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01-02-2011 | Epidemiology

Bilateral breast cancer: analysis of incidence, outcome, survival and disease characteristics

Authors: Elrasheid A. H. Kheirelseid, Hanzali Jumustafa, Nicola Miller, Catherine Curran, Karl Sweeney, Carmel Malone, Ray McLaughlin, John Newell, Michael J. Kerin

Published in: Breast Cancer Research and Treatment | Issue 1/2011

Abstract

There has been conflicting evidence on the impact of bilateral breast cancer (BBC) on the survival and management of patients. The objectives of this study were to address the incidence of BBC and to investigate its characteristics and outcome compared to unilateral cancer. Data were acquired from the prospectively maintained NUIG breast cancer database between 1988 and 2008. BBC were then categorized as synchronous (within 12 months) or metachronous (after 12 months of first tumour). SPSS was used for data analysis. The incidence of BBC in our population was 4.4% (112 of 2,524). Of those 2.1% were synchronous while 2.3% were metachronous. Compared to unilateral cases, bilateral cancer patients were younger (P = 0.021) and had smaller size (P = 0.001) and earlier stage (P < 0.001) tumours at diagnosis. We identified the HER2/neu positivity as a risk factor for developing contralateral breast tumour and ER negativity as a risk factor for developing metachronous tumours. While there was no significant difference in survival for patients with bilateral compared to unilateral tumour (P > 0.05), the synchronous tumour was associated with poorer survival (P = 0.010) in comparison to metachronous tumour. This large single-institutional experience does not support the increasing practice of prophylactic mastectomy but does justify regular follow-up with mammography for early detection of contralateral tumour.

Jemal A, Siegel R, Ward E, Hao Y, Xu J, Murray T, Thun MJ (2008) Cancer statistics, 2008. CA Cancer J Clin 58:71–96CrossRefPubMed

Donovan AJ (1990) Bilateral breast cancer. Surg Clin N Am 70:1141–1149PubMed

Michowitz M, Noy S, Lazebnik N, Aladjem D (1985) Bilateral breast cancer. J Surg Oncol 30:109–112CrossRefPubMed

Gogas J, Markopoulos C, Skandalakis P, Gogas H (1993) Bilateral breast cancer. Am Surg 59:733–735PubMed

Chen Y, Thompson W, Semenciw R, Mao Y (1999) Epidemiology of contralateral breast cancer. Cancer Epidemiol, Biomark Prev 8:855–861

Chaudary MA, Millis RR, Hoskins EO, Halder M, Bulbrook RD, Cuzick J, Hayward JL (1984) Bilateral primary breast cancer: a prospective study of disease incidence. Br J Surg 71:711–714CrossRefPubMed

Heron DE, Komarnicky LT, Hyslop T, Schwartz GF, Mansfield CM (2000) Bilateral breast carcinoma: risk factors and outcomes for patients with synchronous and metachronous disease. Cancer 88:2739–2750CrossRefPubMed

Newman LA, Sahin AA, Cunningham JE, Bondy ML, Mirza NQ, Vlastos GS, Whitman GJ, Brown H, Buchholz TA, Lee MH, Singletary SE (2001) A case-control study of unilateral and bilateral breast carcinoma patients. Cancer 91:1845–1853CrossRefPubMed

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

10.

Hartman M, Czene K, Reilly M, Bergh J, Lagiou P, Trichopoulos D, Adami H-O, Hall P (2005) Genetic implications of bilateral breast cancer: a population based cohort study. Lancet Oncol 6:377–382CrossRefPubMed

11.

Lee MM, Heimann R, Powers C, Weichselbaum RR, Chen LM (1999) Efficacy of breast conservation therapy in early stage bilateral breast cancer. Breast J 5:36–41CrossRefPubMed

12.

Jobsen JJ, Jvd Palen, Ong F, Meerwaldt JH (2003) Synchronous, bilateral breast cancer: prognostic value and incidence. Breast 12:83–88CrossRefPubMed

13.

Tuttle TM, Jarosek S, Habermann EB, Arrington A, Abraham A, Morris TJ, Virnig BA (2009) Increasing rates of contralateral prophylactic mastectomy among patients with ductal carcinoma in situ. J Clin Oncol 27:1362–1367CrossRefPubMed

14.

Hartmann LC, Schaid DJ, Woods JE, Crotty TP, Mayers JL, Arnold PG, Petty PM, Sellers TA, Johnson JL, McDonnell SK, Frost MH, Jenkins RB (1999) Efficacy of bilateral prophylactic mastectomy in women with a family history of breast cancer. N Engl J Med 340:77–84CrossRefPubMed

15.

Quan G, Pommier SJ, Pommier RF (2008) Incidence and outcomes of contralateral breast cancers. Am J Surg 195:645–650CrossRefPubMed

16.

Lee SG, Orel SG, Woo IJ, Cruz-Jove E, Putt ME, Solin LJ, Czerniecki BJ, Schnall MD (2003) MR imaging screening of the contralateral breast in patients with newly diagnosed breast cancer: preliminary results. Radiology 226:773–778CrossRefPubMed

17.

