外科理论与实践

外科理论与实践 >

2026 , Vol. 31 >Issue 03: 243 - 249

DOI: https://doi.org/10.16139/j.1007-9610.2026.03.10

论著

同时性双侧乳腺癌的临床病理特征及预后分析

  • 陈园园 ,
  • 王杰 ,
  • 陈方
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  • 1 上海交通大学医学院附属国际和平妇幼保健院乳腺科， 上海市胚胎源性疾病重点实验室， 上海 200030
    2 上海交通大学医学院苏州九龙医院医学影像科， 江苏 苏州 215028
作者贡献/Authors’ contributions

陈园园负责数据申请、图表制作、文章撰写和修改；王杰负责指导、审校、提供意见；陈方负责整理数据、审校、修改文章。所有作者均阅读并确认最终稿。

王杰，E-mail: jiewang76@hotmail.com;
陈方，E-mail: 1129634501@qq.com

收稿日期: 2024-11-20

  网络出版日期: 2026-03-02

基金资助

国际和平妇幼保健院院级课题(YN201905)

收起

Clinicopathological characteristics and prognosis of synchronous bilateral breast cancer

  • CHEN Yuanyuan ,
  • WANG Jie ,
  • CHEN Fang
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  • 1 Department of Breast, the International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Embryo Original Diseases, Shanghai 200030, China
    2 Department of Medical Imaging, Suzhou Jiulong Hospital, Shanghai Jiao Tong University School of Medicine, Jiangsu Suzhou 215028, China

Received date: 2024-11-20

  Online published: 2026-03-02

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摘要

目的：基于上海交通大学乳腺癌数据库分析原发的同时性双侧乳腺癌（SBBC）的临床病理特征，探究SBBC的预后因素。方法：回顾性分析2009年1月至2022年6月上海交通大学乳腺癌数据库内可手术SBBC病人的临床病理特征、治疗方案和生存信息。采用COX回归分析评估无病生存（DFS）和无乳腺癌间期（BCFI）的影响因素。结果：共纳入322例SBBC病人。第一癌的肿瘤直径>2.0 cm、淋巴结转移及Ki-67高表达的比例较第二癌高（均P<0.05），第一癌的孕激素受体（PR）阳性率较第二癌低（P<0.05）。两侧乳房的手术方式具有中度一致性，Kappa值为0.548。双侧浸润性癌与单侧浸润性癌的DFS及BCFI差异无统计学意义（均P<0.05）。多因素分析显示，双侧PR阴性是DFS预后的独立危险因素（P<0.05），乳腺癌家族史、双侧LN 1~3、双侧PR阴性是BCFI预后的危险因素（P<0.05）。结论：双侧PR阴性的SBBC预后差，需密切随访。

关键词： 双侧原发性乳腺癌; 同时性; 生存分析

本文引用格式

陈园园 , 王杰 , 陈方 . 同时性双侧乳腺癌的临床病理特征及预后分析[J]. 外科理论与实践, 2026 , 31(03) : 243 -249 . DOI: 10.16139/j.1007-9610.2026.03.10

Abstract

Objective To analyze the clinicopathological characteristics and prognosis of primary synchronous bilateral breast cancer (SBBC) based on Shanghai Jiao Tong University Breast Cancer Database, and to explore risk factors of prognosis. Methods This retrospective study enrolled operable SBBC patients from Shanghai Jiao Tong University Breast Cancer Database (January 2009 to June 2022) to assess clinicopathological characteristics, treatments, and survival outcomes. COX proportional hazards regression analysis was used to evaluate the factors influencing prognosis of disease-free survival (DFS) and breast cancer free interval (BCFI). Results A total of 322 cases with SBBC were included. In the first tumor, there were more cases who had tumors with a diameter greater than 2.0 cm, lymph node metastasis, and high Ki-67 index, compared with the second tumor (All P<0.05). And the proportion of progesterone receptor (PR) positivity in the first tumor was lower (P<0.05). The surgical approaches for both breasts showed moderate consistency, with Kappa value of 0.548. There were no significant differences in DFS and BCFI between the cases with bilateral invasive carcinoma and unilateral invasive carcinoma(both P>0.05). Multivariate analysis showed that bilateral lesions with PR negativity was an independent prognostic risk factor associated with DFS (P<0.05) while family history of breast cancer, bilateral lesions with LN 1-3, and bilateral lesions with PR negativity are prognostic risk factors associated with BCFI (P<0.05). Conclusions SBBC patients with PR negativity of bilateral lesions have a poor prognosis, and required close follow-up.

Key words： Bilateral primary breast cancer(BPBC); Synchronous; Survival analysis

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