Table of ContentsView AllTable of ContentsWhat Is It?Diagnosis and StagingTreatment and Recurrence
Table of ContentsView All
View All
Table of Contents
What Is It?
Diagnosis and Staging
Treatment and Recurrence
There are several different kinds of breast cancer, including multifocal, multicentric, and unifocal. Multifocal breast cancer is a type in which there is more than one tumor, and all of the tumors originate from the same primary tumor. The multiple tumors are usually in the same section, or quadrant, of the breast.
Diagnosis methods range from clinical breast exams and mammograms to ultrasounds and biopsies. Treatment depends on the stage of the cancer, the age of the patient, and a range of other factors. Options include radiation, chemotherapy, and surgery.
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What Is Multifocal Breast Cancer?
Multifocal breast cancer is a type of breast cancer in which two or more tumors are present in the breast. These tumors originate from the primary tumor and are usually located in the same region of the same breast.
Multifocal vs. Multicentric Breast Cancer
There are multiple tumors in both multifocal and multicentric breast cancer, but in multicentric, they did not originate from the primary one. They are likely in different areas of the breast.
The research estimates that multifocal and multicentric breast cancers represent about 10%–60% of all breast cancer cases. This wide range is due to there being different definitions of the disease, as well as different diagnostic tools used.
Type OverviewMultifocal: Two or more tumors originating from the primary tumorMulticentric: Two or more tumors developing separately, often in different areas of the breastUnifocal: One tumor present in the breast
Type Overview
Multifocal: Two or more tumors originating from the primary tumorMulticentric: Two or more tumors developing separately, often in different areas of the breastUnifocal: One tumor present in the breast
Research has shown that individuals with multifocal or multicentric breast cancer are at a higher risk of metastasis than those with unifocal breast cancer. This means that cancer cells are more likely to spread beyond the breast tissue into surrounding lymph nodes and other areas of the body.
A 2015 study found that multifocal and multicentric breast cancers are also more likely to recur than unifocal breast cancers. Multifocal and multicentric breast cancers have been associated with a younger age at diagnosis, a larger tumor size, and a higher incidence of lymph node involvement.
Types of Breast Cancer
Breast cancer usually begins in the lobules or ducts in the breast. The lobules are milk-producing glands, and the ducts are the passages that drain milk from the lobule to the nipple. Part of the diagnostic process for breast cancer is to determine if cancer cells have spread beyond these tissues, including:
Common types of breast cancer include:
Less common types of breast cancer include:
Diagnosis and Staging of Multifocal Breast Cancer
If your physician suspects that you have developed breast cancer, they will recommend several tests to both diagnose and stage the disease. The diagnostic tests determine if you have breast cancer, and the staging tests determine how advanced the disease is.
Diagnosing Multifocal Breast Cancer
There are several tests used to diagnose breast cancer, including:
Is Multifocal Breast Cancer Rare?Multifocal breast cancer is considered a rare cancer, but it is difficult to determine the exact number of cases. This is because there are different definitions of and diagnostic criteria for multifocal breast cancer. The research estimates that multifocal and multicentric breast cancers represent about 10%–60% of all breast cancer cases.
Is Multifocal Breast Cancer Rare?
Multifocal breast cancer is considered a rare cancer, but it is difficult to determine the exact number of cases. This is because there are different definitions of and diagnostic criteria for multifocal breast cancer. The research estimates that multifocal and multicentric breast cancers represent about 10%–60% of all breast cancer cases.
Staging Multifocal Breast Cancer
Once breast cancer is diagnosed, additional tests are performed to stage cancer. This tells the medical team how advanced the cancer is and whether it has begun to spread to other areas of the body. Understanding the stage of cancer is an important factor when determining the appropriate treatment plan.
How to Stage Multifocal Breast Cancer
To stage multifocal breast cancer, your medical team will order several tests to determine how advanced the disease is. These include imaging studies, blood tests, and a biopsy. For multifocal breast cancer, the medical team focuses on the size and growth of the primary tumor.
A common way tostage breast canceris to use the TNM system. This system is based on these three important factors:
Stages
Stage 0: This is noninvasive breast cancer in which there are no cancer cells detected beyond the primary tumor–also called ductal carcinoma in situ (DCIS) or Paget’s disease of the breast.
