Considerations on the Prognosis of Bilateral Breast Cancer

Abstract

Bilateral breast cancer accounts for 3.1% of 3272 cases of malignant breast tumors observed during the period 1956–1965. Of the 104 cases of bilateral cancer selected 12 were synchronous and 92 asynchronous. The treatment was radical mastectomy, followed by radiotherapy in cases with metastatic involvement of the axillary lymph-nodes: in 6 cases not amenable to radical surgery the treatment was tumorectomy plus radiotherapy. As to the 12 patients with synchronous bilateral cancer 6 were alive and free of disease 5 years after the treatment: only 1 case was alive after 10 years. The median survival figure was 7.3 years. For the 92 patients treated for successive bilateral cancer the 5- and 10-year survival rate was 78.5% and 64.5% when calculated from the observation of the first tumor: the correspondent figures calculated from the observation of the second tumor were 48.5% and 33% respectively. The median survival figure was 12.7 and 4.8 years respectively. Survival rates for successive bilateral cancer must be calculated from the observation of the second tumor in order to avoid misleading evaluations: the authors do not consider that bilateral cancer has a prognosis similar or even better than unilateral breast cancer. As to treatment, although there are no unequivocal criteria for regarding bilateral cancer as independent tumors, bilateral radical mastectomy is justified and is the treatment of choice.