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Clinicopathological profile of bilateral breast cancer at a tertiary cancer center in South India

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Abstract

Background

Bilateral breast cancer (BBC) is an unusual clinical entity. Unlike unilateral breast cancer, there is fewer data regarding clinicopathological aspects and treatment guidelines in BBC. The present study was carried out at a tertiary oncology center in South India to analyze the clinicopathological profile of patients diagnosed with BBC.

Methods

This was a retrospective observational study of patients diagnosed with BBC in the department of medical oncology from August 2012 to July 2013.

Results

Out of a total of 300 breast cancer patients during a 1-year period, 15 had BBC. Synchronous and metachronous breast cancers were seen in six and nine patients, respectively. The median age at presentation for BBC was 40 years. Family history of breast cancer was present only in two cases. The median age of menarche and first child birth was 13 and 22 years, respectively. History of breast feeding was positive in all except one who was nulliparous. Out of the 15 patients, 11 were premenopausal and 4 postmenopausal. Contralateral breast cancer was detected mammographically in 4 patients and by clinical examination in 11. Out of 30 tumors, all were invasive ductal carcinomas (IDC). Nine patients had bilateral mastectomy, and five had unilateral mastectomy. Out of 30 tumors, 14 were triple negative, 9 estrogen receptor (ER)/progesterone (PR) positive, and 7 Her2neu positive. Neoadjuvant chemotherapy (NACT) was given in four synchronous and three metachronous breast cancer cases for contralateral breast cancer. All patients received chemotherapy during the course in the form of either adjuvant or palliative chemotherapy.

Conclusions

BBC is an uncommon clinical entity. For women with younger premenopausal age, the incidence of BBC is higher compared with older women. As the prognosis of BBC is poor, it is crucial to be aware of this entity, and every patient with breast cancer should be regularly followed up. These patients require individualized treatment planning based on the tumor factors and treatment factors of the primary lesion.

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References

  1. Chaudary MA, Millis RR, Hoskins EO, et al. Bilateral primary breast cancer: a prospective study of disease incidence. Br J Surg. 1984;71:711–4.

    Article  PubMed  CAS  Google Scholar 

  2. El Hanchi Z, Berrada R, Fadli A, et al. Bilateral breast cancer: incidence and risk factors. Gynecol Obstet Fertil. 2004;32:128–34. In French.

    Article  PubMed  CAS  Google Scholar 

  3. Heron DE, Komarnicky LT, Hyslop T, Schwartz GF, Mansfield CM. Bilateral breast carcinoma: risk factors and outcomes for patients with synchronous and metachronous disease. Cancer. 2000;88:2739–50.

    Article  PubMed  CAS  Google Scholar 

  4. Al-Jurf AS, Jochimsen PR, Urdaneta LF, Scott DH. Factors influencing survival in bilateral breast cancer. J Surg Oncol. 1981;16:343–8.

    Article  PubMed  CAS  Google Scholar 

  5. Cody HS, 3rd. Routine contralateral breast biopsy: helpful or irrelevant? Experience in 871 patients, 1979–1993. Ann Surg. 1997;225:370–6.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Chen Y, Thompson W, Semenciw R, et al. Epidemiology of contralateral breast cancer. Cancer Epidemiol Biomarkers Prev. 1999;8:855–61.

  7. Hislop TG, Elwood JM, Coldman AJ, Spinelli JJ, Worth AJ, Ellison LG. Second primary cancers of the breast: incidence and risk factors. Br J Cancer. 1984;49:79–85.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  8. Jobsen JJ, van der Palen J, Ong F, Meerwaldt JH. Synchronous, bilateral breast cancer: prognostic value and incidence. Breast. 2003;12(2):83–8.

    Article  PubMed  CAS  Google Scholar 

  9. Robinson E, Rennert G, Rennert HS, Neugut AI. Survival of first and second primary breast cancer. Cancer. 1993;71:172–6.

  10. Haagensen CD. The natural history of breast cancer. In: Diseases of the breast. 2nd ed. Philadelphia: Saunders; 1971. S. 380–465.

    Google Scholar 

  11. MacMahon B, Cole P, Lin TM, Lowe CR, Mirra AP, et al. Age at first birth and breast cancer risk. Bull World Health Organ. 1970;43(2):209–21.

    PubMed  CAS  PubMed Central  Google Scholar 

  12. Bernstein JL, Thompson WD, Risch N, Holford TR. Risk factors predicting the incidence of second primary breast cancer among women diagnosed with a first primary breast cancer. Am J Epidemiol. 1992;136(8):925–36.

    PubMed  CAS  Google Scholar 

  13. Horn PL, Thompson D. Risk of contralateral breast cancer: associations with factors related to initial breast cancer. Am J Epidemiol. 1988;128:309–23.

    PubMed  CAS  Google Scholar 

  14. Khairy GA, Guraya SY, Ahmed ME, Ahmed MA. Bilateral breast cancer. Incidence, diagnosis and histological patterns. Saudi Med J. 2005;26(4):612–5.

    PubMed  Google Scholar 

  15. Slack NH, Bross ID, Nemoto T, Fisher B. Experience with bilateral primary carcinoma of the breast. Surg Gynecol Obstet. 1973;136(3):433–40.

