Breast Cancer

, Volume 12, Issue 3, pp 196–202 | Cite as

The impact of bilateral breast cancer on the prognosis of breast cancer: a comparative study with unilateral breast cancer

  • Hiromasa Takahashi
  • Kenichi Watanabe
  • Masato Takahashi
  • Kazunori Taguchi
  • Fumiaki Sasaki
  • Satoru Todo
Original article



The clinical significance of bilateral breast cancer is unclear and its influence on prognosis is controversial. We assessed the impact of synchronous and metachronous bilateral breast cancer on the prognosis compared with unilateral breast cancer.


Between January 1, 1960 and December 31, 2001, 1,214 women were treated for primary operable breast cancers. Thirteen (1.1%) had synchronous bilateral breast cancer; 33 (2.7%) had a metachronous contralateral breast cancer. We compared age at operation, menopausal status, clinical stage, tumor size and histology, lymph node status, hormone receptor status, and use of adjuvant chemotherapy or hormone therapy, and we analyzed the impact of these factors on recurrence and survival in the 46 patients with bilateral breast cancer and the 1,168 patients with unilateral breast cancer.


The 5- and 10-year disease-free survival rates, respectively, were 65% and 65% in metachronous cases, 85.7% and 64.3% in synchronous cases, and 77.9% and 72.1% in unilateral cases. There was no significant difference in overall survival among the three groups. On multivariate analysis, metachronous bilaterality, tumor size, lymph node status and adjuvant hormone therapy were each independent risk factors for recurrence, whereas bilaterality of breast cancer did not influence overall survival. Conclusions: Our data suggest that metachronous bilateral breast cancer is associated with shorter disease-free survival than synchronous bilateral or unilateral breast cancer, although overall survival does not differ among the 3 groups. Patients with metachronous bilateral breast cancer should be followed particularly closely in order to detect recurrence early and maximize quality of life.

