Multifocal and Multicentric Breast Cancer

@polianad22, I see you are learning more about multifocal and multicentric breast cancer, sometimes referred to as MMBC. Breast cancers are defined as multifocal when there is more than one distinct tumor within the same quadrant of the breast (MF) and multicentric when multiple cancers develop in different quadrants of the breast (MC).

Members @betsyk and @anne72 have mentioned having multifocal breast cancer and may be able to share their experiences with lymph node testing and spread.

I found this study that supports your understanding of lymph node spread and dissection options:
- Multiple synchronous (multifocal and multicentric) breast cancer: Clinical implications https://www.sciencedirect.com/science/article/abs/pii/S0960740410000587

Excerpt
"Multifocality in breast cancer is a frequent phenomenon, whose prevalence may vary between 13 and 75%. The differences in estimation of the prevalence of multifocality across studies may be explained by the differing definitions used for multifocality and multicentricity; this inconsistency makes it difficult to analyze the literature on the subject. The incidence of multifocality is probably often underestimated. Currently, the diagnosis relies on imaging. "
"Multifocality may also modify the management of the axillary basin; studies have shown that multifocality is associated to an over-risk of 20% of lymph node invasion."

It is likely that more members have multifocal and/or multicentric breast cancer.

Poliana, what are you learning about MMBC that is influencing your diagnostic and treatment options?

What confuses me is that the surgeon offered me lumpectomy or mastectomy. Women with lumpectomy don't have the axillary nodes removed.

Please let me know.

My head is spinning. I am confused about how to move forward with the surgeries.

My second surgeon told me that lumpectomy would work well with what I have. Both were offered, lumpectomy and mastectomy. My first surgeon offered both too.

My sister's oncologist surgeon from Romania saw my images and said that she wouldn't offer any lumpectomy. She said that the mastectomy is the right surgery for the multifocal cancer.

Did any of you have Multifocal Ductal carcinoma? Please share your experience?

Hi -
I feel like we are in sort of of the same situation. I have DCIS (2 cm) and ALH in the left breast. The surgeon said that it was a 50/50 chance that they would get clear margins if they did a lumpectomy for both. After lumpectomy I would need radiation. I believe that I will go for a mastectomy because I am afraid of cancer recurring and reconstruction options are better without radiation. I am still so conflicted and not sure I am thinking clearly about this. Can you tell me what your thoughts are on how to decide?
thanks!

There is always so much information coming at you at the beginning and I remember feeling an urgency to make decisions right then. 😳 I felt overwhelmed and unable to deal with the sadness I should have been feeling.
There is a group that talks a lot about mastectomy and reconstruction pros and cons. Have you read this conversation yet.
https://connect.mayoclinic.org/discussion/mastectomy-1/
I wish I would have taken the time and had this resource when I was diagnosed. I find that slowing down and taking the time to consume as much information as possible helps me to make the best decision I can for myself.
This is a very hard time for you, have you stopped long enough to breathe yet? 💕Do you have someone to bounce thoughts around with that knows you well enough to know what is important to you?

@dmart37. I have two tumors in my left breast one is 2cm and another 1cm or smaller. I decided to go with mastectomy as mine is multifocal. You never know how many other small tumors we might have in our breast that you cannot see at MRI. Also, I would like to go aesthetic flat where the plastician does a very smooth work hopefully, no silicone, no flap surgery. I have been thinking for weeks about lumpectomy versus mastectomy. Unifocal cancer is very different in my perspective and lumpectomy is a better fit. I will meet the plastician soon and hopefully have the surgery at the beginning of November.

Thank you for your response and thought process. I hope that your meeting with the plastician and your surgery goes well. None of this is easy.

Hi - Thank you for your response and information - I will look at the website. I have had some time to think about this, do some research and talk to the surgeon again to answer some questions. Agreed that consuming as much information as possible will help.

I had 10 tumours over 2 quadrants of my right breast with 2 affected sentinel nodes , mastectomy, dose dense chemotherapy and 25 rounds of radiation. I am coming up to my 2 year anniversary wondering what is the most definitive imaging for follow up ?

I didn’t have lumpectomy option. I was told I needed unilateral and I immediately knew I wanted bilateral. I would have chosen mastectomy over lumpectomy anytime. Going thru this once is already devastating. I have read too many stories of women having recurrence after lumpectomy. I am not saying mastectomy eliminates recurrence 100% but I would at least think it decreases the local recurrence. I did my mastectomy Sept 2022. Have expanded currently and will have reconstruction around October 23. I do not feel any less having had mastectomy.