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ORIGINAL ARTICLE
Year : 2018  |  Volume : 45  |  Issue : 1  |  Page : 17-18

Five-year analysis of breast carcinoma, with emphasis on bilaterality of the lesion


Department of Pathology, D.Y. Patil Medical College, Navi Mumbai, Maharashtra, India

Date of Web Publication27-Jul-2018

Correspondence Address:
Pragati Upasham
Department of Pathology, D. Y. Patil Medical College, Sector 5, Nerul, Navi Mumbai - 400 706, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jss.JSS_14_18

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  Abstract 


Introduction: Bilaterality of an infiltrating duct carcinoma (IDC) is an infrequent event. Literary information also reports the low incidence of the same. The present study was undertaken to know the prevalence of breast carcinoma cases diagnosed in our institute with emphasis on finding the bilateral lesion. Aim: Five-year analysis of breast carcinoma and its laterality was done on histopathologically confirmed cases. Materials and Methods: A retrospective study for a period of 5 years was undertaken. Review of data and of histopathology slides (which could be retrieved) was done. The presence of IDC, other variants, and cases with laterality of the lesion was keenly studied. Results: In a duration of 5 years, only two out of 85 cases were found to have bilateral IDC. Conclusion: Bilateral breast carcinomas have a rare occurrence as accounted in our study.

Keywords: Bilateral breast carcinomas, histopathology, infiltrating duct carcinomas


How to cite this article:
Upasham P, Bhat R, Roplekar P. Five-year analysis of breast carcinoma, with emphasis on bilaterality of the lesion. J Sci Soc 2018;45:17-8

How to cite this URL:
Upasham P, Bhat R, Roplekar P. Five-year analysis of breast carcinoma, with emphasis on bilaterality of the lesion. J Sci Soc [serial online] 2018 [cited 2018 Aug 16];45:17-8. Available from: http://www.jscisociety.com/text.asp?2018/45/1/17/237753




  Introduction Top


Although breast cancer is a most common type of cancer in women,[1] finding it bilaterally is an uncommon event.[2] Strong family history, young age at diagnosis of first cases, and BRCA mutations increase the risk for bilateral breast carcinoma (BBC).[3] It can be synchronous or metachronous.

Various authors have given the duration for classifying the entities as synchronous when two tumors are diagnosed, within a month to 1 year.[3]

Some authors mentioned the tumors as synchronous if they occur at the same time,[4] whereas bilateral tumors were classified into metachronous variety when the second tumor is diagnosed after 6 months from the first breast carcinoma diagnosis, in the contralateral breast or in the same breast with different histopathological features.[5]

We aimed to find out the infiltrating duct carcinoma (IDC) prevalence as well as status of bilaterality of the breast carcinoma cases in our institute; hence, we decided to analyze the data and histopathology findings related to this condition. The study was aimed at finding the prevalence of BBC cases diagnosed in pathology section of our tertiary care institute.


  Materials and Methods Top


This is a retrospective study. Period of 5 years from January 2010 to December 2014 was selected for the study. Data were analyzed and slides which could be retrieved were reviewed. Histopathologically confirmed breast carcinoma cases were included in the analysis. All the cases were diagnosed either on biopsy and/or on mastectomy specimen. Analysis of database was done, wherever possible slides which were available were reviewed. In other cases, paraffin blocks were retrieved for histopathological processing. Main emphasis was kept on finding the bilateral lesion.


  Results Top


Over a period of 5 years, 85 cases of breast carcinoma were diagnosed on histopathology. Maximum cases were detected to have an invasive ductal carcinoma not otherwise specified type (81 cases). One patient had IDC with neuroendocrine differentiation. Two patients had mucinous/colloid carcinoma followed by a single case of malignant phyllodes tumor [Table 1].
Table 1: Number of histopathological variants of breast carcinoma detected in a 5-year study period

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Mere two cases were noted to have BBC. It was noted that both were falling into the category of IDC, in the age range of 65–45 years, respectively, and were found to have a synchronous lesion [Table 2].
Table 2: Details of two cases diagnosed to have a bilateral lesion

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  Discussion Top


Various authors have studied the spectrum of bilateral lesions in breast cancer. The etiology of bilateral breast cancer is unknown; however, it is seen that familial etiology is seen in metachronous bilateral breast cancer than synchronous bilateral lesions.[6]

