Top

Published in:

01-11-2007 | Epidemiology

Survival after bilateral breast cancer: results from a population-based study

Authors: Helena M. Verkooijen, Vanessa Chatelain, Gérald Fioretta, Georges Vlastos, Elisabetta Rapiti, André-Pascal Sappino, Christine Bouchardy, Pierre O. Chappuis

Published in: Breast Cancer Research and Treatment | Issue 3/2007

Abstract

Background

Controversy exists on the impact of bilaterality of breast cancer on survival. We used population-based data to compare survival of women with unilateral versus bilateral breast cancer.

Patients and methods

At the Geneva cancer registry, we identified all 7,912 women diagnosed with invasive breast cancer between 1970 and 2002. Breast cancers were categorized as unilateral, synchronous bilateral (contralateral tumour diagnosed within six months after the first tumour) and metachronous bilateral (contralateral tumour diagnosed over six months after the first tumour). With multivariate modelling we compared characteristics and survival between women with unilateral and bilateral disease.

Results

Patients with synchronous bilateral tumours (n = 155, 2.0%) had more often lobular histology and less frequently stage I disease than women with unilateral disease. Women with metachronous breast cancer (n = 219, 2.8%) received less often chemotherapy or hormone therapy for their first tumours. Ten-year disease-specific survival was similar (66%) after unilateral and metachronous bilateral breast cancer, but worse after synchronous bilateral cancer (51%). After adjustment, breast cancer mortality risks were not significantly increased for women with either synchronous or metachronous bilateral disease (Hazard ratios 1.1 (0.8–1.5) and 0.8 (0.5–1.4), respectively).

Conclusion

This large population-based study indicates that bilaterality of breast cancer is not associated with impaired survival.

Dawson LA, Chow E, Goss PE (1998) Evolving perspectives in contralateral breast cancer. Eur J Cancer 34:2000–2009PubMedCrossRef

Vaittinen P, Hemminki K (2000) Risk factors and age-incidence relationships for contralateral breast cancer. Int J Cancer 88:998–1002PubMedCrossRef

Carmichael AR, Bendall S, Lockerbie L et al (2002) The long-term outcome of synchronous bilateral breast cancer is worse than metachronous or unilateral tumours. Eur J Surg Oncol 28:388–391PubMedCrossRef

Newman LA, Sahin AA, Cunningham JE et al (2001) A case-control study of unilateral and bilateral breast carcinoma patients. Cancer 91:1845–1853PubMedCrossRef

Gajalakshmi CK, Shanta V, Hakama M (1999) Survival from contralateral breast cancer. Breast Cancer Res Treat 58:115–122PubMedCrossRef

Anderson DE, Badzioch MD (1985) Bilaterality in familial breast cancer patients. Cancer 56:2092–2098PubMedCrossRef

Hemminki K, Vaittinen P (1999) Familial risks in second primary breast cancer based on a family cancer database. Eur J Cancer 35:455–458PubMedCrossRef

Hartman M, Czene K, Reilly M (2005) Genetic implications of bilateral breast cancer: a population based cohort study. Lancet Oncol 6:377–382PubMedCrossRef

Imyanitov EN, Hanson KP (2003) Molecular pathogenesis of bilateral breast cancer. Cancer Lett 191:1–7PubMedCrossRef

10.

Haffty BG, Harrold E, Khan AJ et al (2002) Outcome of conservatively managed early-onset breast cancer by BRCA1/2 status. Lancet 359:1471–1477PubMedCrossRef

11.

Chappuis PO, Stoppa-Lyonnet D, Asselain B et al (2002) The natural history of hereditary breast cancer. In: Morrison PJ, Hodgson SV, Haites NE (eds) Familial breast and ovarian cancer. Cambridge University Press, Cambridge

12.

Steinmann D, Bremer M, Rades D et al (2001) Mutations of the BRCA1 and BRCA2 genes in patients with bilateral breast cancer. Br J Cancer 85:850–858PubMedCrossRef

13.

Holmberg L, Adami HO, Ekbom A et al (1988) Prognosis in bilateral breast cancer. Effects of time interval between first and second primary tumours. Br J Cancer 58:191–194PubMed

14.

Wanebo HJ, Senofsky GM, Fechner RE et al (1985) Bilateral breast cancer. Risk reduction by contralateral biopsy. Ann Surg 201:667–677PubMedCrossRef

15.

Levi F, Randimbison L, Te VC et al (2003) Prognosis of bilateral synchronous breast cancer in Vaud, Switzerland. Breast 12:89–91PubMedCrossRef

16.

Kollias J, Ellis IO, Elston CW et al (1999) Clinical and histological predictors of contralateral breast cancer. Eur J Surg Oncol 25:584–589PubMedCrossRef

17.

