title: Clinical implications of multifocality as a prognostic factor in breast carcinoma - a multivariate analysis study comprising 460 cases.
abstract: BACKGROUND
  Multifocality is not listed among prognostic factors in international breast cancer guidelines. This study aims to analyze survival in multiple breast carcinomas (MFMC cc) compared to unifocal ones (UF cc), in order to assess the prognostic impact of multifocality.
  
  
  METHODS
  The study included 460 breast carcinomas (2002-2006) with a median follow-up time of 104 months (74-134 months). We assessed mortality rates, overall survival at 5 years and 10 years in general, overall survival at 5 and 10 years in MFMC cc compared to UF cc, as well as median survival and survival rate according to age, T status and axillary lymph node status in MFMC cc compared to UF cc. We carried out a multivariate analysis in order to identify independent predictor factors for survival.
  
  
  RESULTS
  69/460 (15%) of cases were MFMC cc. Mortality rates were 56.5% in MFMC cc versus 45.1% (UF cc) (P = 0.08). 5-year overall survival was 55.9% in MFMC cc vs. 64.7% UF cc, and the 10-year overall survival was 34.9% MFMC cc vs. 52.7% UF cc (P = 0.27). Median survival in MFMC cc was 78 months (6.5 years), whereas in UF cc it was 126 months (10.5 years). However, in the multivariate analysis, survival was independently influenced only by tumor size and the presence of axillary lymph node metastases (P < 0.0001).
  
  
  CONCLUSIONS
  Breast cancer multifocality is associated with higher general mortality rates, lower 5 and 10-year overall survival, yields a lower median survival, but it does not constitute an independent prognostic factor in multivariate analysis.
authors: Department of Pathology, County Emergency Clinical Hospital Oradea, Romania.
authors: Monica
authors: M
authors: Boros
authors: Department of Medical Informatics and Biostatistics, University of Medicine and Pharmacy Targu Mures (UMPhTgM) Romania.
authors: Septimiu
authors: S
authors: Voidazan
authors: Department of Histology, UMPhTgM Romania.
authors: Cosmin
authors: C
authors: Moldovan
authors: Department of Surgery, UMPhTgM Romania.
authors: Rares
authors: R
authors: Georgescu
authors: Department of Oncology, UMPhTgM Romania.
authors: Cornelia
authors: C
authors: Toganel
authors: Department of Pathology, UMPhTgM Romania.
authors: Denisa
authors: D
authors: Moncea
authors: Department of Obstetrics and Gynecology, UMPhTgM Romania.
authors: Claudiu V
authors: CV
authors: Molnar
authors: Department of Cardiology, UMPhTgM Romania.
authors: Cristian
authors: C
authors: Podoleanu
authors: Department of Breast Tumors, Cancer Institute "I. Chiricuta" Cluj-Napoca, Romania.
authors: Alexandru
authors: A
authors: Eniu
authors: Department of Pathology, UMPhTgM Romania.
authors: Simona
authors: S
authors: Stolnicu
keywords: Multiple breast carcinoma; prognostic factor; survival