Kuan Li Lian, Tiong Leong Ung, Parkyn Robert, Walters David, Lai Christine, Walsh David
Breast and Endocrine Surgery Unit, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia.
ANZ J Surg. 2017 Oct;87(10):E125-E128. doi: 10.1111/ans.13193. Epub 2015 Jun 15.
Few studies have shown that multifocal breast cancer (MBC) has poorer outcomes compared with unifocal breast cancer (UBC). Currently, there is no long-term data on disease recurrence and survival in patients with MBC. The aim of this study is to evaluate whether patients with MBC have worse outcomes compared with UBC in respect to disease recurrence and survival.
This is a retrospective study of patients diagnosed with stage I-III MBC from 2000 to 2007 in comparison with UBC with a median follow-up of 7 years. Prognostic factors were prospectively collected from the breast cancer unit database. Univariate and multivariable analyses for disease recurrence and survival were performed as well as Kaplan-Meier curves.
A total of 152 patients were included; 75 with MBC, 77 with UBC. The multifocal group was treated more aggressively with mastectomy (73% versus 25%, P < 0.0001) and chemotherapy (53% versus 42%). Breast cancer recurred in nine (11.7%) patients in the UBC group and nine (12%) patients in the MBC group respectively (hazard ratio (HR): 1.13, 95% confidence interval (CI): 0.45-2.86, P = 0.794). There were 10 (13%) mortalities in the unifocal group as compared with 11 (14.7%) in the multifocal group (HR: 1.02, 95% CI: 0.42-2.48, P = 0.969). There were no statistically significant differences in the all-cause mortality and disease recurrence rates between both groups.
There were no statistically significant differences in disease recurrence or mortality rates between MBC and UBC at a median follow-up of 7 years. However, patients in the MBC group received more aggressive treatment than the unifocal group.
很少有研究表明多灶性乳腺癌（MBC）与单灶性乳腺癌（UBC）相比预后更差。目前，尚无关于MBC患者疾病复发和生存的长期数据。本研究的目的是评估在疾病复发和生存方面，MBC患者与UBC患者相比是否有更差的预后。
这是一项对2000年至2007年诊断为I - III期MBC患者的回顾性研究，并与UBC患者进行比较，中位随访时间为7年。从乳腺癌科室数据库前瞻性收集预后因素。对疾病复发和生存进行单因素和多因素分析以及绘制Kaplan - Meier曲线。
共纳入152例患者；75例为MBC，77例为UBC。多灶性组接受乳房切除术（73%对25%，P < 0.0001）和化疗（53%对42%）的治疗更为积极。UBC组有9例（11.7%）患者乳腺癌复发，MBC组有9例（12%）患者复发（风险比（HR）：1.13，95%置信区间（CI）：0.45 - 2.86，P = 0.794）。单灶性组有10例（13%）死亡，多灶性组有11例（14.7%）死亡（HR：1.02，95% CI：0.42 - 2.48，P = 0.969）。两组间全因死亡率和疾病复发率无统计学显著差异。
在中位随访7年时，MBC和UBC之间的疾病复发率或死亡率无统计学显著差异。然而，MBC组患者接受的治疗比单灶性组更为积极。
