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Synchronous bilateral breast cancer: a nationwide study on histopathology and etiology
- Source :
- Breast Cancer Research and Treatment. 182:229-238
- Publication Year :
- 2020
- Publisher :
- Springer Science and Business Media LLC, 2020.
-
Abstract
- The aim of the present study was to describe histopathologic characteristics of synchronous bilateral breast cancer (SBBC), and by comparing SBBC to unilateral breast cancer (UBC), identify possible etiological mechanisms of SBBC. Patients with primary SBBC (diagnosed within 4 months) and UBC diagnosed in Denmark between 1999 and 2015 were included. Detailed data on histopathology were retrieved from the Danish Breast Cancer Group database and the Danish Pathology Register. Associations between bilateral disease and the different histopathologic characteristics were evaluated by odds ratios and estimated by multinomial regression models. 1214 patients with SBBC and 59,221 with UBC were included. Patients with SBBC more often had invasive lobular carcinomas (OR 1.29; 95% CI 1.13–1.47), a clinically distinct subtype of breast cancer, than UBC patients. Further, they were older than UBC patients, more often had multifocal cancer (OR 1.13; 95% CI 1.01–1.26), and a less aggressive subtype than UBC patients. Invasive lobular carcinoma was associated with having multiple tumors in breast tissue—both in the form of bilateral disease and multifocal disease, and this association was independent of laterality. No similar pattern was observed for other tumor characteristics. We identified two etiological mechanisms that could explain some of the occurrence of SBBC. The high proportion of less aggressive carcinomas and higher age of SBBC compared to UBC patients suggests that many are diagnosed at a subclinical stage as slow-growing tumors have a higher probability of simultaneous diagnosis. The high proportion of invasive lobular carcinoma observed in bilateral and multifocal disease, being independent of laterality, suggests that these patients have an increased propensity to malignant tumor formation in breast tissue.
- Subjects :
- 0301 basic medicine
Oncology
Cancer Research
medicine.medical_specialty
Receptor, ErbB-2
Denmark
Breast Neoplasms
Neoplasms, Multiple Primary
03 medical and health sciences
0302 clinical medicine
Breast cancer
Internal medicine
medicine
Humans
Neoplasm Invasiveness
Stage (cooking)
Aged
Neoplasm Staging
Subclinical infection
business.industry
Carcinoma, Ductal, Breast
Cancer
Odds ratio
Middle Aged
medicine.disease
Carcinoma, Lobular
030104 developmental biology
Receptors, Estrogen
030220 oncology & carcinogenesis
Invasive lobular carcinoma
Etiology
Female
Histopathology
Receptors, Progesterone
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 15737217 and 01676806
- Volume :
- 182
- Database :
- OpenAIRE
- Journal :
- Breast Cancer Research and Treatment
- Accession number :
- edsair.doi.dedup.....0cbeaf2557adf73a72862be1e73acb14
- Full Text :
- https://doi.org/10.1007/s10549-020-05689-0