Contralateral breast cancer

The incidence of contralateral breast cancer is increasing at a frightening rate. It ranges from 0.22% to 68%.This second breast cancer remains, however largely sub-clinical. There are pathological and clinical factors, which can be utilized to identify those women at a particularly higher risk of contralateral breast cancer. These factors include: family histories, Lobular carcinoma in-situ (LCIS), precancerous mastopathy, extensive intraductal papilloma, and duct cell hyperplasia with cell atypia. The risk is eleven times higher in these patients. This recognition is important so that this group can be treated before a second invasive carcinoma occurs. This will invariably improve survival. The concept of bilaterality of breast cancer treatment should be introduced at first visit in patients presenting with a unilateral lesion. Prophylactic mastectomy has the potential for reducing the incidence of second breast cancer in patients with an extraordinary high risk. Good cosmetic results can now be expected with bilateral mastectomies and reconstruction. The prospect for patients with synchronous or metachronous bilateral breast carcinoma is poor and worse than a unilateral lesions. (Nig J Surg Res 2003; 5: 1 – 6) Key words: Contralateral, breast cance