Detection of metachronous breast carcinoma: the role of follow-up?

Second primary (metachronous) breast carcinoma occurs at a rate of approximately 1% per year. Early detection of metachronous carcinomas will optimise the chances of curative treatment. The aim of this study was to identify the method of detection of metachronous carcinomas, so that efforts to detect these tumours can be made more focused. Thirteen patients presented twice to a surgical department in a 7-year period with second primary breast carcinomas. The means of detection of the second primary carcinoma was identified in each case. Eleven of the patients presented with new symptoms which they had noticed themselves. The remaining two carcinomas were detected mammographically, and their presence was confirmed on clinical examination. In no case was the second primary carcinoma detected by clinical examination alone. Metachronous carcinoma is unlikely to be detected by routine clinical examination, but rapid assessment of new symptoms should be facilitated. Follow-up mammography at regular intervals should also improve early detection of metachronous breast carcinoma.