Synchronous and metachronous breast malignancies: a cross-sectional retrospective study and review of the literature.

Ambrogio P Londero,Roberto Petri,Cinzia Dri,Filippo Caponnetto,Serena Bertozzi,Antonio Minucci,Giuliana Gentile,Sergio Bernardi,Vito Angione

doi:10.1155/2014/250727

Abstract

Objective. There is increasing interest in patients with metachronous (MBC) and synchronous breast cancer (SBC). The objective of this study was to evaluate the occurrence and outcome of MBCs and SBCs. Methods. A retrospective study on women operated in our department for breast cancer between 2002 and 2005 was carried out. Patients were divided into three groups: women with MBC, SBC, and unilateral breast cancer (UBC). Moreover, we performed a meta-analysis of the English literature about multiple breast cancers between 2000 and 2011 taking into consideration their prevalence and overall survival (OS). Results. We identified 584 breast cancer patients: 16 women (3%) presented SBC and 40 MBC (7%, second cancer after 72-month follow-up IQR 40–145). Although the meta-analysis showed significant OS differences between MBC or SBC and UBC, we did not observe any significant OS difference among the three groups of our population. Anyway, we found a significant worse disease-free survival in MBC than UBC and a significant higher prevalence of radical surgery in MBC and SBC than UBC. Conclusions. Despite the low prevalence of MBC and SBC, the presence of a long time risk of MBC confirms the crucial role of ipsi- and contralateral mammographies in the postoperative follow-up.

Highlights

The increasing incidence rate of breast cancer (BC) and its long term survival, due to both an improved prognosis and a growing life expectancy, have brought interest in patients with a second primary metachronous (MBC) or synchronous breast cancer (SBC) [1,2,3]
Among 736 patients operated for a breast pathology in our department during the study period, we identified 584 breast cancer patients with the first BC diagnosis made during the same period: 16 women (3%) presented SBC and 40 presented MBC (7%)
The median time interval between the first and the second primary cancer diagnosis in case of MBC resulted 72 months (IQR 40–120), being the 59% of metachronous cancers diagnosed after the 5th year of follow-up and the 40% after the 10th

Summary

Introduction

The increasing incidence rate of breast cancer (BC) and its long term survival, due to both an improved prognosis and a growing life expectancy, have brought interest in patients with a second primary metachronous (MBC) or synchronous breast cancer (SBC) [1,2,3]. There is conflicting evidence about the impact of SBCs and MBCs on the management of patients with regard to surgical treatment options, such as the role of prophylactic mastectomy. These patients undergo more often bilateral mastectomies rather than breast conserving interventions, there are reports confirming the efficacy of less invasive management in bilateral breast cancer as for unilateral tumors [14, 16]

Methods

Results

Discussion

Conclusion