title: Multifocal and multicentric breast cancer is associated with increased local recurrence regardless of surgery type.
abstract: Multifocal and multicentric breast cancers have been correlated with poor prognostic factors and worse outcomes versus unifocal disease. We evaluated the impact of multifocal and multicentric disease versus case controls with unifocal disease, matching for age, grade, T-, and N-stage. A total of 110 patients with multifocal (n = 93) or multicentric (n = 17) disease and 263 matched case controls were identified with a median follow-up of 53 months and 64 months, respectively. The actuarial local control rates for the multifocal/multicentric and unifocal group were 88% and 97%, respectively at both 5 and 10 years (p < 0.001). On multivariate analysis, multifocal/multicentric disease remained associated with higher local recurrence after controlling for other covariates including surgery type. The disease-free survival rates in the multifocal/multicentric group at 5 and 10 years were 75% and 71%, respectively, versus 87% and 78% at 10 years (p = 0.01). On multivariate analysis, multifocal/multicentric disease was no longer associated with worse disease-free survival. There was no difference in the cohorts in terms of regional control, overall survival, or cancer specific survival. Our findings suggest that multifocal/multicentric disease may be associated with worse outcomes versus unifocal disease regardless of type of surgery. This suggests a more biologically aggressive cancer and may be an important consideration when managing these patients. Further studies are needed to better understand the impact of multifocal/multicentric breast cancers on outcomes.
authors.affiliation: Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania.
authors.forename: Talha
authors.initials: T
authors.lastname: Shaikh
authors.forename: Tiffany Y
authors.initials: TY
authors.lastname: Tam
authors.forename: Tianyu
authors.initials: T
authors.lastname: Li
authors.forename: Shelly B
authors.initials: SB
authors.lastname: Hayes
authors.forename: Lori
authors.initials: L
authors.lastname: Goldstein
authors.forename: Richard
authors.initials: R
authors.lastname: Bleicher
authors.forename: Marcia
authors.initials: M
authors.lastname: Boraas
authors.forename: Elin
authors.initials: E
authors.lastname: Sigurdson
authors.forename: Paula D
authors.initials: PD
authors.lastname: Ryan
authors.forename: Penny
authors.initials: P
authors.lastname: Anderson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008408:Mastectomy / Q000379:methods; D015412:Mastectomy, Segmental / Q000379:methods; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*
keywords: breast cancer; breast conservation; mastectomy; multicentric; multifocal