Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul.
Ann Oncol. 2013 Sep;24(9):2298-304. doi: 10.1093/annonc/mdt187. Epub 2013 May 23.
In this study, the prognostic impact of the presence of the multifocal or multicentric tumor (MMT) and its association with molecular subtypes were investigated.
We investigated the breast cancer metastasis and survival in patients with multifocal or multicentric invasive foci in the same breast. The study population includes 2882 patients in the Seoul National University Hospital Breast Care Center (SNUHBCC) dataset and 41 179 patients in Korean Breast Cancer Registry (KBCR) dataset.
From SNUHBCC dataset, we observed a significant role of MMT in developing distant metastasis and death when the tumors were triple-negative subtype. This subtype-specific prognostic importance of MMT in overall survival was also seen in KBCR dataset (HR, 1.32; 95% CI, 1.02-1.69). In tumors <2 cm, the hazard ratios (HRs) for node metastasis and death were similar along the tumor size change in triple-negative subtype, while other subtypes showed a stepwise increment, suggesting the biologic importance of small invasive foci in this subtype.
Our results demonstrate the prognostic importance of MMT in patients with triple-negative breast cancers. Small additional invasive foci in triple-negative breast cancer patients should be considered as clinically relevant tumor deposits.
在这项研究中，我们研究了多灶性或多中心肿瘤（MMT）的存在及其与分子亚型的相关性对预后的影响。
我们研究了同一乳房中存在多灶性或多中心浸润性病灶的乳腺癌转移和生存情况。研究人群包括首尔国立大学医院乳腺保健中心（SNUHBCC）数据集的 2882 例患者和韩国乳腺癌登记处（KBCR）数据集的 41179 例患者。
从 SNUHBCC 数据集来看，我们观察到 MMT 在三阴性肿瘤中对远处转移和死亡的发生具有显著作用。在 KBCR 数据集也观察到 MMT 在总生存方面对三阴性肿瘤具有特定的预后重要性（HR，1.32；95%CI，1.02-1.69）。在<2cm 的肿瘤中，三阴性肿瘤中随着肿瘤大小的变化，淋巴结转移和死亡的风险比（HRs）相似，而其他亚型则呈逐步递增，表明在该亚型中小的浸润性病灶具有重要的生物学意义。
我们的研究结果表明 MMT 在三阴性乳腺癌患者中具有预后意义。三阴性乳腺癌患者中较小的额外浸润性病灶应被视为具有临床相关性的肿瘤沉积物。
