Breast Cancer Research and Treatment

, Volume 113, Issue 3, pp 577–583 | Cite as

Conservative surgery in patients with multifocal/multicentric breast cancer

  • Oreste Gentilini
  • Edoardo Botteri
  • Nicole Rotmensz
  • Luciana Da Lima
  • Mujgan Caliskan
  • Carlos A. Garcia-Etienne
  • Irina Sosnovskikh
  • Mattia Intra
  • Giovanni Mazzarol
  • Simona Musmeci
  • Paolo Veronesi
  • Viviana Galimberti
  • Alberto Luini
  • Giuseppe Viale
  • Aron Goldhirsch
  • Umberto Veronesi
Epidemiology

Abstract

Purpose Many physicians recommend mastectomy in case of multifocal (MF) or multicentric (MC) breast cancer due to a theoretical risk of poor local control with less extensive surgery. We retrospectively evaluate outcome of patients with MF/MC cancers who had breast conservation with specific attention on local control and predictive factors of recurrence. Patients and methods Four hundred and seventy six patients with either MF (n = 421) or MC (n = 55) breast cancer, underwent breast-conserving surgery between 1997 and 2002 in a single institution. Median follow up was 73 months (range 11–118). Results Median age was 53 years (range 23–86). Invasive lobular carcinoma was found in 88 patients (18.5%) and mixed ductal-lobular cancer in 27 (5.7%) patients. Two hundred and sixty-seven patients (76.7%) had two identified tumor foci, 55 patients (15.3%) had three and 29 patients (8.0%) had four or more. Two hundred and sixty-one patients (55.3%) had nodal involvement. The 5-year cumulative incidence of local relapse was 5.1%. At the multivariate analysis, over-expression of HER2/neu and lack of both estrogen and progesterone receptors (HR: 3.2, 95% C.I. 1.01–10.0, and HR: 2.7, 95% C.I. 1.06–7.7, respectively) were associated with a higher ipsilateral breast cancer reappearance rate. Involvement of four or more lymph nodes and lack of estrogen and progesterone receptors (HR: 2.7, 95% C.I. 1.06–6.7, and HR: 4.7, 95% C.I. 2.1–10.4, respectively) were associated with poorer overall survival. Conclusions In selected patients with MF/MC breast cancer, wide conservative surgery is not associated with poor local disease control and can be considered whenever acceptable cosmetic results can be achieved.

Keywords

Conservative surgery Breast cancer Quadrantectomy Multifocal Multicentric 

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Copyright information

© Springer Science+Business Media, LLC. 2008

Authors and Affiliations

  • Oreste Gentilini
    • 1
  • Edoardo Botteri
    • 2
  • Nicole Rotmensz
    • 2
  • Luciana Da Lima
    • 1
  • Mujgan Caliskan
    • 1
  • Carlos A. Garcia-Etienne
    • 1
  • Irina Sosnovskikh
    • 1
  • Mattia Intra
    • 1
  • Giovanni Mazzarol
    • 3
  • Simona Musmeci
    • 1
  • Paolo Veronesi
    • 1
    • 4
  • Viviana Galimberti
    • 1
  • Alberto Luini
    • 1
  • Giuseppe Viale
    • 1
    • 4
  • Aron Goldhirsch
    • 5
  • Umberto Veronesi
    • 1
  1. 1.Division of Breast SurgeryEuropean Institute of OncologyMilanItaly
  2. 2.Division of Epidemiology and BiostatisticsEuropean Institute of OncologyMilanItaly
  3. 3.Division of Pathology and Laboratory MedicineEuropean Institute of OncologyMilanItaly
  4. 4.University of Milan School of Medicine, European Institute of OncologyMilanItaly
  5. 5.Department of MedicineEuropean Institute of OncologyMilanItaly

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