Prognostic significance of synchronous and metachronous bilateral breast cancer

Kollias, James; Ellis, Ian O.; Elston, C.W.; Blamey, R.W.

doi:10.1007/bf03215857

Cited by 75 publications

(69 citation statements)

References 44 publications

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“…Evidence of the prognostic significance of synchronous bilateral compared with unilateral breast cancer is available from a number of studies (Gollamudi et al, 1997;Heron et al, 2000;Kollias et al, 2001;Newman et al, 2001;Jobsen et al, 2003;Polednak, 2003;Tousimis, 2005;Beckmann et al, 2011). While results vary, most indicate that synchronous bilateral breast cancers (SBBC) have either an equivalent or moderately poorer survival compared with unilateral cases.…”

Section: Introductionmentioning

confidence: 99%

“…By comparing observed survivals with survivals predicted by these models, shortfalls can be identified for guiding quality improvement initiatives. The relevance of including SBBC in such models is uncertain from the international evidence (Gollamudi et al, 1997;Heron et al, 2000;Kollias et al, 2001;Newman et al, 2001;Jobsen et al, 2003;Polednak, 2003;Tousimis, 2005;Beckmann et al, 2011) and is investigated in this study, using the Audit database.…”

Section: Introductionmentioning

confidence: 99%

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Survival From Synchronous Bilateral Breast Cancer: The Experience of Surgeons Participating in the Breast Audit of the Society of Breast Surgeons of Australia and New Zealand

Roder

Silva²,

Zorbas³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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Background: Previous studies generally indicate that synchronous bilateral breast cancers (SBBC) have an equivalent or moderately poorer survival compared with unilateral cases. The prognostic characteristics of SBBC would be relevant when planning adjuvant therapies and follow-up medical surveillance. The frequency of SBBC among early breast cancers in clinical settings in Australia and New Zealand was investigated, plus their prognostic significance, using the Breast Cancer Audit Database of the Society of Breast Surgeons of Australia and New Zealand, which covered an estimated 60% of early invasive lesions in those countries. Design: Rate ratios (95% confidence limits) of SBBC were investigated among 35,370 female breast cancer cases by age of woman, histology type, grade, tumour diameter, nodal status, lymphatic/vascular invasion and oestrogen receptor status. Univariate and multivariable disease-specific survival analyses were undertaken. Results: 2.3% of cases were found to be SBBC (i.e., diagnoses occurring within 3 months). The figure increased from 1.4% in women less than 40 years to 4.1% in those aged 80 years or more. Disease-specific survivals did not vary by SBBC status (p=0.206). After adjusting for age, histology type, diameter, grade, nodal status, lymphatic/vascular invasion, and oestrogen receptor status, the relative risk of breast cancer death for SBBC was 1.17 (95% CL: 0.91, 1.51). After adjusting for favourable prognostic factors more common in SBBC cases (i.e., histology type, grade, lymphatic/ vascular invasion, and oestrogen receptor status), the relative risk of breast cancer death for SBBC was 1.42 (95% CL: 1.10, 1.82). After adjusting for unfavourable prognostic factors more common in SBBC cases (i.e., older age and large tumour diameter), the relative risk of breast cancer death for SBBC was 0.98 (95% CL: 0.76, 1.26). Conclusions: Results confirm previous findings of an equivalent or moderately poorer survival for SBBC but indicate that SBBC status is likely to be an important prognostic indicator for some cases.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Survival From Synchronous Bilateral Breast Cancer: The Experience of Surgeons Participating in the Breast Audit of the Society of Breast Surgeons of Australia and New Zealand

Roder

Silva²,

Zorbas³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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“…It was also observed in other cases with PMT [14]. This may indicate the adaptation of the macroorganism of the patient to the struggle against disastrous diseases.…”

Section: Discussionmentioning

confidence: 56%

“…More and more data about the survival of patients with PMT appears in the reports, comparatively with patients who have a neoplasia of one localization [14]. It is connected with the presence of more differentiated forms of cancers in case of PMT which requires less aggressive therapy.…”

Section: Introductionmentioning

confidence: 99%

Primary multiple tumor with affection of the thyroid gland, uterus, urinary bladder, mammary gland and other organs

