[Bilateral carcinoma of the breast]

In the light of literature and personal experience the Authors analyse the problem of bilateral breast cancer. Distinction between primary cancer (synchronous or metachronous) and metastasis in the second breast is made on the bases of clinical and histological criteria. Lobular cancer, either in situ of infiltrating, has a higher incidence of bilaterality. Aethiology, incidence, prognostic significance of the second cancer are briefly discussed; particularly, it is emphasized that there is a "high risk" group of patients in which the incidence of primary contralateral cancer is much higher. The Authors stress the importance of clinical examination of the other breast at the time of initial mastectomy for a proven breast cancer. The risk of metachronous cancer may be prevented by prophylactic contralateral mastectomy in the "high risk" patients or by random biopsy of the opposite breast in all the patients undergoing surgical therapy for cancer in the first breast. It is opinion of the Authors that early diagnosis may be also obtained if the patients are carefully followed by regular physical examinations and by diagnostic aids (mammography, ultrasonography, thermography).