Tsyhyka D. Bilateral breast cancer: features of diagnostic and therapeutic approach

The work is a comprehensive study which worked prognostic factors that influence the risk of bilateral breast cancer (BBC) grounded optimal algorithm for diagnosis and treatment strategy based on significant prognostic factors. It was established that a high risk group of metachronous BBC are patients with the following parameters of the first tumor: size > 5 cm , N category >= pN2, stage > II, negative steroid hormone receptors status, a history of high dose radiotherapy of primary breast cancer, lack of combined treatment of the first tumor standard fractionation radiotherapy, chemotherapy and hormone therapy. We proposed algorithm for monitoring of patient with increased risk of BBC for the first 5 years that include follows: monthly self-examination, quarterly reviews of mammologist, breast ultrasound every half-year, annual mammography control. Proved on a large clinical material that BВС in its course and prognosis is more unfavorable than unilateral BC. The recommended surgery in patients with BBC is breastconcerving surgery in the absence of contraindications to its implementation. Adjuvant chemotherapy should be used in all cases of synchronous and metachronous bilateral breast cancer, regardless of stage of the process. Preference is given to schemes that include anthracyclines and/or taxanes.