Synchronous Bilateral Breast Cancers
Background: Bilateral breast cancer (BBC) is not an uncommon entity in contemporary breast clinics. Improved life expectancy after breast cancer treatment and routine use of contra-lateral breast mammography has led to increased incidence of BBC. Our study objective was to define the epidemiolog...
Main Authors: | , , |
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Format: | Article |
Language: | English |
Published: |
JCDR Research and Publications Private Limited
2015-09-01
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Series: | Journal of Clinical and Diagnostic Research |
Subjects: | |
Online Access: | https://jcdr.net/articles/PDF/6511/14880_CE[Ra1]_F(AK)_PF1(PAK)_PFA(AK)_PF2(PAG).pdf |
Summary: | Background: Bilateral breast cancer (BBC) is not an uncommon
entity in contemporary breast clinics. Improved life expectancy
after breast cancer treatment and routine use of contra-lateral
breast mammography has led to increased incidence of BBC.
Our study objective was to define the epidemiological and
tumour characteristics of BBC in India.
Materials and Methods: A total of 1251 breast cancer patients
were treated during the period January 2007 to March 2015 and
30 patients were found to have BBC who constituted the study
population (60 tumour samples). Synchronous bilateral breast
cancers (SBC) was defined as two tumours diagnosed within
an interval of 6 months and a second cancer diagnosed after
6 months was labelled as metachronous breast cancer (MBC).
Analyses of patient and tumour characteristics were done in
this prospective data base of BBC patients.
Results: Median patient age was 66 years (range 39-85).
Majority of the patients had SBC (n=28) and in 12 patients
the second tumour was clinically occult and detected only by
mammography of the contra-lateral breast. The second tumour
was found at lower tumour size compared to the first in 73%
of cases and was negative for axillary metastasis in 80% of
cases (24/30). Infiltrating ductal carcinoma was the commonest
histological type (n=51) and majority of the tumours were ER/PR
positive (50/60). Her2 was overexpressed in 13 tumours (21%).
Over 70% (22/30) of patients had similar histology in both
breasts and amongst them grade concordance was present in
about 69% (15/22) of patients. Concordance rates of ER, PR and
Her2 statuses were 83%, 80% and 90% respectively. Bilateral
mastectomy was the commonest surgery performed in 80% of
the patients followed by bilateral breast conservation in 13%. At
the end of study period, 26 patients were alive and disease free.
Median survival was 29 months (range 3-86 months).
Conclusion: In most patients with BBC, the second tumour is
identified at an early stage than index tumours supporting the
importance of contralateral breast cancer screening at the time
of primary diagnosis and during follow-up. BBC occurs more
frequently in old age group and majority of these tumours are
estrogen dependent. There is good pathological concordance
between the index tumour and the contralateral breast cancer. |
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ISSN: | 2249-782X 0973-709X |