Multifocal (multicentric) Breast Cancer: Morbidity, Results of Diagnostic Tests and Surgical Treatment

Aim of the study: to evaluate women morbidity, clinical and radiological features of multifocal breast cancer and results of surgical treatment. Objectives: 1. To determine the incidence of multifocal breast cancer in women. 2. To compare clinical and pathological findings of multifocal breast cancer. 3. To compare radiological and pathological findings of multifocal breast cancer. 4. To analyze surgical methods used to treat multifocal breast cancer and their postoperative outcomes. Methods: a retrospective study of women diagnosed with multifocal breast cancer and treated at the LUHS KK Department of Breast surgery was performed. The data for statistical analysis was collected using Microsoft Office Excel 2013. The data of clinical and radiological findings of multifocal (multicentric) breast cancer was obtained from medical records and results were compared with pathological findings. In this study surgical methods used to treat multifocal (multicentric) breast cancer were analyzed and postoperative outcomes were assessed. Statistical data analysis was performed using IBM SPSS 22.0 Statistics. Results were considered as statistically significant when p < 0,05. Participants of the study: 300 women who were diagnosed with multifocal (multicentric) breast cancer and who were treated at the LUHS KK Department of Breast cancer surgery from January 2017 to April 2019. Results: 300 women who were treated for suspected multifocal (multicentric) breast cancer at the LUHS KK Department of Breast surgery from January 2017 to April 2019 and who met the inclusion criteria were included in this study. Clinically multifocal (multicentric) breast cancer was suspected in 49 (16%) women, on mammography in 83 (27,7%) women, on ultrasound breast scan in 123 (41%) women and on MRI - 158 (71,8%) women. Pathological examination revealed multifocal (multicentric) breast cancer in 243 (81%) women. Comparing results of the clinical and radiological findings, statistically significantly more often multifocal breast cancer was suspected on MRI. In our study we determined that sensitivity of mammography in the diagnosis of multifocal (multicentric) breast cancer was 27,9%, of ultrasound - 37,4% and of MRI - 70,1%. In 108 (77%) cases type I oncoplastic operations with the breast reconstruction using its own tissues and preservation of the lymph nodes were performed. In 29 (36%) cases simple mastectomy with lymphonodectomy was performed. Conclusions: 1. Morbidity of multifocal (multicentric) breast cancer in 2017 it was 16,4%, in 2018 - 27,9% and in 2019 from January to April - 15,5%. 2. Most of the breast cancer foci are impalpable during clinical examination but usually they are detected by pathological examination 3. Comparing radiological and pathological tests multifocal (multicentric) breast cancer is most often diagnosed by pathological examination, but of all radiological tests MRI has the highest sensitivity - 70,1% than mammography (27,9%) and ultrasound (37,4%) tests. 4. For surgical treatment of multifocal (multicentric) breast cancer breast conserving surgery with reconstruction was performed statistically significantly more often than mastectomy (p < 0,05)