The study confirms previous reports that patients with SND have a higher incidence of carcinoma than those with PND. The results suggest that older age, higher number of pregnancies, and longer duration of lactation may predispose to cancer development in patients with SND. The possibility of breast cancer should also be kept in mind when one is assessing patients with PND. Careful physical examination and close follow-up is the optimal management strategy for patients with any type of ND.

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From 1959 to 1987, a total of 1,182 histologically proven breast cancer patients were followed. Of these, 48 (4.06%) with bilateral breast carcinoma were reviewed. Eight patients (0.68%) had simultaneous breast carcinomas and the remaining 40 (3.38%) had nonsimultaneous breast carcinomas. The period between the development of the first and second primary carcinoma ranged from 17 to 200 months (mean, 86 months). The second primary carcinoma was found symmetrically located with the first primary carcinoma in only 34.5% of the cases. No significant differences were observed between the bilateral carcinoma patients and the unilateral carcinoma patients with respect to pregnancy, delivery, family history, and the size and localization of the carcinomas. Axillary metastasis was seen in a higher percentage of the second primary carcinomas (48% versus 37.5%). It was observed that the shorter the time interval between the presentation of the carcinomas, the shorter the survival.

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