National trends of synchronous bilateral breast cancer incidence in the United States
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Increase in breast cancer survivorship, advancements in diagnostic imaging and standardization of contralateral breast screening before breast cancer surgery have resulted in increased detection of contralateral breast cancer (CBC). The aim of this study was to assess national trends of synchronous bilateral breast cancer (sBBC) and metachronous bilateral breast cancer (mBBC) incidence in newly diagnosed breast cancer patients.
The Surveillance, Epidemiology, and End Results (SEER) database (1973–2014) was used to identify 11,177 women diagnosed with CBC. CBC was classified as sBBC when primary breast cancer in both breasts is diagnosed in the same year, or as mBBC, when diagnosed more than one year from primary breast cancer. Temporal trends in sBBC incidence were then evaluated using the Cochran-Armitage test for trend.
Of the 11,177 women diagnosed with CBC, 4228 (38%) had sBBC and 6949 (62%) had mBBC. The incidence of sBBC increased significantly from 1.4% in 1975 to 2.9% in 2014 (p < 0.001). sBBC was more likely to be diagnosed as early stage in recent years (78% in 1975 vs. 90% in 2014 [p < 0.001]), and 69% of patients were treated with mastectomy in 2014.
The number of sBBC has increased, and contralateral tumors are more likely to be detected at an early stage with the first primary breast cancer. Despite the early stage findings, most were treated with mastectomy. Further studies are needed to define the best therapy for patients with contralateral disease and optimal surveillance and detection methods.
KeywordsSynchronous Metachronous Bilateral breast cancer Incidence Trends SEER
No funding was used in the preparation, design, or writing of this paper.
Compliance with ethical standards
Conflict of interest
The authors have no conflict of interest to declare.
This study was epidemiological study using de-identified data from the SEER database. Therefore, consent for patient participation and study publication was not required. Because this study did not meet the definition of human subject research, the protocol was considered exempt from review from the Dana-Farber Cancer Institute Institutional Review Board (DFCI Protocol No.: 18-034).
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