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Article type: Research Article
Authors: Abdallah, Ahmeda | Hamdy, Omara | Zuhdy, Mohammada | Elbalka, Saleh S.a | Abdelkhalek, Mohameda | Zaid, Amir M.a | Atef, Ahmeda | Elmadawy, Mohamed G.a | Refky, Basela | Wahab, Khaled Abdela | Bayoumi, Daliab | Ali, Khadiga M.c | Metwally, Islam H.a | Shetiwy, Mosaba;
Affiliations: [a] Department of Surgical Oncology, Oncology Center, Mansoura University (OCMU), Mansoura, Egypt | [b] Department of Radio-Diagnosis, Faculty of Medicine, Mansoura University, Mansoura, Egypt | [c] Department of Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Correspondence: [*] Corresponding author: Mosab Shetiwy, Department of Surgical Oncology, Oncology Center Mansoura University (OCMU), Gehan st., Mansoura, 35516, Egypt. Tel.: +20 1000 3600 60; Fax: +20 50 223 8673. E-mail: [email protected]. ORCID: http://orcid.org/0000-0003-4465-0980
Abstract: BACKGROUND:Multifocal (MFBC)/multicentric (MCBC) breast cancer is being more recognized due to the improved imaging modalities and the greater orientation with this form of breast cancer, however, optimal surgical treatment, still poses a challenge. The standard surgical treatment is mastectomy, however, breast-conserving surgeries (BCS) may be appropriate in certain situations. METHODS:A total of 464 cases of MF/MCBC out of 4798 cases of breast cancer were retrospectively analyzed from the database of the Oncology Center, Mansoura University (OCMU), between January 2008 and December 2019. RESULTS:Radiologic involvement of multiple quadrants was reported in 27.9% by ultrasonography, 19% by mammography, and 59.1% by magnetic resonance imaging. BCS was performed in 32 cases (6.9%) while 432 cases underwent a mastectomy. Postoperative pathology revealed infiltration of other quadrants grossly in 23.5%, and under the microscope in 63.6% of the examined cases. Mean disease-free and overall survival were 95.5 and 164.6 months, respectively. When compared with MFBC, MCBC showed higher pathologic tumor size (p < 0.001), higher stages (p < 0.001), higher recurrence rates (p = 0.006), and lower DFS (P = 0.009) but with similar OS (P = 0.8). CONCLUSION:Mastectomy is still the primary treatment option for MCBC with higher recurrence rates compared with MFBC. However, BCS for properly selected MFBC is considered oncologically safe, following the same rules of breast conservation for unifocal disease.
Keywords: Breast, carcinoma, conservation, multicentric, outcome, survival
DOI: 10.3233/BD-220066
Journal: Breast Disease, vol. 42, no. 1, pp. 101-114, 2023
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