿瘤转移的患者。第二种癌症的转移较少。它们在类型上往往与第一次癌症相似。观察到20年生存率为27%。尽管进行了所有的随访，但66%的第二种癌症在切除时并不早。第二种癌症与第一种癌症的复发相结合，几乎使预期的生存时间减半。第一次癌症的早期诊断和抢救取得的成果越多，第二次癌症就越重要。第一次乳房切除术后的最初几年是第二种癌症出现的主要时间。
A prospecitve 20-year study on the occurrence of bilateral breast ca ncer is presented. Among 1458 patients treated at Memorial Hospital New York 1940-1943 follow-up has proved a primary cancer in both breasts in 91. Incidence has averaged 7 patients per year per 1000 patients at risk. It is thought that overall frequency may have been greater than recorded. Women less than 50 years of age at the time of first mastectomy had about twice the risk as women who were over 60. The overall risk of a second cancer is 5 times greater than that of breast cancer in the general female population. It is 10 times normal for women less than age 50 but under 2 times normal after age 70. Women who have survived their first cancer (5-year survival) and are presently alive have an average life expectancy of another 15 years. The story for many is only half told but the risk tends to decrease with age. There has been development of a second breast cancer for each 8 deaths from the first cancer or 1 for each 3 deaths from other causes. About 1 in every 10 in the original series will be affected despite deaths fro m recurrence of the first cancer and other causes. The highest incidenc e was found among patients who had multiple cancers in the first breast. When the first tumors were low-grade duct cancers incidence of second cancers was least. When first tumors were comedocarcinomas or colloid carcinomas incidence was highest. Mixed patterns including mixed grades were common. Patients with metastases at bilateral cancers to develop. Second cancers had fewer metastases. They tended to resemble first cancers in type. The observed 20-year survival rate was 27%. Despite all the follow-up efforts 66% of the second cancers were not early when removed. Second cancers acting in conjuction with recurrence of the first cancer almost halved the survival expected. The greater the gains in early diagnosis and salvage from first cancers the more important become the second ones. The early years after the first mastectomy are the primary time for second cancers to appear.