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Bilateral Breast Cancer — SCE Medical Oncology MCQ

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ModerateBreast CancerBilateral Breast CancerSCE Medical Oncology

A 65-year-old woman presents with bilateral breast masses. Biopsy confirms bilateral invasive breast cancer (synchronous primaries). Both are ER+/HER2-. What is important for treatment planning?

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Correct answer: E — Each cancer is staged and biologically profiled independently

Synchronous bilateral breast cancer (occurring within 6 months) requires independent staging and biological characterisation of each tumour. Treatment decisions (chemotherapy, endocrine therapy, radiation) are guided by the higher-risk primary. Each tumour may have different ER/PR/HER2 status and genomic risk profiles. Bilateral disease is not automatically classified as metastatic (it is staged as two separate primaries). Surgical management is individualised (bilateral BCS, bilateral mastectomy, or combination).

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/cancer