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Lyndin

Smiyanov

et al. 2017

Pathology - Research and Practice

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a b s t r a c tBackground: Nowadays multiple primary tumor is characterized by growth and development of two or more tumors in one patient. The total world sickness rate ranges from 1% to 37%. The presence of four or more tumors in one patient is rare case and presented as casuistry. Case presentation: We showed a case of multiple primary tumor with metahronic lesion of the thyroid, uterus and breast, followed by synchronous benign tumors of the subcutaneous fat, urinary bladder and gallbladder were considered. The development of all malignant tumors in all cases was accompanied by the presence of benign precancerous processes. Analysis of neoplasia histology shows the predominance of poorly differentiated forms of cancers in women with increased aggressiveness of cancerous tissue in each subsequent case and the growth of metastatic ability. The influence of heredity on the tumors progress is confirmed by immunohistochemical characteristics of cancer cells. Steroid-sensitive tissue of the uterus and breast in both cases didn't express ER and PR, in all cases the tissue had overexpression of Ki-67, p53, bax and bcl-2 receptors. The results of DNA testing for determination the Lynch syndrome revealed the presence of microsatellite instability in genetic material. The results of studies revealed the absence of mutations in these genes (MLH1, MSH2 and MSH6). Despite the negative results of the study, it doesn't exclude the possibility of Lynch syndrome for 100%, and its presence may be caused by the mutations of other genes (PMS1, PMS2 and MLH3), responsible for DNA repair. Unfortunately there wasn't any opportunity to study their mutations. Conclusions: While studying the anamnesis of life and disease of women it was revealed that she had multiple primary tumor with lesions of the breast, urinary bladder, thyroid, uterus and other organs. This study shows that neoplastic tissue in all cases had high rates of cell proliferation, their antiapoptotic stability, expression of prognostically unfavorable-receptors, and absence of favorable prognostic markers. Histological study revealed high rates of malignant neoplastic tissue. It indicates to the existence of common mechanisms of malignant tumors and their genetic predisposition that can be clearly observed in many generations of patient.

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“…This hypothesis is supported by the fact that patients with bilateral carcinomas have a better prognosis compared to patients with distant metastases. 5 However, the relationship of a local recurrence to either of the bilateral tumors has not yet been studied by molecular genetic analysis.…”

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confidence: 99%

Bilateral carcinomas of the breast with local recurrence: analysis of genetic relationship of the tumors

Regitnig¹,

Ploner

Maderbacher³

et al. 2004

Modern Pathology

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Local recurrence of bilateral breast carcinomas is rare, but of biological interest, since it is unclear as to which tumor the local recurrence is related to, the ipsilateral or the contralateral, or whether it is an independent neoplasm. The aim of this study was to investigate the genetic relationship of bilateral breast carcinomas to each other and to their local recurrences. Eight cases of bilateral breast carcinomas, five with and three without local recurrence were analyzed using a microsatellite assay for 13 microsatellite loci. The presence of loss of heterozygosity and microsatellite instability in the various tumors was used for clonal analysis. All eight bilateral breast carcinomas showed divergent alterations in at least two microsatellite loci, which ruled out a genetic relationship. Four of five local recurrences were genetically related to the ipsilateral tumor and unrelated to the contralateral tumor. Only one local recurrence that occurred 11.8 years after the surgery of an infiltrative lobular carcinoma simultaneously with distant metastases was genetically related to the contralateral breast carcinoma. Although the number of cases in our study is limited, there is evidence that local recurrence of bilateral breast carcinoma frequently arises from the ipsilateral tumor. Keywords: bilateral breast carcinoma; local recurrence; microsatellite analysis; loss of heterozygosity; clonality Epidemiologic data on breast carcinomas show that 2-11% of breast carcinoma patients will develop contralateral breast carcinoma in their lifetime. Women with unilateral breast carcinoma are at a 2-6-fold increased risk of developing contralateral breast carcinoma, compared to the risk in the general population. 1 Bilateral breast carcinomas are of particular interest with respect to their relationship, whether they represent independent neoplasms or occur by metastatic tumor spread. This issue becomes more complex in the setting of local tumor recurrence. In this situation, the question arises whether the local recurrence is related to one of the bilateral tumors or is an independent, de novo arising neoplasm, or whether both of the tumors and the recurrence are metastases of the other tumor. The fact that whether bilateral breast carcinomas and its local recurrence have to be considered a local or a metastatic process has important therapeutic and prognostic implications.A second independently arising breast carcinoma is favored, if the histological tumor types are different. However, if the histological tumor types are identical, the distinction between a subsequently occurred novel tumor and a local recurrence of the original tumor is difficult. Conventional parameters such as the histopathological grade and various immunohistochemical analyses such as estrogen, progesterone and HER-2/neu receptor expression are not reliable to prove the relationship of these tumors.During recent years, several studies using different molecular methods have indicated that bilateral breast carcinomas are most likely genetically u...

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Prognostic significance of synchronous and metachronous bilateral breast cancer

Cited by 75 publications

References 44 publications

Survival From Synchronous Bilateral Breast Cancer: The Experience of Surgeons Participating in the Breast Audit of the Society of Breast Surgeons of Australia and New Zealand

Survival From Synchronous Bilateral Breast Cancer: The Experience of Surgeons Participating in the Breast Audit of the Society of Breast Surgeons of Australia and New Zealand

Primary multiple tumor with affection of the thyroid gland, uterus, urinary bladder, mammary gland and other organs

Bilateral carcinomas of the breast with local recurrence: analysis of genetic relationship of the tumors

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