Evaluation of 19 Cases of Bilateral Breast Cancer
Long-term survival cases after unilateral mastectomy for breast cancer are increasing as a result of improvement in both diagnosis and treatment. Under those circumstances, bilateral breast cancer (BLBC) is encountered frequently. The knowledge concerning BLBC may be important to follow up the patie...
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Published in | Japanese Journal of National Medical Services Vol. 42; no. 5; pp. 432 - 436 |
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Main Authors | , , |
Format | Journal Article |
Language | Japanese |
Published |
Japanese Society of National Medical Services
1988
一般社団法人 国立医療学会 |
Subjects | |
Online Access | Get full text |
ISSN | 0021-1699 1884-8729 |
DOI | 10.11261/iryo1946.42.432 |
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Abstract | Long-term survival cases after unilateral mastectomy for breast cancer are increasing as a result of improvement in both diagnosis and treatment. Under those circumstances, bilateral breast cancer (BLBC) is encountered frequently. The knowledge concerning BLBC may be important to follow up the patients who had already undergone unilateral mastectomy. Therefore, we evaluated clinically the risk factors and diagnostic problems of patients who had to have a second mastectomy after their initial mastectomy. Nineteen cases of BLBC which were operated on at Sagamihara National Hospital from 1959 through 1986 were studied. The patients were separated in two groups: 13 cases of primary BLBC (p-BLBC), and 6 of metastatic (m-BLBC). Their age at time of first mastectomy was found to be a factor of high risk; the younger the age of patients with unilateral breast cancer was, the higher the incidence of BLBC was. A family history of cancer and past history of abortion and interrupted pregnancies were of higher frequency in BLBC patients. The cellular immunoactivity of some breast cancer patients was low, but cellular immunoactivity was individually different. Most of the patients with BLBC noticed the second tumor. But, about half of the tumor were not detected by mammography. Thus, we conclude that the occurrence of a second breast cancer after a unilateral mastectomy may be related with some factors of patient's hormonal conditions, heredity and survival over a long period of time. These results were almost in agree with the experiences of other investigators. But, the relationship between an occurrence of a second breast cancer and the patient's immunoactivity remains unclear. Self-examination should be regulary performed over a long period of time by patients undergoing first mastectomy, and a biopsy should be immediately done if a occurrence of second breast cancer is suspected. |
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AbstractList | Long-term survival cases after unilateral mastectomy for breast cancer are increasing as a result of improvement in both diagnosis and treatment. Under those circumstances, bilateral breast cancer (BLBC) is encountered frequently. The knowledge concerning BLBC may be important to follow up the patients who had already undergone unilateral mastectomy. Therefore, we evaluated clinically the risk factors and diagnostic problems of patients who had to have a second mastectomy after their initial mastectomy. Nineteen cases of BLBC which were operated on at Sagamihara National Hospital from 1959 through 1986 were studied. The patients were separated in two groups: 13 cases of primary BLBC (p-BLBC), and 6 of metastatic (m-BLBC). Their age at time of first mastectomy was found to be a factor of high risk; the younger the age of patients with unilateral breast cancer was, the higher the incidence of BLBC was. A family history of cancer and past history of abortion and interrupted pregnancies were of higher frequency in BLBC patients. The cellular immunoactivity of some breast cancer patients was low, but cellular immunoactivity was individually different. Most of the patients with BLBC noticed the second tumor. But, about half of the tumor were not detected by mammography. Thus, we conclude that the occurrence of a second breast cancer after a unilateral mastectomy may be related with some factors of patient's hormonal conditions, heredity and survival over a long period of time. These results were almost in agree with the experiences of other investigators. But, the relationship between an occurrence of a second breast cancer and the patient's immunoactivity remains unclear. Self-examination should be regulary performed over a long period of time by patients undergoing first mastectomy, and a biopsy should be immediately done if a occurrence of second breast cancer is suspected. Long-term survival cases after unilateral mastectomy for breast cancer are increasing as a result of improvement in both diagnosis and treatment. Under those circumstances, bilateral breast cancer (BLBC) is encountered frequently. The knowledge concerning BLBC may be important to follow up the patients who had already undergone unilateral mastectomy. Therefore, we evaluated clinically the risk factors and diagnostic problems of patients who had to have a second mastectomy after their initial mastectomy.Nineteen cases of BLBC which were operated on at Sagamihara National Hospital from 1959 through 1986 were studied. The patients were separated in two groups: 13 cases of primary BLBC (p-BLBC), and 6 of metastatic (m-BLBC). Their age at time of first mastectomy was found to be a factor of high risk; the younger the age of patients with unilateral breast cancer was, the higher the incidence of BLBC was. A family history of cancer and past history of abortion and interrupted pregnancies were of higher frequency in BLBC patients. The cellular immunoactivity of some breast cancer patients was low, but cellular immunoactivity was individually different. Most of the patients with BLBC noticed the second tumor. But, about half of the tumor were not detected by mammography.Thus, we conclude that the occurrence of a second breast cancer after a unilateral mastectomy may be related with some factors of patient's hormonal conditions, heredity and survival over a long period of time. These results were almost in agree with the experiences of other investigators. But, the relationship between an occurrence of a second breast cancer and the patient's immunoactivity remains unclear. Self-examination should be regulary performed over a long period of time by patients undergoing first mastectomy, and a biopsy should be immediately done if a occurrence of second breast cancer is suspected. 乳癌の診断・治療法の進歩に伴い, 乳癌術後長期生存例が増加し, 両側乳癌に遭遇する機会も多く, 両側乳癌は乳癌術後のfollow upの上で, 大きな課題である. そこで, 当科で経験した19例の両側乳癌(原発性13例, 転移性6例)をもとに, 対側乳癌(第2癌)発生の危険因子, および第2癌の診断について臨床的検討を行つた.危険因子は, 従来いわれている, 第1癌手術後の長期生存, 遺伝因子, ホルモン環境の異常などが考えられ, 特に, 第1癌発生時の年令が若いほど, 第2癌発生の頻度は大であつた. 両側乳癌患者の第2癌出現時の免疫能が低下しているものも多いが, 免疫能の関与の程度は不明であつた. 腫瘤は15例中14例で自己発見され, その約半数が生検により診断されていた. すなわち, 自己検診の指導と共に, 特に, 若年で乳房切断術を受けた患者の対側乳腺腫瘤は, 両側乳癌を考慮した積極的な生検が必要であると考えられた. |
Author | MINOURA, Hirohiko KATO, Yasuyuki AKIYAMA, Noriyoshi |
Author_FL | 加藤 康行 箕浦 宏彦 秋山 憲義 |
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References | 2) 霞富士男他: 癌の臨床, 22, 1341, 1976 8) 梶原哲朗他: 外科診療, 25, 899, 1983 5) Hadjinichael, O. C. et al.: Brit. J. Cancer, 53, 281, 1986 10) 川守田究他: 臨床外科学会雑誌, 48, 898, 1987 3) 北条慶一他: 日癌治療会誌, 14, 394, 1968 6) Chaudary, M. A. et al.: Brit. J. Surg., 71, 711, 1984 4) 秋山憲義他: 医療, 37, 1174, 1983 9) Wanebo, H. J.: Ann. Surg., 201, 667, 1985 1) Robbins, G. F. et al.: Cancer, 17, 1501, 1964 7) Hughes, L. E. et al.: Brit. Med. J., 290, 1229, 1985 |
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SubjectTerms | 両側乳癌 原発性両側乳癌 細胞性免疫能 転移性両側乳癌 |
Title | Evaluation of 19 Cases of Bilateral Breast Cancer |
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