Conservative surgery in patients with multifocal/multicentric breast cancer

Oreste Gentilini, Edoardo Botteri, Nicole Rotmensz, Luciana Da Lima, Mujgan Caliskan, Carlos A. Garcia-Etienne, Irina Sosnovskikh, Mattia Intra, Giovanni Mazzarol, Simona Musmeci, Paolo Veronesi, Viviana Galimberti, Alberto Luini, Giuseppe Viale, Aron Goldhirsch, Umberto Veronesi

Research output: Contribution to journalArticle

Abstract

Purpose: Many physicians recommend mastectomy in case of multifocal (MF) or multicentric (MC) breast cancer due to a theoretical risk of poor local control with less extensive surgery. We retrospectively evaluate outcome of patients with MF/MC cancers who had breast conservation with specific attention on local control and predictive factors of recurrence. Patients and methods: Four hundred and seventy six patients with either MF (n = 421) or MC (n = 55) breast cancer, underwent breast-conserving surgery between 1997 and 2002 in a single institution. Median follow up was 73 months (range 11-118). Results: Median age was 53 years (range 23-86). Invasive lobular carcinoma was found in 88 patients (18.5%) and mixed ductal-lobular cancer in 27 (5.7%) patients. Two hundred and sixty-seven patients (76.7%) had two identified tumor foci, 55 patients (15.3%) had three and 29 patients (8.0%) had four or more. Two hundred and sixty-one patients (55.3%) had nodal involvement. The 5-year cumulative incidence of local relapse was 5.1%. At the multivariate analysis, over-expression of HER2/neu and lack of both estrogen and progesterone receptors (HR: 3.2, 95% C.I. 1.01-10.0, and HR: 2.7, 95% C.I. 1.06-7.7, respectively) were associated with a higher ipsilateral breast cancer reappearance rate. Involvement of four or more lymph nodes and lack of estrogen and progesterone receptors (HR: 2.7, 95% C.I. 1.06-6.7, and HR: 4.7, 95% C.I. 2.1-10.4, respectively) were associated with poorer overall survival. Conclusions: In selected patients with MF/MC breast cancer, wide conservative surgery is not associated with poor local disease control and can be considered whenever acceptable cosmetic results can be achieved.

Original languageEnglish
Pages (from-to)577-583
Number of pages7
JournalBreast Cancer Research and Treatment
Volume113
Issue number3
DOIs
Publication statusPublished - Feb 2009

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Keywords

  • Breast cancer
  • Conservative surgery
  • Multicentric
  • Multifocal
  • Quadrantectomy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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