The study conducted in 1990 mentions about 28 years’ experience on the incidence of BBCs, whereas 4.06% of patients had bilateral occurrence. (0.68% had simultaneous breast carcinomas and the remaining 3.38% had nonsimultaneous breast carcinomas.)[7]

Another study of 12-year analysis has also reported the incidence of bilateral breast cancer as 4.3%. (1.6% had synchronous breast carcinomas and 2.7% had metachronous breast carcinomas).[8]

Our findings also revealed that the lesion has an uncommon occurrence since only two cases of BBC were seen, thus constituting 2.3% of all the confirmed cases of carcinoma breast.

One more study reports the incidence of BBC as 1.3% (7 out of 521 cases). However, the authors also point out that this incidence is subjected to the conflict of cutoff times for synchronous and metachronous lesions.[2]

The most common type of carcinoma noted in our analysis was an IDC, which is corresponding to the fact also observed by the other authors.[8],[9]

Attempts were made to know the family history status, especially of those two cases, but could not obtain conclusive evidence to document it. In both the cases, the lesion was of synchronous in nature.

Factors such as the presence of an intraductal component, different degree of histopathological differentiation will differentiate this primary lesion from the metastatic one. Apart from this, primary synchronous BBC show higher rate of estrogen receptor and progesterone receptor positivity.[10]

Limitations of this study include a small sample size, loss of follow-up of the patients who were diagnosed as breast malignancy on fine-needle aspiration cytology (FNAC) examination but did not seek histopathological confirmation and further management in the same center.

Although our sample size is small, we would like to mention that there has been a growing alertness from our side to do bilateral breast inspection in a patient subjected for FNAC of palpable breast lump and also to evaluate family history of the patient, which is the strong parameter related to this lesion (BBC).


  Conclusion Top


Although bilateral IDC has a grave prognosis, the fact is that it is an uncommon entity.

We recommend that thorough clinical examination of the contralateral breast and lymph nodes must be done in a patient suspected of having carcinoma breast. Furthermore, we recommend thorough evaluation of patients having positive family history of breast cancer.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM, et al. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 2010;127:2893-917.  Back to cited text no. 1
    
2.
Khairy GA, Guraya SY, Ahmed ME, Ahmed MA. Bilateral breast cancer. Incidence, diagnosis and histological patterns. Saudi Med J 2005;26:612-5.  Back to cited text no. 2
    
3.
Padmanabhan N, Subramanyan A, Radhakrishna S. Synchronous bilateral breast cancers. J Clin Diagn Res 2015;9:XC05-8.  Back to cited text no. 3
    
4.
Bassarova AV, Torlakovic E, Sedloev T, Hristova SL, Trifonov DV, Nesland JM, et al. Simultaneous bilateral breast carcinoma: Histopathological characteristics and CD44/catenin-cadherin profile. Histol Histopathol 2005;20:791-9.  Back to cited text no. 4
    
5.
Londero AP, Bernardi S, Bertozzi S, Angione V, Gentile G, Dri C, et al. Synchronous and metachronous breast malignancies: A cross-sectional retrospective study and review of the literature. Biomed Res Int 2014;2014:250727.  Back to cited text no. 5
    
6.
Gülay H, Hamaloǧlu E, Bulut O, Göksel HA. Bilateral breast carcinoma: 28 years’ experience. World J Surg 1990;14:529-33.  Back to cited text no. 6
    
7.
Maculotti L, Gandini F, Pradella P. Bilateral breast carcinoma 12 years’ experience. Minerva Chir 1996;51:33-7.  Back to cited text no. 7
    
8.
Alwan NA. Breast cancer: Demographic characteristics and clinico-pathological presentation of patients in Iraq/cancer du sein: Caracteristiques demographiques des patientes et presentation clinico-pathologique en Iraq. East Mediterr Health J 2010;16:1159.  Back to cited text no. 8
    
9.
Makki J. Diversity of breast carcinoma: Histological subtypes and clinical relevance. Clin Med Insights Pathol 2015;8:23-31.  Back to cited text no. 9
    
10.
Krishnappa R, Chikaraddi SB, Deshmane V. Primary synchronous bilateral breast cancer. Indian J Cancer 2014;51:256-8.  Back to cited text no. 10
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Introduction
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