    PubMed  CAS  Google Scholar 

  16. Hankey BF, Curtis RE, Naughton MD, Boice JD, Jr., Flannery JT. A retrospective cohort analysis of second breast cancer risk for primary breast cancer patients with an assessment of the effect of radiation therapy. J Natl Cancer Inst. 1983;70(5):797–804.

    PubMed  CAS  Google Scholar 

  17. Storm HH, Jensen OM. Risk of contralateral breast cancer in Denmark 1943–80. Br J Cancer. 1986;54(3):483–92.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  18. Robbins GF, Berg JW. Bilateral primary breast cancer, a prospective clinicopathological study. Cancer. 1964;17:1501–27.

    Article  PubMed  CAS  Google Scholar 

  19. Suryanarayana Deo V, Shridhar D, Shukla NK, Kumar S, Purkayastha J, Raina V, Rath GK. Clinical profile and management of bilateral breast cancer. Breast Cancer Res. 2005;7(Suppl. 1):P6. doi:10.1186/bcr1240.

  20. Bernstein JL, Lapinski RH, Thakore SS, Doucette JT, Thompson WD. The descriptive epidemiology of second primary breast cancer. Epidemiology. 2003;14(5):552–8.

    Article  PubMed  Google Scholar 

  21. Li CI, Malone KE, Porter PL, Daling JR. Epidedmiologic and molecular risk factors for contralateral breast cancer among young women. Br J Cancer. 2003;89(3):513–8.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  22. Gong SJ, Rha SY, Jeung HC, Roh JK, Yang WI, Chung HC. Bilateral breast cancer: differential diagnosis using histological and biological parameters. Jpn J Clin Oncol. 2007;37:487–92.

    Article  PubMed  Google Scholar 

  23. Henderson IC, Patek AJ. The relationship between prognostic and predictive factors in management of breast cancer. Breast Cancer Res Treat. 1998;52(1–3):261–88.

    Article  PubMed  CAS  Google Scholar 

  24. Anderson WF, Chatterjee N, Ershler WB, Brawley OW. Estrogen receptor breast cancer phenotypes in the Surveillance, Epidemiology and End Results database. Breast Cancer Res Treat. 2002;76(1):27–36.

    Article  PubMed  CAS  Google Scholar 

  25. Horn PL, Thompson WD. Risk of contralateral breast cancer. Association with histologic, clinical, and therapeutic factors. Cancer. 1988;62(2):412–4.

    Article  PubMed  CAS  Google Scholar 

  26. Mariani L, Coradini D, Biganzoli E, Boracchi P, Marubini E, Pilotti S, Salvadori B, Silvestrini R, Veronesi U, Zucali R, Rilke F. Prognosic factors for metachronous contralateral breast cancer: a comparison of linear Cox regression model and its artificial neural network expression. Breast Cancer Res Treat. 1997;44(2):167–78.

    Article  PubMed  CAS  Google Scholar 

  27. Safal M, Lower EE, Hasselgren PO, Hungness ES, Gazder P, Aron B, Shaughnessy EA, Yassin R. Bilateral synchronous breast cancer and HER-2/neu overexpression. Breast Cancer Res Treat. 2002;72(3):195–201.

    Article  PubMed  Google Scholar 

  28. van Agthoven T, Timmermans M, Dorssers LC, Henzen-Logmans SC. Expression of estrogen, progesterone and epidermal growth factor receptor in primary and metastatic breast cancer. Int J Cancer. 1995;63:790–3.

    Article  PubMed  Google Scholar 

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Acknowledgement

Department of Pathology, Surgical Oncology and Pathology, Kidwai Memorial Institute of Oncology, Bangalore.

Conflict of interest

The authors declare that there are no actual or potential conflicts of interest in relation to this article.

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Authors and Affiliations

  1. Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India

    K. C. Lakshmaiah MD, DM, Umesh Das MD, K. Govind Babu MD, DM, T. M. Suresh MD, DM, D. Lokanatha MD, DM, Linu A. Jacob MD, DM & Suresh Babu MD, DM

  2. Department of Pathology, Kidwai Memorial Institute of Oncology, Bangalore, 560029, Karnataka, India

    G. Mukherjee

  3. Room No. 5, OPD Block, Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, 560029, Karnataka, India

    Umesh Das MD

  4. Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, 560029, Karnataka, India

    M. Vijayakumar

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  1. K. C. Lakshmaiah MD, DM
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  2. Umesh Das MD
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  3. K. Govind Babu MD, DM
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  5. D. Lokanatha MD, DM
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  6. Linu A. Jacob MD, DM
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  7. Suresh Babu MD, DM
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  8. G. Mukherjee
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Correspondence to Umesh Das MD.

Additional information

The article was published as a poster in Indian Cancer Congress 2013, Delhi.

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Lakshmaiah, K., Das, U., Babu, K. et al. Clinicopathological profile of bilateral breast cancer at a tertiary cancer center in South India. memo 7, 157–161 (2014). https://doi.org/10.1007/s12254-014-0153-9

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  • DOI: https://doi.org/10.1007/s12254-014-0153-9

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