OCCURRENCE AND PROGNOSIS OF CONTRALATERAL CARCINOMA OF THE BREAST

Of the 4,554 patients who registered at The University of Texas M. D. Anderson Cancer Center, Houston, Texas from 1965 to 1988 with a diagno sis of carcinoma of the breast and who underwent surgical treatment of at least one carcinoma of the breast at this institution, 142 had eit her a history of a prior carcinoma of the breast (metachronous; n=55) or a contralateral carcinoma of the breast detected within four months of registration (synchronous; n=87). We retrospectively studied the r ecords of these 142 patients and found that the occurrence of bilatera l carcinoma of the breast was low (3.1 percent), the frequency of meta chronous carcinoma of the breast remained relatively constant over tim e, the nodal status of the second carcinoma of the breast correlated w ith the method of discovery rather than the stage of the first carcino ma of the breast and survival rates from the second carcinoma of the b reast were similar for metachronous and synchronous disease. These dat a support the role of vigilant surveillance of the contralateral breas t with screening at the time of initial diagnosis and during follow-up evaluation. Because the likelihood of detecting a second carcinoma of the breast at an early stage is high, with subsequent good survival r ates, the use of prophylactic mastectomy should be very selective and based on the emotional needs of the patient.