Incidence and Prognosis of Synchronous and Metachronous Bilateral Breast Cancer

Hartman, Mikael; Czene, Kamila; Reilly, Marie; Adolfsson, Jan; Bergh, Jonas; Adami, Hans‐Olov; Dickman, Paul W.; Hall, Per

doi:10.1200/jco.2006.10.5056

Cited by 198 publications

(236 citation statements)

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“…As we have previously shown, the incidence of synchronous CBC has increased considerably during the 1970s and 1980s, while the incidence of metachronous CBC has decreased steadily during the past 30 years [7]. Possibly, this pattern reflects a shift towards earlier diagnosis of existing tumors, making cancers formerly classified as metachronous to be diagnosed earlier and consequentially fall within the 3-month definition of synchronous CBCs.…”

mentioning

confidence: 74%

“…A more plausible explanation therefore seems to be a decreasing incidence of metachronous cancer [7] possibly due to adjuvant therapy for the first cancer. The change of latency proportions can be further explained by the increasing incidence of synchronous cancer during the 1970s and 1980s in Sweden [7]. This increase could be in agreement with increasing incidence of unilateral breast cancer.…”

Section: Interpretationsmentioning

confidence: 99%

“…CBCs diagnosed more than 3 months after primary diagnosis has a stable incidence of 0.5% per year throughout life and are referred to as metachronous [5][6][7][8].…”

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confidence: 99%

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Diagnostic work-up of contralateral breast cancers has not improved over calendar period

Sandberg

Hartman

Edgren

et al. 2010

Breast Cancer Res Treat

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Women who have been treated for breast cancer are typically followed up with regular mammography and palpation, with the aim of detecting recurrences and contralateral breast cancer (CBC). This study aims to investigate if the diagnostic work-up of breast cancer patients has improved over the last 25 years and resulted in earlier diagnoses of CBC. Two population-based cohorts were used; all CBCs in Sweden 1976Sweden -2004Sweden (n: 2932, and all CBCs in Stockholm, Sweden, 1976Sweden, -2005, both cohorts with a maximum of 3 years between the two cancers. Synchronous CBC was defined as two cancers \3 months apart, the remainder was defined as metachronous CBC. We calculated the odds ratio of being diagnosed synchronously, relative to metachronously, using logistic regression, adjusting for whether the second cancer was detected through clinical work-up or not. The odds of synchronous CBC were significantly increased: 1.27 (95% CI, 1.13-1.42) per 5-year period, compared to metachronous, and was not affected by detection mode, but seemed to be explained by adjuvant therapy. The proportion of CBCs detected by clinical work-up did not increase over the study period, and the mean size of the second tumor remained constant. We found an increase in the proportion of synchronous CBCs compared to metachronous, over calendar period, a change that was not associated with clinical work-up, but with adjuvant therapy. This study gives no indications that any improvement in diagnostic work-up of CBC have occurred over the last 25 years.

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confidence: 74%

Section: Interpretationsmentioning

confidence: 99%

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Diagnostic work-up of contralateral breast cancers has not improved over calendar period

Sandberg

Hartman

Edgren

et al. 2010

Breast Cancer Res Treat

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“…Women with breast cancer have, 20 years after their initial diagnosis, 10-15% cumulative incidence of second primary breast cancer in the opposite breast; contralateral breast cancer (CBC) [4,5]. We and others have previously shown that women with CBC have significantly worse prognosis compared to women with unilateral cancer [2,3]. It is likely that for a subset of the patients, the second cancer is not a new primary tumor, but instead a metastasis of the first cancer, which could, in part, explain the poor prognosis of these patients.…”

Section: Introductionmentioning

confidence: 99%

Exome sequencing of contralateral breast cancer identifies metastatic disease

Klevebring

Lindberg

Rockberg

et al. 2015

Breast Cancer Res Treat

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“…[1] Hence, optimal surveillance and clinical management of women who have had one or two primary breast cancers is a challenge. However, there are only limited data on incidence rates of synchronous and metachronous breast cancer, [2,3] results on temporal trends in incidence are conflicting, [4] and little is known about the prognostic outlook after treatment of a second primary cancer. [5,6] …”

Section: Introductionmentioning

confidence: 99%