The incidence of synchronous bilateral breast cancer (SBBC) is comprising between 1 and 3% of all cases of breast cancers. Most studies have defined SBBC as the presentation of bilateral breast cancer within 0–6 months of each other. The aim of this study was to describe the epidemiological profile, the clinicopathological and therapeutic features of bilateral breast cancer and to evaluate their prognosis and survival.
We have undertaken a monocentric retrospective study of 101 patients with SBBC treated and followed at the Salah Azaiez Institute. Cases diagnosed within 6 months of diagnosis of the first breast cancer were classified as synchronous.
The frequency of BBC was 1,65%. One hundred and one patients had synchronous one. The mean age was 51 years. Fifty-eight percent were postmenopausal. Eleven percent had a positive family history for breast carcinoma. Mammography showed opacity with malignant features in the contralateral breast in 55,4% of the cases. The average tumor size was 46 mm. T4 stage was found in 44,8% patients. Twenty-five (24,7%) had metastatic disease at diagnosis. Bilateral surgery was performed in 72,2% whose radical one was done in 36,6% of the cases. On pathology, ductal invasive carcinoma was found in 81,1% of cases whereas lobular invasive carcinoma in 10,9%. The mean diameter of resected tumours measured by pathologists was 31,3 mm. Positive lymph nodes accounted for 61% of all tumors. Hormone receptor status was positive in 78% of the cases. Human epidermal growth factor receptor (HER2), was amplified in 23 of 69 tumors. Radiotherapy was delivered in 77,3% of patients, chemotherapy in 87% and hormonal treatment in 73,6%. The median follow-up was 57 months. The five-year overall survival was 60%. The main prognostic factor on overall survival was the clinical stage (p
The most common approach when determining adjuvant treatment for SBBC is to use the higher stage and most adverse histological characteristics of the tumors as index. Improvement of diagnosis and treatment of breast cancer should increase the incidence of SBBC. Management of these cancers aims to control the disease without risking cumulative toxicity.
Clinical trial indentification
Legal entity responsible for the study
Salah Azaiz Institute
All authors have declared no conflicts of interest.