TY - JOUR
T1 - Multifocality and multicentricity in breast cancer and survival outcomes
AU - Lynch, S. P.
AU - Lei, X.
AU - Chavez-Macgregor, M.
AU - Hsu, L.
AU - Meric-Bernstam, F.
AU - Buchholz, T. A.
AU - Zhang, A.
AU - Hortobagyi, G. N.
AU - Valero, V.
AU - Gonzalez-Angulo, A. M.
N1 - Funding Information:
National Cancer Institute (1K23CA121994-01); National Cancer Institute through The University of Texas MD Anderson Cancer Center (P30 CA016672). The MD Anderson Breast Cancer Management System and the Breast Tumor Bank is supported in part by the Nelly B. Connally Breast Cancer Research Fund.
PY - 2012/12
Y1 - 2012/12
N2 - Background: The clinicopathological characteristics and the prognostic significance of multifocal (MF) and multicentric (MC) breast cancers are not well established. Patients and Methods: MF and MC were defined as more than one lesion in the same quadrant or in separate quadrants, respectively. The Kaplan-Meier product limit was used to calculate recurrence-free survival (RFS), breast cancer-specific survival (BCSS), and overall survival (OS). Cox proportional hazards models were fit to determine independent associations of MF/MC disease with survival outcomes. Results: Of 3924 patients, 942 (24%) had MF (n = 695) or MC (n = 247) disease. MF/MC disease was associated with higher T stages (T2: 26% versus 21.6%; T3: 7.4% versus 2.3%, P < 0.001), grade 3 disease (44% versus 38.2%, P < 0.001), lymphovascular invasion (26.2% versus 19.3%, P < 0.001), and lymph node metastases (43.1% versus 27.3%, P < 0.001). MC, but not MF, breast cancers were associated with a worse 5-year RFS (90% versus 95%, P = 0.02) and BCSS (95% versus 97%, P = 0.01). Multivariate analysis shows that MF or MC did not have an independent impact on RFS, BCSS, or OS. Conclusions: MF/MC breast cancers were associated with poor prognostic factors, but were not independent predictors of worse survival outcomes. Our findings support the current TNM staging system of using the diameter of the largest lesion to assign T stage.
AB - Background: The clinicopathological characteristics and the prognostic significance of multifocal (MF) and multicentric (MC) breast cancers are not well established. Patients and Methods: MF and MC were defined as more than one lesion in the same quadrant or in separate quadrants, respectively. The Kaplan-Meier product limit was used to calculate recurrence-free survival (RFS), breast cancer-specific survival (BCSS), and overall survival (OS). Cox proportional hazards models were fit to determine independent associations of MF/MC disease with survival outcomes. Results: Of 3924 patients, 942 (24%) had MF (n = 695) or MC (n = 247) disease. MF/MC disease was associated with higher T stages (T2: 26% versus 21.6%; T3: 7.4% versus 2.3%, P < 0.001), grade 3 disease (44% versus 38.2%, P < 0.001), lymphovascular invasion (26.2% versus 19.3%, P < 0.001), and lymph node metastases (43.1% versus 27.3%, P < 0.001). MC, but not MF, breast cancers were associated with a worse 5-year RFS (90% versus 95%, P = 0.02) and BCSS (95% versus 97%, P = 0.01). Multivariate analysis shows that MF or MC did not have an independent impact on RFS, BCSS, or OS. Conclusions: MF/MC breast cancers were associated with poor prognostic factors, but were not independent predictors of worse survival outcomes. Our findings support the current TNM staging system of using the diameter of the largest lesion to assign T stage.
KW - Breast cancer
KW - Multicentric
KW - Multifocal
KW - Outcomes
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U2 - 10.1093/annonc/mds136
DO - 10.1093/annonc/mds136
M3 - Article
C2 - 22776706
AN - SCOPUS:84869855171
SN - 0923-7534
VL - 23
SP - 3063
EP - 3069
JO - Annals of Oncology
JF - Annals of Oncology
IS - 12
M1 - mds136
ER -