Stage 1: This is invasive breast cancer that typically has started to grow into surrounding breast tissues.
Stage 2: Invasive breast cancer typically indicates a larger primary tumor or that cancer has spread to more lymph nodes.
Stage 3: This is invasive breast cancer in which cancer has spread farther than stage 2 but has not metastasized beyond the local tissues and organs near the breast.
Stage 4: This is invasive breast cancer which has spread beyond the breast to other organs such as the lungs, bones, liver, or brain.
What else determines prognosis?In addition to the stage, other factors that affect breast cancer prognosis include the type of cancer, how fast the tumor is growing, your age, your overall health, and your menopausal status.
What else determines prognosis?
In addition to the stage, other factors that affect breast cancer prognosis include the type of cancer, how fast the tumor is growing, your age, your overall health, and your menopausal status.
Knowing the stage of your cancer allows your medical team to develop the most effective treatment plan for you. It also helps them to determine your prognosis and five-year survival rate. This rate is used to describe the likelihood of your treatment plan being effective. The five-year survival rates for all types of breast cancer are as follows:
It’s important to note that the prognoses for unifocal and multifocal breast cancers are different. A 2017 study found that multifocal breast cancer tended to be more aggressive and have a poorer prognosis than unifocal breast cancer.
Multifocal Breast Cancer: Treatment and Recurrence
Once your medical team has determined your diagnosis and cancer stage, the next step is to develop a comprehensive treatment plan.
Treatment
Treatment optionsfor multifocal breast cancer vary based on factors like age, stage, and spread of cancer, and may include:
Surgery TypesTypes of breast cancer surgery include:Lumpectomy: The surgeon removes the cancerous tumor while sparing as much breast tissue as possible. This may be an option when the tumors are located in the same quadrant of the breast.Mastectomy: The surgeon removes the entire breast and surrounding lymph nodes.
Surgery Types
Types of breast cancer surgery include:Lumpectomy: The surgeon removes the cancerous tumor while sparing as much breast tissue as possible. This may be an option when the tumors are located in the same quadrant of the breast.Mastectomy: The surgeon removes the entire breast and surrounding lymph nodes.
Types of breast cancer surgery include:
Recurrence
Recurrence is a concern for those with multifocal breast cancer. Recurrence refers to cancer coming back after being successfully treated. One study found that 8.3% of patients with multifocal breast cancer who underwent a lumpectomy experienced disease recurrence. Of the individuals who underwent a mastectomy, 7.7% experienced recurrence.
A 2019 meta-analysis found that those who underwent surgery experienced a recurrence rate of anywhere from 2% to 23%.
Support and Coping
Multifocal breast cancer is an overwhelming diagnosis and finding support resources is essential. Talk with your oncologist about your concerns, and lean on friends and family who offer help. Joining a cancersupport groupor online community may be helpful as well.
Summary
Multifocal breast cancer occurs when two or more tumors that originated from one primary tumor are found in the breast. These tumors are usually located in the same region of the breast.
Multifocal breast cancer can be diagnosed with a clinical breast exam, mammogram, breast MRI, breast ultrasound, and biopsy. There are several treatment options including surgery, radiation therapy, and chemotherapy.
