{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T15:04:01Z","timestamp":1770822241657,"version":"3.50.1"},"reference-count":21,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2002,3,28]],"date-time":"2002-03-28T00:00:00Z","timestamp":1017273600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2002,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Both the widespread use of screening mammography and emphasis on breast conservation have raised many questions regarding the clinical and therapeutic management of multicentric mammary carcinoma (MMC). MMC has been postulated to be either a clonal proliferation of a single mammary carcinoma or multiple independent synchronous primary tumors in the same breast. The goal of the current study was to evaluate the histologic features and immunohistochemical profile of MMC. We also compared the clinical outcomes of the patients in the current study with stage\u2010matched and treatment\u2010matched groups of patients with unicentric mammary carcinoma.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>The authors studied 32 patients with T1\u2010T2, N0\u20101, M0 multicentric invasive mammary carcinomas diagnosed between 1983\u20131988 and treated at The University of Texas M. D. Anderson Cancer Center. The histologic features of each tumor (including tumor type, nuclear grade, presence of in situ carcinoma, pattern of in situ carcinoma, and lymphovascular invasion) were evaluated. The authors performed immunohistochemical analysis of estrogen receptor (ER), progesterone receptor (PR), HER\u20102\/<jats:italic>neu<\/jats:italic>, and Ki\u201067 in 25 cases, including 14 from which &gt; 1 tumor was available to perform comparative immunohistochemical analysis. The clinical parameters of each case were compared with those of the unicentric breast carcinoma controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>The median age of the patients with MMC was 45 years (range, 28\u201369 years). Twelve patients had a family history of breast carcinoma (37.5%). The maximum tumor dimension ranged from 0.2\u20133.2 cm in the index lesion (median, 2.0 cm) and 0.1\u20132.5 cm in the second lesion (median, 0.9 cm). Twelve patients were clinically classified as having Stage I disease and 20 patients were considered to have Stage II disease at the time of presentation. Follow\u2010up data were available for all the patients and follow\u2010up ranged from 4.5\u201316 years (median, 6 years). The disease\u2010free survival was 84% at 5 years and 73% at 10 years in the MMC patients and 78% and 70%, respectively, in patients with unicentric breast carcinoma (<jats:italic>P<\/jats:italic> = 0.4368). Histologically, 24 of the multicentric tumors were found to be infiltrating ductal tumors and 8 were found to be infiltrating lobular carcinomas. The nipple was involved in 10 cases. The histology of the multicentric invasive tumor was nearly identical in 31 cases (97%). Approximately 72% of the cases had in situ carcinoma in both tumors and 44% had lymphovascular invasion. Comparative immunohistochemical analysis of separate tumors was equivalent with regard to ER, PR, and HER\u20102\/<jats:italic>neu<\/jats:italic>. The quantitative immunohistochemical staining for the proliferative marker Ki\u201067 differed between tumors in two cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>The near\u2010identical morphologic and immunohistochemical patterns in the MMC cases in the current study support the hypothesis that early\u2010stage synchronous tumors are a clonal proliferation of a single mammary carcinoma. Furthermore, the results of the current study support evaluating prognostic markers in only one tumor per MMC patient. There was no appreciable difference in the disease\u2010free survival of patients with unicentric and multicentric breast carcinoma. Cancer 2002;94:1910\u20136. \u00a9 2002 American Cancer Society.<\/jats:p><jats:p>DOI 10.1002\/cncr.10452<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.10452","type":"journal-article","created":{"date-parts":[[2002,8,25]],"date-time":"2002-08-25T19:46:56Z","timestamp":1030304816000},"page":"1910-1916","source":"Crossref","is-referenced-by-count":55,"title":["Multicentric mammary carcinoma"],"prefix":"10.1002","volume":"94","author":[{"given":"Lavinia P.","family":"Middleton","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Vlastos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadeem Q.","family":"Mirza","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Eva Singletary","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aysegul A.","family":"Sahin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2002,3,28]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(197501)35:1<247::AID-CNCR2820350130>3.0.CO;2-S"},{"key":"e_1_2_6_3_2","first-page":"139","volume-title":"The breast","author":"McDivitt RW","year":"1984"},{"key":"e_1_2_6_4_2","first-page":"21","article-title":"Multicentricity in breast cancer: a submacroscopic study","author":"Sarnelli R","year":"1986","journal-title":"Pathol Annu."},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.1996.442"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/0360-3016(93)90381-5"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/99.3.238"},{"key":"e_1_2_6_8_2","first-page":"23","article-title":"Multicentric breast tumor: an anatomical\u2010clinical study of 100 cases","volume":"18","author":"Spinelli C","year":"1992","journal-title":"Eur J Surg Oncol."},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19820315)49:6<1123::AID-CNCR2820490610>3.0.CO;2-R"},{"key":"e_1_2_6_10_2","first-page":"1","volume-title":"Tumors of the breast: their pathology, symptoms, diagnosis and treatment","author":"Cheatle GL","year":"1931"},{"key":"e_1_2_6_11_2","first-page":"83","article-title":"The concept and implications of multicentricity in breast carcinoma","volume":"16","author":"Lagios MD","year":"1981","journal-title":"Pathol Annu."},{"key":"e_1_2_6_12_2","first-page":"172","volume-title":"American Joint Committee on Cancer. Cancer staging manual","author":"Flemming ID","year":"1997"},{"key":"e_1_2_6_13_2","first-page":"252","article-title":"The impact of multicentricity on clinical outcome in patients with T1\u20102, N0\u20101, MO) breast cancer","volume":"180","author":"Vlastos G","year":"2000","journal-title":"Ann Surg Oncol."},{"key":"e_1_2_6_14_2","first-page":"97","article-title":"Nuclear structures in cancer tissues","volume":"105","author":"Black MM","year":"1957","journal-title":"Surg Gynecol Obstet."},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(196910)24:4<653::AID-CNCR2820240402>3.0.CO;2-B"},{"key":"e_1_2_6_16_2","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1177\/29.4.6166661","article-title":"Use of avidin biotin peroxidase complex (ABC) in immunoperoxidase techniques","volume":"29","author":"Hsu SM","year":"1981","journal-title":"J Histochem Cytochem."},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4612-2146-3_8"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(196904)23:4<855::AID-CNCR2820230420>3.0.CO;2-8"},{"issue":"2","key":"e_1_2_6_19_2","first-page":"234","article-title":"Multicentricity and bilaterality in invasive breast carcinoma","volume":"19","author":"Lesser ML","year":"1982","journal-title":"Surgery."},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19801001)46:7<1705::AID-CNCR2820460734>3.0.CO;2-Q"},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00390043"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/0046-8177(95)90085-3"}],"container-title":["Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fcncr.10452","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.10452","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T09:38:49Z","timestamp":1760261929000},"score":1,"resource":{"primary":{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/10.1002\/cncr.10452"}},"subtitle":["Evidence of monoclonal proliferation"],"short-title":[],"issued":{"date-parts":[[2002,3,28]]},"references-count":21,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2002,4]]}},"alternative-id":["10.1002\/cncr.10452"],"URL":"https:\/\/doi.org\/10.1002\/cncr.10452","archive":["Portico"],"relation":{},"ISSN":["0008-543X","1097-0142"],"issn-type":[{"value":"0008-543X","type":"print"},{"value":"1097-0142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2002,3,28]]}}}