Moutafoff C, Coutant C, Bézu C, Antoine M, Werkoff G, Benbara A, Uzan S, Rouzier R
Service de gynécologie-obstétrique et médecine de la reproduction, hôpital Tenon, AP-HP, université Pierre-et-Marie-Curie Paris-6, 4 rue de la Chine, Paris, France.
Gynecol Obstet Fertil. 2011 Jul-Aug;39(7-8):425-32. doi: 10.1016/j.gyobfe.2011.05.001. Epub 2011 Jul 12.
Multicentricity is not listed as a major prognostic parameter in invasive breast carcinoma, and is not by itself an indication of systemic adjuvant treatment. Furthermore, evaluating the size of these tumors is discussed. The aims of this study are to evaluate prognostic value of multicentricity, and to compare different way for measuring multicentric breast carcinomas.
Between 2001 and 2008, 1458 patients having breast invasive carcinoma were included in Tenon Hospital, Paris, France; 16% had a multicentric cancer. We have compared impact of multicentricity on lymph node (LN) involvement, and compared 3 ways for measuring these cancers.
LN involvement was significantly associated with multicentricity. We found an over-risk of 20% for LN involvement in patients having multicentric cancer, whatever the size of the tumors. Considering the diameter of the largest focus is the best way for measuring these cancers.
We did not find a subgroup of patients at low risk of LN involvement when having a multicentric breast cancers. These results lead us to extend indications of adjuvant chemotherapies in all multicentric breast cancer. These results should be validated by randomized prospective studies.
多中心性未被列为浸润性乳腺癌的主要预后参数，其本身也不是全身辅助治疗的指征。此外，还讨论了评估这些肿瘤大小的方法。本研究的目的是评估多中心性的预后价值，并比较测量多中心性乳腺癌的不同方法。
2001年至2008年期间，法国巴黎特农医院纳入了1458例患有乳腺浸润性癌的患者；其中16%患有多中心癌。我们比较了多中心性对淋巴结（LN）受累的影响，并比较了测量这些癌症的3种方法。
LN受累与多中心性显著相关。我们发现，无论肿瘤大小如何，多中心癌患者的LN受累风险高出20%。考虑最大病灶的直径是测量这些癌症的最佳方法。
我们未发现患有多中心性乳腺癌的患者中LN受累低风险的亚组。这些结果促使我们扩大所有多中心性乳腺癌辅助化疗的指征。这些结果应通过随机前瞻性研究进行验证。
