Synchronous and metachronous bilateral breast cancer among women with a history of lobular carcinoma in situ Journal Article


Authors: Mallory, M. A.; Whiting, K.; Park, A.; Gönen, M.; Gilbert, E.; King, T. A.; Pilewskie, M. L.
Article Title: Synchronous and metachronous bilateral breast cancer among women with a history of lobular carcinoma in situ
Abstract: Purpose Lobular carcinoma in situ (LCIS) confers increased cancer risk in either breast, but it remains unclear if this population is at increased risk for bilateral breast cancer (BC) development. Here we report bilateral BC incidence among women with a history of LCIS. Methods Women with classic-type LCIS diagnosed from 1980 to 2017 who developed unilateral BC (UBC) or bilateral BC were identified. Bilateral BC was categorized as synchronous (bilateral BC diagnosed < 6 months apart; SBBC) or metachronous (bilateral BC diagnosed >= 6 months apart; MBBC). Five-year incidence rates of bilateral BC among this population were evaluated. Comparisons were made to identify factors associated with bilateral BC. Results At 7 years' median follow-up, 249/1651 (15%) women with LCIS developed BC; 34 with bilateral BC (2%). There were no clinicopathologic feature differences between those with UBC and bilateral BC. SBBC occurred in 18 without significant differences versus UBC. Among 211 with UBC and a contralateral breast at risk, 16 developed MBBC at a median follow-up of 3 years. MBBC patients were less likely to receive endocrine therapy and more likely to receive chemotherapy versus UBC. Tumor histology was not associated with MBBC. Estimated 5-year MBBC risk was 6.4%. Index estrogen/progesterone receptor positivity and endocrine therapy were the only factors associated with MBBC risk. Conclusion Bilateral BC occurred in 2% of women with LCIS history at median follow-up of 7 years. Similar to the general BC population, a decrease in MBBC is seen among women with a history of LCIS who develop hormone receptor-positive disease and those who receive endocrine therapy, highlighting the protective effects of this treatment.
Keywords: survival; breast cancer; risk; tamoxifen; receptor; outcomes; breast surgery; lobular carcinoma in situ; disease; prevention; prophylactic mastectomy; contralateral breast cancer; contralateral breast; bilateral; hormone receptor-positive; prognosis
Journal Title: Breast Cancer Research and Treatment
Volume: 194
Issue: 1
ISSN: 0167-6806
Publisher: Springer  
Date Published: 2022-07-01
Start Page: 137
End Page: 148
Language: English
ACCESSION: WOS:000788927400001
DOI: 10.1007/s10549-022-06532-4
PROVIDER: wos
PUBMED: 35488092
PMCID: PMC11325477
Notes: Article -- Source: Wos
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MSK Authors
  1. Mithat Gonen
    1029 Gonen
  2. Anna Yong Park
    31 Park
  3. Melissa Louise Pilewskie
    112 Pilewskie
  4. Elizabeth Gardner Gilbert
    18 Gilbert
  5. Karissa A. Whiting
    47 Whiting