BILATERAL BREAST CANCER, THERAPEUTIC APPROACH

Mădălina Gabriela Iacob1, Cristina Tomescu1, M. Gheorghe2, Cristina Iosif2, Luminita Cociu2, F. Băcanu 2, I.N. Mateş2, S. Constantinoiu2


1"Carol Davila" University of Medicine and Pharmacy  
2"The Clinic of General Surgery and Esophageal Center of Excellence in Surgery, St. Mary's Hospital, Bucharest, Romania

Corresponding author: Silviu Constantinoiu
Phone no.  0040722637810
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Abstract

 

We present a rare case of breast neoplasm, synchronous (simultaneous) bilateral breast cancer, methods of diagnosis, multimodal treatment and the standard follow-up program. Bilateral breast cancer is a rare entity, with an incidence between 0.3 and 12%, representing 1 to 2.6% of all breast cancers. Bilateral breast cancer is defined as the presence of cancer cells in both breasts at the same time or at a distance of up to 3 months from the identification of the first tumor (synchronous), or metachronous if it occurs after more than 3 months from the identification of the primary tumor. There is not a general agreement regarding the optimal treatment. The prognosis is considered more severe than that of a unilateral neoplasm and the patients are treated more frequently by undergoing bilateral mastectomy rather than conservative surgery. We present the case of a 57- year-old patient diagnosed by clinical and imaging investigations (mammography, MRI) with bilateral breast tumor formations. The 57-year-old patient was referred to our clinic for a bilateral synchronous breast pathology. The pathological examination of the biopsy revealed bilateral invasive ductal breast cancer, with an intermediate histological grade G2, ER +, PR +, HER2 - (score 0 ASCO-CAP). Therefore, the diagnosis was simultaneous bilateral breast cancer, a rare entity which represents the real bilateral cancer of the breast. Neoadjuvant therapy was started and then Madden modified radical mastectomy was performed. The histopathological examination confirmed the invasive ductal carcinoma in the left breast - pT1cN1aG2 and in the right breast- pT1cN0aG2. Considering that it is a rare variant of breast cancer, with a severe prognosis, the presented case reflects the current diagnostic and treatment approaches, and the gaining of better long-term results are ensured by a correct multidisciplinary approach.

Keywordsbilateral breast cancer, breast neoplasm, ductal breast cancer

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