| Citation: |
LIU Jia, ZHOU Xingtong, SUN Qiang. Research Progress of Multifocal/Multicentric Breast Cancer[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(3): 632-641. DOI: 10.12290/xhyxzz.2023-0562
|
Advances in imaging techniques have allowed an increasing number of multifocal/multicentric breast cancers (MMBC) to be detected at an early stage. Traditionally, MMBC has been considered to have a worse prognosis than unifocal breast cancer(UBC) and should be treated with escalation therapy. With the advancement of medical technology in recent years, the diagnosis, individualized treatment strategies, and the safety of breast-conserving surgery for MMBC need to be re-examined. This paper reviews the epidemiologic features, preoperative imaging assessment, pathological heterogeneity, molecular markers, and surgical approaches of MMBC, so as to deepen the knowledge of clinicians.
| [1] |
Masannat Y A, Rocco N, Garreffa E, et al. Global variations in the definition and management of multifocal and multicentric breast cancer: the MINIM international survey[J]. Br J Surg, 2022, 109(8): 656-659. DOI: 10.1093/bjs/znac080
|
| [2] |
Winters Z E, Horsnell J, Elvers K T, et al. Systematic review of the impact of breast-conserving surgery on cancer outcomes of multiple ipsilateral breast cancers[J]. BJS Open, 2018, 2(4): 162-174. DOI: 10.1002/bjs5.53
|
| [3] |
Holland R, Veling S H, Mravunac M, et al. Histologic multifocality of Tis, T1-2 breast carcinomas. Implications for clinical trials of breast-conserving surgery[J]. Cancer, 1985, 56(5): 979-990. DOI: 10.1002/1097-0142(19850901)56:5<979::AID-CNCR2820560502>3.0.CO;2-N
|
| [4] |
Bendifallah S, Werkoff G, Borie-Moutafoff C, et al. Multiple synchronous (multifocal and multicentric) breast cancer: clinical implications[J]. Surg Oncol, 2010, 19(4): e115-e123. DOI: 10.1016/j.suronc.2010.06.001
|
| [5] |
Vera-Badillo F E, Napoleone M, Ocana A, et al. Effect of multifocality and multicentricity on outcome in early stage breast cancer: a systematic review and meta-analysis[J]. Breast Cancer Res Treat, 2014, 146(2): 235-244. DOI: 10.1007/s10549-014-3018-3
|
| [6] |
Masannat Y A, Agrawal A, Maraqa L, et al. Multifocal and multicentric breast cancer, is it time to think again?[J]. Ann R Coll Surg Engl, 2020, 102(1): 62-66. DOI: 10.1308/rcsann.2019.0109
|
| [7] |
Mariscotti G, Durando M, Tagliafico A, et al. Preoperative breast cancer staging with multi-modality imaging and surgical outcomes[J]. Eur J Radiol, 2020, 122: 108766. DOI: 10.1016/j.ejrad.2019.108766
|
| [8] |
Bozzini A, Renne G, Meneghetti L, et al. Sensitivity of imaging for multifocal-multicentric breast carcinoma[J]. BMC Cancer, 2008, 8: 275. DOI: 10.1186/1471-2407-8-275
|
| [9] |
Lameijer J R, Coolen A M, Nederend J, et al. Frequency and characteristics of additionally detected ipsilateral breast lesions following recall at screening mammography[J]. Breast, 2018, 42: 94-101. DOI: 10.1016/j.breast.2018.08.104
|
| [10] |
Krammer J, Stepniewski K, Kaiser C G, et al. Value of additional digital breast tomosynthesis for preoperative staging of breast cancer in dense breasts[J]. Anticancer Res, 2017, 37(9): 5255-5261.
|
| [11] |
Mariscotti G, Houssami N, Durando M, et al. Accuracy of mammography, digital breast tomosynthesis, ultrasound and MR imaging in preoperative assessment of breast cancer[J]. Anticancer Res, 2014, 34(3): 1219-1225.
