Clinicopathological characteristics and prognostic analysis of bilateral primary breast cancer

Abstract

The aim of this study is to explore the clinicopathological characteristics, diagnosis, multidiscipline therapy and prognosis of bilateral primary breast cancer (BPBC). Clinical data of 133 patients with BPBC seen in Cancer Institute and Hospital of Tianjin Medical University from January 2005 to December 2008 were retrospectively analyzed and compared with those of 266 patients with unilateral primary breast cancer (UPBC). BPBC accounted for 2.08% of all breast cancer cases. Compared with UPBC, BPBC patients had earlier menarche, more postmenopause disease and fewer fertility(P<0.05). The T stage, pathological type, histological grade and tumor stage of the second tumor in BPBC patients were significantly different from those in UPBC cases (P<0.05). The ER and HER-2 status of both the two tumors in BPBC and the PR status of the second tumor in BPBC were also significantly different from those in UPBC(P<0.05). Besides, the menopause status when the first tumor happened and the lymph node metastasis status when the second tumor occurred were independent prognostic factors. There was no significant difference between the five-year disease free survival rates of UPBC and BPBC (79.3% and 72.8%, P>0.05), but the 5-year overall survival rates of UPBC and BPBC had significant difference(89.8% and 84.9%, P=0.02). The prognosis of UPBC and BPBC has significant differences. If the patient is premenopause when the first tumor occurs or had more than ten metastatic axillary lymph nodes in patient with the second one, she has a poorer prognosis. The pationts who underwent unilateral breast radical mastectomy have an increased risk of contralateral breast cancer. In order to have early detection, diagnosis and treatment, we should strengthen the follow-up of the high risk patients.