Bilateral Breast Cancer: Clinical Features And Clinicapathological Characteristics

[Background]:Nowadays, breast cancer is the most common malignancy and second only to lung cancer as the major cause of cancer-related deaths among women in the western world.Improved diagnosis and management modalities and growing life expectancy have resulted in increasing numbers of women at risk of developing contralateral primary breast cancer.Women with breast cancer have a more than 2-fold higher risk of developing a second breast cancer than the risk women in the general population have of developing a primary breast cancer.In spite of this, the incidence of bilateral breast cancer is still low, between 2 and 12% aboard, while between 1.8 and 4% interiorly, according to different series published.There has been conflicting evidence on the impact of bilateral breast cancer (BBC) on relationship between the lesions.The fact that Contralateral breast cancer is either a metastatic lesion or the second primary cancer remains controversial.Even if the cancers develop from different origins,subjected to similar hormonal, environmental, and genetic influences,they may not truly be independent.Meanwhile,as all this going on,different diagnostic criteria result to different scientific findings.From biological and therapeutic viewpoints, it is important to differentiate metastatic lesions from second primary cancer in bilateral breast cancer.With the improvements in research,and to try to explain the etiology of the bilateral breast cancer, one has to not only aim the epidemiology, laying stress on age, family history, menstruation,, but one has to be absorbed in the research that reveal the characteristics and origin of the bilateral lesions, guidance patients with bilateral breast cancer to prevent the secondary tumor, and give appropriate individualized treatment. Currently, some opinions consider breast cancer histology, and hormone receptor status to be a prophetic sign of the second tumor.[Objective]:To investigate the clinicapathological characteristics of the bilateral primary breast cancer (BPBC),stressing the difference and similarity of HER2 and hormone receptor status between first and second tumors.To study their association with the risk factors,management and prognosis.[Methods]:Data were acquired from the Qilu Hospital.the data that a total of 26 patients diagnosed with bilateral breast cancers(BBC)were analyzed.BBC were then categorized as synchronous (within12 months) or metachronous (after 12 months of first tumour). The expression of estrogen receptor(ER), progesterone receptor(PR), HER-2 were detected with immunohistochemistry. SPSS was used for data analysis.[Results]:There were 24 cases of bilateral breast cancer identified in the study. Among the patients with BBC,10(41.7%) had synchronous cancers and 14(58.3%) had metachronous breast cancers.the interval time between the development of the mBBC was 1.8～14.8 years. The mean age of appearance of metachronous cancer was 41.7 years (range:33～55 years).The mean age of appearance of synchronous carcinoma was 44.8 years (range:24～61 years).Women with mBBC were younger than the sBBC group at the time of the diagnosis of their initial tumours (t=0.801, P=0.432).The mean size of the first cancer was 2.04+-1.07cm, The mean size of the second cancer was 1.53+-1.03cm, Contralateral tumours of BBC patients measured significantly smaller than their associated initial tumour of BBC (t=2.632, P=0.015). The mean score of the first cancer was 1.93+-0.22, The mean score of the second cancer was 1.73+-0.42, The histological differentiation of the second lesion is better than the first one (t=2.632, P=0.015)Regarding receptors status, there were significant differences in the rates of estrogen receptors (ER) and HER2/neu expression but not the rate of progesterone receptor (PR) between the initial and contralateral tumours of BBC (ER:V2=3.970, P=0.046; PR:V2=1.313, P=0.252; HER-2:V2=5.243, P=0.022). There was accordance in the rates of estrogen receptors (ER) and progesterone receptor (PR) expression between the initial and contralateral tumours of sBBC ER:V2=0.046, P=0.830; PR:V2=1.276, P=0.259); There was accordance in the rates of progesterone receptors (PR) but not estrogen receptor (ER) expression between the initial and contralateral tumours of mBBC (ER:V2=3.933, P=0.047; PR:V2=0.034, P=0.853)Moreover, bilateral tumours were more likely to be associated with negative axillary lymph nodes.The number of the initial tumours of BBC who underwent axillary lymph node dissection were lymph node positive was 5 while the contralateral one was 4.There were no significant differences between bilateral lesions (V2=0.417, P=0.519)[Conclusion]:Women with mBBC were younger than the sBBC group at the time of the diagnosis of their initial tumours, but the different was no significant.Contralateral tumours of BBC patients measured significantly smaller than their associated initial tumour of BBC, while The histological differentiation of the second lesion is better than the first one but no significant differences between bilateral axillary lymph nodes metastasis. There was a association in progesterone receptor status, but not estrogen receptor status, and CerbB-2 status between bilateral cancer.