Breast conserving surgery for multifocal breast cancer.
OBJECTIVE
The purpose of this study is to examine the oncological safety of breast conserving surgery (BCS) for patients with multifocal breast cancer.


BACKGROUND
Few studies have reported about BCS for multifocal breast cancer. BCS for multifocal cancer has a risk of local failure in previous reports, whereas recent studies reported the feasibility of BCS. However, because all studies have dealt with a small number of patients, multifocal breast cancer is still considered a relative contraindication for BCS.


METHODS
This retrospective study includes 478 patients with multifocal breast cancer who underwent BCS or mastectomy and 930 with unifocal cancer who underwent BCS for stage 0-II. Multifocal cancer was defined as 2 or more distinct cancers in the same quadrant. Of 478 patients, 147 underwent BCS and 331 underwent mastectomy. We compared the local recurrence rate (LRR), disease free survival, and overall survival for BCS with mastectomy for multifocal cancer. In addition, the LRR of BCS for multifocal cancer was compared for unifocal cancer.


RESULTS
There is no significant difference in stage distribution and other clinical and pathologic characteristics except Her-2/neu for stage IIA between BCS and mastectomy for multifocal cancer. The mean follow-up period was 59.33 months (range, 1.00-177.20) for breast conserving group and 64.98 months (range, 6.23-196.03) for mastectomy group. The 5-year overall survival was 93.38% for BCS and 94.53% for mastectomy (log rank P = 0.208). The 5-year disease-free survival was 89.08% for BCS and 91.88% for mastectomy (log rank P = 0.451). The local failure occurred in 3 (2.0%) of 147 patient underwent BCS, 3 (0.9%) of 331 patients underwent mastectomy (P = 0.378). Compared with BCS for unifocal cancer patients, the LRR of patients with multifocal cancer was not statistically different (2.0% for multifocal, 1.3% for unifocal; P = 0.445).


CONCLUSIONS
Our study demonstrates that BCS for multifocal breast cancer is oncologically safe in selected patients.
Lim
Woosung
W
Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Songpa-Gu, Seoul, Korea. wslim@amc.seoul.kr
Park
Eun-Hwa
EH
Choi
Sung-Lim
SL
Seo
Jin-Young
JY
Kim
Hee-Jung
HJ
Chang
Mi-Ae
MA
Ku
Bo-Kyung
BK
Son
Byungho
B
Ahn
Sei-Hyun
SH
D000328:Adult; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008408:Mastectomy / Q000379:methods*; D012189:Retrospective Studies; D015996:Survival Rate