Prognosis of patients with bilateral carcinoma of the breast

Ninety-five patients with bilateral carcinoma of the breast treated with mastectomy (60 patients), conservation of the breast (17 patients), or both (18 patients), were studied. Cumulative five year local control rates for the 138 mastectomies was 94 percent and for the 52 breast conservations, 90 percent. Distant metastases appeared in one-third of the patients but one-half of them occurred beyond 60 months. Cumulative five year distant disease-free survival rate measured from treatment for the second carcinoma was 74 percent. Second carcinomas were diagnosed at significantly earlier stage than first carcinomas--28 percent of first carcinomas were stage I compared with 43 percent of second carcinomas (p < 0.05). Distant recurrence-free survival rates for metachronous carcinomas were better then for synchronous carcinomas, but this difference can be attributed to earlier overall staging of metachronous carcinomas. The interval between the diagnosis of first and second carcinomas had a profound effect on outcome for second carcinomas--cumulative five year distant recurrence-free survival rate of patients with second carcinomas diagnosed within five years was 58 percent compared with 95 percent for patients diagnosed more than five years after the first carcinoma.