Published in:
01-01-2019 | Breast Oncology
Reply to “Multicentric Ipsilateral Invasive Breast Carcinomas Might Have Higher 21-Gene Recurrence Score Compared with Multifocal Ipsilateral Invasive Breast Carcinomas”
Authors:
Anne Grabenstetter, MD, Edi Brogi, MD, PhD, Joanne Chou, MPH, Monica Morrow, MD, Maura Dickler, MD, Larry Norton, MD, Hannah Wen, MD, PhD
Published in:
Annals of Surgical Oncology
|
Issue 1/2019
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Excerpt
We appreciate the interesting hypothesis raised by Dr. Altundag regarding possible differences in the 21-gene recurrence score (RS) between multicentric (MC) and multifocal (MF) breast carcinomas (BCs). Traditionally, MC carcinoma is defined as two or more BCs in separate quadrants, and MF as BCs in the same quadrant; however, others have suggested defining MC as multiple tumors in the same breast, and MF as multiple foci of the same tumor.
1,
2 These terms are not used uniformly by various authors, which contributes to some confusion on the topic. In comparing MC/MF BCs with unifocal BCs (UBCs), worse prognostic factors (including younger age at diagnosis, larger tumor size, higher grade, presence of lymphovascular invasion, and increased rate of lymph node metastases) have been reported in association with both MC and MF BCs,
3 and, in one study, associated only with MC and not MF BCs.
4 In contrast, Vera-Badillo et al.
5 found relative balance in prognostic factors between MC/MF and UBCs. Conflicting data also exist when examining survival outcomes of patients, with some reporting an association of worse overall survival with MC/MF BCs
5 and others finding no difference in patient outcomes.
2,
3 …
