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

Londero, Ambrogio P.; Bernardi, Sergio; Bertozzi, Serena; Angione, Vito; Gentile, G; Dri, Cinzia; Minucci, Antonio; Caponnetto, Filippo; Petri, Roberto

doi:10.1155/2014/250727

Cited by 23 publications

(24 citation statements)

References 41 publications

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“…However, the small numbers of patients with BBC noted are consistent with published data. In a recent report by Londero et al, 22 a review of the published literature reveals the prevalance of MBC and SBC is low, at 3% and 7%, respectively.…”

Section: Discussionmentioning

confidence: 96%

Breast-Conserving Surgery in Bilateral Breast Cancer

O’Brien

Wright

et al. 2015

Ann Surg Oncol

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Background Bilateral breast cancer (BBC) may present as synchronous(SBC) or metachronous breast cancer(MBC). Optimal surgical management of BBC patients is not well defined. Here we report on histopathology, treatment, and outcomes in BBC patients. Methods Upon IRB approval, we identified BBC patients diagnosed and treated for invasive breast cancer between 1999–2007. Retrospective chart review for demographics, histopathology, treatment, and outcomes was performed. Factors associated with BCS choice were collected. Contraindication to BCS was defined as any of the following one-breast findings: multicentric disease; tumor considered too large for BCS; patient without a nominal breast size for acceptable cosmetic results. McNemar's test for matched pairs(binary variables) or the paired t-test(continuous variables) was used to examine if a pathologic characteristic differed within a cancer pair. Kaplan-Meier methods estimated overall survival(OS). Results 203 BBC patients(119 SBC,84 MBC) comprised our study group. Histopathologic characteristics of the first and second cancers diagnosed in both the SBC and MBC patients were very similar in histologic type and in molecular profiles. 57% of MBC patients underwent breast-conserving surgery at initial diagnosis versus 34% of patients with SBC. BCS contraindications were similar in both groups: 16(34%) of MBC and 28(36%) of SBC patients. Kaplan-Meier OS estimates at 5yrs/10yrs were 86%/78% for MBC, and 87%/77% for SBC patients, respectively. Conclusions OS was excellent for both MBC and SBC groups. Contraindications to breast-conserving surgery did not differ between groups. However, patients with SBC were less likely to undergo BCS compared to patients with MBC at time of initial diagnosis.

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Section: Discussionmentioning

confidence: 96%

Breast-Conserving Surgery in Bilateral Breast Cancer

O’Brien

Wright

et al. 2015

Ann Surg Oncol

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“…Using the SEER database, we compared the clinical and pathological characteristics of sCBC and mCBC patients. We used 6 months as the interval time to divide CBC into sCBC or mCBC; this cutoff was previously used in other studies [710]. However, there is no consensus on the definite cutoff time for differentiating sCBC from mCBC.…”

Section: Discussionmentioning

confidence: 99%

“…However, whether the development of sCBC or mCBC influenced patient prognosis remains unclear. Some studies suggested that sCBC patients had poor outcomes, whereas others indicated a similar survival in sCBC and mCBC patients [8910]. In addition, the cutoff value of the interval time to differentiate sCBC from mCBC remains inconsistent [71011].…”

Section: Introductionmentioning

confidence: 99%

Comparative Analysis of Outcomes and Clinicopathological Characteristics of Synchronous and Metachronous Contralateral Breast Cancer: A Study of the SEER Database

et al. 2019

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Purpose Numerous previous studies have reported inconsistent results about the differences between synchronous contralateral breast cancer (sCBC) and metachronous contralateral breast cancer (mCBC). This study aimed to compare the clinical characteristics and outcomes between sCBC and mCBC and determine predictive factors for the survival of sCBC and mCBC patients. Methods Using the Surveillance, Epidemiology, and End Results Program database, we identified sCBC or mCBC patients from 2000 to 2010. The Kaplan-Meier method and Cox proportional hazards regression analysis were used to analyze overall survival and breast cancer-specific survival (BCSS) rates of sCBCs and mCBCs, respectively. Results Overall, 14,057 sCBC (n = 8,139, 57.9%) and mCBC (n = 5,918, 42.1%) patients were included. The first tumors of sCBC were more likely to have higher stage and more lymph and distant metastases, whereas those of mCBC were more often infiltrating ductal carcinoma (IDC), had localized stage, were estrogen receptor (ER) and progesterone receptor (PR) negative, and had less axillary nodal involvement. The second tumors of mCBC tended to be IDC and have higher grade, adverse stage, ER and PR-negativity; and more axillary nodal involvement, compared to the second tumors of sCBC. mCBC patients had significantly favorable 5-year BCSS but worse long-term BCSS compared with sCBC patients. Moreover, subgroup analysis revealed no significant difference of BCSS between sCBC and mCBC among patients aged 18–60 years. Multivariate analysis indicated that age, grade, and stage of 2 tumors; surgery for second tumor; and ER status of the second tumor were independent prognostic factors for BCSS of contralateral breast cancer (CBC). Conclusion The characteristics and outcomes of sCBCs and mCBCs were substantially different. sCBC and mCBC patients may have different prognosis, and the prognosis of CBC depends on the first and second tumors.