Jobsen JJ, van der PJ, Ong F et al (2003) Synchronous, bilateral breast cancer: prognostic value and incidence. Breast 12:83–88PubMedCrossRef

18.

Polednak AP (2003) Bilateral synchronous breast cancer: a population-based study of characteristics, method of detection, and survival. Surgery 133:383–389PubMedCrossRef

19.

Heron DE, Komarnicky LT, Hyslop T et al (2000) Bilateral breast carcinoma: risk factors and outcomes for patients with synchronous and metachronous disease. Cancer 88:2739–2750PubMedCrossRef

20.

Abdalla I, Thisted RA, Heimann R (2000) The impact of contralateral breast cancer on the outcome of breast cancer patients treated by mastectomy. Cancer J 6:266–272PubMed

21.

Mose S, Adamietz IA, Thilmann C et al (1997) Bilateral breast carcinoma versus unilateral disease. Review of 498 patients. Am J Clin Oncol 20:541–545

22.

Bouchardy C (1997) Switzerland Geneva. In: Parkin DM, Whelan SL, Ferlay J et al (eds) Cancer incidence in five continents, vol VII. International Agency for Research on Cancer, Lyon

23.

ICD-O International classification of diseases for oncology (1976) 1st edn. World Health Organization, Geneva

24.

TNM classification of malignant tumours (2002) 6th edn. UICC, New York

25.

Intra M, Rotmensz N, Viale G et al (2004) Clinicopathologic characteristics of 143 patients with synchronous bilateral invasive breast carcinomas treated in a single institution. Cancer 101:905–912PubMedCrossRef

26.

Mertens WC, Hilbert V, Makari-Judson G (2004) Contralateral breast cancer: factors associated with stage and size at presentation. Breast J 10:304–312PubMedCrossRef

27.

Early Breast Cancer Trialists’ Collaborative Group (2005) Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials. Lancet 365:1687–1717CrossRef

28.

Gajalakshmi CK, Shanta V, Hakama M (1998) Risk factors for contralateral breast cancer in Chennai (Madras), India. Int J Epidemiol 27:743–750PubMedCrossRef

29.

Verkooijen HM, Fioretta G, Chappuis PO et al (2004) Set-up of a population-based familial breast cancer registry in Geneva, Switzerland: validation of first results. Ann Oncol 15:350–353PubMedCrossRef

30.

Gershoni-Baruch R, Dagan E, Fried G et al (1999) BRCA1 and BRCA2 founder mutations in patients with bilateral breast cancer. Eur J Hum Genet 7:833–836PubMedCrossRef

31.

Nelson HD, Huffman LH, Fu R et al (2005) Genetic risk assessment and BRCA mutation testing for breast and ovarian cancer susceptibility: systematic evidence review for the U.S. Preventive Services Task Force. Ann Intern Med 143:362–379PubMed

32.

Hampel H, Sweet K, Westman JA et al (2004) Referral for cancer genetics consultation: a review and compilation of risk assessment criteria. J Med Genet 41:81–91PubMedCrossRef

33.

Kollias J, Ellis IO, Elston CW et al (2001) Prognostic significance of synchronous and metachronous bilateral breast cancer. World J Surg 25:1117–1124PubMed

34.

Takahashi H, Watanabe K, Takahashi M et al (2005) The impact of bilateral breast cancer on the prognosis of breast cancer: a comparative study with unilateral breast cancer. Breast Cancer 12:196–202PubMedCrossRef

35.

Healey EA, Cook EF, Orav EJ et al (1993) Contralateral breast cancer: clinical characteristics and impact on prognosis. J Clin Oncol 11:1545–1552PubMed

Title: Survival after bilateral breast cancer: results from a population-based study
Authors: Helena M. Verkooijen
Vanessa Chatelain
Gérald Fioretta
Georges Vlastos
Elisabetta Rapiti
André-Pascal Sappino
Christine Bouchardy
Pierre O. Chappuis
Publication date: 01-11-2007
Publisher: Springer US
Published in: Breast Cancer Research and Treatment / Issue 3/2007
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-006-9455-x

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras

Prof. Fabrice Barlesi

Developed by: Springer Medicine

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Patients and methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 3/2007

Type of TP53 mutation and ERBB2 amplification affects survival in node-negative breast cancer

A synthetic uracil derivative with antitumor activity through decreasing cyclin D1 and Cdk1, and increasing p21 and p27 in MCF-7 cells

BRCA1 genetic testing in 106 breast and ovarian cancer families from southern Italy (Sicily): a mutation analyses

Impact of a programme of mass mammography screening for breast cancer on socio-economic variation in survival: a population-based study

JNK pathway regulates estradiol-induced apoptosis in hormone-dependent human breast cancer cells

N-cadherin engagement provides a dominant stop signal for the migration of MDA-MB-468 breast carcinoma cells

Keynote webinar | Spotlight on antibody–drug conjugates in cancer