| Objective:To analyze the clinical characteristics, treatments and prognosis influencing factors of patients with bilateral primary breast cancer(BPBC).Methods:Collect32cases of bilateral primary breast cancer (according to the latest diagnosis standard) in Shan Dong Provincial Hospital affiliated to Shandong University from January2005to March2013. Select100cases of unilateral primary breast cancer randomly in Shan Dong Provincial Hospital affiliated to Shandong University from January2005to December2005. All the patients received operations, and some of them received other therapies including chemotherapies, radiotherapies, endocrine therapies and traditional Chinese medicine therapies. Review literatures related to BPBC. Analyze the characters of bilateral primary breast cancer in etiology, pathology, treatments and prognosis. Compare with patients with unilateral breast cancer. Divide the32cases of bilateral primary breast cancer into two groups (synchronous BPBC and heterochronous BPBC) according to the onset time and compare the prognosis. Inspection level a=0.05.Results:All the32cases of the bilateral primary breast cancer and the100cases of unilateral primary breast cancer can meet the latest diagnosis standard. Patients (average42.6) with BPBC are younger than those (average47.2) with UPMC when they are diagnosed and their menarches come earlier and end later. The rate of BPMC patients with a family history (15.6%) is higher than that of UPMC patients (6.0%). The positive rate of lymph node in axillary31.3%、52.4%、73.7%when the first tumor is T1、 T2、T3in bilateral primary breast cancer; while The positive rate of lymph node in axillary31.0%、52.0%、73.0%when the tumor is T1、T2、T3in unilateral breast cancer. The difference is obvious (P<0.05). The average time of BPMC patients who have born babies is smaller than that of UPBC patients. The difference in abortion and alcohol abuse between BPMC and UPMC patients is not obvious. The average BMI of BPBC patients is29.6while the average BMI of UBC patients is26.4. The difference is obvious. There are28.1%people over-weighed in the patients with BPBC while there are only25.0%people over-weighed in the patients with UBC. There are77.8%patients with synchronous BPBC whose positions of the two tumors are symmetrical, while there are only43.5%patients with heterochronic BPBC whose positions of the two tumors are symmetrical, and the difference is obvious (P<0.05). The positive rate of ER, PR in BPMC patients is higher than that of UPMC patients. And the positive rate of HER-2in BPMC patients is higher than that of UPMC patients. There is no obvious difference in the expressing rate of Ki-67in those two groups. Five-year survival rate of BPMC patients is lower than that of UPMC patients.Conclusion:(1) Patients with BPBC have lower age at onset, earlier menarche and later menopaushan those with UPBC.(2) The positive rate of family history in BPBC patients is obviously higher than that in UPBC patients. That means patients with BPBC may have a familial and genetic tendency.(3) There is no significant difference in homolateral axillary lymph node metastasis rate between Patients with BPBC and Patients with UPBC. (4) It is a risk factor of BPBC that the delivering time is too little. Obesity and over nutrition are also risk factors of BPBC.(5) Abortion, alcohol dependence and radiotherapy are not directly related to bilateral breast cancer.(6) The second tumor of synchronous BPBC tends to grow in the mirror-image position.(7) The positive rate of ER, PR and HER-2is higher in BPBC patients. While the positive rate of Ki-67has no difference.(8) The prognosis of bilateral primary breast cancer is worse. But the conclusion depends on the diagnosis standard of BPBC and the starting time of five-year survival rate. |
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