Contralateral breast cancer

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.

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.

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!

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.

Hope surgery goes well rrshannon