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Bilateral Breast Cancer: Differential Diagnosis Using Histological and Biological Parameters

Authors
 Soo Jung Gong  ;  Sun Young Rha  ;  Hyun Cheol Chung  ;  Woo Ick Yang  ;  Jae Kyung Roh  ;  Hei Cheul Jeung 
Citation
 JAPANESE JOURNAL OF CLINICAL ONCOLOGY, Vol.37(7) : 487-492, 2007 
Journal Title
JAPANESE JOURNAL OF CLINICAL ONCOLOGY
ISSN
 0368-2811 
Issue Date
2007
MeSH
Adult ; Aged ; Breast Neoplasms/chemistry ; Breast Neoplasms/diagnosis* ; Breast Neoplasms/pathology* ; Female ; Gene Expression ; Genes, erbB-2 ; Humans ; Immunohistochemistry ; Middle Aged ; Neoplasms, Multiple Primary/diagnosis ; Neoplasms, Second Primary/diagnosis ; Receptors, Estrogen/analysis ; Receptors, Progesterone/analysis
Keywords
bilateral breast cancer ; histology ; biomarker
Abstract
BACKGROUND:
Contralateral breast cancer is either a metastatic lesion or the second primary cancer. From biological and therapeutic viewpoints, it is important to differentiate metastatic lesions from second primary cancer in bilateral breast cancer.
METHODS:
Based on Chaudary's histological criteria, we analysed the tumors in 14 and 27 patients with synchronous and metachronous bilateral breast cancers with full histological and biological evaluations. The Nottingham combined histological grade and immunohistochemistry (IHC) for the estrogen receptor, progesterone receptor and cerbB-2 were used.
RESULTS:
The median age of the patients at first diagnosis was 41 years (range, 26-68 years) and the median time interval between first and second tumors was 34 months (range; 7-209 months) in metachronous cancers. The histopathological type was found in 93% of synchronous cancers and 59% of metachronous cancers (P = 0.02). The concordance rates of T stage and TNM stage were 71 and 64% respectively in synchronous cancers, while they were 24 and 32% respectively in metachronous cancers (P = 0.03). For progesterone receptor status, the concordance rates were 86 and 52% in synchronous and metachronous cancers respectively (P = 0.03). In addition, there was no statistically significant difference in terms of N stage, histological grade, intraductal component, estrogen receptor status, or cerbB-2 expression.
CONCLUSION:
In spite of the limitation of Chaudary's criteria and the number of patients involved, the combination of histopathological type, T stage and TNM stage shows that synchronous cancers are closer to same clonal lesions (metastatic lesions) than metachronous cancers and that a biomarker, such as progesterone receptor status, plays a role in addition to the histological parameters in differentiating metastatic cancers from second primary cancers.
Files in This Item:
T200700287.pdf Download
DOI
10.1093/jjco/hym056
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
Roh, Jae Kyung(노재경)
Rha, Sun Young(라선영) ORCID logo https://orcid.org/0000-0002-2512-4531
Yang, Woo Ick(양우익) ORCID logo https://orcid.org/0000-0002-6084-5019
Chung, Hyun Cheol(정현철) ORCID logo https://orcid.org/0000-0002-0920-9471
Jeung, Hei Cheul(정희철) ORCID logo https://orcid.org/0000-0003-0952-3679
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/96211
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