Key words

Bilateral breast cancer Contralateral breast cancer Synchronous bilateral breast cancer Metachronous bilateral breast cancer 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1).
    Kasumi F: BILATERAL BREAST CANCER.J Jpn Surg Soc 86: 266–279, 1985 (in Japanese with English abstract).Google Scholar
  2. 2).
    WHO: Histological typing of breast tumours. International histological classification of tumours. 2nd ed, World Health Organization, Geneva, 1981.Google Scholar
  3. 3).
    The questionnaire survey of fifty-fourth Japanese society of breast cancer.J Jpn Soc Clin Oncol Soc 27: 99- 109, 1992.Google Scholar
  4. 4).
    Muto N, Sakamoto G, Akiyama F, Morizono H, Yoshimoto M, Utada T, Fujiuchi N, Kasumi F: Heterochronous Bilateral Multicentric Cancers of the Breast.Jpn J Breast Cancer 4: 524–527, 1999 (in Japanese with English abstract).Google Scholar
  5. 5).
    Dawson PJ, Maloney T, Gimotty P, Juneau P, Ownby H, Wolman SR: Bilateral breast cancer: one disease or two.Br Cancer Res Treat 19: 233–244, 1991.CrossRefGoogle Scholar
  6. 6).
    Brenner H, Engelmann B, Stegmaier C, Ziegler H: Clinical epidemiology of bilateral breast cancer.Cancer 72: 3629–3635, 1993.PubMedCrossRefGoogle Scholar
  7. 7).
    Kollias J, Ellis IO, Elston CW, Blarney RW: Prognostic Significance of Synchronous and Metachronous Bilateral Breast Cancer.World J Surg 25: 1117–1124, 2001.PubMedGoogle Scholar
  8. 8).
    Gulay H, Hamalogu E, Bulut O, Goksel HA: Bilateral breast carcinoma: 28 years’ experience.World J Surg 14: 529–533, 1990.PubMedCrossRefGoogle Scholar
  9. 9).
    Burns PE, Dabbs K, May C, Lees AW, Birkett LR, Jenkins HJ, Hanson J: Bilateral breast cancer in northern Alberta: risk factors and survival patterns.Can Med Assoc J 130: 881–886, 1984.PubMedGoogle Scholar
  10. 10).
    Holmberg L, Adami HO, Ekbom A, Bergstrom R, Sandstrom A, Lindgren A: Prognosis in bilateral breast cancer. Effects of time interval between first and second primary tumours.Br J Cancer 58: 191–194, 1988.PubMedGoogle Scholar
  11. 11).
    Michowitz M, Noy S, Lazebnik N, Aladjem D: Bilateral Breast Cancer.J Surg Oncol 30: 109–112, 1985.PubMedCrossRefGoogle Scholar
  12. 12).
    Schell SR, Montague ED, Spanos WJ Jr, Tapley ND, Fletcher GH, Oswald MJ: Bilateral breast cancer in patients with initial stage I and II disease.Cancer 50: 1191–1194, 1982.PubMedCrossRefGoogle Scholar
  13. 13).
    Berte E, Buzdar AU, Smith TL, Hortobagyi GN: Bilateral Primary Breast Cancer in Patients Treated with Adjuvant Therapy.Am J Clin Oncol 11: 114–118, 1988.PubMedCrossRefGoogle Scholar
  14. 14).
    Senofsky GM, Wanebo HJ, Wilhelm MC, Pope TL, Fechner RE, Broadus W, Kaiser DL: Has Monitoring of the Contralateral Breast Improved the Prognosis in Patients Treated for Primary Breast Cancer?Cancer 57: 597–602, 1986.PubMedCrossRefGoogle Scholar
  15. 15).
    Carmichael AR, Bendali S, Lockerbie L, Prescott R, Bates T: The long-term outcome of synchronous bilateral breast cancer is worse than metachronous or unilateral tumours.Eur J Surg Oncol 28: 388–391, 2002.PubMedCrossRefGoogle Scholar
  16. 16).
    Mose S, Adamietz IA, Thilmann C, Saran F, Bernhard M, Pahnke R, Bottcher H: Bilateral Breast Carcinoma Versus Unilateral Disease Review of 498 Patients.Am J Clin Oncol 20: 541–545, 1997.PubMedCrossRefGoogle Scholar
  17. 17).
    Sterns EE, Fletcher WA: Bilateral cancer of the breast: a review of clinical, histologic, and immunohistologic characteristics.Surgery 110: 617–622, 1991.PubMedGoogle Scholar
  18. 18).
    Fracchia AA, Robinson D, Legaspi A, Greenall MJ, Kinne DW, Groshen S: Survival in bilateral breast cancer.Cancer 55: 1414–1421, 1985.PubMedCrossRefGoogle Scholar
  19. 19).
    Sears HF, Janus C, McDermott A, Grotzinger P: Bilateral breast carcinoma: prospective evaluation of factors assisting diagnosis.J Surg Oncol 32: 203–207, 1986.PubMedCrossRefGoogle Scholar
  20. 20).
    Oshiro T, Kataoka T, Kodaya T, Sugi K, Takahashi M, Haruta R, Asahara T, Dohi K: Clinicopathological Study of Primary Bilateral Breast Cancer.J Jpn Surg Assoc 61: 11–16, 2000 (in Japanese with English abstract).Google Scholar
  21. 21).
    Abdalla I, Thisted RA, Heimann R: The impact of contralateral breast cancer patients treated by mastectomy.Cancer J 6: 266–272, 2000.PubMedGoogle Scholar
  22. 22).
    Healey EA, Cook EF, Orav EJ, Schnitt SJ, Connolly JL, Harris JR: Contralateral breast cancer: clinical characteristics and impact on prognosis.J Clin Oncol 11: 1545–1552, 1993.PubMedGoogle Scholar
  23. 23).
    Ishiga N, Murakami S, Sho T, Ishihara K, Sakai K, Iwafuji K, Yamamoto Y: A Study of Bilateral Breast Cancer.Jpn J Breast Cancer 6: 523–526, 1991.Google Scholar
  24. 24).
    Sakota Y, Kohno N, Kanbara Y, Ishikawa Y, Sashikata T: A STUDY OF BILATERAL BREAST CANCER.J Jpn Surg Assoc 54: 1439–1444, 1993 (in Japanese with English abstract).Google Scholar
  25. 25).
    Fisher ER, Fisher B, Sass R, Wickerham L: Pathologic Findings From the National Surgical Adjuvant Breast Project (Protocol No. 4) XL Bilateral Breast Cancer.Cancer 54: 3002–3011, 1984.PubMedCrossRefGoogle Scholar
  26. 26).
    De la Rochefordiere A, Asselain B, Scholl S, Campana F, Ucia L, Vilcoq JR, Durand JC, Pouillart P, Fourquet A: Simultaneous bilateral breast carcinoma: a retrosepective review of 149 cases.Int J Radiat Oncol Biol Phys 30: 35–41, 1994.PubMedGoogle Scholar
  27. 27).
    Nomura Y, Tsutsui S, Murakami S, Takenaka Y: Prognostic impact of second cancer on the survival of early breast cancer patients.Int J Oncol 14: 1103- 1109, 1993.Google Scholar
  28. 28).
    Nielsen M, Christensen L, Andersen J: Contralateral cancerous breast lesions in women with clinical invasive breast carcinoma.Cancer 57: 897–903, 1986.PubMedCrossRefGoogle Scholar
  29. 29).
    Gustafsson A, Tartter PI, Brower ST, Lesnick G: Prognosis of patients with bilateral carcinoma of the breast.J Am Coll Surg 178: 111–116, 1994.PubMedGoogle Scholar
  30. 30).
    Skowronek J, Piotrowski T: Bilateral breast cancer.Neoplasma 49: 49–54, 2002.PubMedGoogle Scholar

Copyright information

© The Japanese Breast Cancer Society 2005

Authors and Affiliations

  • Hiromasa Takahashi
    • 1
  • Kenichi Watanabe
    • 2
  • Masato Takahashi
    • 2
  • Kazunori Taguchi
    • 2
  • Fumiaki Sasaki
    • 1
  • Satoru Todo
    • 2
  1. 1.Department of Pediatric SurgeryHokkaido University Postgraduate School of MedicineSapporoJapan
  2. 2.First Department of SurgeryHokkaido University Postgraduate School of MedicineJapan

Personalised recommendations