Like every year, the month of October is dedicated to the fight against breast cancer, through the national Pink October campaign. An important event to inform and carry out prevention because, as the National Cancer Institute points out, in 2023, 61,214 new cases will be diagnosed. And if breast cancer is the most common in women, it is also the deadliest with a death rate of 14%. A widespread pathology, it can also take a rarer form by affecting both breasts, simultaneously or not. This is called bilateral breast cancer.
WHAT IS BILATERAL BREAST CANCER?
Bilateral breast cancer is manifested by the simultaneous appearance of a tumor in each breast, or one after the other, within a short period of time, that is to say at most in the six months. This form is much rarer since it concerns around 5% of breast cancers. Although this pathology is predominantly genetic, there are other risk factors on which it is possible to act, namely alcohol consumption, overweight or obesity, tobacco and a sedentary lifestyle in menopausal women, which would prevent nearly 20,000 cases each year.
IDENTICAL SYMPTOMS AND TREATMENTS
Often diagnosed early, that is to say before the age of fifty, bilateral breast cancer can, like the unilateral form, go unnoticed or manifest in the same way: a hard mass, lymph nodes located under the armpits, discharge spontaneous sensations in the nipples and a change in the appearance of the breasts and nipples. Nausea, headache, loss of appetite, shortness of breath, and bone pain may also accompany these symptoms.
Whether simultaneous or not, bilateral breast cancer is treated in the same way as its unilateral counterpart. Local treatments, carried out on both breasts, are offered in addition to general preventive treatment, intended to limit recurrences as much as possible. Thus, surgery which consists of the removal of one or both breasts, chemotherapy, hormonal therapy or even radiotherapy are among the therapeutic solutions.
TUMORS INDEPENDENT OF EACH OTHER
Although it is rare, the bilateral form of this pathology interests researchers. A study carried out by the Institut Curie and published in March 2023, the first on the subject, demonstrated that the two tumors would be independent of each other. By analyzing the records of 404 patients with bilateral breast cancer, the researchers discovered that the response of the immune system was not the same if the right and left tumors were of different subgroups (luminal, triple negative or HER2). In a press release, the Institut Curie gives an example: “Luminal breast cancers (characterized by the expression of the estrogen receptor) do not usually respond to neoadjuvant treatment (before surgery), but in the presence of a contralateral tumor triple negative type, the immune response and response to treatment are increased. »
Thus, it would be appropriate to consider tumors as two different entities to determine appropriate therapeutic solutions, since they may have a different response to treatment. This could make it possible to improve patient care in the years to come thanks to other clinical trials.
M.K
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