Abstract
Seventeen patients with bilateral primary breast cancer (4.2% of all breast cancers) treated in our hospital from 1984 to June, 1995 were investigated in regard to clinical, histologic and prognostic characteristics. In five patients (1.2%) the lesions were synchronous and in 12 they were metachronous (3.0%). The ratio of synchronous to metachronous cases was 1 : 2.5. Mean age in the synchronous cases was 59.0 years. Mean age at the time of the first metachronous cancer was 48.0 years, and at the time of the second, 60.8 years. Two metachronous cases were diagnosed at an interval of over 30 years. The clinical stage in the synchronous cases was 1 Tis, 6 stage I, 2 stage II and 1 stage III b, In the first metachronous cancers there were 6 patients with stage I, and 4 with stage II lesions. The second cancers were stage I lesions in 4 patients, stage II in 5 patients, stage III a in 1 patient, and stage IV in 2. The stage of the second cancer was more advanced than that of the first. The pathological type of most of the lesions was solid-tubular carcinoma and papillo-tubular carcinoma. Axillary lymph node involvement was found in 2 (20%) of the synchronous cases and 10 (42%) of the metachronous cases. Only one patient was for lymph node positive bilaterally. Four synchronous and 7 metachronous cases have had a disease-free survival. In patients with unilateral breast cancer, examination of the contralateral breast, regular and long-term follow up, and breast self-examination are important in the early detection of a second breast cancer.
