Multicentricity of breast carcinoma demonstrated by routine correlated serial multicentric breast carcinoma subgross and radiographic examination

Abstract

Occult multicentric foci of carcinoma, separate from the tumor that directed biopsy (reference tumor), were documented in mastectomy specimens with a correlated serial subgross and radiographic method of examination (Egan et al2). The relative frequencies of histologic types, sizes and calculated volumes of invasive tumors, and clinical data among patients with a single focus and with multicentric foci of breast carcinoma were compared. Multicentric foci of carcinoma occurred in 18 of 85 cases (21%). Half of the occult lesions were second invasive carcinomas, and in three cases the occult second invasive tumor was larger and/or more poorly differentiated than the reference tumor. However, in no instance was a metastasis documented from an occult carcinoma. On the average, the invasive carcinomas in breasts with multicentric foci of cancer were significantly smaller in diameter and calculated volume was than that of unicentric invasive carcinomas. Patients with multicentric breast carcinoma were more likely to have a positive family history of breast cancer and to have had contralateral cancer than were patients with a single focus of disease. Compared with other types of invasive cancers, tubular carcinomas were significantly more likely to be associated with multicentric invasive carcinomas in this study; half of the reference tubular carcinomas were so associated. Duct carcinoma in situ (DCIS) less than 25 mm in extent was unassociated with occult invasive or significant in situ multicentricity, whereas more diffuse DCIS frequently was associated with occult invasive carcinoma. These latter data suggest an association between the extent of the in situ lesion and the likelihood of occult invasive carcinoma.