Multifocal BC, worse, good, or same?
Hi,
My mom was dxed with multifocal BC, lobular and ductal features, 1 cm and 1.5cm with DCIS and LCIS too. Is multifocal BC worse, same or better than having 1 tumour? What really matters and how was yours staged, by adding them all up or by the largest tumour dimension?
Thanks, G from Montreal
Comments
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The question is what is your mom's dx? What grade? What stage? Multifocal means more areas of the breast is infected with cancer cells. The multi-focal can be non-invasive cancer, which means it is not life threatening. One tumor, its only in one place. But, if the size of the one tumor is larger than 2 C then it could be worse, especially if there is a invasive component. In that case, it's pretty serious. I'm no expert.
My first dx I had one tumor 2 C that was removed with wide margins. The second dx (1 yr later) it was 100% multifocal. The multifocal scares me. I live with the realization that I could still be plagued with cancer cells in my breast. I think if its multifocal, mx should be considered. Next time for me. Right now, I' find myself reading more on invasive cancer, which has made me wish I had gotten a mx. ug....
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Hi,
Sorry, it was grade 2 for both, ER++, HER-. They staged her at 1c. With extensice DCIS. she had a Mx, and chemo and is on AI's. 9/9 nodea clean.
Thanks
G
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Hi,
Multifocal means there is more than one tumor site. They stage by the largest of the tumors since that is the "oldest" and generally the primary source. Multifocal in itself is not greatly different with a few caveats. Generally, mast is recommended for multifocal instead of lumpectomy. There is also a study questioning if multifocal is undertreated because of the staging done only by the largest tumor. In general, most oncs follow the stage, but if the tumor is on the borderline, they will treat it on the more agressive side.
To give you an example: I had a primary DCIS, a primary IDC and 18 secondary IDC. They used the largest tumor (the primary IDC) for staging but then instead of treating as IIa they treated as IIIa. I'm now "dancing with NED (no evidence of disease.)" Your mom will hopefully be doing the same.
Each person is an individual situation and your mom's oncologist will give her the best information. IF she has any hesitation or question, she should consider a 2nd opinion.
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Thanks. She was staged 1c. This multifocal stuff is confusing. G
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Here is a recent article about multifocal/multicentric tumors. The major finding in it is that these tumors tend to have more positive nodes. Since your mom does not have positive nodes I don't know that it's relevant, but I'll pass it along. It gives formulas they used to measure the tumor volume and surface area when you have more than one tumor. They indicate that just adding up the diameters of the foci overestimates the size.
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