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“…The WHO Classification of Tumours of the Breast adopts this definition, which is used frequently in studies (Alkner et al 2011;Hartman et al 2007;Sandberg et al 2012b;Schmid et al 2011), but also mentions the benefit of a longer time interval for epidemiological [10] assessments. Many studies favour a longer cut-off time to distinguish bilateral breast cancers (Bernstein et al 2003;Londero et al 2014;Nichols et al 2011;Rubino et al 2010;Schaapveld et al 2008;Verkooijen et al 2007;Vichapat et al 2011a;Vichapat et al 2012;Vichapat et al 2011b;Yerushalmi et al 2009). As there is no consensus concerning these definitions, we conducted further analyses with different cut-off times.…”

Section: Discussionmentioning

confidence: 99%

Incidence of metachronous contralateral breast cancer in the Canton of Zurich: a population-based study of the cancer registry

Prater¹,

Valeri

Korol³

et al. 2015

J Cancer Res Clin Oncol

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PURPOSE To examine the incidence and characteristics of metachronous contralateral breast cancer (CBC) among women in the Canton of Zurich, Switzerland. METHODS For 1980-2006 with unilateral invasive breast cancer (UBC) were analysed for metachronous CBC. Poisson's regression was used to estimate incidence rates of metachronous CBC according to age, year of diagnosis, follow-up period since first breast cancer and morphology. RESULTS Of 16,323 patients with UBC, 700 (4.3 %) developed a second malignant tumour of the opposite breast. Median age at first breast cancer was lower in the CBC group than in the full cohort. Median interval time between first and second breast cancer was 5.5 (interquartile range 2.6-10.1) years. Incidence rate at age 20-29 was 1006 (95 % confidence interval, CI, 452-2238) cases per 100,000 person-years and decreased to 299 (199-450) at 80-84. Age-adjusted incidence rates according to period of diagnosis decreased from 618 (530-721) for 1980-1984 to 329 (217-500) cases per 100,000 person-years for [2005][2006]. Incidence rate ratio of CBC for lobular carcinoma was 1.28 (95 % CI 0.99-1.67) adjusted by age group and period of diagnosis compared to ductal carcinoma. CONCLUSIONS In our study, incidence rates for CBC are comparable with findings from the literature. A reduction in the incidence of metachronous CBC, thought to be due to adjuvant therapies, is seen in our data. In our cohort, younger age and lobular carcinoma were associated with an increased risk of CBC. Incidence rate ratio of CBC for lobular carcinoma was 1.28 (95% CI 0.99 -1.67) adjusted by age group and period of diagnosis compared to ductal carcinoma.Conclusions: In our study, incidence rates for CBC are comparable with findings from the literature. A reduction in the incidence of metachronous CBC, thought to be due to adjuvant therapies, is seen in our data. In our cohort, younger age and lobular carcinoma was associated with increased risk for CBC.Keywords Metachronous contralateral breast cancer, lobular carcinoma, incidence rates, year of diagnosis, follow-up period [3]

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

Cited by 23 publications

References 41 publications

Breast-Conserving Surgery in Bilateral Breast Cancer

Breast-Conserving Surgery in Bilateral Breast Cancer

Comparative Analysis of Outcomes and Clinicopathological Characteristics of Synchronous and Metachronous Contralateral Breast Cancer: A Study of the SEER Database

Incidence of metachronous contralateral breast cancer in the Canton of Zurich: a population-based study of the cancer registry

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