Boetes C, Veltman J (2005) Screening women at increased risk with MRI. Cancer Imaging 23:S10–S15CrossRef

18.

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

19.

Adami HO, Bergstrom R, Hansen J (1985) Age at first primary as a determinant of the incidence of bilateral breast cancer: cumulative and relative risks in a population-based case-control study. Cancer 55:643–647CrossRefPubMed

20.

Brenner H, Engelsmann B, Stegmaier C, Ziegler H (1993) Clinical epidemiology of bilateral breast cancer. Cancer 72:3629–3635CrossRefPubMed

21.

Rauschecker HF, Sauerbrei W, Gatzemeier W, Sauer R, Schauer A, Schmoor C, Schumacher M (1998) Eight-year results of a prospective non-randomized study on therapy of small breast cancer. The German Breast Cancer Study Group (GBSG). Eur J Cancer 34:315–323CrossRefPubMed

22.

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

23.

Samant RS, Olivotto IA, Jakson ISH, Mates D (2001) Diagnosis of metachronous contralateral breast cancer. Breast J 7:405–410CrossRefPubMed

24.

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

25.

Irvine T, Allen DS, Gillett C, Hamed H, Fentiman IS (2009) Prognosis of synchronous bilateral breast cancer. Br J Surg 96:376–380CrossRefPubMed

26.

Lesser ML, Rosen PP, Kinne DW (1982) Multicentricity and bilaterality in invasive breast carcinoma. Surgery 91:234–240PubMed

27.

de la Rochefordiere A, Asselain B, Scholl S, Campana F, Ucla L, Vilcoq JR, Durand JC, Pouillart P, Fourquet A (1994) Simultaneous bilateral breast carcinoma: a retrospective review of 149 cases. Int J Radiat Oncol Biol Phys 30:35–41CrossRef

28.

Coradini D, Oriana S, Mariani L, Miceli R, Bresciani G, Marubini E, Di Fronzo G (1998) Is steroid receptor profile in contralateral breast cancer a marker of independence of the corresponding primary tumour? Eur J Cancer 34:825–830CrossRefPubMed

29.

Lehman CD, Gatsonis C, Kuhl CK, Hendrick RE, Pisano ED, Hanna L, Peacock S, Smazal SF, Maki DD, Julian TB, DePeri ER, Bluemke DA, Schnall MD (2007) MRI evaluation of the contralateral breast in women with recently diagnosed breast cancer. N Engl J Med 356:1295–1303CrossRefPubMed

30.

Kriege M, Brekelmans CT, Boetes C, Besnard PE, Zonderland HM, Obdeijn IM, Manoliu RA, Kok T, Peterse H, Tilanus-Linthorst MM, Muller SH, Meijer S, Oosterwijk JC, Beex LV, Tollenaar RA, de Koning HJ, Rutgers EJ, Klijn JG (2004) Efficacy of MRI and mammography for breast-cancer screening in women with a familial or genetic predisposition. N Engl J Med 351:427–437CrossRefPubMed

31.

Viehweg P, Rotter K, Laniado M, Lampe D, Buchmann J, Kölbl H, Heywang-Köbrunner S (2004) MR imaging of the contralateral breast in patients after breast-conserving therapy. Eur Radiol 14:402–408CrossRefPubMed

32.

Lehman CD, Blume JD, Thickman D, Bluemke DA, Pisano E, Kuhl C, Julian TB, Hylton N, Weatherall P, O’loughlin M, Schnitt SJ, Gatsonis C, Schnall MD (2005) Added cancer yield of MRI in screening the contralateral breast of women recently diagnosed with breast cancer: results from the International Breast Magnetic Resonance Consortium (IBMC) trial. J Surg Oncol 92:9–15CrossRefPubMed

33.

Moore SG, Shenoy PJ, Fanucchi L, Tumeh JW, Flowers CR (2009) Cost-effectiveness of MRI compared to mammography for breast cancer screening in a high risk population. BMC Health Serv Res 9:9CrossRefPubMedPubMedCentral

34.

Bertelsen L, Bernstein L, Olsen JH, Mellemkjaer L, Haile RW, Lynch CF, Malone KE, Anton-Culver H, Christensen J, Langholz B, Thomas DC, Begg CB, Capanu M, Ejlertsen B, Stovall M, Boice JD Jr, Re S, Women’s Environment CaRESCG, Bernstein JL (2008) Effect of systemic adjuvant treatment on risk for contralateral breast cancer in the Women’s Environment, Cancer and Radiation Epidemiology Study. J Natl Cancer Inst 100:32–40CrossRefPubMed

35.

