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Bilateral breast cancer.

¹University of Southern California School of Medicine, Los Angeles.

The Surgical Clinics of North America

|October 1, 1990

Summary

This summary is machine-generated.

Women with a history of breast cancer face a fivefold increased risk of developing a second primary breast cancer, primarily metachronous. Early detection and appropriate treatment lead to a favorable prognosis for secondary breast cancer.

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Area of Science:

Oncology
Breast Cancer Research
Clinical Medicine

Background:

A prior breast cancer diagnosis significantly elevates a woman's risk for a second primary breast cancer.
This secondary cancer can occur synchronously (at the same time) or metachronously (later).
Key risk factors include multifocal disease, lobular carcinoma in situ, and early-onset cancer with long survival.

Purpose of the Study:

To review the incidence, risk factors, detection, and management of second primary breast cancers.
To inform clinical practice regarding the follow-up and treatment of patients with a history of breast cancer.

Main Methods:

Literature review and synthesis of existing data on synchronous and metachronous breast cancers.
Analysis of risk factors, diagnostic modalities (mammography, biopsy), and treatment outcomes.

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Main Results:

The majority of second primary breast cancers are metachronous, with an incidence of 5-6% compared to 1-2% for synchronous bilateral cancers.
Lobular carcinoma in situ is a strong marker for subsequent contralateral breast cancer.
Mammography aids in detecting synchronous cancers but doesn't alter overall incidence; routine random biopsy is not recommended.

Conclusions:

Long-term surveillance with physical examination and annual mammography is crucial for the contralateral breast.
Treatment for secondary breast cancer should be stage-appropriate.
Prognosis for a second primary breast cancer is generally favorable, contingent on the stage of both primary and secondary tumors.