|
| [12] |
Mercier J, Kwiatkowski F, Abrial C, et al. The role of tomosynthesis in breast cancer staging in 75 patients[J]. Diagn Interv Imaging, 2015, 96(1): 27-35. DOI: 10.1016/j.diii.2014.06.010
|
| [13] |
Lorek A, Steinhof-Radwańska K, Barczyk-Gutkowska A, et al. The usefulness of spectral mammography in surgical planning of breast cancer treatment-analysis of 999 patients with primary operable breast cancer[J]. Curr Oncol, 2021, 28(4): 2548-2559. DOI: 10.3390/curroncol28040232
|
| [14] |
Lee S C, Hovanessian-Larsen L, Stahl D, et al. Accuracy of contrast-enhanced spectral mammography compared with MRI for invasive breast cancers: prospective study in population of predominantly underrepresented minorities[J]. Clin Imaging, 2021, 80: 364-370. DOI: 10.1016/j.clinimag.2021.08.015
|
| [15] |
Maskarinec G, Meng L, Ursin G. Ethnic differences in mammographic densities[J]. Int J Epidemiol, 2001, 30(5): 959-965. DOI: 10.1093/ije/30.5.959
|
| [16] |
周星彤, 沈松杰, 孙强. 中国乳腺癌筛查现状及进展[J]. 中国医学前沿杂志(电子版), 2020, 12(3): 6-11. https://www.cnki.com.cn/Article/CJFDTOTAL-YXQY202003002.htm
Zhou X T, Shen S J, Sun Q. Current situation and progress of breast cancer screening in China[J]. Chin J Front Med Sci (Electron Version), 2020, 12(3): 6-11. https://www.cnki.com.cn/Article/CJFDTOTAL-YXQY202003002.htm
|
| [17] |
Rehman S, Niazi I K, Naveed M A, et al. Sonographic evaluation of incidental synchronous masses in patients with breast cancer: clinical significance and diagnostic workup[J]. Eur J Breast Health, 2021, 17(1): 28-35. DOI: 10.4274/ejbh.2020.5858
|
| [18] |
Moon W K, Noh D Y, Im J G. Multifocal, multicentric, and contralateral breast cancers: bilateral whole-breast US in the preoperative evaluation of patients[J]. Radiology, 2002, 224(2): 569-576. DOI: 10.1148/radiol.2242011215
|
| [19] |
Sriussadaporn S, Sriussadaporn S, Pak-Art R, et al. Ultrasonography increases sensitivity of mammography for diagnosis of multifocal, multicentric breast cancer using 356 whole breast histopathology as a gold standard[J]. Surg Pract, 2022, 26(3): 181-186. DOI: 10.1111/1744-1633.12543
|
| [20] |
Helal M, Mansour S, Khaled R, et al. The role of automated breast ultrasound in the assessment of the local extent of breast cancer[J]. Breast J, 2021, 27(2): 113-119. DOI: 10.1111/tbj.14132
|
| [21] |
Gilbert F J, Pinker-Domenig K. Diagnosis and staging of breast cancer: when and how to use mammography, tomosynthesis, ultrasound, contrast-enhanced mammography, and magnetic resonance imaging[M]//Hodler J, Kubik-Huch R A, Von Schulthess G K. Diseases of the Chest, Breast, Heart and Vessels 2019—2022. Cham: Springer, 2019: 155-166.
|
| [22] |
Houssami N, Ciatto S, Macaskill P, et al. Accuracy and surgical impact of magnetic resonance imaging in breast cancer staging: systematic review and meta-analysis in detection of multifocal and multicentric cancer[J]. J Clin Oncol, 2008, 26(19): 3248-3258. DOI: 10.1200/JCO.2007.15.2108
|
| [23] |
Rabasco P, Caivano R, Dinardo G, et al. Magnetic resonance imaging in the pre-surgical staging of breast cancer: our experience[J]. Cancer Invest, 2017, 35(1): 43-50. DOI: 10.1080/07357907.2016.1251943
|
| [24] |
Song S E, Park E K, Cho K R, et al. Additional value of diffusion-weighted imaging to evaluate multifocal and multicentric breast cancer detected using pre-operative breast MRI[J]. Eur Radiol, 2017, 27(11): 4819-4827. DOI: 10.1007/s00330-017-4898-5
|
| [25] |
Janeva S, Krabbe E, Parris T Z, et al. Clinical evaluation of molecular surrogate subtypes in patients with ipsilateral multifocal primary breast cancer[J]. Breast Cancer Res, 2023, 25(1): 36. DOI: 10.1186/s13058-023-01632-5
|
| [26] |
Dal F, Ökmen H, Ulusan K, et al. Does focal heterogeneity affect survival in postoperative ipsilateral multifocal and multicentric breast cancers?[J]. Rev Assoc Med Bras (1992), 2022, 68(3): 405-412. DOI: 10.1590/1806-9282.20211168
|
| [27] |
Li S, Wu J Y, Huang O, et al. Association of molecular biomarker heterogeneity with treatment pattern and disease outcomes in multifocal or multicentric breast cancer[J]. Front Oncol, 2022, 12: 833093. DOI: 10.3389/fonc.2022.833093
|
| [28] |
Tong Y, Sun F X, Zhang C P, et al. Multifocal/multicentric breast cancer: Does each focus matter?[J]. Cancer Med, 2023, 12(7): 8815-8824. DOI: 10.1002/cam4.5626
|
| [29] |
Buggi F, Folli S, Curcio A, et al. Multicentric/multifocal breast cancer with a single histotype: is the biological characterization of all individual foci justified?[J]. Ann Oncol, 2012, 23(8): 2042-2046. DOI: 10.1093/annonc/mdr570
|
| [30] |
Toole M J, Kidwell K M, Van Poznak C. Oncotype dx results in multiple primary breast cancers[J]. Breast Cancer (Auckl), 2014, 8: 1-6.
