Selective biopsy of the opposite breast

Area of Science:

• Oncology
• Surgical Pathology

Background:

• Contralateral breast cancer detection rates are approximately 14%.
• Previous studies often excluded younger patients or those with early-stage disease.
• The management of noninfiltrating cancers and patient age influenced mastectomy decisions.

Purpose of the Study:

• To assess the incidence of contralateral breast cancers in younger patients (<65 years) with early-stage (Stage I/II) initial breast cancer.
• To determine the diagnostic yield of contralateral breast biopsy in this specific patient cohort.
• To evaluate the potential benefit of contralateral biopsy for improving patient prognosis.

Main Methods:

• Retrospective review of patients treated for breast cancer between September 1978 and December 1984.
• Inclusion criteria: age <65 years, clinical Stage I/II initial breast cancer.
• Contralateral breast biopsy performed on 258 eligible patients (42% of 610 initial breast cancer cases).

Main Results:

• Forty-three contralateral primary breast cancers were detected, yielding an incidence of 16.7%.
• Suspicious lesions (11 cases) were all infiltrating carcinomas.
• Random biopsies (32 cases) revealed 14.2% yield: 12.5% infiltrating and 87.5% ductal carcinoma in situ.

Conclusions:

• Contralateral breast biopsy in younger patients with early-stage breast cancer is a worthwhile procedure.
• This approach detects a significant incidence of new primary breast cancers.
• Biopsy of the contralateral breast offers potential for improved patient outcomes.