Bilateral Carcinoma Breast

Bilateral Carcinoma Breast

When the patient presents with features of Bilateral Breast Cancer, there are two possibilities.

The contralateral cancer can be a Second primary cancer or a Metastatic lesion.

The differentiation is very important in the management.

Synchronous Primary Cancer-when the two primary cancers develop with in 6 months

Metachronous Primary Cancer- when the second cancer develop after 6 months.

Histological grade, Immunohistochemistry, ERPR Status of both lesions must be studied. These are similar for a metastatic lesion and are different for a second primary lesion.

A complete metastatic work up for the patient is also necessary to rule out hepatic, lung, bone or brain metastasis.

If there is no evidence of metastasis, the diagnosis goes in favor of the second primary lesion.

Chaudary’s criteria is widely followed for the diagnosis of a second primary breast cancer.

Chaudary’s criteria

1.There must be insitu changes in the contralateral tumour.

2.The second tumour is histologically different from the first.

3.The histological differentiation grade of the second tumour greater than the first.

4.There must be no evidence of  metastasis.