[Bilateral breast cancer: risk factors, prognostic factors and patient monitoring].

AIM OF THE STUDY: To identify and explore the most important clinical and morphological and molecular factors that affect the likelihood and prediction bilateral breast cancer (BBC). Develop an algorithm of diagnostic tests and monitoring of patients with high risk of BBC.

PATIENTS AND

METHODS

272 cases of BBC during the period from 1995 to 2011 in different oncological institutions of Ukraine have been analyzed, 195 of them were with metachronous and 77 with synchronous BBC.

RESULTS

We found that the most important morphological factors that affect the likelihood of bilateral breast cancer development are menstrual status of the patients (p = 0.00007703), the first stage of breast cancer (p = 0.000015), the degree of affection of the regional lymph nodes (p = 0.00006915) and tumor size (p = 0.000112) at the time of first detection of breast cancer. Significant effect on the occurrence BBC makes of the fact that history high doze irradiation in the treatment of the first tumor (p = 0.00779).

CONCLUSION

At high risk group of development of metachronous BBC are patients with the following parameters of the first tumor: size > 5 cm, N category > pN2, stage > 2, a history of high doze exposure of contrlateral breast cancer, lack of radiotherapy in standard fractionation, chemotherapy and hormone therapy in complex treatment of the first tumor. Optimal algorithm for monitoring patient group increased risk of BBC for the first 5 years of follow include: monthly self testing, quarterly reviews of mammologist, breast ultrasound every half-year, annual mammography control.