Infiltrating Breast Carninomas Multifocality: Clinical and Biological Features

In order to know the associations between multifocality (MF), without related multicentricity (MC), and common clinical and biological parameters, and posterior influence in breast carcinoma behavior, we have developed this study. 816 successive women affected from invasive breast carcinomas, of which 96 were multifocal and 720 nonmultifocal were included in the study. We considered age, size, lymph node involvement, distant metastasis, histological grade, ploidy, cellular synthesis phase, as well as expression of estrogen receptor (ER), progesterone receptor (PgR), androgen receptor (AR), p53, bcl2 and Ki67 by immunohistochemical assays. Taken as a whole, multifocal invasive carcinomas (11%) showed exclusively more distant metastasis and more tumorrelated-deaths. However, when tumors were classified according to histological type, in ductal carcinomas MF courses exclusively with greater lymph node involvement, while in non ductal carcinomas MF showed higher percentage of distant metastasis, higher proliferation and higher number of recurrences. Also, there were NO differences between axillary lymph node involvement and tumor size in multifocal tumors regardless of histology. Our results suggest: 1) MF was found in 11% of invasive breast carcinomas and was associated with higher distant metastasis and number of tumor-related-deaths. 2) in invasive ductal carcinomas, MF was associated, exclusively, with increased axillary node involvement, whereas in other histological types, with a predominance of lobular, it did with higher distant metastasis, cell proliferation and recurrence number, suggesting, in this subtype of tumors where there is higher prognostic/diagnostic value has the MF presence.