Multiple synchronous (multifocal and multicentric) breast cancer: clinical implications.

Area of Science:

• Oncology
• Radiology
• Surgical Pathology

Background:

• Multifocality in breast cancer is common, with prevalence estimates varying widely due to inconsistent definitions.
• Accurate diagnosis of multifocality is essential for guiding breast cancer treatment and surgical planning.

Purpose of the Study:

• To review the diagnostic modalities for multifocality in breast cancer.
• To discuss the implications of multifocality on surgical management and axillary staging.
• To explore the prognostic significance of multifocality in breast cancer.

Main Methods:

• Literature review of diagnostic imaging techniques for breast cancer multifocality.
• Analysis of studies reporting on surgical outcomes and axillary node status in multifocal breast cancer.
• Examination of research investigating the prognostic value of multifocality.

Main Results:

• Mammography has limited sensitivity for multifocality; ultrasonography improves detection. Breast MRI shows higher accuracy but carries a risk of false positives, precluding its first-line use.
• Multifocality influences surgical choices, potentially necessitating wider excision to achieve clear margins. Its impact on conservative surgery outcomes is debated.
• Multifocality is linked to a higher risk of lymph node metastasis, impacting axillary staging decisions, such as sentinel lymph node biopsy.

Conclusions:

• Diagnostic inconsistencies for multifocality hinder literature analysis and clinical consensus.
• Further research is required to establish definitive guidelines for managing multifocal breast cancer and to clarify its prognostic implications.