Bilateral breast cancer Book Section
| Authors: | Barrio, A. V.; Cody, H. S. 3rd |
| Editors: | Bland, K. I.; Copeland, E. M. 3rd; Klimberg, V. S.; Gradishar, W. J.; White, J.; Korourian, S. |
| Article/Chapter Title: | Bilateral breast cancer |
| Abstract: | Among breast cancer survivors, a contralateral breast cancer (CBC) is the most frequent second-cancer event, with a reported incidence rate of 0.5% to 1.0% per year. CBC risk is even higher among carriers of BRCA1 or BRCA2 mutations and noncarriers with a significant family history of breast cancer. However, recent studies have shown a favorable decline in CBC in the United States since 1985, which is largely due to the widespread adoption of tamoxifen in the mid-1980s for the adjuvant treatment of breast cancer. Despite the documented declining incidence of CBC during this time period, a dichotomous shift toward more aggressive surgical therapy with contralateral prophylactic mastectomy (CPM) has occurred. Reasons for this aggressive approach are multifactorial and include an overestimation of CBC risk among patients, increasing use of breast magnetic resonance imaging, availability of postmastectomy reconstruction, and overestimation of benefit of CPM. In the era of modern systemic therapy, the subject of bilateral breast cancer and, in particular, CBC, is of particular importance when considering the appropriate management and counseling of patients with unilateral breast cancer. In this chapter, we review risk factors for CBC, including age at diagnosis, genetic risk assessment, family history, prior radiation exposure, invasive lobular histology, and a personal history of lobular carcinoma in situ (LCIS). We also discuss the impact of advanced imaging on detection of synchronous CBC and discuss the effects of adjuvant systemic therapy on declining CBC risk. We review prognosis among breast cancer patients who have developed a CBC. Finally, we discuss the CPM epidemic that has developed in the United States since the early 2000s, and we review the benefits and risks associated with more aggressive surgery. © 2018 Elsevier Inc. All rights reserved. |
| Keywords: | contralateral prophylactic mastectomy; contralateral breast cancer; bilateral breast cancer |
| Book Title: | The Breast: Comprehensive Management of Benign and Malignant Diseases. 5th ed |
| ISBN: | 978-0-323-35955-9 |
| Publisher: | Elsevier Inc. |
| Publication Place: | Philadelphia, PA |
| Date Published: | 2018-01-01 |
| Start Page: | 967 |
| End Page: | 973.e2 |
| Language: | English |
| DOI: | 10.1016/b978-0-323-35955-9.00075-1 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Book Chapter: 75 -- Export Date: 1 November 2018 -- Source: Scopus |
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