Optimal treatment of multiple ipsilateral primary breast cancers

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• 作者：Susanne Carpenter ; Jason Fraser ; Mark Fleming ; Richard Gray ; Michele Halyard ; Barbara Pockaj
• 关键词：Breast cancer ; Multifocal ; Multicentric ; Multiple ipsilateral ; Segmental mastectomy ; Breast-conservation therapy ; Sentinel lymph node biopsy
• 刊名：The American Journal of Surgery
• 出版年：2008
• 出版时间：October 2008
• 年：2008
• 卷：196
• 期：4
• 页码：530-536
• 全文大小：142 K

文摘

Introduction

The success of breast-conservation therapy (BCT) for patients with multiple ipsilateral invasive breast cancers (MIBC) is sparsely documented.

Methods

A retrospective review of single-institution experience. Patients with 2 or more invasive cancers separated by normal breast tissue were included; patients with 1 invasive cancer with additional in situ lesions and those receiving neoadjuvant therapy were excluded.

Results

One hundred forty-nine patients were treated over 19 years. Fifty-eight (39 % ) patients underwent BCT. Preoperatively, multiple tumors were suspected in more mastectomy patients than BCT patients (75 % versus 62 % ). Most patients had 2 tumors and 1 histology. Fifty-five percent of patients with tumors within 1 quadrant underwent BCT versus 10 % of patients with tumors in more than 1 quadrant. One hundred eight patients underwent sentinel lymph node (SLN) biopsy. Twenty-seven percent (34) were SLN positive. There were no regional recurrences among the SLN-negative patients. Six patients recurred: 1 nodal, 1 local, and 4 distant. The locoregional BCT recurrence rate was 3.4 % .

Discussion

MIBC patients can safely undergo BCT with low recurrence risk. SLNB can be performed with minimal risk of regional recurrence.