Clinical characteristics and the associated risk factors of the development of bilateral breast cancers: A case-control study. (December 2020)

• Record Type: Journal Article
• Authors: Anwar, Sumadi Lukman; Prabowo, Dayat; Avanti, Widya Surya; Dwianingsih, Ery Kus; Harahap, Wirsma Arif; Aryandono, Teguh
• Is Part Of: Annals of medicine and surgery. Volume 60(2021)
• Page Start: 285
• Page End: 292
• Publication Date: 2020-12
• Subjects: Bilateral -- Contralateral -- Breast cancer -- Risks -- Survival -- Outcome; Surgery -- Periodicals; Medicine -- Periodicals; General Surgery -- Periodicals; Education, Medical -- Periodicals; Periodicals; 617
• DOI: 10.1016/j.amsu.2020.10.064
• Languages: English
• ISSNs: 2049-0801

Abstract

Abstract: Background: The clinical impacts of bilateralism on prognosis and clinical decision-making remain contradictory particularly in areas with low incidence and delayed diagnosis of primary breast cancer. Identification of women at risk of bilateral breast cancer is required to improve patient management and to design the appropriate surveillance. Methods: A total of 1083 women were enrolled and analyzed for the presence of synchronous and metachronous bilateral breast cancer as cases and unilateral breast cancer as controls during the median follow-up of 4.8 years. Results: The incidence of bilateral breast cancer was 7.5% (81 of 1083). In comparison with unilateral breast cancers, bilateral cases were significantly diagnosed in younger women ( P = 0.037, mean age was 35.6 years) who had a larger tumor size ( P = 0.012, mean tumor size was 8 cm in diameter). Histological type of lobular cancer was identified as one of the risk factors for the development of contralateral breast cancer (OR 5.564, 95% CI: 3.219–9.620) and synchronous bilateral breast cancer (OR 2.561, 95% CI: 1.182–5.550). Bilateral breast cancer had significantly shorter progression-free survival (Mean survival was 26.6 vs 52.5 months for bilateral and unilateral breast cancers, respectively; P = 0.001) and shorter time to develop distant metastasis (Mean survival was 41.7 vs 104 months for bilateral and unilateral breast cancers, respectively; P = 0.001). Conclusion: Patients with first primary breast tumors with lobular histological type and advanced stages were observed to have higher risks for the development of contralateral breast cancers. Highlights: Lack of available data of risks of bilateral breast cancer in non-Caucasians. Identification of risks of contralateral breast cancer is useful to design surveillance. Lobular type is a significant risk for the development of contralateral breast cancer.