Bilateral Breast Cancer: Clinical Profile and Management

Ashutosh Mishra; Ajit Singh Oberoi; Suryanarayana Deo; Jyoti Sharma; Ajay Gogia; D N Sharma; Sandeep Mathur; Ekta Dhamija

doi:10.1007/s13193-023-01731-x

Bilateral Breast Cancer: Clinical Profile and Management

Indian J Surg Oncol. 2023 Sep;14(3):651-658. doi: 10.1007/s13193-023-01731-x. Epub 2023 Mar 7.

Authors

Ashutosh Mishra¹, Ajit Singh Oberoi¹, Suryanarayana Deo¹, Jyoti Sharma¹, Ajay Gogia², D N Sharma³, Sandeep Mathur⁴, Ekta Dhamija⁵

Affiliations

¹ Department of Surgical Oncology, BRA-IRCH, AIIMS, New Delhi, India.
² Department of Medical Oncology, BRA-IRCH, AIIMS, New Delhi, India.
³ Department of Radiation Oncology, BRA-IRCH, AIIMS, New Delhi, India.
⁴ Department of Pathology, AIIMS, New Delhi, India.
⁵ Department of Radiology, AIIMS, New Delhi, India.

PMID: 37900630
PMCID: PMC10611650 (available on 2024-09-01)
DOI: 10.1007/s13193-023-01731-x

Abstract

There is paucity of literature regarding the demography, histopathology, management, and outcomes of bilateral breast cancer (BBC). We present our experience of treating 127 BBC with multimodality management. An audit of prospectively maintained computerized breast cancer database of the department of surgical oncology at a tertiary care center was performed. Demography, clinical profile, molecular sub-types, treatment patterns, and outcomes were analyzed. A total 127 patients presented with BBC between 1992 and 2019. Ninety-four had metachronous (MBBC) and 33 had synchronous breast cancer (SBBC). Most contralateral breast cancer (CBC) patients had early-stage breast cancer in comparison to the index side cancer (37% vs 32%). Ninety-four patients underwent bilateral mastectomy and only 18 patients underwent bilateral breast conservation. Seventy-one patients undergoing BCS and surgery for LABC were given postoperative radiotherapy. All patients received adjuvant chemo- and/or hormonal therapy both for index and CBC based on the stage and hormone receptor status. Thirty-three percent of patients had either locoregional or distant relapse. The 5-year overall survival (OS) and 5-year disease-free survival (DFS) of the entire cohort were 86.6% and 68.4% respectively. There was no difference in the OS and DFS between SBBC and MBBC. The incidence of BBC is expected to increase with effective diagnostic and therapeutic interventions and improving survival. Patients require individualized treatment planning in a multidisciplinary treatment setting.

Keywords: Bilateral breast cancer; Metachronous breast cancer; Multidisciplinary team; Synchronous breast cancer.

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