1: Br J Cancer 1996 Sep;74(5):820-4

Multicentricity of breast cancer: whole-organ analysis and clinical
implications.

Vaidya JS, Vyas JJ, Chinoy RF, Merchant N, Sharma OP, Mittra I

Department of Surgical Oncology, Tata Memorial Hospital, Bombay, India.

We studied the spatial relationship within the breast between multicentric foci
(MCF) and the primary tumour in 30 modified radical mastectomy specimens using
Egan's correlated pathological-radiological method using 5 mm slices of the
whole breast. The relative positions within the breast of the primary tumour and
MCF were used to calculate the relative distribution of primary tumour and MCF
in the four quadrants of the breast and the per cent breast volume that would be
required to be excised to include all MCF. Nineteen (63%) breast harboured MCF.
The relative distribution of primary tumour and MCF in the four breast quadrants
was significantly different (P = 0.034). MCF were present beyond the index
quadrant (25% of breast volume including the tumour) in as many as 79% (15/19)
of breasts that harboured MCF; and in half the cases (15/30) when all breast
were considered. This is in variance with the suggestion put forward previously
that MCF are contained within the index quadrant in 90% of cases. Although the
number of patients in the present series is small, the probability of our
finding being due to play of chance is 1 in 1500. In a large series of breast
conservation studies > 90% of early breast recurrences have been found to occur
in the index quadrant. Our finding, that in half the patients (15/30) MCF are
present in quadrants other than the index quadrant, suggests that MCF do not
give rise to early breast recurrence.

PMID: 8795588, UI: 96388187