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[The prognosis of bilateral breast carcinoma compared to unilateral breast tumor. 5- and 10-year follow-ups].

PURPOSE
A review of published data does not provide a certainty whether survival rates are comparable or worse in women with bilateral breast cancer versus patients with an unilateral tumor. Therefore results of therapy in one-sided and both-sided breast cancer were retrospectively analysed.


PATIENTS AND METHODS
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, metachronous n = 30) that was treated by mastectomy (n = 28) and conservative surgery (n = 12), respectively, followed by radiotherapy in 26 women.


RESULTS
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.


CONCLUSIONS
Survival of patients with bilateral breast cancer is not significantly decreased compared with unilateral disease although in patients with both-sided carcinoma local recurrences and metastases seem to occur more frequently.