Characteristics of Multifocal and Multicentric Breast Cancers

Kanumuri, Prathima; Hayse, Brandon; Killelea, Brigid K.; Chagpar, Anees B.; Horowitz, Nina; Lannin, Donald R.

doi:10.1245/s10434-015-4430-6

Cited by 37 publications

(47 citation statements)

References 29 publications

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“…Previous work has demonstrated that women with a history of ADH or ALH are at increased risk for developing breast cancer . However, to our knowledge, no study has reported on the risk of MFBC with respect to a prior history of PBDA . Our results demonstrate that in a cohort of women with breast cancer, those with a history of PBDA are more likely to present with MFBC than women with no history of PBDA.…”

Section: Discussionsupporting

confidence: 45%

“…Our study was underpowered to detect an association between LCIS and MFBC (OR, 2.81; 95% CI, 0.52‐14.92) . The study contained only 15 women with a prior diagnosis of LCIS, and 2 of these women were confirmed to have MFBC.…”

Section: Discussionmentioning

confidence: 98%

“…Prior studies have demonstrated an association between these benign proliferative breast diseases with atypia (PBDAs) and breast cancer, and other studies have associated MFBC with a poorer prognosis in comparison with unifocal breast cancer . To our knowledge, although many studies have confirmed the relation between PBDA and cancer risk, none have reported on the risk of MFBC among women with a history of PBDA …”

Section: Introductionmentioning

confidence: 96%

“…MFBC is usually detected through imaging, particularly magnetic resonance imaging, and the identification of MFBC might alter clinical management . Furthermore, prior studies suggest worse survival among patients with MFBC versus unifocal breast cancer . However, the epidemiology and biology of MFBC remain poorly understood without clearly identified risk factors or specific etiologies.…”

Section: Introductionmentioning

confidence: 99%

“…1 Furthermore, prior studies suggest worse survival among patients with MFBC versus unifocal breast cancer. [1][2][3]6,7,10 However, the epidemiology and biology of MFBC remain poorly understood without clearly identified risk factors or specific etiologies.…”

Section: Introductionmentioning

confidence: 99%

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Personal history of proliferative breast disease with atypia and risk of multifocal breast cancer

Nutter

Weiss

Marotti

et al. 2017

Cancer

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show abstract

Section: Discussionsupporting

confidence: 45%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Personal history of proliferative breast disease with atypia and risk of multifocal breast cancer

Nutter

Weiss

Marotti

et al. 2017

Cancer

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Multifocal/multicentric breast cancer: Does each focus matter?

et al. 2023

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Background: Multifocal (MF) and multicentric (MC) breast cancer cases have been increasingly diagnosed owing to the extensive use of improved preoperative breast imaging. The current tumor-node-metastasis staging system uses the dimension of the largest tumor and recommends reporting the pathological features of the largest tumor in MF/MC breast cancers.Aim: This study aimed to explore whether the largest or aggregate dimensions of MF and MC breast cancers can better predict tumor behavior. We also attempted to study the histological and biological heterogeneities of separate foci in MF and MC breast cancers to determine whether it was necessary to examine each lesion. Methods:We retrospectively analyzed 121 patients with MF/MC (103 with MF and 18 with MC) breast cancers and 484 patients with unifocal breast cancer who were treated at the First Affiliated Hospital of Nanjing Medical University.Two methods were used to record the T stage (using the dimensions of the largest lesion and aggregate dimensions of all lesions). The histological grade, immunohistochemical parameters, and molecular subtypes of the largest lesion and other lesions in MF/MC breast cancers were studied to assess intertumoral heterogeneity. Results:The use of aggregate dimensions upstaged 63 patients with MF/MC breast cancers to a more advanced stage and removed the independent effect of cancer multiplicity on lymph node positivity compared with the use of the largest dimension. Mismatches were found in the pathological type (9.9%), histological grade (4.1%), and molecular subtype (8.3%) among different foci. Conclusion:The tendency of MF/MC breast tumors to metastasize may be related to tumor load, which can be better predicted by the aggregate dimensions of all foci. The use of the current staging systems may require further evaluation and modification. Intertumoral heterogeneity indicates the necessity for pathological and immunohistochemical assessments of each lesion in patients with MF/MC breast cancers.

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Multifocal breast cancers are more prevalent in BRCA2 versus BRCA1 mutation carriers

McCrorie

Ashfield

Begley

et al. 2020

The Journal of Pathology CR

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Multifocal (MF)/multicentric (MC) breast cancer is generally considered to be where two or more breast tumours are present within the same breast, and is seen in~10% of breast cancer cases. This study investigates the prevalence of multifocality/multicentricity in a cohort of BRCA1/2 mutation carriers with breast cancer from Northern Ireland via cross-sectional analysis. Data from 211 women with BRCA1/2 mutations (BRCA1-91, BRCA2-120) and breast cancer were collected including age, tumour focality, size, type, grade and receptor profile. The prevalence of multifocality/ multicentricity within this group was 25% but, within subgroups, prevalence amongst BRCA2 carriers was more than double that of BRCA1 carriers (p = 0.001). Women affected by MF/MC tumours had proportionately higher oestrogen receptor positivity (p = 0.001) and lower triple negativity (p = 0.004). These observations are likely to be driven by the higher BRCA2 mutation prevalence observed within this cohort. The odds of a BRCA2 carrier developing MF/MC cancer were almost four-fold higher than a BRCA1 carrier (odds ratio: 3.71, CI: 1.77-7.78, p = 0.001). These findings were subsequently validated in a second, large independent cohort of patients with BRCA-associated breast cancers from a UK-wide multicentre study. This confirmed a significantly higher prevalence of MF/MC tumours amongst BRCA2 mutation carriers compared with BRCA1 mutation carriers. This has important implications for clinicians involved in the treatment of BRCA2-associated breast cancer, both in the diagnostic process, in ensuring that tumour focality is adequately assessed to facilitate treatment decision-making, and for breast surgeons, particularly if breast conserving surgery is being considered as a treatment option for these patients.No conflicts of interest were declared.

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Characteristics of Multifocal and Multicentric Breast Cancers

Abstract: MF and MC tumors seem to be biologically different diseases. MC is clinicopathologically more aggressive than MF disease and is more frequently associated with younger age and larger tumor size and also is an independent predictor of node positivity.

Cited by 37 publications

References 29 publications

Personal history of proliferative breast disease with atypia and risk of multifocal breast cancer

Personal history of proliferative breast disease with atypia and risk of multifocal breast cancer

Multifocal/multicentric breast cancer: Does each focus matter?

Multifocal breast cancers are more prevalent in BRCA2 versus BRCA1 mutation carriers

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