Tailored approach to management of bilateral breast cancer in Indian women

Introduction: Bilateral breast cancer BCC is relatively uncommon with an overall incidence of 5-20% in women with early breast cancer. They are divided into synchronous if cancers are detected simultaneously or within 6 months of each other and metachronous if they are detected more than 6 months apart from each other. Family history and hereditary cancers multicentricity and lobular histology are some of the factors associated with BCC. In this background, we sought to evaluate the incidence, clinicopathological profile, and management of women with bilateral primary breast cancer at our institute. Materials and Methods: We retrospectively reviewed the medical records of women who underwent surgery for BCC at the breast services unit at our institute from October 2010 to April 2015. The clinicopathological profile and outcomes were analyzed using SPSS 22 software and appropriate statistical tests. Results: Out of 1330 women who underwent surgery for early breast cancer between October 2010 and April 2015, 44 were bilateral. Twenty-eight were synchronous and 16 were metachronous. Mean age of the presentation of patients was 53 years (range 30-79 years). The histological type were same in 82.14% of synchronous tumors and 87.5% of metachronous tumors (P = 0.496). The grades were similar in 42.85% of synchronous tumors and 56.25% of metachronous lesions (P = 0.294). The stage concordance among synchronous tumors was 39.28%, whereas it was 60% among metachronous lesions (P = 0.164). Conclusions: The management of BCC is complex and has to be tailored to the individual based on characteristics of index and second tumor, prior therapy, adjuvant treatment, and risk stratification. Moreover, the concordance of receptor expression is higher in synchronous cancers than metachronous cancers.