Surgery Today

, Volume 49, Issue 3, pp 224–230 | Cite as

Prognostic impact of multifocal and multicentric breast cancer versus unifocal breast cancer

  • Atsushi Fushimi
  • Atsushi YoshidaEmail author
  • Hiroshi Yagata
  • Osamu Takahashi
  • Naoki Hayashi
  • Koyu Suzuki
  • Hiroko Tsunoda
  • Seigo Nakamura
  • Hideko Yamauchi
Original Article



The clinical behavior of multifocal and multicentric breast cancers (MMBCs) is not well characterized. We conducted this study to ascertain whether patients with MMBCs have a worse prognosis than patients with unifocal breast cancers (UBC).


The subjects of this retrospective study were 734 consecutive patients who underwent definitive surgery for invasive breast carcinoma at our hospital between January 2004 and December 2006. MMBC was defined as ≥ 2 separate invasive unilateral breast tumors and pathological T stage was redefined based on the sum of the maximum diameter of each tumor. We evaluated disease-free survival (DFS) using the Kaplan–Meier method and Cox proportional hazards models.


Of the 734 patients, 136 (18.5%) had MMBC. The pathological T stage of 36 of the patients with MMBC was upstaged by adopting the sum of each focus. MMBC did not have any survival impact, but MMBC upstaged by the modified pathological T stage was associated with worse DFS than non-upstaging MMBC (P = 0.004). Multivariate analysis revealed that upstaging MMBC was an independent factor for poor prognosis and worse DFS (HR 2.757, P = 0.043).


MMBC itself may not be predictive of a worse prognosis; however, the sum of the invasive diameters of MMBC might be an important prognostic factor. Further studies are needed to confirm the prognosis associated with MMBC, taking into consideration the biological characteristics of each invasive focus.


Breast cancer Multifocal Multicentric Prognosis 



We thank the staff of the Department of Breast Surgical Oncology, St Luke’s International Hospital, for their help in collecting the clinical data.

Compliance with ethical standards

Conflict of interest

We have no conflicts of interest to declare.


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Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  • Atsushi Fushimi
    • 1
    • 2
  • Atsushi Yoshida
    • 1
    Email author
  • Hiroshi Yagata
    • 1
    • 3
  • Osamu Takahashi
    • 4
  • Naoki Hayashi
    • 1
  • Koyu Suzuki
    • 5
  • Hiroko Tsunoda
    • 6
  • Seigo Nakamura
    • 1
    • 7
  • Hideko Yamauchi
    • 1
  1. 1.Department of Breast Surgical OncologySt. Luke’s International HospitalTokyoJapan
  2. 2.Department of SurgeryThe Jikei University School of MedicineTokyoJapan
  3. 3.Department of Breast Care, Saitama Medical CenterSaitama Medical UniversitySaitamaJapan
  4. 4.St. Luke’s International Hospital Center for Clinical Epidemiology, St. Luke’s Life Science InstituteTokyoJapan
  5. 5.Department of PathologySt. Luke’s International HospitalTokyoJapan
  6. 6.Department of RadiologySt. Luke’s International HospitalTokyoJapan
  7. 7.Department of Breast SurgeryShowa UniversityTokyoJapan

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