|
| [31] |
Lang Z Q, Wu Y Q, Pan X B, et al. Study of differential gene expression between invasive multifocal/ multicentric and unifocal breast cancer[J]. J BUON, 2018, 23(1): 134-142.
|
| [32] |
Lang Z Q, Wu Y Q, Pan X B, et al. The identification of multifocal breast cancer-associated long non-coding RNAs[J]. Eur Rev Med Pharmacol Sci, 2017, 21(24): 5648-5654.
|
| [33] |
Zehni A Z, Batz F, Vattai A, et al. The prognostic impact of retinoid X receptor and thyroid hormone receptor alpha in unifocal vs. multifocal/multicentric breast cancer[J]. Int J Mol Sci, 2021, 22(2): 957. DOI: 10.3390/ijms22020957
|
| [34] |
Zati Zehni A, Jacob S N, Mumm J N, et al. Hormone receptor expression in multicentric/multifocal versus unifocal breast cancer: especially the VDR determines the outcome related to focality[J]. Int J Mol Sci, 2019, 20(22): 5740. DOI: 10.3390/ijms20225740
|
| [35] |
Houvenaeghel G, Tallet A, Jalaguier-Coudray A, et al. Is breast conservative surgery a reasonable option in multifocal or multicentric tumors?[J]. World J Clin Oncol, 2016, 7(2): 234-242. DOI: 10.5306/wjco.v7.i2.234
|
| [36] |
Patani N, Carpenter R. Oncological and aesthetic considerations of conservational surgery for multifocal/multicentric breast cancer[J]. Breast J, 2010, 16(3): 222-232. DOI: 10.1111/j.1524-4741.2010.00917.x
|
| [37] |
Fang M, Zhang A A, Zhang H, et al. Local control of breast conservation therapy versus mastectomy in multifocal or multicentric breast cancer: a systematic review and meta-analysis[J]. Breast Care (Basel), 2019, 14(4): 188-193. DOI: 10.1159/000499439
|
| [38] |
Shaikh T, Tam T Y, Li T Y, et al. Multifocal and multicentric breast cancer is associated with increased local recurrence regardless of surgery type[J]. Breast J, 2015, 21(2): 121-126. DOI: 10.1111/tbj.12366
|
| [39] |
Silverstein M J, Savalia N, Khan S, et al. Extreme oncoplasty: breast conservation for patients who need mastectomy[J]. Breast J, 2015, 21(1): 52-59. DOI: 10.1111/tbj.12356
|
| [40] |
Curigliano G, Burstein H J, Winer E P, et al. De-escalating and escalating treatments for early-stage breast cancer: the St. Gallen International Expert Consensus Conference on the Primary Therapy of Early Breast Cancer 2017[J]. Ann Oncol, 2017, 28(8): 1700-1712. DOI: 10.1093/annonc/mdx308
|
| [41] |
Gradishar W J, Moran M S, Abraham J, et al. Breast cancer, version 3.2022, NCCN clinical practice guidelines in oncology[J]. J Natl Compr Canc Netw, 2022, 20(6): 691-722. DOI: 10.6004/jnccn.2022.0030
|
| [42] |
Hartsell W F, Recine D C, Griem K L, et al. Should multicentric disease be an absolute contraindication to the use of breast-conserving therapy?[J]. Int J Radiat Oncol Biol Phys, 1994, 30(1): 49-53. DOI: 10.1016/0360-3016(94)90518-5
|
| [43] |
Gentilini O, Botteri E, Rotmensz N, et al. Conservative surgery in patients with multifocal/multicentric breast cancer[J]. Breast Cancer Res Treat, 2009, 113(3): 577-583. DOI: 10.1007/s10549-008-9959-7
|
| [44] |
Leopold K A, Recht A, Schnitt S J, et al. Results of conservative surgery and radiation therapy for multiple synchronous cancers of one breast[J]. Int J Radiat Oncol Biol Phys, 1989, 16(1): 11-16. DOI: 10.1016/0360-3016(89)90004-7
|
| [45] |
Kurtz J M, Jacquemier J, Amalric R, et al. Breast-conserving therapy for macroscopically multiple cancers[J]. Ann Surg, 1990, 212(1): 38-44. DOI: 10.1097/00000658-199007000-00006
