Search

There is a “high risk” group of patients in which the incidence of primary contralateral breast cancer is much higher than the overall figure of 7–10%. In addition, if cancer develops in the remaining breast it has a truly deleterious influence on the survival of the patient. Management of the other breast is, therefore, one of grave concern. It is suggested that this could best be accomplished by a random biopsy of the opposite breast in all patients undergoing primary therapy for operable Stage I and II cancers in the first breast. If a cancer is detected, then appropriate therapy is carried out. If not, the patient is carefully followed by regular physical examinations and by diagnostic aids (thermography and mammography). Only if the patient is in a “high risk” group for developing primary contralateral breast cancer is prophylactic, delayed simple mastectomy of the remaining breast advised. In 91 cases where this has been done, 16 unsuspected primary cancers were found for an incidence of 17%. The survival rate for 56 of these patients followed for over 5 years was 96.5%.