Kefah Mokbel, Chair of Breast Cancer Surgery at London Breast Institute, shared on LinkedIn:
“Breast-Conserving Surgery in Multicentric Breast Cancer: Evolving Evidence and Patient Selection.
Our latest publication is out today in Cancers (impact factor 4.8).
For decades, multicentric breast cancer – two or more tumour foci in different parts of the same breast – has been treated as an almost automatic indication for mastectomy. That categorical position is no longer supported by the totality of the evidence.
But it should not be replaced by an equally categorical rule in the other direction either.
In our new narrative review (with Mariam Rizk), what emerges instead is a conditional, multidisciplinary pathway: for appropriately selected patients, breast-conserving surgery appears to offer oncological outcomes not inferior to mastectomy – provided complete excision with negative margins is achieved, adjuvant radiotherapy is delivered, and an acceptable cosmetic result is attainable.
That depends on adequate, histologically confirmed imaging, oncoplastic feasibility, guideline-concordant systemic therapy, and – where relevant – informed consideration of hereditary risk (BRCA, PALB2 and TP53 favour mastectomy).
Under these conditions, recurrence rates comparable to conventional breast conservation for unifocal disease can be achieved.
The future of surgery for this disease is unlikely to be defined by a universal preference for conservation or for mastectomy. It will be defined by accurate disease characterisation, multidisciplinary selection, and matching the extent of surgery to tumour biology – not to anatomical multiplicity alone.
Open access, full text below.”
Title: Breast-Conserving Surgery in Multicentric Breast Cancer: Evolving Evidence and Patient Selection
Authors: Mariam Rizk, Kefah Mokbel
You can also read:
Can Breast-Conserving Surgery Be Oncologically Safe for Multiple Ipsilateral Breast Cancers
