Bilateral breast carcinoma

Abstract

BACKGROUND The aim of this study was to compare the outcomes of bilateral breast carcinoma (BBC) patients with those of patients who had unilateral disease. METHODS From 1960 to 1995, 1465 Stage 0–III patients with primary breast carcinoma were treated with either mastectomy or breast conservation therapy at the Kimmel Cancer Center of Jefferson Medical College and Thomas Jefferson University Hospital. There were 1315 (89.9%) unilateral, 103 (7.1%) metachronous, and 47 (3.0%) synchronous breast carcinoma patients. Patients with synchronous breast carcinoma were defined as having a contralateral cancer diagnosed within 1 year of initial diagnosis. The percentage of patients with Stage 0–I disease at initial diagnosis was 49.4%, whereas 68% had Stage 0–I disease at subsequent diagnosis. For patients with metachronous breast carcinomas, the median interval between the first and second diagnosis was 44 months (range, 13–287 months). The median follow‐up time was 58 months (range, 12–229 months) for patients with synchronous cancers and 87 months (range, 0.25–414 months) for those with metachronous cancers. Rates of overall survival and survival with no evidence of disease (NED survival), local control, and distant metastasis from the time of the second diagnosis were calculated for patients with synchronous and metachronous disease. These figures were then compared with each other and also with those for unilateral breast carcinoma patients. RESULTS Patients with synchronous and metachronous breast carcinoma had worse 5‐ and 8‐year NED survival rates compared with unilateral breast carcinoma patients, as well as an increased risk of distant metastasis. In multivariate analysis, differences in local control and overall survival were not statistically significant for patients who had bilateral disease compared with those who had unilateral disease. There was no difference when patients with metachronous and unilateral breast carcinoma were compared with respect to local control and overall survival. CONCLUSIONS Patients with bilateral breast carcinoma who present with synchronous disease are at greater risk for distant metastasis than women with unilateral or metachronous breast tumors. There was a trend toward decreased overall survival and local control for patients with synchronous bilateral breast carcinoma compared with patients who had either metachronous or unilateral disease. Cancer 2000;88:2739–2750. © 2000 American Cancer Society.

Synchronous and Metachronous Breast Malignancies: A Cross-Sectional Retrospective Study and Review of the Literature

“…In our population, a shorter time interval between the first and the second tumor in women affected by MBC resulted to be associated with a significantly lower hormone receptors positivity ( P < 0.05), higher grading, multifocality, extended in situ component, and peritumoral vascular invasion (p n.s.). And actually, in terms of biological aggressiveness, very close MBCs resemble SBCs, which the literature demonstrates to have a more aggressive histological type and to be poorly differentiated [37] and at greater risk for distant metastasis than UBCs [1, 15, 37]. Anyway, in our population, a shorter time interval between the two breast cancers did not predict a worse OS in MBC patients, as described also by other authors [33, 43].…”

“…Then, we selected and retrieved 24 full articles to be candidate for the analysis, 7 of which resulted to be appropriate for the meta-analysis comparing SBCs with UBCs and 6 comparing MBCs with UBCs. Table 6 summarized the data characteristics of the included studies [7, 15, 17–19, 25, 26]. Flow diagram depicting selection of articles for review is included as Supplemental Figure 1 in the Supplementary Materials available online at http://dx.doi.org/10.1155/2014/250727 and more details about included and excluded studies are reported in Supplemental List 1.…”

“…In fact, some studies suggest poor survival while others report similar survival compared to patients with unilateral breast cancer (UBC). In particular, women affected by SBCs seem to have a lower long term survival [13–15], even if this difference is not always significant. Moreover, there is conflicting evidence about the impact of SBCs and MBCs on the management of patients with regard to surgical treatment options, such as the role of prophylactic mastectomy.…”

Contralateral Prophylactic Mastectomy After Unilateral Breast Cancer

“…Depending on a given researcher’s decision as to what period of time is sufficiently long to distinguish a synchronous contralateral breast cancer (SCBC) from a metachronous one, MCBC has been defined as a new CBC diagnosed anywhere from one month to two years after an index tumor. 11 But the magnitude of MCBC risk is not uniformly distributed among patients with UBC: among women without a BRCA mutation, less than 10% would be expected to eventually develop MCBC, 2,12 but among women with a family history of breast cancer and/or an identified genetic mutation in BRCA1 or BRCA2, incidence of MCBC has been estimated to be anywhere from 12% to 47%. 13–15 CPM has historically been prescribed for these higher risk patients as a means through which to decrease MCBC and, concomitantly, mortality associated with MCBC.…”

Development and Testing of a Second Generation Hand-held Optical Imager

“…Bilateral imaging allows for a comparison between two distinct tissue regions given that breast cancer is typically unilateral. Hence, bilateral imaging allows for comparison of the diseased breast tissue with the contralateral breast (healthy breast) [41]. Comparison with the contralateral breast allows the patient to serve as both the target (diseased breast tissue) and the background (healthy breast tissue) since both breasts should have similar optical properties for healthy breast tissue.…”