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Background <p>The ACOSOG Z11102 trial demonstrated the safety of breast-conserving surgery (BCS) with adjuvant radiation in women with multiple ipsilateral breast cancer (MIBC) undergoing upfront surgery, reporting a 5-year local recurrence (LR) of ~3%. However, the oncologic safety of BCS in women with MIBC receiving neoadjuvant systemic therapy (NST) remains uncertain.</p> Patients and Methods <p>Patients with stage I–III unifocal or MIBC who underwent BCS following NST from 2016 to 2023 were identified in a prospectively maintained institutional database. MIBC was defined preoperatively as the presence of 2–3 foci of biopsy-proven breast cancer with at least 2 cm of intervening normal breast tissue and at least one focus of invasive disease.</p> Results <p>A total of 1515 patients were identified: 73 (4.8%) with MIBC and 1442 (95.2%) with unifocal disease. Baseline clinicopathologic characteristics were similar between groups. Median age was 55 years, and most received neoadjuvant chemotherapy (82.2% vs. 83.4%). Molecular subtype distribution was similar between cohorts (<i>p</i> = 0.97). Of the patients with MIBC, 48 (65.8%) underwent single-site lumpectomy, 23 (31.5%) two-site lumpectomy, and 2 (2.7%) three-site lumpectomy. At median follow-up of 34.7 months, there was no difference in LR (1.4% vs. 3.1%, <i>p</i> = 0.40), distant recurrence (5.5% vs. 4.6%, <i>p</i> = 0.37), or breast cancer mortality (4.1% vs. 2.6%, <i>p</i> = 0.45) between groups.</p> Conclusions <p>In this retrospective analysis of women with MIBC who underwent BCS after NST, local recurrence (LR) was 1.4% at 3-year median follow-up, which was similar to patients with unifocal breast cancer. These findings suggest BCS is a safe surgical option in well-selected patients with MIBC undergoing NST.</p>

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Breast-Conserving Therapy for Multiple Ipsilateral Breast Cancer After Neoadjuvant Systemic Therapy

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月3日

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  • Monika K. Masanam,
  • Jennifer R. Bellon,
  • José P. Leone,
  • Elizabeth A. Mittendorf,
  • Tari A. King,
  • Olga Kantor

摘要

Background

The ACOSOG Z11102 trial demonstrated the safety of breast-conserving surgery (BCS) with adjuvant radiation in women with multiple ipsilateral breast cancer (MIBC) undergoing upfront surgery, reporting a 5-year local recurrence (LR) of ~3%. However, the oncologic safety of BCS in women with MIBC receiving neoadjuvant systemic therapy (NST) remains uncertain.

Patients and Methods

Patients with stage I–III unifocal or MIBC who underwent BCS following NST from 2016 to 2023 were identified in a prospectively maintained institutional database. MIBC was defined preoperatively as the presence of 2–3 foci of biopsy-proven breast cancer with at least 2 cm of intervening normal breast tissue and at least one focus of invasive disease.

Results

A total of 1515 patients were identified: 73 (4.8%) with MIBC and 1442 (95.2%) with unifocal disease. Baseline clinicopathologic characteristics were similar between groups. Median age was 55 years, and most received neoadjuvant chemotherapy (82.2% vs. 83.4%). Molecular subtype distribution was similar between cohorts (p = 0.97). Of the patients with MIBC, 48 (65.8%) underwent single-site lumpectomy, 23 (31.5%) two-site lumpectomy, and 2 (2.7%) three-site lumpectomy. At median follow-up of 34.7 months, there was no difference in LR (1.4% vs. 3.1%, p = 0.40), distant recurrence (5.5% vs. 4.6%, p = 0.37), or breast cancer mortality (4.1% vs. 2.6%, p = 0.45) between groups.

Conclusions

In this retrospective analysis of women with MIBC who underwent BCS after NST, local recurrence (LR) was 1.4% at 3-year median follow-up, which was similar to patients with unifocal breast cancer. These findings suggest BCS is a safe surgical option in well-selected patients with MIBC undergoing NST.