Conservative treatment of multifocal breast cancer: a comparative study

Conservative treatment of multifocal breast cancer is still very controvers ial. This retrospective study concerns 56 patients with stage I or II multi focal breast cancer who underwent conservative treatment at the Institute C urie fi om January 1983 to December 1989. These patients (group 1) were mat ched with 132 patients with multifocal lesions treated by mastectomy (group 2). Surgical treatment consisted of a single wide lumpectomy followed by e xternal radiotherapy. Adjuvant systemic therapy, and regional nodal irradia tion were administered as indicated by current protocol. The actuarial 5-ye ar overall survival rate was 94%, +/- 6 in group I, and 90% +/- 6 in group 2 (NS). The actuarial 5-year ipsilateral breast recurrence rate was 11% +/- 8 in group I, and 11% +/- 5 in group 2 (NS). in group I patients, the ipsi lateral breast recurrence rate um related neither to type of multifocality nor to presence of intra ductal breast carcinoma, nodal status, tumor margi ns, radiotherapy boost, or distance between tumors. Consequently, conservat ive treatment of multifocal breast-cancers which can be completely removed by a single lumpectomy seems when technically feasible, an alternative to m astectomy.