Contralateral breast cancer

Sandy1950

I was treated for stage 1 breast cancer nine years ago and was just diagnosed with cancer in the other breast. It's very tiny and grade 1 but it is concerning that I've now had breast cancer twice. I'm just wondering how others feel about this and what your experiences have been.

Ingerp

I dunno. I had ALH on the right side 10 years ago, then DCIS on the left three years ago, then IDC on the right last year. The IDC was a different tumor type so considered a new primary. I try not to think too much about why these things keep developing. I have not had genetic testing because I have no family history of cancer and two of my doctors said they were sure it would come back negative. For now I’ll complete my current treatment and depend on my doctors to monitor me. I try to keep the thoughts about what I might do if something shows up again out of my head. In a perfect world I’ll never have to make treatment decisions again.

KBeee

My mom had IDC in 1992. She had UMX and chemo. She had ILC in 2016 in the contralateral breast. She's doing well now. We both have a VUS in the CHEK2 gene. Have you had genetic testing? Sorry you're dealing with this again.

Sandy1950

Thanks for sharing that info about your Mom! I'm 68. I had genetic testing after the first cancer and again last year because there were some newer genes to test. No genetic issues. My age and family history are probably the contributing factors. I'm so glad your Mom is doing well and I hope you are, too!

Sandy1950

Thanks for sharing your experiences. We're so lucky that mammograms can pick up these cancers when they are still small.

Beesie

I think contralateral breast cancer is a lot more common than we have been led to believe.

The following study starts off by saying:

"Contralateral second primary breast cancers occur in 4% of female breast cancer survivors".

Then the analysis then goes on to conclude that:

"Women who had survived HR-positive (i.e. ER+ and/or PR+) breast cancers had more than a twofold increased risk of a second primary tumor, and women who had survived HR- breast cancers had nearly a fourfold increased risk, compared with the age-, race-, and year-adjusted general population.".

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC27209...

So the report tells us that 1 in 25 (4%) breast cancer survivors will develop a contralateral breast cancer, but then explains that our risk is at least double that of the general population. As we know, the breast cancer risk for the general population is 1 in 8 (12.5%). Huh?

I think the disconnect in the figures is due to the fact that: 1) most studies that evaluate the rate of contralateral breast cancer cover a relatively short time period, 5 years, 7 years or at most 10 years; and 2) most studies don't factor in the approx. 30% of women who have a BMX at the time of their first diagnosis, bringing their risk level down to just 1%-2%.

As more women are being diagnosed at a younger age, as more women are surviving their first diagnosis, as more women are living longer, and as more women have been taking endocrine therapy which offers a degree of contralateral protection for 7 - 8 years (based on 5 years of Tamoxifen or an AI), I think we are starting to see a much higher rate of contralateral breast cancer among survivors who are 8+ years out, including many who are even 20+ years out. I know that the women on this board are not a representative sample, but most of the second primary breast cancers I recall seeing over the past few years have occurred well beyond the time frame of most of these studies that have found such low contralateral breast cancer rates.

KBeee

I agree 100% with everything Beesie said.

Tassie

My first cancer was in 2011, did the five years of Armidex and stopped in July 2016.  By February 2017 I was diagnosed with second primary in the opposite breast.  hadn't counted on that.  I'm back on Arimidex and wonder if I will be on it for life!

Sandy1950

Hi, Tassie

My surgeon said I'll probably be put on something other than Arimadex this time. She said it's supposed to still be effective up to five years after discontinuing it. I stopped taking it in 2015. I'll find out for sure after my surgery and radiation in a couple weeks. Maybe the new protocol will be to take something longer than five years!

bgirl

Tassie,

I'm with you October 2011 - 5 years of Tamoxifen finished December 2016 (46)

Diagnosed April 4 2018 - new contralateral primary - new pathology - started on Letrozole 2 1/2 months ago ... at least 5 years and probably 10. (53)

By then there may be new guidelines. They have changed since my first for chemo, etc.

Also, apparently bilateral BC buys you a trip to genetics. Had blood draw last week. Now we wait. 3 daughters and 3 sisters.

rrshannon

My 1st diagnosis at age 35 ILC which was Triple Negative. I am negative for genetics and had no family histroy. Now 15 years later my ER+ IDC is right next to the first location. Having my bilateral mastectomy tomorrow. Praying that the other side is free and clear.

bgirl

Hope surgery goes well rrshannon

Sandy1950

I hope all went well today, rrshannon!❤️