Abstract
Of 2231 women with stage I, II or III breast cancer who were registered and seen between 1971 and 1979 and followed to the end of 1981, 48 (2.2%) had synchronous and 58 (2.6%) asynchronous bilateral breast cancer. The unadjusted incidence rate for a second breast cancer was 6.4/1000 breast-years at risk, compared with a rate of 0.70 for the risk of a first breast cancer in women. When calculated from the date of diagnosis of the first breast cancer the survival rate was better for the group with asynchronous disease than for the group with synchronous disease or for a group with unilateral disease, but when calculated from the date of diagnosis of the second cancer the rate was the same in all three groups. Comparison of known risk factors showed a significant association between the development of bilateral cancer and a later age at the birth of the first child and a longer interval between menarche and that birth. There was a trend towards greater age and more stage III cancer in the group with synchronous disease. There was no correlation between receiving radiotherapy for the first breast cancer and development of the second cancer. Annual mammography and clinical examination of asymptomatic women at a cancer centre resulted in the detection of a significantly higher proportion of minimal breast cancers in the second breast compared with the first. Such screening practices should be even more valuable in the earlier detection of unilateral breast cancer in asymptomatic women who have not had breast cancer.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Adami H. O., Hansen J., Jung B., Rimsten A. Characteristics of familial breast cancer in Sweden: absence of relation to age and unilateral versus bilateral disease. Cancer. 1981 Oct 1;48(7):1688–1695. doi: 10.1002/1097-0142(19811001)48:7<1688::aid-cncr2820480736>3.0.co;2-w. [DOI] [PubMed] [Google Scholar]
- Al-Jurf A. S., Jochimsen P. R., Urdaneta L. F., Scott D. H. Factors influencing survival in bilateral breast cancer. J Surg Oncol. 1981;16(4):343–348. doi: 10.1002/jso.2930160407. [DOI] [PubMed] [Google Scholar]
- Baker L. H. Breast Cancer Detection Demonstration Project: five-year summary report. CA Cancer J Clin. 1982 Jul-Aug;32(4):194–225. doi: 10.3322/canjclin.32.4.194. [DOI] [PubMed] [Google Scholar]
- Burns P. E., Kredentser J., Grace M., Hanson J. Breast cancer in northern Alberta: pilot study in computerized registration. Can Med Assoc J. 1977 May 21;116(10):1131–1135. [PMC free article] [PubMed] [Google Scholar]
- Burns P. E., Lees A. W., Hurlburt M. E., May C. L., Grace M. Reproductive events and family history as risk factors for breast cancer in northern Alberta. Can Med Assoc J. 1981 Jun 1;124(11):1451–1457. [PMC free article] [PubMed] [Google Scholar]
- Burns P. E., May C., Gutter Z., Ferri H. A., Grace M. Relative accuracy of clinical examination and mammography in a breast clinic in Alberta. J Can Assoc Radiol. 1978 Mar;29(1):22–27. [PubMed] [Google Scholar]
- Fisher E. R., Fisher B. Lobular carcinoma of the breast: an overview. Ann Surg. 1977 Apr;185(4):377–385. doi: 10.1097/00000658-197704000-00001. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Frazier T. G., Copeland E. M., Gallager H. S., Paulus D. D., Jr, White E. C. Prognosis and treatment in minimal breast cancer. Am J Surg. 1977 Jun;133(6):697–701. doi: 10.1016/0002-9610(77)90156-8. [DOI] [PubMed] [Google Scholar]
