Synchronous multiple ipsilateral breast cancers: implications for patient management.

Area of Science:

• Oncology
• Surgical Oncology
• Pathology

Background:

• Synchronous multiple ipsilateral breast cancer (SMI BC) has been documented since the early 1920s.
• Reported incidence varies widely (9-75%) due to differing definitions, detection methods, and pathological assessments.
• Despite multifocal presentation, clinical trials show no survival difference compared to unifocal breast cancer.

Purpose of the Study:

• To review current definitions and incidence of SMI BC.
• To examine pathological assessment, staging, and surgical options for SMI BC.
• To consolidate understanding of SMI BC management.

Main Methods:

• Literature review of studies on synchronous multiple ipsilateral breast cancer.
• Analysis of definitions, incidence rates, and pathological findings.
• Evaluation of surgical outcomes and survival data from randomized clinical trials.

Main Results:

• Incidence rates are highly variable, influenced by diagnostic criteria and methods.
• Randomized trials indicate comparable distant disease-free survival and overall survival between SMI BC and unifocal breast cancer.
• Surgical options include total mastectomy and segmental mastectomy, with or without radiation.

Conclusions:

• Management strategies for SMI BC require clear definitions and consistent pathological assessment.
• Surgical intervention for SMI BC does not negatively impact long-term survival compared to unifocal disease.
• Further research may refine staging and optimize surgical approaches for SMI BC.