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The Capital Region of Denmark - a part of Copenhagen University Hospital

Breast cancer mortality in synchronous bilateral breast cancer patients

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BACKGROUND: Evidence suggests that patients with synchronous bilateral breast cancer (SBBC), diagnosed within 4 months, have an inferior prognosis compared to unilateral breast cancer (UBC) patients. Using data from nationwide Danish clinical databases, this cohort study investigated whether the inferior prognosis could be explained by SBBC patients having a more aggressive disease, or whether the prognosis could be explained by the fact that they have two simultaneous cancers.

METHODS: Patients were diagnosed from 1999-2015. The main outcome was excess mortality, subtracting background population mortality from observed mortality. Differences between SBBC and UBC patients were evaluated by rate ratios (RR) and estimated by Poisson regression.

RESULTS: In total, 1214 SBBC and 59 177 UBC patients were included. SBBC patients had a significantly higher excess mortality than UBC patients after adjustment for age and period (RR = 1.73; 95% CI:1.44-2.08; p < 0.01) and after adjusting for characteristics of the worst tumour as traditionally done (RR = 1.31; 95% CI:1.08-1.57; p = 0.01). However, adjusting for characteristics of both tumours, using a more advanced competing risks model, no difference was observed (RR = 1.01; 95% CI:0.83-1.22; p = 0.93).

CONCLUSIONS: Our study does not support that the inferior prognosis in SBBC patients is due to having more aggressive tumours per se, but rather the combined effect of having two simultaneous cancers.

Original languageEnglish
JournalBritish Journal of Cancer
Issue number7
Pages (from-to)761-767
Number of pages7
Publication statusPublished - Apr 2019

    Research areas

  • Adult, Aged, Breast Neoplasms/mortality, Carcinoma/mortality, Case-Control Studies, Denmark, Female, Humans, Middle Aged, Mortality, Neoplasms, Multiple Primary/mortality, Prognosis, Unilateral Breast Neoplasms/mortality

ID: 59078897