PURPOSE: Because the incidence of breast cancer is increasing and prognosis is improving, a growing number of women are at risk of developing bilateral disease. Little is known, however, about incidence trends and prognostic features of bilateral breast cancer. PATIENTS AND METHODS: Among 123,757 women with a primary breast cancer diagnosed in Sweden from 1970 to 2000, a total of 6,550 developed bilateral breast cancer. We separated synchronous (diagnosed within 3 months after a first breast cancer) and metachronous bilateral cancer, and analyzed incidence and mortality rates of breast cancer using Poisson regression models. RESULTS: The incidence of synchronous breast cancer increased by age and by 40% during the 1970s, whereas the incidence of metachronous cancer decreased by age and by approximately 30% since the early 1980s, most likely due to increasing use of adjuvant therapy. Women who developed bilateral cancer within 5 years and at age younger than 50 years were 3.9 times (95% CI, 3.5 to 4.5) more likely to die as a result of breast cancer than women with unilateral cancer. Women with a bilateral cancer diagnosed more than 10 years after the first cancer had a prognosis similar to that of a unilateral breast cancer. Adjuvant chemotherapy of primary cancer is a predictor of poor survival after diagnosis of early metachronous cancers. CONCLUSION: We found profound differences in the incidence trends and prognostic outlook between synchronous and metachronous bilateral breast cancer diagnosed at different ages. Adjuvant chemotherapy therapy has a dual effect on metachronous cancer: it reduces the risk, while at the same time it seems to worsen the prognosis.
PURPOSE: Because the incidence of breast cancer is increasing and prognosis is improving, a growing number of women are at risk of developing bilateral disease. Little is known, however, about incidence trends and prognostic features of bilateral breast cancer. PATIENTS AND METHODS: Among 123,757 women with a primary breast cancer diagnosed in Sweden from 1970 to 2000, a total of 6,550 developed bilateral breast cancer. We separated synchronous (diagnosed within 3 months after a first breast cancer) and metachronous bilateral cancer, and analyzed incidence and mortality rates of breast cancer using Poisson regression models. RESULTS: The incidence of synchronous breast cancer increased by age and by 40% during the 1970s, whereas the incidence of metachronous cancer decreased by age and by approximately 30% since the early 1980s, most likely due to increasing use of adjuvant therapy. Women who developed bilateral cancer within 5 years and at age younger than 50 years were 3.9 times (95% CI, 3.5 to 4.5) more likely to die as a result of breast cancer than women with unilateral cancer. Women with a bilateral cancer diagnosed more than 10 years after the first cancer had a prognosis similar to that of a unilateral breast cancer. Adjuvant chemotherapy of primary cancer is a predictor of poor survival after diagnosis of early metachronous cancers. CONCLUSION: We found profound differences in the incidence trends and prognostic outlook between synchronous and metachronous bilateral breast cancer diagnosed at different ages. Adjuvant chemotherapy therapy has a dual effect on metachronous cancer: it reduces the risk, while at the same time it seems to worsen the prognosis.
Authors: S A Narod; N Tung; J Lubinski; T Huzarski; M Robson; H T Lynch; S L Neuhausen; P Ghadirian; C Kim-Sing; P Sun; W D Foulkes Journal: Curr Oncol Date: 2014-04 Impact factor: 3.677
Authors: Tara O Henderson; Alison Amsterdam; Smita Bhatia; Melissa M Hudson; Anna T Meadows; Joseph P Neglia; Lisa R Diller; Louis S Constine; Robert A Smith; Martin C Mahoney; Elizabeth A Morris; Leslie L Montgomery; Wendy Landier; Stephanie M Smith; Leslie L Robison; Kevin C Oeffinger Journal: Ann Intern Med Date: 2010-04-06 Impact factor: 25.391
Authors: Christel Devaud; Liza B John; Jennifer A Westwood; Carmen Sm Yong; Paul A Beavis; Reto A Schwendener; Phillip K Darcy; Michael H Kershaw Journal: Oncoimmunology Date: 2015-06-17 Impact factor: 8.110
Authors: Elżbieta Senkus; Jolanta Szade; Beata Pieczyńska; Anna Zaczek; Joanna Pikiel; Katarzyna Sosińska-Mielcarek; Agnieszka Karpińska; Jacek Jassem Journal: Int J Clin Exp Pathol Date: 2013-12-15