Prediction of outcome after diagnosis of metachronous contralateral breast cancerReport as inadecuate

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BMC Cancer

, 11:114

Clinical oncology


BackgroundAlthough 2-20% of breast cancer patients develop a contralateral breast cancer CBC, prognosis after CBC is still debated. Using a unique patient cohort, we have investigated whether time interval to second breast cancer BC2 and mode of detection are associated to prognosis.

MethodsInformation on patient-, tumour-, treatment-characteristics, and outcome was abstracted from patients- individual charts for all patients diagnosed with metachronous CBC in the Southern Healthcare Region of Sweden from 1977-2007. Distant disease-free survival DDFS and risk of distant metastases were primary endpoints.

ResultsThe cohort included 723 patients with metachronous contralateral breast cancer as primary breast cancer event. Patients with less than three years to BC2 had a significantly impaired DDFS p = 0.01, and in sub-group analysis, this effect was seen primarily in patients aged <50. By logistic regression analysis, patients diagnosed with BC2 within routine follow-up examinations had a significantly lower risk of developing metastases compared to those who were symptomatic at diagnosis p < 0.0001. Chemotherapy given after breast BC1 was a negative prognostic factor for DDFS, whereas endocrine treatment and radiotherapy given after BC2 improved DDFS.

ConclusionsIn a large cohort of patients with CBC, we found the time interval to BC2 to be a strong prognostic factor for DDFS in young women and mode of detection to be related to risk of distant metastases. Future studies of tumour biology of BC2 in relation to prognostic factors found in the present study can hopefully provide biological explanations to these findings.

Keywordsmetachronous breast cancer contralateral breast cancer prognosis detection adjuvant therapy AbbreviationsBC1First breast cancer

BC2Second breast cancer

CBCContralateral breast cancer

CIConfidence interval

DDFSDistant disease-free survival

HRHazard ratio

IQRinterquartile range.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2407-11-114 contains supplementary material, which is available to authorized users.

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Author: Sara Alkner - Pär-Ola Bendahl - Mårten Fernö - Jonas Manjer - Lisa Rydén



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