Bilateral breast cancer at the Johns Hopkins Hospital. A discussion of the dilemma of contralateral breast cancer.

Abstract

A study of 490 cases of breast cancer at the Johns Hopkins Hospital revealed 42 cases (8.6%) with bilateral disease. There were 8 cases (1.7%) of bilateral primary simultaneous breast cancer and 34 cases (6.9%) of bilateral primary non-simulaneous breast cancer. There were 6 cases of lobular carcinoma in situ included in this series; 3 cases were simultaneous and 3 cases were non-simultaneous. If these 6 cases were deleted from the study, the total incidence of bilateral breast cancer would be 7.3%. A similar study of 67 cases of breast cancer in private patients revealed only 1 case (1.5%) with bilateral breast cancer over a long period of follow-up. The incidence of latent or occult cancer of the contralateral breast is discussed in relation to the incidence of overt bilateral breast cancer. Careful follow-up examination is the recommended method of management for all patients with primary breast cancer. Periodic physical examinations supplemented by mammography and other meaningful diagnostic aids (thermography, xeroraadiography, and ultrasonography) are to be preferred to random biopsy or prophylactic mastectomy of the asymptomatic contralateral breast.