Multicentricity in XXXX : a submacroscopic study.

@entity1 @entity0 @entity5
One hundred @entity1 female breasts surgically removed by radical mastectomy for clinical @entity5 were analyzed under a dissecting microscope to search for other submacroscopic (less than 0.5 cm) foci collateral to and independent from the clinical one. These foci were found in 36 percent of cases, either in situ (17 percent), or infiltrating (12 percent), or both in situ and infiltrating (7 percent). This high percentage of @entity5 confirms previous data, suggesting the wide intramammary distribution of @entity0 . Multicentricity appears to be significantly associated with the incidence of @entity0 (p less than 0.05) and advanced @entity1 age in the range between 71 and 80 years (p less than 0.005). Axillary lymph node metastases are significantly associated with @entity5 (p less than 0.025), but not with submacroscopic foci of infiltrating @entity5 and the general character of the mammary glandular parenchyma, @entity5 size or histologic type of the clinical @entity5 . The critical question is whether multicentricity makes a difference clinically and especially to @entity1 who do not have their entire breast removed. Radical mastectomy results in a severe cosmetic and functional problem for @entity1 . According to many authors, the goal of the treatment should be the removal of @entity0 by conservative surgical techniques (lumpectomy, subcutaneous mastectomy, quadrantectomy), using adjuvant radiotherapy and/or chemotherapy. The use of radiotherapy as primary treatment of early @entity0 has been also suggested. There is disagreement about surgical management of @entity0 . In fact, some investigators emphasize that the natural biologic history of @entity5 has not been documented by any adequate follow-up series in @entity1 who do not have their entire breast removed. Thus far, no difference has been seen in disease-free or overall survival between groups of @entity1 with early @entity0 treated by an alternative therapeutic procedure and @entity1 treated by radical mastectomy. However, Veronesi et al. (1981) refer to 4 second @entity5 of the ipsilateral breast in the 352 cases of small @entity5 treated by quadrantectomy, axillary dissection, and adjuvant radiotherapy. Moreover, Hellman et al. (1980), using radiation therapy without mastectomy for the primary treatment of 176 @entity1 with early @entity0 , found 1 case of new @entity5 in a separate quadrant. Further evaluation is necessary to establish the long-term results of the alternative treatments of @entity0 and for the understanding of the clinical significance of microscopic @entity5 in the mammary gland.
