Bilateral synchronous carcinoma breast- a rare case presentation.
BACKGROUND
Bilateral Breast Carcinoma (BBC) is a rare entity with incidence of synchronous carcinoma being 2-5% of all breast malignancies, which is much less than metachronous carcinoma. Synchronicity/ metachronicity are usually associated with local and lymphatic spread and with blood-borne spread to lungs, bones and liver. Moreover BBC are mostly lobular carcinomas but we report a rare case of Infiltrating Ductal Carcinoma (IDC) as the primary carcinoma and Lobular Carcinoma as the secondary.


METHODS
56 year old female who presented with a Stage IIIB fungating growth around 10x8cm in the lower inner, lower outer and upper outer quadrant of right breast since 6 months and a StageIIA 4x4cm tumour felt in the left breast in the upper inner and lower outer quadrant. Wedge biopsy of the right breast fungating mass showed Ductal Carcinoma and FNAC of the left breast lump suggested Lobular carcinoma which was confirmed on Histopathology after surgery. Patient was subjected to Hormonal therapy (Tab Tamoxifen), chemotherapy (Cyclophosphamide, 5 FU, and Doxorubicin) followed by Radiotherapy. Patient recovered well and shows no recurrence or signs of metastasis in the 8 months of follow up.


RESULTS
Different histological subtypes with different grades of tumour in both breasts suggested two different synchronous primary tumours. Early detection of the contralateral tumour is of utmost importance emphasising the significance of breast self-examination. Screening tools like MRI have a greater sensitivity compared to Mammography. There are no clear treatment guidelines for bilateral breast cancer. Patients are often treated with bilateral mastectomy, with breast conservative surgery having unclear importance.


CONCLUSIONS
Meticulous diagnosis and appropriate management help to improve the longitivity with an improved quality of life.
Department of Surgery, M.R. Medical College, Sedam Road, Gulbarga, Karnataka 585101 India.
Vijay Kumar Shankarrao
0000-0002-3571-4930
VK
Kappikeri
Department of Surgery, M.R. Medical College, Sedam Road, Gulbarga, Karnataka 585101 India.
Akshay Mahesh
AM
Kriplani
Bilateral breast carcinoma; Infiltrating ductal carcinoma; Lobular carcinoma; Simple mastectomy; Synchronous breast carcinoma; Toilet mastectomy