- Gallager H. S. The developmental pathology of breast cancer. Cancer. 1980 Aug 15;46(4 Suppl):905–907. doi: 10.1002/1097-0142(19800815)46:4+<905::aid-cncr2820461309>3.0.co;2-p. [DOI] [PubMed] [Google Scholar]
- Harris R. E., Lynch H. T., Guirgis H. A. Familial breast cancer: risk to the contralateral breast. J Natl Cancer Inst. 1978 May;60(5):955–960. doi: 10.1093/jnci/60.5.955. [DOI] [PubMed] [Google Scholar]
- Leis H. P., Jr Bilateral breast cancer. Surg Clin North Am. 1978 Aug;58(4):833–841. doi: 10.1016/s0039-6109(16)41595-1. [DOI] [PubMed] [Google Scholar]
- Leis H. P., Jr Managing the remaining breast. Cancer. 1980 Aug 15;46(4 Suppl):1026–1030. doi: 10.1002/1097-0142(19800815)46:4+<1026::aid-cncr2820461327>3.0.co;2-l. [DOI] [PubMed] [Google Scholar]
- Lewison E. F., Neto A. S. Bilateral breast cancer at the Johns Hopkins Hospital. A discussion of the dilemma of contralateral breast cancer. Cancer. 1971 Nov;28(5):1297–1301. doi: 10.1002/1097-0142(1971)28:5<1297::aid-cncr2820280532>3.0.co;2-5. [DOI] [PubMed] [Google Scholar]
- Lubin J. H., Burns P. E., Blot W. J., Lees A. W., May C., Morris L. E., Fraumeni J. F., Jr Risk factors for breast cancer in women in northern Alberta, Canada, as related to age at diagnosis. J Natl Cancer Inst. 1982 Feb;68(2):211–217. [PubMed] [Google Scholar]
- Martin J. K., Jr, van Heerden J. A., Gaffey T. A. Synchronous and metachronous carcinoma of the breast. Surgery. 1982 Jan;91(1):12–16. [PubMed] [Google Scholar]
- McCredie J. A., Inch W. R., Alderson M. Consecutive primary carcinomas of the breast. Cancer. 1975 May;35(5):1472–1477. doi: 10.1002/1097-0142(197505)35:5<1472::aid-cncr2820350536>3.0.co;2-m. [DOI] [PubMed] [Google Scholar]
- Milbrath J. R., Moskowitz M., Bauermeister D. Breast cancer screening. Crit Rev Diagn Imaging. 1981;16(3):181–218. [PubMed] [Google Scholar]
- ROBBINS G. F., BERG J. W. BILATERAL PRIMARY BREAST CANCER; A PROSPECTIVE CLINICOPATHOLOGICAL STUDY. Cancer. 1964 Dec;17:1501–1527. doi: 10.1002/1097-0142(196412)17:12<1501::aid-cncr2820171202>3.0.co;2-p. [DOI] [PubMed] [Google Scholar]
- RYAN A. J., GRISWOLD M. H., ALLEN E. P., KATZENSTEIN R., GREENBERG R., KEOGH J., WILDER C. Breast cancer in Connecticut, 1935-1953; study of 8,396 proved cases. J Am Med Assoc. 1958 May 17;167(3):298–307. doi: 10.1001/jama.1958.02990200024005. [DOI] [PubMed] [Google Scholar]
- Schell S. R., Montague E. D., Spanos W. J., Jr, Tapley N. D., Fletcher G. H., Oswald M. J. Bilateral breast cancer in patients with initial stage I and II disease. Cancer. 1982 Sep 15;50(6):1191–1194. doi: 10.1002/1097-0142(19820915)50:6<1191::aid-cncr2820500628>3.0.co;2-f. [DOI] [PubMed] [Google Scholar]
- Slack N. H., Bross I. D., Nemoto T., Fisher B. Experiences with bilateral primary carcinoma of the breast. Surg Gynecol Obstet. 1973 Mar;136(3):433–440. [PubMed] [Google Scholar]
- Urban J. A., Papachristou D., Taylor J. Bilateral breast cancer: biopsy of the opposite breast. Cancer. 1977 Oct;40(4 Suppl):1968–1973. doi: 10.1002/1097-0142(197710)40:4+<1968::aid-cncr2820400832>3.0.co;2-t. [DOI] [PubMed] [Google Scholar]