Clinical review of bilateral breast cancer

Jeon, Myung Hoon; Kim, Beom Seok; Kang, Su Hwan; Lee, Dong Shik; Lee, Nam Hyuk; Lee, Soo Jung; Kwun, Koing Bo

Abstract

PURPOSE
Bilateral breast cancer is categorized as synchronous or metachronous. The aim of this study was to evaluate the characteristics of synchronous and metachronous breast cancers. METHODS: Between 1989 and 2003, 1111 patients were treated for breast cancer at Yeung-Nam University Hospital. We retrospectively analyzed 27 women with bilateral breast cancer. RESULTS: Among the 27 cases (2.4% of the patients) of bilateral cancers, 7 (0.6%) were synchronous and 20 (1.8%) were metachronous. The mean age of the patient with synchronous and metachronous cancer was 46.9 and 41.1 years, respectively. Eighty percent (16/20) of the metachronous cases were under the age of 50. For the metachronous cancers, 65% of the cases (13/20) were down-staged, and 20% and 15% of the patients were up-staged and at same stage, respectively, compared to the primary cancer. The ER, PR, C-erbB2 and p53 positivity was 20% (4/20), 15%, 21.1% and 52.9% in metachronous cancers, respectively, compared to 65%, 60%, 31.6% and 41.2% in the primary cancers, respectively. During the mean follow up of 74.3 months, the recurrence rate and mortality rate was 42.9% and 28.6%, respectively, for the synchronous cancers, and 5% and 5%, respectively, for the metachronous cancers. CONCLUSION: The stage of the metachronous cancer was lower than that of the primary cancer, and this was probably due to careful follow-up. The lower proportion of ER and/or PR positive tumor in metachronous cancer might be associated with the effect of tamoxifen treatment. The prognosis was less favorable for the synchronous cases than for the metachronous second breast cancers in this study.