Kefah Mokbel, Chair of Breast Cancer Surgery at London Breast Institute and Honorary Professor of Medicine at Cardiff University School of Medicine, shared on LinkedIn:
“Delighted to share a preprint of our review article, currently under peer review, on the topic of breast-conserving surgery in multicentric breast cancer.
Breast-Conserving Surgery in Multicentric Breast Cancer: Evolving Evidence and Patient Selection
Multicentric breast cancer has long been treated as a near-automatic indication for mastectomy. In this narrative review with Mariam Rizk, we examine the evidence reshaping that position – including the ACOSOG Z11102 (Alliance) trial’s 5-year local recurrence rate of 3.1% after breast-conserving therapy for two to three ipsilateral foci, and the persistent unresolved question of whether preoperative MRI actually improves outcomes despite driving more mastectomy conversions.
We cover:
- Definitions and biology of multifocal vs. multicentric disease
- The evolving role of oncoplastic technique
- Margin and radiotherapy planning for multisite resection
- Neoadjuvant systemic therapy and hereditary cancer considerations
- Current guideline landscape (ASBrS, NCCN, ESMO, AGO)
We propose a practical, multidisciplinary framework for patient selection and outline the key evidence gaps still to be addressed.
Read the preprint.”
