IntrOductIOnBilateral breast cancer (BBC) is not an uncommon entity in contemporary breast clinics. We have an increasing incidence of BBC as a result of improved life expectancy after breast cancer treatment and routine use of contra-lateral breast mammography in newly diagnosed breast cancers. Lobular cancer in the index breast, family history of breast cancer, young age at diagnosis of first cancer and BRCA mutations are important risk factors that are known to be at increased risk for BBC. [5]. Accordingly the incidence of SBC has been varying in different series. Controversies also exist about the origin of second cancer (metastatic spread or independent primary) and its prognostic significance. More often than not, women with BBC are treated with most radical surgeries based on the notion that these tumours are biologically aggressive. However, scientific evidence for this belief is divided. There is no population based or large sample size studies analysing the survival outcomes of BBC in Indian women. The objective of this study was to define the epidemiological and tumour characteristics of bilateral breast cancer in India. Here in this study we analysed the clinical and pathologic characteristics, treatment parameters and outcome of BBC in Indian women from a single institution cohort. mAterIAls And metHOdsWe examined a consecutive cohort of breast cancer patients treated at our center between January 2007 to March 2015. A total of 1251 breast cancer patients were treated during this period. Clinical details were prospectively collected which include patient characteristics, tumour pathology, treatment variables, disease free survival and date of death. Patients were followed up with routine clinical examination, annual mammogram and other investigations if required.In this period 30 patients were found to have BBC which constituted the study population. This study was approved by institutional ethical committee and informed consent was obtained from all the patients who were included in the study. Synchronous bilateral breast cancers (SBC) was defined as two tumours diagnosed within an interval of 6 months and a second cancer diagnosed after 6 months was labelled as metachronous breast cancer (MBC). A patient was considered to have positive family history when a first degree relative had a history of breast cancer. Analyses of various patient and tumour characteristics were done in this prospective data base of BBC patients. resultsOverall 30 patients had BBC during the study period and majority were synchronous tumours (93.3%; n=28). Most patients with synchronous tumours (n=25) had their second cancers diagnosed during the initial presentation. Three SBC patients had their contralateral cancers diagnosed during 3, 4 and 6 months after the first tumour. Two cases of MBC were diagnosed 16 and 54 months after the first tumour [Table/ Fig-1]. Infiltrating ductal carcinoma was the commonest histological type (n =51) followed by DCIS, lobular and papillary types (n=7, 1, 1 respectively). DCIS was present...

Highlights Multicystic Peritoneal mesothelioma is a distinct type of peritoneal mesothelioma with borderline malignant potential and tendency to recur after tumor debulking. Morphologically MCPM has grapelike cysts filled with clear fluid and microscopically it has cystic spaces lined by cuboidal epithelium. There are areas of increased proliferative activity in the background of benign cyst representing potential for aggressiveness. Peritoneal free floating cysts can be formed from disintegration of main mass and deposit in other areas to form metastatic deposits. Comprehensive treatment – Complete cytoreduction, involved peritonectomy and HIPEC is required for treatment of macroscopic tumor and microscopic residue.

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Background Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) improves survival in selected patients with peritoneal metastasis (PM) from colorectal cancer (CRC). However, little has been reported on characteristics and clinical course of long-term survivors with CRC-PM beyond 5 years. The objective of this study was to identify the clinical and oncological features affecting long-term survival of CRC-PM after comprehensive treatment. Methods Between January 1990 and April 2015, CRC-PM patients who underwent CRS with or without HIPEC in two Japanese tertiary hospitals were analyzed. Clinicopathological parameters and therapeutic details for long-term survivors (patients surviving ≥ 5 years after CRS) were described and compared with those for non-survivors (patients surviving < 5 years). Results The study identified 236 patients with CRC-PM who underwent CRS, with a median follow-up period of 2.5 years. Thirty-three patients (14.0%) were considered as long-term survivors. Compared with non-survivors, long-term survivors had a lower median peritoneal cancer index (PCI) [4 (1–27) vs 9 (0–39), p < 0.001]. Complete cytoreduction (CCR-0) was achieved in all long-term survivors, with a significantly higher rate [33/33 (100%) vs 141/203 (69.8%), p < 0.001]. Metachronous onsets of PM were more frequently observed in the long-term survivor group [26/33 (78.8%) vs 103/203 (50.3%), p = 0.018]. Regarding histopathology, long-term survivors more frequently had mucinous adenocarcinoma than non-survivors [8/33 (24.2%) vs 27/203 (13.3%)] and less likely exhibited poorly differentiated or signet ring cell carcinoma [2/33 (6.1%) vs 48/203 (23.7%)] (p < 0.001). Conclusions One in seven patients with CRC-PM achieved the long-term milestone after CRS. A long-term survival was associated with the presence of low PCI, CCR-0, metachronous onset, and mucinous histology.