Breast conservation treatment for multifocal and multicentric breast cancers in women with small-volume breast tissue

Breast conservation treatment (BCT) is an established option in the treatment of early breast cancer, but women with small breast volume (SVB) are considered poor candidates for BCT. Multifocal and multicentric breast cancers (MFMCBC) are conventionally considered a relative contraindication to BCT. These arguments form the basis of limited eligibility for BCT for a woman with SVB and MFMCBC. This study was performed to investigate this syllogism.

Consecutive patients with breast malignancies treated from 2009 to 2011 were included. Patients were deemed to have successful BCT if they had pathologically clear margins and had completed all recommended adjuvant treatment. Those who had MFMCBC based on clinical, imaging and pathological data were selected for detailed evaluation. Comparisons were made with unifocal breast cancer.

Data from a total of 160 patients who underwent treatment during the study period were analysed. The mean age was 48.8 years. One hundred and six patients (66.3%) were of Chinese ethnicity, 36 (22.5%) were of other Asian ethnicity and 18 were Caucasian (11.2%). Forty-one (25.6%) patients had clinical evidence of MFMCBC. Of these patients, 35 (85.4%) underwent BCT. After a mean follow-up of 45 months, none of the patients with MFMCBC developed a local recurrence. Two patients with MFMCBC, one who underwent mastectomy and one with BCT, succumbed to cancer from distant disease.

BCT is feasible in women with MFMCBC in a predominantly Chinese community where majority are expected to have SVB. Further investigation is warranted to confirm the findings.