Introduction:
Bilateral breast cancer means occurrence of breast cancer in both breasts. The growth of abnormal cancer cells in the breasts is usually unilateral. Bilateral breast cancer is more fatal as compared to unilateral breast cancer. Age, genetics, medical history, and environmental risk factors are all responsible for causing bilateral breast cancer. Surgical treatments, including medical therapies are advised to treat breast cancer. It is to be noted that the prognosis of bilateral breast cancer is poor.
What Is Bilateral Breast Cancer?
Bilateral breast cancer is also known as contralateral breast cancer, which can occur in individuals with a history of breast cancer. It occurs in both breasts of an individual. It can be an invasive or non-invasive cancer. However, most bilateral breast cancers are invasive, spread to the surrounding tissues, and affect the lymph nodes.
What Are the Various Types of Bilateral Breast Cancer?
Following are the various types of bilateral breast cancers:
- Metachronous Breast Cancer - It is a commonly occurring breast cancer. Most metachronous breast cancers are genetically occurring cancers. They occur at different times in either of the breasts.
- Synchronous Breast Cancer - It is the most uncommon type of breast cancer and is also known as contralateral breast cancer. It is cancer in which two or more different tumors are present. It can be invasive or non-invasive. The cause of synchronous breast cancer is unknown. It is to be remembered that both metachronous and synchronous breast cancer are equally lethal.
- Bilateral Lobular Breast Cancer - Lobular breast cancer occurs in the breast's lobules. Lobules are the glands in the breast that secrete milk. It is invasive cancer that spreads to the surrounding breast tissue as well as the lymph nodes.
- Bilateral Intraductal Breast Cancer - Lobules in the breast are all connected through ducts making a passage for the milk. Cancer occurring in these ducts is called intraductal cancer.
How Common Is Bilateral Breast Cancer to Unilateral Breast Cancer?
Bilateral breast cancer is a rare finding, yet lethal when compared to unilateral cancer. It can be caused due to genetic mutations or exposure to risk factors. The chances of occurrence of bilateral breast cancer in individuals already having breast cancer are higher than in individuals without cancer.
Who Is Most Prone to Bilateral Breast Cancer?
- Most commonly, older adult female are prone to bilateral breast cancer.
- Younger individuals are also seen to be affected by metachronous bilateral breast cancer.
- Individuals with a previous history of breast cancer which was treated already, also are at a high risk of developing bilateral breast cancer.
Is There a Metastasis of Bilateral Breast Cancer?
Breast cancer commonly occurs in females. Metastasis (spread of cancer from one region to another) is usually seen in regions of bone, lung, brain, and liver and rarely in gastric regions. Gastric metastasis is identified in bilateral breast cancers, and the most commonly affected region is the stomach. Therefore, it is essential to differentiate the primary cancer of the stomach from that of a secondary metastasized cancer.
How Is Metastasized Gastric Cancer Diagnosed?
The spread of bilateral breast cancer into gastric areas is common. An endoscopy is done to collect samples (biopsy) which is then sent to a lab for histopathological examination. The tissues which are collected from a biopsy are examined under a microscope.
Following symptoms are observed in metastatic gastric cancer:
- Abdominal pain.
- Nausea.
- Vomiting.
- Gastrointestinal symptoms.
What Is the Treatment for Metastasized Gastric Cancer?
Most of the secondary metastasized gastric cancer can be treated without any surgical intervention and with the help of chemotherapy and radiotherapy.
What Are the Symptoms of Bilateral Breast Cancer?
The following are the symptoms of bilateral breast cancer:
- Lesion/mass/lump in the breasts.
- Inverted nipple.
- Change in color of the overlying skin.
- Redness or inflammation in the surrounding areas.
- Pain in the axial lymph nodes.
- Changes in the shape and size of the breast.
How Can Breast Cancer Be Diagnosed?
Following are the diagnostic methods by which breast cancer can be diagnosed:
- Ultrasound - Ultrasound is used to diagnose the consistency of the lump or lesion. Multi-lobular solid lesions are usually found. Clustered small calcifications are also seen. Abdomen ultrasound is also carried out to eliminate the chances of metastasis.
- Mammogram - It is a type of X-ray that is performed to detect any abnormalities or changes in the breasts. There are two types of mammograms and they are:
- Screening Mammogram - It is a type of screening that is used to detect the presence of cancer
- Diagnostic Mammogram - Any suspicious breast changes are detected in diagnostic mammograms.
- Magnetic Resonance Imaging (MRI) - MRI uses magnetic and radio waves to visualize the internal abnormalities of breast tissue.
- Fine Needle Aspiration Cytology - It is a diagnostic tool used to confirm the presence of cancer.
- Histopathological Examination - This diagnostic tool is used to confirm the type of breast cancer. It includes collecting the tissue and examining it under a microscope to evaluate the types of cells.
What Is the Treatment for Bilateral Breast Cancer?
Treatment modalities for bilateral breast cancer involve the following approaches:
- Modified Radical Mastectomy With or Without Lymph Node Dissection - Bilateral breast cancers usually include the adjacent lymph nodes, due to which the resection of lymph nodes along with mastectomy (complete removal of breast) is performed. In certain cases, lumpectomy is also performed, which is the removal of only the affected tissue of the breast.
- Chemotherapy - Chemotherapy includes administering anticancer drugs to kill cancer cells.
- Radiotherapy - The body is exposed to high-dose radiation that directly destroys the cancer cells. Radiation therapy is given to patients at one-month intervals.
- Adjuvant Therapies - Adjuvant therapies are treatments added after the surgery to obtain a positive treatment outcome. To improve the treatment outcome, chemotherapy and radiotherapy are advised.
Conclusion:
Bilateral breast cancer is a rare breast cancer with poor prognosis. Though the advancements in treatments are increasing rapidly, the prognosis is still questionable. Early detection of the symptoms and proper diagnosis can help in better treatment results. An oncologist or a general physician should be consulted when symptoms are first noted. Beginning the treatment at the earliest and at the beginning stage can prevent further metastasis and cancer complication.
