Bilateral Breast Carcinoma: Clinical Characteristics and Its Impact on Survival

Abstract

The higher incidence of breast cancer, the improvements in diagnosis and treatment, together with the growing life expectancy have brought about an increase in the number of patients at risk for bilateral breast carcinoma. The aim of this study is to describe the characteristics of patients suffering from bilateral breast carcinoma who underwent surgery at the Breast Pathology Service of the Buenos Aires British Hospital and to analyze impact on survival. Between January 1970 and May 2007, 4,085 cases of breast carcinoma in 3,864 patients were treated at the Breast Diseases Division of the Buenos Aires British Hospital. A retrospective study of 194 patients with bilateral breast carcinoma was carried out: 80 synchronous and 114 metachronous. In order to compare survival, a group of 2,237 patients with unilateral breast carcinoma who had undergone surgery was analyzed. The risk of developing a contralateral breast carcinoma was 0.9% per year, with an accumulated risk at 15 years of 12.75%. The 5-year survival was 85.9% for unilateral carcinomas, 94.6% for metachronous carcinoma, and 63.3% for synchronous carcinoma. The 15-year survival was 65.5% for unilateral carcinomas, 52.3% for metachronous, and 37.2% for synchronous. The incidence of bilateral carcinomas is low. Survival was worse in patients with metachronous carcinoma diagnosed within 5 years of the first malignancy. Survival in patients with metachronous carcinoma diagnosed after 5 years is similar to those with unilateral carcinoma. Synchronous carcinoma was associated to worse survival, being an independent risk factor for mortality.

Clinicopathological Features in Bilateral Breast Cancer

“…As our study does not include unilateral patient data, the median age comparison cannot be made with the BBC, it is compatible with the literature data. In above studies where BBC and UBC case ages are compared, statistically significant difference in ages of both groups have not seen (Takahashi et al, 2005;Vuoto et al, 2010;Kheirelseid et al, 2011).…”

“…Although there was difference between groups, the possible cause of this lower ratio than proportional UBC historical data is the presence of unknown group emergence with a relatively high rate of 11.7% and 27.8%. In one of two different studies evaluating the familial history in the context of the BBC (Vuoto et al, 2010), there were no significant differences between UBC and the BBC. In another study (Kheirelseid et al, 2011) it is suggested that it is increased in synchronous group with odds ratio of 1.5, also data in our study is in favor of SC.…”

“…When compared with UBC historical data (70-80% IDC), the histopathology is similar in BBC patients (SC 81% and 76%; MC 70% and 76%; p=0.9) (Beckmann et al, 2001;Takahashi et al, 2005;Verkooijen et al, 2007;Vuoto et al, 2010 ). In a study comparing BBC and UBC the IDC ratio was reported as 66% (SC) and 63% (MC), respectively (Verkooijen et al, 2007).…”

“…Forty percent of bilateral breast cancer patients was SC and 60% was MC. In a study by Hector de Vuoto et al assessing 194 patients with the BBC, SC was found in 41% ratio and MC was 59% (Vuoto et al, 2010). In another study, SC and MC ratios were reported as 30% and 70% (Hartman et al, 2007).…”

“…In Australia, a BBC cohort study, the median age was found to be 57 and 56 years old (Beckmann et al, 2001). In another study, age was stated as 58 years old in SC tumors, in MC tumors the first and second tumor ages were 51 and 58, respectively, UBC age was stated as 55 years old (Vuoto et al, 2010). Another study evaluated 46 Japanese BBC patients and mean SC age was reported as 50 years, mean MC age as 56 and for unilateral it was reported to be 51 years old (Takahashi et al, 2005).…”