title: Locoregional control of clinically diagnosed multifocal or multicentric breast cancer after neoadjuvant chemotherapy and locoregional therapy.
abstract: OBJECTIVE
  The purpose was to assess whether patients with clinical multifocal or multicentric (MFMC) breast cancer determined by mammogram, ultrasound, or physical examination have inferior outcome compared with patients with clinical unicentric lesions.
  
  
  METHODS
  We retrospectively analyzed 706 consecutive patients with stages I-III breast cancer treated at the M.D. Anderson Cancer Center (Houston, TX) from 1976 to 2003 who received neoadjuvant anthracycline-based chemotherapy followed by breast conservation therapy (BCT), mastectomy alone, or mastectomy plus postmastectomy radiation therapy.
  
  
  RESULTS
  The mean follow-up was 66 months. At presentation, 97 of 706 patients had clinically MFMC disease (13.7%). The 5-year rate of locoregional failure was 10% for unicentric disease compared with 7% for MFMC disease (P = .78). Subset analyses of patients by treatment groups confirmed no statistical difference in locoregional control regardless of the type of locoregional treatment. Among patients with multifocal disease treated with BCT, there were no in-breast recurrences and one supraclavicular recurrence. Five-year disease-free survival and overall survival was equivalent between patients with MFMC and unicentric breast cancers.
  
  
  CONCLUSIONS
  Patients with clinical MFMC breast cancer at the time of diagnosis treated with neoadjuvant chemotherapy followed by locoregional therapy have similar 5-year rates of locoregional control, disease-free survival, and overall survival as those with unicentric disease. Clinically detected MFMC disease did not predict for inferior outcome.
authors.affiliation: Department of Radiation Oncology, The University of Texas M.D. Anderson Cancer Center, 1515 Holcolmbe Blvd, Unit 1202, Houston, TX 77030, USA. joh@mdanderson.org
authors.forename: Julia L
authors.initials: JL
authors.lastname: Oh
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Dryden
authors.forename: Wendy A
authors.initials: WA
authors.lastname: Woodward
authors.forename: Tse-Kuan
authors.initials: TK
authors.lastname: Yu
authors.forename: Welela
authors.initials: W
authors.lastname: Tereffe
authors.forename: Eric A
authors.initials: EA
authors.lastname: Strom
authors.forename: George H
authors.initials: GH
authors.lastname: Perkins
authors.forename: Lavinia
authors.initials: L
authors.lastname: Middleton
authors.forename: Kelly K
authors.initials: KK
authors.lastname: Hunt
authors.forename: Sharon H
authors.initials: SH
authors.lastname: Giordano
authors.forename: Mary Jane
authors.initials: MJ
authors.lastname: Oswald
authors.forename: Delora
authors.initials: D
authors.lastname: Domain
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Buchholz
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods; D018714:Radiotherapy, Adjuvant; D016019:Survival Analysis; D016896:Treatment Outcome