title: Optimal treatment of multiple ipsilateral primary breast cancers.
abstract: BACKGROUND
  The success of breast-conservation therapy (BCT) for patients with multiple ipsilateral invasive breast cancers (MIBC) is sparsely documented.
  
  
  METHODS
  A retrospective review of single-institution experience. Patients with 2 or more invasive cancers separated by normal breast tissue were included; patients with 1 invasive cancer with additional in situ lesions and those receiving neoadjuvant therapy were excluded.
  
  
  RESULTS
  One hundred forty-nine patients were treated over 19 years. Fifty-eight (39%) patients underwent BCT. Preoperatively, multiple tumors were suspected in more mastectomy patients than BCT patients (75% versus 62%). Most patients had 2 tumors and 1 histology. Fifty-five percent of patients with tumors within 1 quadrant underwent BCT versus 10% of patients with tumors in more than 1 quadrant. One hundred eight patients underwent sentinel lymph node (SLN) biopsy. Twenty-seven percent (34) were SLN positive. There were no regional recurrences among the SLN-negative patients. Six patients recurred: 1 nodal, 1 local, and 4 distant. The locoregional BCT recurrence rate was 3.4%.
  
  
  CONCLUSIONS
  MIBC patients can safely undergo BCT with low recurrence risk. SLNB can be performed with minimal risk of regional recurrence.
authors.affiliation: Department of General Surgery, 5777 E. Mayo Boulevard, Mayo Clinic Arizona, Phoenix, AZ 85054, USA.
authors.forename: Susanne
authors.initials: S
authors.lastname: Carpenter
authors.forename: Jason
authors.initials: J
authors.lastname: Fraser
authors.forename: Mark
authors.initials: M
authors.lastname: Fleming
authors.forename: Richard
authors.initials: R
authors.lastname: Gray
authors.forename: Michele
authors.initials: M
authors.lastname: Halyard
authors.forename: Barbara
authors.initials: B
authors.lastname: Pockaj
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D009364:Neoplasm Recurrence, Local; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy; D016896:Treatment Outcome