Prognosis of bilateral breast carcinoma compared to unilateral breast tumor

In a period from 1977 to 1982 (follow-up 5 to 12 years) 531 breast cancer patients with T1-4 N0-3 M0 tumors were treated with mastectomy (n=416) and breast conserving therapy (n=115). Postoperative radiotherapy was performed in all patients (50 Gy, 2 Gy/day 5 times/weekly; chest wall/breast and regional lymph nodes). Patients with positive lymph nodes received chemotherapy. Forty patients developed bilateral breast cancer (simultaneous n=10, metachroneous n=30) that was treated by mastectomy (n=28) and conservative surgery (n=12), respectively, followed by radiotherapy in 26 women. Five- and 10-year survival was 74% and 56% in unilateral affected women. In 83% and 67% there were no metastases, respectively. Incidence of metastases was 27,9%. In bilateral breast cancer group survival rates were 85% and 59% and without evidence of metastases 87% and 60%, respectively. Distant disease was diagnosed in 35%. Differences between the 2 groups were statistically not significant. Whereas in time of follow-up 11% of unilateral cancer locally failed in bilateral cancer patients recurrences of the first and second tumor were seen in 20% and 10%, respectively. (orig./MG)