Contralateral Breast Primary in Breast Cancer Survivors-An Experience from a Tertiary Care Centre in Thiruvananthapuram, Kerala, India
Introduction: Improved life expectancy after breast cancer treatment has led to increased incidence of contralateral breast cancers. There are no well established guidelines for the management of these cancers. There is a paucity of Indian data regarding contralateral breast cancers. Aim: To de...
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| Autores principales: | , , , , |
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| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
JCDR Research and Publications Private Limited
2021
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| Materias: | |
| Acceso en línea: | https://doaj.org/article/8c5ea107c0a14baf82f4bc2d5a5c5901 |
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| Sumario: | Introduction: Improved life expectancy after breast cancer
treatment has led to increased incidence of contralateral
breast cancers. There are no well established guidelines for the
management of these cancers. There is a paucity of Indian data
regarding contralateral breast cancers.
Aim: To describe the clinicopathological profile and prognostic
outlook of patients with contralateral breast cancers.
Materials and Methods: This was a retrospective cross-sectional
study in which all patients who underwent surgery for non metastatic
breast cancer between January 2006-December 2010 at Regional
Cancer Centre, Thiruvananthapuram, Kerala, India, were identified.
The follow-up data of these patients (6240 patients) were retrieved
from medical records division in January 2020. The medical records
of all these patients who developed contralateral breast cancer
were analysed.
Results: A total of 98 patients (1.57%) developed contralateral
breast cancer. Most of the second breast cancers were presented
at a lower stage than index cancer. Twenty five patients (25.51%)
contralateral breast cancers were detected after five years. A
total of 58 patients (59.18%) had interval cancer. Among them,
32 (55.17%) were detected by the treating doctor and 26 patients
(44.83%) were symptomatic. The median duration of follow-up
was 98 months (range 24-150 months). The five year Overall
Survival (OS) was 80.5% and five year Disease Free Survival (DFS)
was 62.8%. The patients who developed contralateral breast
cancer within three years had lower five year OS when compared
to those who developed after three years (75.5% vs 86.7%
p=0.85). Five year OS was 74.8%, 81% and 85% for patient
reported interval cancer, physician detected interval cancers and
mammogram detected cancers respectively (p=0.9).
Conclusion: Most contralateral breast cancers presented in a
lower stage than index cancer. Contralateral breast cancer has
got a reasonably good five year OS. There is no significant OS
difference between mammogram detected second cancer and
interval cancer. There was a need for more frequent clinical
breast examination even after five years to detect contralateral
primary in an early stage. Cost effectiveness of frequent followup mammogram examinations compared to clinical examination
should be evaluated in future prospective studies. |
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