Breast Surgical Conservation Therapy versus Mastectomy in Multifocal or Multicentric Breast Cancer; A Systematic Review and Meta-Analysis

Abstract

Abstract Background Breast cancer affects 1.7 million women annually worldwide, the majority of whom are treated surgically. Multiple ipsilateral breast cancers are collectively defined as more than one synchronous ipsilateral cancer at diagnosis. The term Multiple ipsilateral breast cancers denotes either multifocal breast cancers that occur within proximity separated by approximate radiological distances of 20–50 mm of normal tissue, or multicentric cancers occurring further apart in the breast at distances exceeding 50 mm. Objective To assess overall survival (OS), local recurrence and cosmetic results between conservative surgical approach and mastectomy in ipsilateral MF and MC breast cancer and to explore whether BCT was feasible for female patients with MF/MC breast cancer. Patients and Methods The PubMed, web of science and Scopus were searched on November 2010. The keywords were ipsilateral multiple breast cancer, conservative surgery and Radical mastectomy. Results In our Study twelve trials included 1906 patients, six trials regarding comparison between Breast conservative surgery and mastectomy and six trials regarding Breast conservative surgery in the management of the multifocal/multicentric breast lesions. Regarding local recurrence was assessed in six trials comparing between Breast conservative surgery and mastectomy and six trials regarding Breast conservative surgery in the management of the multifocal/multicentric breast lesions. Conclusion In MF/MC breast cancer patients, Local and regional recurrence in addition to, distant metastasis in patients undergoing BCT has no statistically difference compared to patients undergoing mastectomy. Further prospective studies should be investigated to refine the prognosis and to optimize the treatment in patients with MF/MC breast cancer.