Multifocal/multicenter breast cancer: Clinical/epidemiological profile and immunohistochemical patterns among the foci: Cross-sectional study

Abstract

Multifocal/multicenter breast cancer (MF/MC) is a disease that comprises many paradigms in the current practice of breast cancer. To combat morbidity and mortality of this the best option is a rational therapeutic strategy, which should begin with a clear biological understanding of multicentricity and multifocality, since this is known, the correct treatment can be followed. Our objective was to define the profile of patients with multifocal and multicenter breast cancer and to evaluate whether there is disagreement between tumor foci regarding hormonal receptor and Her-2. We retrospectively analyzed 89 patients with multifocal and multicenter invasive breast cancer in two tertiary institutions in northeastern Brazil, evaluating hormonal receptor, Her-2 and ki67 in each tumor focus of 25 of these patients, highlighting disagreement or not between them, and type and histological grade, lymph node metastasis and distance and age. Of these patients, 9% presented heterogeneity between tumor foci. The proportion of metastasis in axillary lymph node was 42% and only 10% for distant metastasis. 45% of the women in the study had histological grade II or III. We found a prevalence of 40.5% of negative Her-2 and 45% of positive estrogen receptor. There was no statistically significant difference between multifocal and multicenter cancer. We conclude that MF/MC breast cancer shows heterogeneity between tumor foci in relation to biological parameters, which plays a crucial role in making decisions about treatment and consequently on tumor recurrence, prognosis and distant metastasis.