Oncoplastic Surgery of Multicentric (Multifocal) Breast Cancer
The multicentric/multifocal form of breast cancer has been considered as relative contraindication for breast conserving surgery. According to the results of the studies conducted in the last century, the local recurrence rate of the disease after breast conserving surgeries of multicentric/multifocal breast cancer exceeds 40%. Thus these data were considered as main argument for mastectomy advocates, as non-alternative surgical treatment in these cases. Wide clinical application of oncoplastic surgical techniques gave us possibilities to resolve dilemma: excise tumor - containing quadrant with achieving clear margins and satisfactory cosmetic outcome, without increasing risk of diseaserelated complications. In cases of multicentricity/ multicocality of breast cancer, total axillary lymphadenectomy might be avoided when size of tumor is less than 2 cm and there are no signs of malignant involvement of axillar lymph nodes; In case of clinically negative axillary lymph nodes – sentinel lymph node biopsy might be the standard option. Of course, adjuvant treatment should be planned in accordance with the principles of personalized medicine, based on the results of multidisciplinary review and taking into consideration modern advanced guidelines and recommendations.
Irakli Kokhreidze
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