13 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Cancer Institute.Definition of multifocal breast cancer.Ustaalioglu BO, Bilici A, Kefeli U, Şeker M, Oncel M, Gezen C, Gumus M, Demirelli F.The importance of multifocal/multicentric tumor on the disease-free survival of breast cancer patients: single center experience. Am J Clin Oncol. 35(6):580-6. doi: 10.1097/COC.0b013e31822d9cd6Neri A, Marrelli D, Megha T, Bettarini F, Tacchini D, De Franco L, Roviello F.Clinical significance of multifocal and multicentric breast cancers and choice of surgical treatment: a retrospective study on a series of 1158 cases.BMC Surg. 15(1):1. doi:10.1186/1471-2482-15-1Lang Z, Wu Y, Li C, Li X, Wang X, Qu G.Multifocal and multicentric breast carcinoma: A significantly more aggressive tumor than unifocal breast cancer.Anticancer Res. 37(8):4593-4598. doi:10.21873/anticanres.11858Breastcancer.org.Understanding your pathology report.Centers for Disease Control and Prevention.Diagnosing breast cancer.Coombs NJ, Boyages J.Multifocal and multicentric breast cancer: does each focus matter?J Clin Oncol. 23(30):7497-502. doi:10.1200/JCO.2005.02.1147Breastcancer.org.Breast cancer stages.National Cancer Institute.Breast cancer treatment.American Cancer Society.Survival rates for breast cancer.Ghamrini YE, Salama TMS, Hassan MI, Nasser HM.Mapping of multifocal breast cancer to achieve negative margins: A new step in the evolution of conservative breast surgery(A cohort study).Ann Med Surg (Lond). 56:28-33. doi:10.1016/j.amsu.2020.05.030Nijenhuis MV, Rutgers EJ.Conservative surgery for multifocal/multicentric breast cancer.Breast. 24 Suppl 2:S96-9. doi:10.1016/j.breast.2015.07.023Masannat YA, Agrawal A, Maraqa L, Fuller M, Down SK, Tang S, Pang D, Kontos M, Romics L, Heys SD.Multifocal and multicentric breast cancer, is it time to think again? Ann R Coll Surg Engl. 2020 Jan;102(1):62-66. doi: 10.1308/rcsann.2019.0109. Epub 2019 Sep 6. PMID: 31891668; PMCID: PMC6937617.
13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Cancer Institute.Definition of multifocal breast cancer.Ustaalioglu BO, Bilici A, Kefeli U, Şeker M, Oncel M, Gezen C, Gumus M, Demirelli F.The importance of multifocal/multicentric tumor on the disease-free survival of breast cancer patients: single center experience. Am J Clin Oncol. 35(6):580-6. doi: 10.1097/COC.0b013e31822d9cd6Neri A, Marrelli D, Megha T, Bettarini F, Tacchini D, De Franco L, Roviello F.Clinical significance of multifocal and multicentric breast cancers and choice of surgical treatment: a retrospective study on a series of 1158 cases.BMC Surg. 15(1):1. doi:10.1186/1471-2482-15-1Lang Z, Wu Y, Li C, Li X, Wang X, Qu G.Multifocal and multicentric breast carcinoma: A significantly more aggressive tumor than unifocal breast cancer.Anticancer Res. 37(8):4593-4598. doi:10.21873/anticanres.11858Breastcancer.org.Understanding your pathology report.Centers for Disease Control and Prevention.Diagnosing breast cancer.Coombs NJ, Boyages J.Multifocal and multicentric breast cancer: does each focus matter?J Clin Oncol. 23(30):7497-502. doi:10.1200/JCO.2005.02.1147Breastcancer.org.Breast cancer stages.National Cancer Institute.Breast cancer treatment.American Cancer Society.Survival rates for breast cancer.Ghamrini YE, Salama TMS, Hassan MI, Nasser HM.Mapping of multifocal breast cancer to achieve negative margins: A new step in the evolution of conservative breast surgery(A cohort study).Ann Med Surg (Lond). 56:28-33. doi:10.1016/j.amsu.2020.05.030Nijenhuis MV, Rutgers EJ.Conservative surgery for multifocal/multicentric breast cancer.Breast. 24 Suppl 2:S96-9. doi:10.1016/j.breast.2015.07.023Masannat YA, Agrawal A, Maraqa L, Fuller M, Down SK, Tang S, Pang D, Kontos M, Romics L, Heys SD.Multifocal and multicentric breast cancer, is it time to think again? Ann R Coll Surg Engl. 2020 Jan;102(1):62-66. doi: 10.1308/rcsann.2019.0109. Epub 2019 Sep 6. PMID: 31891668; PMCID: PMC6937617.