|
| [46] |
Okumura S, Mitsumori M, Yamauchi C, et al. Feasibility of breast-conserving therapy for macroscopically multiple ipsilateral breast cancer[J]. Int J Radiat Oncol Biol Phys, 2004, 59(1): 146-151. DOI: 10.1016/j.ijrobp.2003.09.088
|
| [47] |
Lim W, Park E H, Choi S L, et al. Breast conserving surgery for multifocal breast cancer[J]. Ann Surg, 2009, 249(1): 87-90. DOI: 10.1097/SLA.0b013e31818e41c0
|
| [48] |
Tan M P, Sitoh N Y, Sitoh Y Y. Optimising breast conservation treatment for multifocal and multicentric breast cancer: a worthwhile endeavour?[J]. World J Surg, 2016, 40(2): 315-322. DOI: 10.1007/s00268-015-3336-6
|
| [49] |
Nos C, Bourgeois D, Darles C, et al. Conservative treatment of multifocal breast cancer: a comparative study[J]. Bull Cancer, 1999, 86(2): 184-188.
|
| [50] |
Kaplan J, Giron G, Tartter P I, et al. Breast conservation in patients with multiple ipsilateral synchronous cancers[J]. J Am Coll Surg, 2003, 197(5): 726-729. DOI: 10.1016/j.jamcollsurg.2003.06.003
|
| [51] |
Kadioğlu H, Yücel S, Yildiz S, et al. Feasibility of breast conserving surgery in multifocal breast cancers[J]. Am J Surg, 2014, 208(3): 457-464. DOI: 10.1016/j.amjsurg.2013.08.008
|
| [52] |
Crown A, Laskin R, Rocha F G, et al. Extreme oncoplasty: expanding indications for breast conservation[J]. Am J Surg, 2019, 217(5): 851-856. DOI: 10.1016/j.amjsurg.2019.01.004
|
| [53] |
Savioli F, Seth S, Morrow E, et al. Extreme oncoplasty: breast conservation in patients with large, multifocal, and multicentric breast cancer[J]. Breast Cancer (Dove Med Press), 2021, 13: 353-359.
|
| [54] |
De Lorenzi F, Borelli F, Pagan E, et al. Oncoplastic breast-conserving surgery for synchronous multicentric and multifocal tumors: is it oncologically safe? A retrospective matched-cohort analysis[J]. Ann Surg Oncol, 2022, 29(1): 427-436. DOI: 10.1245/s10434-021-10800-w
|
| [55] |
Boughey J C, Rosenkranz K M, Ballman K V, et al. Local recurrence after breast-conserving therapy in patients with multiple ipsilateral breast cancer: results from ACOSOG Z11102 (Alliance)[J]. J Clin Oncol, 2023, 41(17): 3184-3193. DOI: 10.1200/JCO.22.02553
|
| [56] |
Bundred J R, Michael S, Stuart B, et al. Margin status and survival outcomes after breast cancer conservation surgery: prospectively registered systematic review and meta-analysis[J]. BMJ, 2022, 378: e070346.
|
| [57] |
Schnabel F, Boolbol S K, Gittleman M, et al. A randomized prospective study of lumpectomy margin assessment with use of MarginProbe in patients with nonpalpable breast malignancies[J]. Ann Surg Oncol, 2014, 21(5): 1589-1595. DOI: 10.1245/s10434-014-3602-0
|
| [58] |
Tamanuki T, Namura M, Aoyagi T, et al. Effect of intraoperative imprint cytology followed by frozen section on margin assessment in breast-conserving surgery[J]. Ann Surg Oncol, 2021, 28(3): 1338-1346. DOI: 10.1245/s10434-020-08955-z
|
| [59] |
Koppiker C B, Noor A U, Dixit S, et al. Extreme oncoplastic surgery for multifocal/multicentric and locally advanced breast cancer[J]. Int J Breast Cancer, 2019, 2019: 4262589.
|
| 1. |
胡荻，水一方，苗轲轲，李孟圈. 他汀类药物对乳腺癌保护作用的孟德尔随机化研究. 肿瘤防治研究. 2025(02): 165-171 .
|
Supported by: Beijing Renhe Information Technology Co., Ltd. 
Submit
Review
Office
Email Alert
RSS
DownLoad: