The risk factors and prognosis of bilateral primary breast cancer: a comparative study with unilateral breast cancer.

This study was performed to determine the risk factors and evaluate the outcome of bilateral breast cancer (BBC). We reviewed the records of 170 patients with BBC and 1,677 with unilateral breast cancer (UBC), and compared their personal history, histopatholgical characteristics, clinical findings, and treatment, and postoperative follow-up records. The patients with UBC were more likely to develop contralateral cancer with the features including: young age at onset, especially younger than 40, premenopause, late primiparity, breast cancer family history, benign mammary disease history, and a tumor larger than 5 cm (p < 0.05). After adjustment by multivariate analysis, we concluded that breast cancer family history and age at onset younger than 40 years old were the independent risk factors for BBC. There were no significant differences for distant metastasis or overall survival between BBC and UBC (p > 0.05). We observed that 64.1% of the second breast cancer occurred within 5 years after the operation of the first cancer, and medical examination could improve the early diagnosis of the contralateral breast cancer. Contrary to common belief, our study showed that BBC and UBC had similar biological features and prognosis (p > 0.05). The excessive treatment and prophylactic measures may be unnecessary in this seemingly aggressive breast cancer. The patients with UBC younger than 40 or with breast cancer family history should have intensive contralateral breast followup, especially within 5 years after in the initial treatment.

[The trend of clinical characteristics and prognosis of women's breast cancer 1981 - 2000].

OBJECTIVE: To investigate the trend of clinical characteristics and prognosis of breast cancer in women during the past 2 decades (1981 - 2000). METHODS: 1678 cases were sampled randomly from the 11400 breast cancer patients who were hospitalized in Tianjin Medical University Cancer Hospital 1981 - 2000. Retrospective analysis of the clinical characteristics and prognosis between different eras was conducted. RESULTS: The numbers of hospitalized female breast cancer patients during the periods 1981 - 1985, 1986 - 1990, 1991 - 1995, 1996 - 2000 were 209, 316, 449, and 704 respectively with an increase of 237% within 20 years and an annual increase rate of 11.8%. The mean onset age remained 46 - 47. The detection rate of breast cancer at early stages (stages 0 approximately I) was 15.5% during 1996 - 2000, higher than that during 1981 - 1985 (12%), and the detection rate of breast cancer at stage III during 1996 - 2000 was 16.5%, lower than that during 1981 - 1985 (24.9%). The proportion of carcinoma in situ during 1996 - 2000 was 4.4%, higher than that during 1981 - 1985 (3.7%). The axillary lymph node positive rate during 1996 - 2000 was 46.3%, lower than that during 1981 - 1985 (51.8%s), and the local recurrence/distance metastasis rate during 1996 - 200 was 13.5%, lower than that during 1981 - 1985 (27.8%). The 5-year and 10-year survival rates during 1996 - 2000 were 86% and 74%, both higher than those during 1981 - 1985 (76% and 63% respectively). CONCLUSION: During the past 2 decades, the incidence of breast cancer shows an uptrend. The proportion of early stage breast cancer increases gradually and the proportion of axillary lymph node positive rate and metastasis rate show a downtrend. The prognosis of the breast cancer patients has been improved during these periods.