Aim  Bilateral breast carcinoma(BBC) is on the rise from past few decades, mainly because of the improved detection capabilities and increased overall survival times after primary breast cancer. The incidence of BBC varies from 4–20%. The probability is between 0.5 to 1% per year with a cumulative incidence of 15% in patients with previous history of breast cancer.  Methods  We reviewed 52 bilateral breast cancer out of 6858 breast cancer patients treated at our hospital from 2006 to 2015. We analysed the significance of concordance of clinical and histological parameters among the synchronous(17) and metachronous groups(35).  Results  We had 17 patients of synchronous and 35 patients with metachronous BBC . The concordance rates of T stage, N stage and TNM stage were seen to be 47%, 53% and 47% respectively in synchronous cancers whereas they were 42%, 49% and 34% respectively in metachronous cancers. Histopathological subtype was same in 72% of patients in synchronous cancers while it was significantly more diverse in metachronous cancers (p=0.03). The concordance rates of histological grade were 53% in synchronous cancers and 38% in metachronous cancers(p=0.002). The concordance rate of estrogen receptor in synchronous cancers was 82% and in metachronous was 63 %(p=0.03). The concordance of progesterone receptor and cerbB–2 receptor expression among both groups was statistically insignificant.  Conclusion  We conclude that biological parameters can complement the histological factors in differentiating metastatic cancer from second primary cancer in synchronous and metachronous bilateral breast cancer cases.