Synchronous and Metachronous Bilateral Breast Cancers

Rodrigo Arrangoiz MS, MD, FACS, FSSO
  • Synchronous and metachronous bilateral breast cancers:
    • Appear in 1% to 20% of patients with breast cancer
    • Improvements in screening and the increased use of MRI:
      • Often diagnose more early-stage synchronous bilateral cancer
  • The role of MRI in the preoperative planning:
    • Is controversial and may be partly responsible for increasing mastectomy rates in the United States
  • MRI may identify additional lesions in both the ipsilateral and contralateral breast in many women diagnosed with unifocal breast cancer:
    • Many of these additional lesions are often found to be benign once additional diagnostic imaging is performed and biopsies are completed
  • Additional MRI findings should not prompt surgeons to recommend mastectomy:
    • Unless they are biopsy-proven to represent additional sites of malignancy not amenable to breast conservation, and / or the patient was inclined toward mastectomy prior to MRI findings
      • There is no survival benefit to bilateral mastectomy compared to breast conservation
  • Retrospective studies evaluating the outcomes of synchronous bilateral breast cancer are limited by small cohort sizes, differing definitions, and non-matched unilateral patients as controls:
    • Most retrospective studies show no differences in local recurrence or survival for bilateral breast cancers:
      • Making bilateral breast-conserving treatment a safe option for early-stage synchronous cancers
  • References:
    • Heron DE, Komarnicky LT, Hyslop T, Schwartz GF, Mansfield CM. Bilateral breast carcinoma: risk factors and outcomes for patients with synchronous and metachronous disease. Cancer. 2000;88(12):2739-2750.
    • Intra M, Rotmensz N, Viale G, et al. Clinicopathologic characteristics of 143 patients with synchronous bilateral invasive breast carcinomas treated in a single institution. Cancer. 2004;101(5):905-912.
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Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

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