Breast care (Basel, Switzerland) · 2026
Feasibility and Oncologic Outcomes of Breast-Conserving Surgery for Multifocal and Multicentric Breast Cancer: A Retrospective Comparative Cohort Study.
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Gelblung Brian, Montoya Diana, Beccar Varela Eduardo, Barber Julia, Morris Brian, Rodriguez Del Busto Belen, Spengler Eunice, Garcia Suarez Pamela, Pousa Victoria, Piñero Federico, McLean Ignacio
Аннотация
INTRODUCTION: Breast-conserving surgery (BCS) is traditionally avoided in multifocal or multicentric (MF/MC) breast cancer due to concerns about oncologic outcomes. Recent evidence suggests BCS may be feasible in selected cases. This study compared outcomes of BCS in MF/MC versus unifocal (UF) breast cancer.
METHODS: This retrospective cohort included women with stage I-II breast cancer treated with BCS at a single institution in Argentina (2000-2023). Patients with prior neoadjuvant chemotherapy, pathogenic germline mutations, or extensive nodal disease were excluded. Outcomes were locoregional recurrence (LRR), distant recurrence (MTS), and overall survival (OS), analyzed with Kaplan-Meier estimates and Cox regression.
RESULTS: Of 1,188 patients undergoing BCS, 91 (7.7%) had MF/MC and 1,097 (92.3%) UF tumors. Median follow-up was 4.9 years. The 5-year cumulative probability of LRR was 3.8% overall; 3.3% in MF/MC; and 5.9% in UF patients (HR 1.04, 95% CI: 0.33-3.33; p = 0.94). Distant recurrence occurred in 3.3% of MF/MC and 4.8% of UF cases (HR 1.16, 95% CI: 0.36-3.73; p = 0.80). Five-year OS was 98.6% in MF/MC and 97.3% in UF patients (HR 1.25, 95% CI: 0.30-5.20; p = 0.76).
CONCLUSION: In this large single-institution cohort, BCS achieved comparable oncologic outcomes in MF/MC and UF breast cancer, supporting its feasibility in appropriately selected patients. These results provide real-world evidence from South America and highlight the need for prospective studies to refine patient selection.
METHODS: This retrospective cohort included women with stage I-II breast cancer treated with BCS at a single institution in Argentina (2000-2023). Patients with prior neoadjuvant chemotherapy, pathogenic germline mutations, or extensive nodal disease were excluded. Outcomes were locoregional recurrence (LRR), distant recurrence (MTS), and overall survival (OS), analyzed with Kaplan-Meier estimates and Cox regression.
RESULTS: Of 1,188 patients undergoing BCS, 91 (7.7%) had MF/MC and 1,097 (92.3%) UF tumors. Median follow-up was 4.9 years. The 5-year cumulative probability of LRR was 3.8% overall; 3.3% in MF/MC; and 5.9% in UF patients (HR 1.04, 95% CI: 0.33-3.33; p = 0.94). Distant recurrence occurred in 3.3% of MF/MC and 4.8% of UF cases (HR 1.16, 95% CI: 0.36-3.73; p = 0.80). Five-year OS was 98.6% in MF/MC and 97.3% in UF patients (HR 1.25, 95% CI: 0.30-5.20; p = 0.76).
CONCLUSION: In this large single-institution cohort, BCS achieved comparable oncologic outcomes in MF/MC and UF breast cancer, supporting its feasibility in appropriately selected patients. These results provide real-world evidence from South America and highlight the need for prospective studies to refine patient selection.