Ismael, N., Al-Hilli, M. (2023). Mammographic and Sonographic Criteria of Contralateral Breast Cancer versus the Index Cancer. Alustath, 22(4), 464-472. doi: 10.52573/ipmj.2023.182304
Noor Ayad Ismael; Mohamed Ridha Alwan Al-Hilli. "Mammographic and Sonographic Criteria of Contralateral Breast Cancer versus the Index Cancer". Alustath, 22, 4, 2023, 464-472. doi: 10.52573/ipmj.2023.182304
Ismael, N., Al-Hilli, M. (2023). 'Mammographic and Sonographic Criteria of Contralateral Breast Cancer versus the Index Cancer', Alustath, 22(4), pp. 464-472. doi: 10.52573/ipmj.2023.182304
Ismael, N., Al-Hilli, M. Mammographic and Sonographic Criteria of Contralateral Breast Cancer versus the Index Cancer. Alustath, 2023; 22(4): 464-472. doi: 10.52573/ipmj.2023.182304

Mammographic and Sonographic Criteria of Contralateral Breast Cancer versus the Index Cancer

Iraqi Postgraduate Medical Journal
Volume 22, Issue 4, October 2023, Pages 464-472    PDF (288.98 K)
Document Type: Review Article
DOI: 10.52573/ipmj.2023.182304
Authors
Noor Ayad Ismael* 1; Mohamed Ridha Alwan Al-Hilli* 2
1Medical City Baghdad/Ghazi Al-Hariri Hospital, Baghdad, Iraq.
2Iraqi Committee in the Arab Board for Health Specializations in Radiology, Baghdad, Iraq.
Abstract
BACKGROUND:
contralateral breast cancer (CBC) exists in two forms: synchronous and metachronous. Screening for CBC is important on initial cancer diagnosis because it allows for informed surgical decision making.
OBJECTIVE:
To assess the clinical, mammographic and sonographic features of CBC and to compare contralateral breast cancer features with those of index cancer.
METHODS:
A case series study conducted in Breast clinic, Oncology Teaching Hospital. The medical records of patients who visited the center during the period between 2018 and 2020 were reviewed. A total of 29 cases with bilateral breast cancer were collected. Twelve of them were with synchronous contralateral breast cancer and 17 have had metachronous breast cancer.  Mammographic films and high-quality US images were reviewed to record lesion characteristics and BI-RADS category classification.
RESULTS:
Patients’ mean age at the time of index tumor diagnosis was 49.7 (±9.87) ranged between 22-70 with 34.49% were 45 years and younger. 51.7% of them reported positive family history of breast cancer. 62.1% of the CBC were non-palpable lesions diagnosed during follow up in contrast to index tumor which were palpable l in 86.2%, P<0.0001. In mammography, microlabulated margin was seen in 71.4% of CBC mass whereas speculated mass was the dominant shape of the index cancer (63%), P=0.037. By sonography, non-mass hypoechoic area constituted 41.4% of CBC compared to 6.9% of index cancer, P=0.005. Moreover, CBC lesions were significantly smaller than index tumors with mean diameter of 15.3 (±9.5) vs 27.95 (±11.9), P <0.0001. 51.7% of CBC were irregular with 24.1% had indistinct margin compared with 44.8% of index cancers which exhibited speculated margin, P=0.027. 
CONCLUSION:
CBC has mammographic and sonographic feature different from index tumor. Careful contralateral whole breast examination of patients newly diagnosed with breast cancer is essential particularly in younger patient and those with family history.
 
Keywords
contralateral breast cancer; metachronous cancer; synchronous cancer; mammography; whole breast ultrasound
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