Abstract
BackgroundMultiple breast cancers may present with different clinical and biological characteristics. The data indicate that multifocal (MF), multicentric (MC), and bilateral synchronous (BS) breast cancers (BC) are more aggressive and have an equivalent or moderately poorer survival rate compared with unilateral cases. However, a comparison of these multiple breast cancers has not been covered in the literature. The aim of this study was to describe the histopathological characteristics of patients suffering from MF, MC, and BS breast carcinoma and to compare their prognoses.MethodsRetrospective data for MF, MC, and BS breast carcinoma patients treated in five different breast cancer units in Turkey between 2003 and 2012 were collected. MF and MC cancers were defined as more than one lesion in the same quadrant or in separate quadrants, respectively.ResultsThere were 507 patients (271 MF, 147 MC, and 89 BS) treated in this time period. BS breast carcinoma patients were younger than the other groups (44.83 ± 9.6, 47.27 ± 11.6, and 51.11 ± 11.8 years for BS, MF, and MC breast carcinoma patients, respectively). MFBC and MCBC patients in this study were younger than the ages reported in Western literature, but this result was similar to the ages reported in Eastern literature. The five-year survival rates and recurrence rates were not statistically different among groups (P = 0.996 and P = 0.263, respectively). According to univariate analyses, tumor size, histological grade, and lymph node status were statistically significant factors that affected survival. However, only lymph node involvement was significant for survival according to multivariate analyses.ConclusionsThe clinical significance of MF, MC, and BS breast cancers is still unclear and their influence on prognosis is controversial. Disease-free and overall survival rates of BS breast cancers might be similar to MF and MC breast cancers.
Highlights
Multiple breast cancers may present with different clinical and biological characteristics
The following patients were excluded from the study: patients who were treated with neo-adjuvant chemotherapy, patients who had a history of contralateral breast cancer, patients who received chemotherapy or radiotherapy for any kind of malignancy, patients who were male; patients who were lost at follow-up, and patients who were not seen by a medical professional in the previous six months
multifocal breast cancer (MFBC) was defined as tumors separated by normal breast tissue in the same quadrant, and multicentric breast cancer (MCBC) was defined as tumors separated by normal breast tissue in different quadrants
Summary
Multiple breast cancers may present with different clinical and biological characteristics. The data indicate that multifocal (MF), multicentric (MC), and bilateral synchronous (BS) breast cancers (BC) are more aggressive and have an equivalent or moderately poorer survival rate compared with unilateral cases. Unilateral, multifocal, and multicentric breast cancers have been of interest to oncology professionals for many years, but their impact on prognosis and survival is controversial [1]. While early clinical trials advocated mastectomy for multifocal and multicentric tumors [2], the Bilateral synchronous breast cancer (BSBC) is a rare entity with an incidence of between 1 and 3%. Different time intervals have been used to define BSBC. In 1921, Kilgore defined BSBC as a breast cancer in which both tumors are diagnosed at the same time [6]. A widely accepted definition of BSBC is that of Hartman et al, who defined BSBC in 2007 as a tumor diagnosed within 90 days of the first tumor [4]
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