Multifocal and Multicentric Breast Cancer: Evaluation of Clinicopathological Features and Survival Outcomes

Objectives: The reported incidence of multifocal breast cancer (MFBC) and multicentric breast cancer (MCBC) varies widely in the literature. This study aimed to compare the clinicopathological characteristics, treatment approaches, and survival outcomes between patients with MFBC/MCBC and those with unifocal breast cancer (UFBC).
Methods: Data from 666 female patients aged >18 years who were histopathologically diagnosed with breast cancer and followed up at the Department of General Surgery of a tertiary hospital between January 2018 and January 2025 were retrospectively reviewed. MF and MC were defined based on tumor localization within breast quadrants and the distance between foci. Clinical, pathological, and treatment-related parameters were compared between the groups.
Results: Of all patients, 83.5% (n=556) had UFBC and 16.5% (n=110) had MF/MCBC. The mean age was 54.89±12.17 years. Axillary lymph node positivity was significantly higher in the MF/MCBC group (p=0.022). Magnetic resonance imaging (MRI) identified MF/MCBC in 71% of cases, demonstrating greater sensitivity than mammography (MMG) and ultrasonography (USG). Mastectomy was performed in 85.4% of patients with MF/MCBC compared with 45% of those in the UFBC group. The rate of neoadjuvant chemotherapy was also significantly higher among patients with MF/MCBC (p=0.008). There were no significant differences between the groups regarding local recurrence, distant metastasis, or overall survival.
Conclusion: Patients with MF/MCBC exhibited higher rates of axillary involvement and more frequent use of neoadjuvant therapy. However, overall survival was comparable to that of patients with UFBC. A multidisciplinary approach remains essential for determining the optimal management strategy in this subgroup.

Keywords: Axillary metastasis, breast cancer, multicentric, multifocal, survival