Bilateral carcinoma of the breast

Abstract

Among the 911 cases of carcinoma of the breast treated between 1969 and 1978 there were 39 cases of bilateral primary cancer. Of these, 17 were synchronous tumours defined as cancers diagnosed and treated during the same primary hospital admission. The remaining 22 patients had tumours that were diagnosed separately (metachronous tumours), with a mean time interval of 5 years and 8 months between presentation of first and second primaries (range 6 months to 20 years). Of the metachronous tumours, 20 had presented within 7 years of the diagnosis of the first primary (2.2 per cent of all patients). The patients with synchronous disease fared badly, but patients in the metachronous group had a good prognosis. This is due, at least in part, to the inherent selection of patients in the metachronous group who have to survive the first primary tumour in order to develop the second. However, careful follow-up after the first primary may also account for the relatively good prognosis of this group. We therefore recommend continuing regular out-patient follow-up, with careful examination of the second breast, for all patients having undergone treatment for cancer of the breast.

Prognosis in bilateral breast cancer. Effects of time interval between first and second primary tumours

“…But in these studies, metachronous bilateral disease seemed to entail a prognosis similar to that in unilateral cancer when survival was calculated from the date of the second diagnosis as in our study. The discrepancies between our results and those of the latter studies might have been smaller, however, if they had taken into account both age and disease stage (McCredie et al, 1975;Bailey et al, 1980;Burns et al, 1984) or had used a life-table technique for computing the survival (McCredie et al, 1975). This assumption is suggested by our finding that correction for age alone gave less marked differences between unilateral and bilateral cases.…”

“…In three other studies (McRedie et al, 1975;Bailey et al, 1980;Burns et al, 1984) it has been observed that patients with synchronous cancers fare badly, while the prognosis for women with metachronous cancers is better. But in these studies, metachronous bilateral disease seemed to entail a prognosis similar to that in unilateral cancer when survival was calculated from the date of the second diagnosis as in our study.…”

“…Both similar prognosis (Schell et al, 1982;Slack et al, 1973;Nielsen et al, 1986; and a poorer prognosis (Robbins et al, 1964) in bilateral cancer have been found. In some studies the results of the comparisons varied, depending on whether the cancers were synchronous or metachronous (McCredie et al, 1975;Bailey et al, 1980;Burns et al, 1984;Turco et al, 1982). However, the findings in several studies of these survival rates are afflicted with uncertainty on account of selection of the patient material, lack of control of confounding factors and inadequate statistical methods.…”

Carcinoma Breast - Don’t Miss the Synchronous Carcinoma in the Second Breast

“…The longer the interval between the diagnoses of the two cases, the better is the survival rate. [7,8,9,10] Optimal surgical management of these primary synchronous breast carcinoma is controversial. In the past these cases were treated more aggressively with bilateral MRMs with the view that the disease has poor survival and outcome.…”

Two Different Primary Carcinomas in One Breast - Diagnostic and Therapeutic Challenge: A Case Report

“…Some believe that this patient's clinical scenario is similar to that of a bilateral breast cancer patient. Generally, it has been recognized that the prognosis of patients with simultaneous bilateral breast cancer is worse than the prognosis of patients with unilateral breast cancer (7)(8)(9)(10)(11)(12). However, some authors have not observed a difference in the survival of patients with bilateral breast cancer and unilateral breast cancer (13,14).…”