M. Plasilova1, B. R. Hayse1, A. B. Chagpar1, B. K. Killelea1, N. R. Horowitz1, D. R. Lannin1 1Yale University School Of Medicine,Yale-New Haven Hospital/Department Of Surgery/Breast Center At Smilow Comprehensive Cancer Center,New Haven, CT, USA
Introduction:
Breast conservation surgery (BCS) is the operation of choice for most unifocal breast cancers. Its use has not been recommended as a standard surgical option for multicentric breast cancer. We report a retrospective analysis from a single breast center of patients who opted for BCS for multicentric breast lesions. Multicentric cancer was defined as two or more lesions in different breast quadrants.
Methods:
Patients with multicentric breast cancer undergoing double lumpectomy, involving 2 separate incisions, were retrospectively identified by using an institutional breast surgical database from 2004-2013. The primary tumor was invasive, but the secondary tumor could be either invasive or in situ. Demographics, clinicopathological features, and clinical outcomes are described.
Results:
We identified 17 patients with biopsy proven invasive breast cancer who underwent double lumpectomy. Median age was 67 (range, 50-71 years). The primary tumor was invasive ductal carcinoma in 15 patients, invasive lobular carcinoma in one patient, and mixed ductal and lobular carcinoma in one patient. The second tumor was identified by physical exam in one patient, mammography in 12 patients, ultrasound in one patient, and MRI in 5 patients. The mean size of the first tumor was 1.4 cm (range, 0.3 to 2.4 cm); the mean tumor size of the second was 0.6 cm (range, 0.1 to 2.6 cm). All patients had sentinel lymph node biopsies (3/17 were positive) and post-operative whole breast radiation therapy. At a median follow-up of 5 years (range, 1-9 years) no patients developed locoregional recurrence, none had distant recurrence, and none died of breast cancer.
Conclusion:
Double lumpectomy performed for multicentric breast cancer may be oncologically safe for selected patients.