Vogel VG, Costantino JP, Wickerham DL, Cronin WM, Cecchini RS, Atkins JN, Bevers TB, Fehrenbacher L, Pajon ER Jr, Wade JL III, Robidoux A, Margolese RG, James J, Lippman SM, Runowicz CD, Ganz PA, Reis SE, McCaskill-Stevens W, Ford LG, Jordan VC, Wolmark N (2006) Effects of tamoxifen vs raloxifene on the risk of developing invasive breast cancer and other disease outcomes: the NSABP Study of Tamoxifen and Raloxifene (STAR) P-2 trial. JAMA 295:2727–2741CrossRefPubMed

36.

Early Breast Cancer Trialists’ Collaborative Group (1998) Tamoxifen for early breast cancer: an overview of the randomised trials. Lancet 351:1451–1467CrossRef

37.

Bedrosian I, Hu CY, Chang GJ (2010) Population-based study of contralateral prophylactic mastectomy and survival outcomes of breast cancer patients. J Natl Cancer Inst 102(6):401–409CrossRefPubMedPubMedCentral

38.

Peralta EA, Ellenhorn JD, Wagman LD, Dagis A, Andersen JS, Chu DZ (2000) Contralateral prophylactic mastectomy improves the outcome of selected patients undergoing mastectomy for breast cancer. Am J Surg 180:439–445CrossRefPubMed

39.

Zion SM, Slezak JM, Sellers TA, Woods JE, Arnold PG, Petty PM, Donohue JH, Frost MH, Schaid DJ, Hartmann LC (2003) Reoperations after prophylactic mastectomy with or without implant reconstruction. Cancer 98:2152–2160CrossRefPubMed

40.

Frost MH, Slezak JM, Tran NV, Williams CI, Johnson JL, Woods JE, Petty PM, Donohue JH, Grant CS, Sloan JA, Sellers TA, Hartmann LC (2005) Satisfaction after contralateral prophylactic mastectomy: the significance of mastectomy type, reconstructive complications, and body appearance. J Clin Oncol 23:7849–7856CrossRefPubMed

41.

Gollamudi SV, Gelman RS, Peiro G, Schneider LJ, Schnitt SJ, Recht A, Silver BJ, Harris JR, Connolly JL (1997) Breast-conserving therapy for stage I–II synchronous bilateral breast carcinoma. Cancer 79:1362–1369CrossRefPubMed

42.

Yamauchi C, Mitsumori M, Nagata Y, Kokubo M, Inamoto T, Mise K, Kodama H, Hiraoka M (2005) Bilateral breast-conserving therapy for bilateral breast cancer: results and consideration of radiation technique. Breast Cancer 12:135–139CrossRefPubMed

43.

Bernstein JL, Thompson WD, Risch N, Holford TR (1992) Risk factors predicting the incidence of second primary breast cancer among women diagnosed with a first primary breast cancer. Am J Epidemiol 136:925–936PubMed

44.

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

45.

Fisher B, Anderson S, Bryant J, Margolese RG, Deutsch M, Fisher ER, Jeong JH, Wolmark N (2002) Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med 347:1233–1241CrossRefPubMed

46.

Boice JD Jr, Harvey EB, Blettner M, Stovall M, Flannery JT (1992) Cancer in the contralateral breast after radiotherapy for breast cancer. N Engl J Med 326:781–785CrossRefPubMed

47.

Storm HH, Andersson M, Boice JD Jr, Blettner M, Stovall M, Mouridsen HT, Dombernowsky P, Rose C, Jacobsen A, Pedersen M (1992) Adjuvant radiotherapy and risk of contralateral breast cancer. J Natl Cancer Inst 84:1245–1250CrossRefPubMed

48.

Gao X, Fisher SG, Emami B (2003) Risk of second primary cancer in the contralateral breast in women treated for early-stage breast cancer: a population-based study. Int J Radiat Oncol Biol Phys 56:1038–1045CrossRefPubMed

49.

Takahashi H, Watanabe K, Takahashi M, Taguchi K, Sasaki F, Todo S (2005) The impact of bilateral breast cancer on the prognosis of breast cancer: a comparative study with unilateral breast cancer. Breast Cancer 12:196–202CrossRefPubMed

50.

Verkooijen HM, Chatelain V, Fioretta G, Vlastos G, Rapiti E, Sappino AP, Bouchardy C, Chappuis PO (2007) Survival after bilateral breast cancer: results from a population-based study. Breast Cancer Res Treat 105:347–357CrossRefPubMed

51.

Mhuircheartaigh JN, Curran C, Hennessy E, Kerin MJ (2008) Prospective matched-pair comparison of outcome after treatment for lobular and ductal breast carcinoma. Br J Surg 95:827–833CrossRefPubMed

Title: Bilateral breast cancer: analysis of incidence, outcome, survival and disease characteristics
Authors: Elrasheid A. H. Kheirelseid
Hanzali Jumustafa
Nicola Miller
Catherine Curran
Karl Sweeney
Carmel Malone
Ray McLaughlin
John Newell
Michael J. Kerin
Publication date: 01-02-2011
Publisher: Springer US
Published in: Breast Cancer Research and Treatment / Issue 1/2011
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-010-1057-y

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