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Cancer Institute.Definition of multifocal breast cancer.Ustaalioglu BO, Bilici A, Kefeli U, Şeker M, Oncel M, Gezen C, Gumus M, Demirelli F.The importance of multifocal/multicentric tumor on the disease-free survival of breast cancer patients: single center experience. Am J Clin Oncol. 35(6):580-6. doi: 10.1097/COC.0b013e31822d9cd6Neri A, Marrelli D, Megha T, Bettarini F, Tacchini D, De Franco L, Roviello F.Clinical significance of multifocal and multicentric breast cancers and choice of surgical treatment: a retrospective study on a series of 1158 cases.BMC Surg. 15(1):1. doi:10.1186/1471-2482-15-1Lang Z, Wu Y, Li C, Li X, Wang X, Qu G.Multifocal and multicentric breast carcinoma: A significantly more aggressive tumor than unifocal breast cancer.Anticancer Res. 37(8):4593-4598. doi:10.21873/anticanres.11858Breastcancer.org.Understanding your pathology report.Centers for Disease Control and Prevention.Diagnosing breast cancer.Coombs NJ, Boyages J.Multifocal and multicentric breast cancer: does each focus matter?J Clin Oncol. 23(30):7497-502. doi:10.1200/JCO.2005.02.1147Breastcancer.org.Breast cancer stages.National Cancer Institute.Breast cancer treatment.American Cancer Society.Survival rates for breast cancer.Ghamrini YE, Salama TMS, Hassan MI, Nasser HM.Mapping of multifocal breast cancer to achieve negative margins: A new step in the evolution of conservative breast surgery(A cohort study).Ann Med Surg (Lond). 56:28-33. doi:10.1016/j.amsu.2020.05.030Nijenhuis MV, Rutgers EJ.Conservative surgery for multifocal/multicentric breast cancer.Breast. 24 Suppl 2:S96-9. doi:10.1016/j.breast.2015.07.023Masannat YA, Agrawal A, Maraqa L, Fuller M, Down SK, Tang S, Pang D, Kontos M, Romics L, Heys SD.Multifocal and multicentric breast cancer, is it time to think again? Ann R Coll Surg Engl. 2020 Jan;102(1):62-66. doi: 10.1308/rcsann.2019.0109. Epub 2019 Sep 6. PMID: 31891668; PMCID: PMC6937617.
National Cancer Institute.Definition of multifocal breast cancer.
Ustaalioglu BO, Bilici A, Kefeli U, Şeker M, Oncel M, Gezen C, Gumus M, Demirelli F.The importance of multifocal/multicentric tumor on the disease-free survival of breast cancer patients: single center experience. Am J Clin Oncol. 35(6):580-6. doi: 10.1097/COC.0b013e31822d9cd6
Neri A, Marrelli D, Megha T, Bettarini F, Tacchini D, De Franco L, Roviello F.Clinical significance of multifocal and multicentric breast cancers and choice of surgical treatment: a retrospective study on a series of 1158 cases.BMC Surg. 15(1):1. doi:10.1186/1471-2482-15-1
Lang Z, Wu Y, Li C, Li X, Wang X, Qu G.Multifocal and multicentric breast carcinoma: A significantly more aggressive tumor than unifocal breast cancer.Anticancer Res. 37(8):4593-4598. doi:10.21873/anticanres.11858
Breastcancer.org.Understanding your pathology report.
Centers for Disease Control and Prevention.Diagnosing breast cancer.
Coombs NJ, Boyages J.Multifocal and multicentric breast cancer: does each focus matter?J Clin Oncol. 23(30):7497-502. doi:10.1200/JCO.2005.02.1147
Breastcancer.org.Breast cancer stages.
National Cancer Institute.Breast cancer treatment.
American Cancer Society.Survival rates for breast cancer.
Ghamrini YE, Salama TMS, Hassan MI, Nasser HM.Mapping of multifocal breast cancer to achieve negative margins: A new step in the evolution of conservative breast surgery(A cohort study).Ann Med Surg (Lond). 56:28-33. doi:10.1016/j.amsu.2020.05.030
Nijenhuis MV, Rutgers EJ.Conservative surgery for multifocal/multicentric breast cancer.Breast. 24 Suppl 2:S96-9. doi:10.1016/j.breast.2015.07.023
Masannat YA, Agrawal A, Maraqa L, Fuller M, Down SK, Tang S, Pang D, Kontos M, Romics L, Heys SD.Multifocal and multicentric breast cancer, is it time to think again? Ann R Coll Surg Engl. 2020 Jan;102(1):62-66. doi: 10.1308/rcsann.2019.0109. Epub 2019 Sep 6. PMID: 31891668; PMCID: PMC6937617.
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