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目的:探讨乳腺癌术后发生在非乳腺部位的多原发恶性肿瘤(MPMN)临床特点、发生原因及预后。方法:回顾性分析了2009年1月至2011年11月治疗的15例经病理证实的乳腺癌术后非乳腺部位发生的MPMN。结果:①乳腺癌与发生第二原发肿瘤中位间隔时间为30个月,同时性(间隔≤6个月)发生4例,异时性(间隔>6个月)发生11例。②第二原发恶性肿瘤部位依次为:肺、子宫内膜、胸壁、卵巢、食管、胰腺和甲状腺。③13例乳腺癌无复发和转移,双侧胸水和单侧进展各1例,第二原发肿瘤治疗中采用手术方法7例,15例病人中9例死亡,8例死亡原因为MPMN。结论:①乳腺癌术后易发生MPMN;②MPMN的发生与乳腺癌治疗有关;③MPMN的预后比乳腺癌转移复发的预后好。
Objective: To investigate the clinical features, causes and prognosis of multiple primary malignant tumors (MPMN) occurring in non-breast sites after breast cancer surgery. Methods: A retrospective analysis of 15 patients with pathologically confirmed non-breast cancer after operation from January 2009 to November 2011 was performed. Results: ①The median interval between breast cancer and the second primary tumor was 30 months. There were 4 cases with simultaneity (interval≤6 months) and 11 cases with heterochronous (interval> 6 months). The second primary malignant tumor sites were: lung, endometrium, chest wall, ovary, esophagus, pancreas and thyroid. ③13 cases of breast cancer without recurrence and metastasis, bilateral pleural effusion and unilateral progression in 1 case, the second primary tumor treatment using surgical methods in 7 cases, 15 patients died in 9 cases, 8 cases of death due to MPMN. Conclusion: ①MPMN occurs easily after breast cancer; ②MPMN is related to the treatment of breast cancer; ③MPMN prognosis is better than that of breast cancer metastasis and recurrence.