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目的 :探讨双侧原发性乳腺癌临床特点及诊治。方法 :回顾性分析 1985年 11月～ 2 0 0 0年 1月行乳腺癌根治性手术 6 5 5例中双侧原发性乳腺癌 (bilateralprimarybreastcancer,BPBC) 10例的临床资料。结果 :BPBC较单侧乳腺癌发病年龄明显提前。BPBC绝经前较绝经后发病率高。BPBC好发部位多集中于腺体丰富区域和导管集中部位 ,即乳房外上象限及乳晕区域最常见。同时性癌及异时性癌的首发癌以Ⅱ、Ⅲ期较多。首发癌及时正确的治疗是影响BPBC预后的重要因素。BPBC病灶大小、腋淋巴转移数目及水平均影响预后。同时性BPBC发病较少 ,预后较差 ;异时性BPBC多见 ,预后较好。结论 :BPBC较单侧癌预后差 ,对单侧癌术前要常规做联合诊断检查 ,术后严密随访 ,要特别注意检查对侧乳腺。对高危病人有可疑病变要及时切除活检 ,以利于早期发现及时治疗。无腋淋巴转移也是发生BPBC的危险因素
Objective: To investigate the clinical features and diagnosis and treatment of bilateral primary breast cancer. Methods: The clinical data of 10 cases of bilateral primary breast cancer (BPBC) in 655 cases of radical mastectomy for breast cancer from November 1985 to January 2000 were retrospectively analyzed. Results: The incidence of BPBC was significantly earlier than that of unilateral breast cancer. BPBC premenopausal menopausal than the high incidence. BPBC predilection sites are more concentrated in the glandular rich region and catheter focus, that is, the upper quadrant and the areola area most common. At the same time, the first cancer of cancer and metachronous cancer in Ⅱ, Ⅲ more. The timely and correct treatment of the first cancer is an important factor affecting the prognosis of BPBC. The size of BPBC, the number and level of axillary lymph node metastasis affect the prognosis. Concurrent BPBC less incidence, poor prognosis; allogeneic BPBC more common, the prognosis is better. Conclusion: The prognosis of BPBC is worse than that of unilateral carcinoma. Unilateral diagnosis of unilateral carcinoma should be done routinely before operation and close follow-up after operation. Special attention should be paid to the contralateral breast. Suspected lesions of high-risk patients to promptly removed biopsy, in order to facilitate the early detection of timely treatment. No axillary lymph node metastasis is also a risk factor for the occurrence of BPBC