A clinicopathological study of early-stage synchronous bilateral breast cancer: a retrospective evaluation and prospective validation of potential risk factors

Jia-Jian Chen; Yan Wang; Jing-Yan Xue; Ying Chen; Ya-Ling Chen; Qin Xiao; Wen-Tao Yang; Zhi-Min Shao; Jiong Wu

doi:10.1371/journal.pone.0095185

A clinicopathological study of early-stage synchronous bilateral breast cancer: a retrospective evaluation and prospective validation of potential risk factors

PLoS One. 2014 Apr 15;9(4):e95185. doi: 10.1371/journal.pone.0095185. eCollection 2014.

Authors

Jia-Jian Chen¹, Yan Wang¹, Jing-Yan Xue¹, Ying Chen¹, Ya-Ling Chen², Qin Xiao³, Wen-Tao Yang⁴, Zhi-Min Shao¹, Jiong Wu¹

Affiliations

¹ Department of Breast Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
² Department of Ultrasound, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
³ Department of Diagnostic Radiology, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
⁴ Department of Pathology, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.

Abstract

Background: The aim of the present study was to investigate potential risk factors for synchronous bilateral breast cancer sBBC).

Methods: A retrospective analysis was performed of patients diagnosed and treated with operable bilateral breast cancer (BBC) between June 2007 and December 2011. Risk factors for sBBC were evaluated in this cohort and further validated in a prospective observational validation analysis of patients between January 2012 and December 2012. Patients treated with operable unilateral breast cancer during the same period were used as a control group.

Results: A total of 11,247 patients with primary breast cancer underwent operations at the Fudan University Shanghai Cancer Center between June 2007 and December 2012. The incidence of sBBC was 1.6%. The age at diagnosis (HR = 2.4, 95% C.I.: 1.4-4.0, p = 0.001), presence of sclerosing adenosis (HR = 11.8, 95% C.I.: 5.3-26.3, p<0.001), lobular carcinoma component involvement (HR = 5.6, 95% C.I.: 2.6-12.1, p<0.001), and family history of first-degree relatives with breast cancer (HR = 2.0, 95% C.I.: 1.1-3.4, p<0.001) were independent risk factors for sBBC. A subsequent validation study failed to confirm the significance of family history. No significant difference on survival was found between patients with early-stage sBBC and control cases.

Conclusions: Patients with the presence of sclerosing in the affected breast, and lobular carcinoma component involvement may be at high risk for developing sBBC. This study supports the hypothesis that the host-carcinoma biological relationship, especially for the tumor microenvironment, played a critical role in the carcinogenesis of sBBC.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Aged
Aged, 80 and over
Breast Neoplasms / epidemiology*
Breast Neoplasms / pathology*
China / epidemiology
Female
Humans
Middle Aged
Neoplasm Staging
Observational Studies as Topic
Prospective Studies
Reproducibility of Results
Retrospective Studies
Risk Factors
Young Adult

Grants and funding

This study was supported in part by grants from the Research Foundation of the Fudan University Shanghai Cancer Center (No. YJ200908) and Youth Scientific Research Foundation of the Shanghai Municipal Health Bureau (No. 20124Y067). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.