文章：

所有同步性双侧乳腺癌患者是否都需要进行转移性分期？

Is Metastatic Staging Needed for All Patients with Synchronous Bilateral Breast Cancers?

原文发布日期：19 December 2023

DOI: 10.3390/cancers16010017

类型: Article

开放获取: 是

英文摘要：

Background: Patients with bilateral breast cancers are uncommon and are associated with a poorer prognosis. While metastatic staging guidelines in patients with unilateral cancer were established, the indication of metastatic staging in patients with bilateral breast cancers is unclear. We aimed to determine which patients with synchronous bilateral breast cancers require metastatic staging at diagnosis. This is the first such reported study, to the best of our knowledge. Methods: A retrospective review of newly diagnosed synchronous bilateral invasive breast cancer patients at our institution was performed. We excluded patients with malignant phyllodes or no metastatic staging. Patients’ demographics and pathological and staging results were analysed to determine the group of bilateral breast cancer patients who required metastatic staging. Results: A total of 92 patients with synchronous bilateral invasive cancers were included. The mean age was 58 years old, and 64.1% had bilateral invasive ductal carcinoma. 23.9% had systemic metastasis. Nodal status was statistically significant for systemic metastasis on staging (p= 0.0081), with only three patients (3.3%) having negative nodal status and positive metastatic staging. These three patients, however, showed symptoms of distant metastasis. 92.3% of patients with negative nodes also had negative metastatic staging. Using negative nodal status as a guide avoided metastatic staging in 40.4% of all patients. Conclusions: Negative nodal status was the most predictive factor for no systemic metastasis on staging in patients with synchronous bilateral invasive breast cancers. Hence, metastatic staging could be reserved for patients with symptoms of systemic metastasis and/or metastatic nodes. This finding could be validated in larger studies.

摘要翻译： 

背景：双侧乳腺癌患者较为罕见，且预后较差。虽然单侧乳腺癌患者的转移分期指南已确立，但双侧乳腺癌患者转移分期的指征尚不明确。本研究旨在确定哪些同步性双侧乳腺癌患者在诊断时需要接受转移分期检查。据我们所知，这是首次报道此类研究。 方法：我们对本机构新诊断的同步性双侧浸润性乳腺癌患者进行了回顾性分析。排除恶性叶状肿瘤患者及未接受转移分期的患者。通过分析患者的人口统计学特征、病理学及分期结果，确定需要接受转移分期的双侧乳腺癌患者群体。 结果：共纳入92例同步性双侧浸润性乳腺癌患者。平均年龄58岁，64.1%为双侧浸润性导管癌。23.9%存在全身转移。淋巴结状态与分期中的全身转移具有统计学显著性（p=0.0081），仅3例患者（3.3%）淋巴结阴性但转移分期阳性，且这3例患者均表现出远处转移症状。92.3%的淋巴结阴性患者转移分期亦为阴性。以淋巴结阴性作为指导标准，可使40.4%的患者避免接受转移分期检查。 结论：在同步性双侧浸润性乳腺癌患者中，淋巴结阴性是预测分期无全身转移的最重要因素。因此，转移分期检查可仅限于出现全身转移症状和/或淋巴结转移的患者。这一发现有待更大规模研究验证。

原文链接：

Is Metastatic Staging Needed for All Patients with Synchronous Bilateral Breast Cancers?