One of the most important causes of women death because of malignancies is breast cancer. In the recent decades, mastectomy was the primary treatment for some stages of breast cancer but nowadays, breast conservative therapy is a suitable therapeutic protocol for patients who suffer from breast cancer especially in early stages (І, П) disease. Breast conservative therapy is considered an adequate therapeutical method for patients with early stage of breast cancer. This method consists of partial mastectomy, axillary dissection and radiotherapy. Beside the therapeutic effect of conservative therapy, cosmetic outcome of patients is also substantially better than mastectomy. Also conservative therapy means conservative surgery combined with radiotherapy, reduces the risk of local recurrence of breast cancer. Chemotherapy is also another choice to add to this treatment protocol.

Breast Conservative Therapy: A Literature Review.

Local Recurrence and Survival Outcomes of Multifocal/Multicentric Breast Cancer after Breast Conserving Therapy: a systematic review and meta-analysis

The incidence of multifocal (MF) and multicentric (MC) carcinomas varies widely among clinical studies, depending on definitions and methods for pathological sampling. Magnetic resonance imaging is increasingly used because it can help identify additional and conventionally occult tumors with high sensitivity. However, false positive lesions might incorrectly influence treatment decisions. Therefore, preoperative biopsies must be performed to avoid unnecessary surgery. Most studies have shown higher lymph node involvement rates in MF/MC tumors than in unifocal tumors. However, the rate of local recurrences is usually low after breast conservative treatment (BCT) of MC/MF tumors. It has been suggested that BCT is a reasonable option for MC/MF tumors in women aged 50-69 years, with small tumors and absence of extensive ductal carcinoma in situ. A meta-analysis showed an apparent decreased overall survival in MC/MF tumors but data are controversial. Surgery should achieve both acceptable cosmetic results and negative margins, which requires thorough preoperative radiological workup and localization of lesions. Boost radiotherapy techniques must be evaluated since double boosts might result in increased toxicity, namely fibrosis. In conclusion, BCT is feasible in selected patients with MC/MF but the choice of surgery must be discussed in a multidisciplinary team comprising at least radiologists, surgeons and radiotherapists.

Is breast conservative surgery a reasonable option in multifocal or multicentric tumors

Introduction It is widely supported that multicentric disease of the breast (MCDB) is a contraindication of breast conservative surgery (BCS). Materials and methods This is a multicentric study (two breast cancer units from Greece, one from France) involving patients with at least two primary tumors in separate quadrants of the breast and no diffuse suspicious microcalcifications on mammography. Sixty-one patients were included in the study, but 49 were followed up to the end. Patients were randomly assigned in total mastectomy (TM) and BCS groups. End point of the study was disease-free survival rates three and five years after initial operation. Results Three years after BCS, local recurrence (LR) was observed in two patients (7%) and one after five years (total recurrence rate: 11%). A TM was performed in these patients, and in two there was no LR or distant metastasis (DM) five years after. The third patient was disease free two-years later. Three years after TM, eight patients (36.4%) had DM and 14 (63.6%) did not (p = 0.004). Five years after TM, eight patients (36.4%) had DM and 14 patients (63.6%) di not (p = 0.03). Conclusion The results showed that conservative surgery was an alternative surgical option in multicentric breast cancer with good results regarding disease-free survival and recurrence.

Breast conserving surgery in multicentric breast cancer, preliminary data of our experience.

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Breast conserving surgery in multicentric breast cancer, preliminary data of our experience.