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Breast-Conserving Surgery in Bilateral Breast Cancer

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

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. In this study, we report on histopathology, treatment, and outcomes in BBC patients.

Methods

Upon Institutional Review Board approval, we identified BBC patients diagnosed and treated for invasive breast cancer between 1999 and 2007. Retrospective chart review for demographics, histopathology, treatment, and outcomes was performed, and 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, and a 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) were used to examine if a pathologic characteristic differed within a cancer pair. Kaplan–Meier methods estimated overall survival (OS).

Results

A total of 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 molecular profiles. Overall, 57 % of MBC patients underwent breast-conserving surgery (BCS) at initial diagnosis versus 34 % of patients with SBC. BCS contraindications were similar in both groups: 16 (34 %) MBC patients and 28 (36 %) SBC patients. Kaplan–Meier OS estimates at 5 and 10 years were 86 and 78 % for MBC, and 87 and 77 % for SBC patients, respectively.

Conclusions

OS was excellent for both the MBC and SBC groups. Contraindications to BCS did not differ between groups. However, patients with SBC were less likely to undergo BCS compared with patients with MBC at the time of initial diagnosis.

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Disclosures

Julie A. O’Brien, Alice Ho, G. Paul Wright, Michelle Stempel, Sujata Patil, Kate Krause, Monica Morrow, and Mary L. Gemignani have no disclosures to report. This study, presented in poster format at the 15th Annual Meeting of the American Society of Breast Surgeons, 30 April–4 May 2014, was funded in part by National Institutes of Health/National Cancer Institute (NIH/NCI) Cancer Center Support Grant P30 CA008748.

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Authors and Affiliations

  1. Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Julie A. O’Brien MD, Michelle Stempel MPH, Monica Morrow MD & Mary L. Gemignani MD, MPH

  2. Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Alice Ho MD & Kate Krause BA

  3. Department of Surgery, Michigan State University, Grand Rapids, MI, USA

    G. Paul Wright MD

  4. Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Sujata Patil PhD

Authors
  1. Julie A. O’Brien MD
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  2. Alice Ho MD
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  3. G. Paul Wright MD
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  4. Michelle Stempel MPH
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  5. Sujata Patil PhD
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  6. Kate Krause BA
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  7. Monica Morrow MD
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  8. Mary L. Gemignani MD, MPH
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Corresponding author

Correspondence to Mary L. Gemignani MD, MPH.

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O’Brien, J.A., Ho, A., Wright, G.P. et al. Breast-Conserving Surgery in Bilateral Breast Cancer. Ann Surg Oncol 22, 3389–3396 (2015). https://doi.org/10.1245/s10434-015-4746-2

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  • DOI: https://doi.org/10.1245/s10434-015-4746-2

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