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Published in: Breast Cancer Research and Treatment 1/2020

01-07-2020 | Breast Cancer | Epidemiology

Synchronous bilateral breast cancer: a nationwide study on histopathology and etiology

Authors: Mathias Kvist Mejdahl, Jan Wohlfahrt, Marianne Holm, Ann Søegaard Knoop, Anne Tjønneland, Mads Melbye, Niels Kroman, Eva Balslev

Published in: Breast Cancer Research and Treatment | Issue 1/2020

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Abstract

Purpose

The aim of the present study was to describe histopathologic characteristics of synchronous bilateral breast cancer (SBBC), and by comparing SBBC to unilateral breast cancer (UBC), identify possible etiological mechanisms of SBBC.

Methods

Patients with primary SBBC (diagnosed within 4 months) and UBC diagnosed in Denmark between 1999 and 2015 were included. Detailed data on histopathology were retrieved from the Danish Breast Cancer Group database and the Danish Pathology Register. Associations between bilateral disease and the different histopathologic characteristics were evaluated by odds ratios and estimated by multinomial regression models.

Results

1214 patients with SBBC and 59,221 with UBC were included. Patients with SBBC more often had invasive lobular carcinomas (OR 1.29; 95% CI 1.13–1.47), a clinically distinct subtype of breast cancer, than UBC patients. Further, they were older than UBC patients, more often had multifocal cancer (OR 1.13; 95% CI 1.01–1.26), and a less aggressive subtype than UBC patients. Invasive lobular carcinoma was associated with having multiple tumors in breast tissue—both in the form of bilateral disease and multifocal disease, and this association was independent of laterality. No similar pattern was observed for other tumor characteristics.

Conclusion

We identified two etiological mechanisms that could explain some of the occurrence of SBBC. The high proportion of less aggressive carcinomas and higher age of SBBC compared to UBC patients suggests that many are diagnosed at a subclinical stage as slow-growing tumors have a higher probability of simultaneous diagnosis. The high proportion of invasive lobular carcinoma observed in bilateral and multifocal disease, being independent of laterality, suggests that these patients have an increased propensity to malignant tumor formation in breast tissue.
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Metadata
Title
Synchronous bilateral breast cancer: a nationwide study on histopathology and etiology
Authors
Mathias Kvist Mejdahl
Jan Wohlfahrt
Marianne Holm
Ann Søegaard Knoop
Anne Tjønneland
Mads Melbye
Niels Kroman
Eva Balslev
Publication date
01-07-2020
Publisher
Springer US
Published in
Breast Cancer Research and Treatment / Issue 1/2020
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-020-05689-0

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