B24
Re-operation after breast conservation surgery - multifocal breast cancer
Barbara Madej1, Andrzej Chrościcki1, Bartek Balak2
1Stefan Cardinal Wyszyńskis District Hospital in Lublin, Poland, 2Medical University of Lublin, Poland
Background
Breast conservation surgery is a priority type of surgical operation performed in invasive breast cancer patients. Breast cancer multifocality prevents breast conservation. Routine imaging examination performed prior to operation (mammography and breast ultrasonography) often (5% - 25%) do not show multifocality of breast cancer. The accurate diagnosis is established only on the basis of a postoperative histopathological examination. In such cases the patient needs to undergo another surgery and breast amputation.
The aim of this paper was to analyze the cases of multifocal breast cancer in our own operative material.
Method
In 2007-2008 in the Department of General Surgery and Sub-department of Surgical Oncology 532 breast operations were performed. 151 patients with invasive breast cancer were operated. 91 modified radical mastectomies were conducted and 60 patients received breast conservation therapy (BCT). BCT accounted for 39.7 %. 11 women (7.2 % of breast cancer patients) were diagnosed with multifocal carcinoma. Patients preoperatively diagnosed with multifocal breast cancer (4 women) were immediately qualified for mastectomy. However, 7 women diagnosed with multifocal breast cancer in postoperative examination had to undergo mastectomy instead of breast conservation therapy. The change in treatment affected as many as 11.7 % of patients initially treated with BCT.
Results
Multifocal breast cancer was diagnosed postoperatively in as many as 11.7 % of patients treated with BCT despite of the fact that routine imaging examination was performed prior to operation. Histopathological examination revealed several tumour foci with their diameters ranging from 0.3 to 0.7 cm and were located from 0.5 cm to 3 cm from the primary focus.
Conclusion
Mammography and breast ultrasonography show low sensitivity for multifocal breast cancer with small-diameter tumours.
Due to higher sensitivity of magnetic resonance mammography it should be considered to be administered to all patients qualified for BCT.
