Synchronous Bilateral Breast Carcinoma: A Clinicopathological Report of a Rare Case with Treatment Challenges

Abstract

Synchronous bilateral breast carcinoma (SBBC) is rare manifestation with an incidence ranging from 0.2% to 12%. The prognosis of the disease, its histopathological characteristics, and the molecular behaviour remain unclear. However, many studies have indicated independent chromosomal abnormalities from the two cancers that show an increase CXCR4 receptor expression with a high tendency of visceral metastasis. To date there are no standard protocols for treatment of SBBC and these pose challenges in interpreting survival data and recurrence. A 39-year-old female para 5+1, four alive presented with a 2-year history of a left breast lump and one-year history of a right breast lump. Both lumps were painless and progressively increased in size. The breasts show lumps at the upper outer quadrants measuring 7 x 6 and 6 x 5cm for left and right breast respectively, the overlying skin shows peud'orange. Biopsies confirmed SBBC with a discordant histology with triple-negative hormonal status. The patient had bilateral radical mastectomy and chemotherapy. We present a case of SBBC to re-emphasize the significance of screening for contralateral breast in patients who present with unilateral breast cancer. The standard treatment guideline is still lacking in the management of SBBC worldwide, therefore, multi-institutional prospective studies with long time follow-up of the patients are required for a better management of SBBC.