Faculty of Medicine, University of Milan, Milan, Italy.
Division of Breast Surgery, European Institute of Oncology, IRCCS, Milan, Italy.
Future Oncol. 2020 Mar;16(8):395-412. doi: 10.2217/fon-2019-0540. Epub 2020 Feb 6.
Multiple synchronous (multifocal or multicentric) ipsilateral breast cancers with heterogeneous histopathology are a rare clinical occurrence, however, their incidence is increasing due to the use of MRI for breast cancer screening and staging. Some studies have demonstrated poorer clinical outcomes for this pattern of breast cancer, but there is no evidence to guide clinical practice. In this multidisciplinary review, we reflect on pathology and molecular characteristics, imaging findings, surgical management including conservation and reconstructive options and approach to the axilla, and the role of chemotherapy and radiotherapy. Multidisciplinary discussions appear decisive in planning an appropriate surgical choice and defining the correct systemic treatment tailored to each clinical condition.
多灶性（多中心或多部位）同侧乳腺癌伴异质性组织病理学表现较为罕见，但由于 MRI 广泛用于乳腺癌筛查和分期，其发病率呈上升趋势。一些研究表明，这种乳腺癌模式的临床结局较差，但目前尚无证据指导临床实践。在本次多学科综述中，我们对其病理学和分子特征、影像学表现、包括保乳和重建选择在内的手术管理以及腋窝处理方法，以及化疗和放疗的作用进行了探讨。多学科讨论对于制定合适的手术选择和确定针对每个临床情况的正确系统治疗方案至关重要。
