The incidence of bilateral breast cancer: ii. A proposed model for the analysis of coincidental tumours

Abstract

Summary.-A statistical model has been proposed in an attempt to integrate coincidental (or Analysis in terms of the model showed a 296-fold increase in risk for a second primary tumour in the contralateral breast in a series of nearly 22,000 breast -cancer patients. The corresponding risks for 3 main age-ranges (at the time of diagnosis of the first primary) were 5-3 (ages 15-44), 3-3 (45-59) and 1-5 (60 +). In addition, a maximal risk of 5-0-fold was observed in the series as a whole during the third year after the diagnosis of the first primary.

Bilaterality and recurrence rates for lobular breast cancer: Considerations for treatment

“…With these considerations, the calculated risk of developing a second, contralateral breast cancer after the diagnosis of an index cancer was 0.7% per patient-year of followup. This calculation is similar to that reported in the published literature (14)(15)(16)(17). The median time to development of the second metachronous lesion was 3.3 years.…”

Adjuvant dietary fat intake reduction in postmenopausal breast cancer patient management

“…The potential for interaction between tamoxifen and dietary fat intake A study of dietary fat reduction as an addition to standard systemic adjuvant therapy in which disease-free survival and overall survival are endpoints will determine if dietary fat intake reduction has an effect on breast cancer metastasis and recurrence. Attention to second cancer development in the opposite breast, which occurs in approximately 1%/year of resected breast cancer patients [24,65,69,75], would address directly the effect of dietary fat intake reduction on primary breast cancer prevention, as has been done retrospectively in several tamoxifen adjuvant trials [23,26]. However, definitive assessment of the additional endpoint of second breast cancer development would require an increase in the proposed sample size.…”

“…The one year adherence results [16] in resected breast cancer patients in the Nutrition Adjuvant Study and the two year adher- Table 3. Mechanisms by which high fat intake may increase growth rates and metastatic potential of breast cancer Change in phospholipid composition and fluidity of tumor cell and/or host immune cell membranes: consequent effects on protein hormone-receptor interactions and cell-mediated cytotoxicity [17,55,69,82] Changes in circulating hormone levels and bioavailability [67, …”

The Increasing Use of Prophylactic Mastectomy in the Prevention of Breast Cancer

“…In the American College of Radiology Imaging Network (ACRIN) MRI study, about 3% of patients had occult CBC identified by MRI [16•]. The annual risk of clinically detected metachronous CBC is about 0.6% [4][5][6][7]17]. The annual risk is constant, but the cumulative risk increases with follow-up.…”

“…Screening (with or without MRI), oophorectomy, and chemoprevention are potential alternatives for many women. Patients with unilateral breast cancer have a significantly increased risk of developing a cancer in the contralateral breast [4][5][6][7][8]. Some women choose contralateral prophylactic mastectomy (CPM) to treat an occult synchronous cancer or to prevent a metachronous cancer in the contralateral breast.…”