Gump F E, Shikora S, Habif D V, Kister S, Logerfo P, Estabrook A
Ann Surg. 1986 Oct;204(4):384-90. doi: 10.1097/00000658-198610000-00006.
The term multicentricity has been employed to describe cancer cells beyond the borders of the primary tumor. However, it is not clear if there are multiple independent sites of origin or if the process simply represents spread of the cancer. The present study was designed to examine the distribution and extent of cancer in the breast and identify factors that bear on these events. All mastectomy specimens between 1980 and 1983 were systematically examined by means of multiple sections. One hundred seventy-nine of 657 patients (27%) were found to have separate foci. The most common histologic type (invasive ductal) was least likely to have multifocal disease (19%), while it was extremely common in the small group of patients with intraductal lesions (81%). Size was a factor in ductal but not in lobular lesions. Ninety per cent of the secondary foci were found in close proximity to the primary, suggesting spread rather than multicentricity. This implies a more limited and predictable distribution of cancer cells and opens the way to more rational selection and surgical preparation of patients for breast preservation.
多中心性一词已被用于描述超出原发肿瘤边界的癌细胞。然而，尚不清楚是否存在多个独立的起源部位，或者该过程是否仅仅代表癌症的扩散。本研究旨在检查乳腺癌的分布和范围，并确定与这些情况相关的因素。对1980年至1983年间的所有乳房切除术标本进行了多切片系统检查。657例患者中有179例（27%）被发现有独立病灶。最常见的组织学类型（浸润性导管癌）发生多灶性疾病的可能性最小（19%），而在一小群导管内病变患者中极为常见（81%）。肿瘤大小是导管癌而非小叶癌的一个因素。90%的继发灶位于原发灶附近，提示为扩散而非多中心性。这意味着癌细胞的分布更有限且可预测，为更合理地选择患者进行保乳手术及手术准备开辟了道路。
