Tailoring Escalated Adjuvant Chemotherapy for Multifocal and Multicentric Breast Cancer With Low Tumor Burden.
- 1Department of Breast Surgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
- 2Department of Breast Surgery, Zhejiang Key Laboratory of Intelligent Cancer Biomarker Discovery and Translation, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
- 3Department of Mathematics and Computer Science, Eindhoven University of Technology, Eindhoven, the Netherlands.
Abstract
Purpose
The prognostic significance of multifocal and multicentric breast cancer (MMBC) with low tumor burden remains controversial, and adjuvant chemotherapy guidelines for these patients are lacking.Materials and methods
Female patients with cT1-T2 MMBC or unifocal breast cancer (UBC) diagnosed between 2010 and 2020 were identified from the SEER database. Propensity score matching (PSM) balanced baseline characteristics. Survival outcomes were evaluated using Kaplan-Meier and Cox proportional hazards models, with subgroup analyses stratified by tumor size in node-negative MMBC.Results
After PSM, 9,751 matched pairs of patients with MMBC and UBC were included. Analyses showed MMBC had significantly worse overall survival (OS) and breast cancer-specific survival (BCSS) than UBC (both P < .001). Multivariate Cox regression confirmed chemotherapy improved OS (hazard ratio [HR], 0.583 [95% CI, 0.522 to 0.652]) and BCSS (HR, 0.830 [95% CI, 0.702 to 0.980]) in MMBC. In eligible cases, 1,731 matched pairs with and without chemotherapy were identified. Subgroup analyses showed that in node-negative MMBC, chemotherapy improved OS only when tumors were ≥1 cm (tumor <1 cm: HR, 0.804 [95% CI, 0.506 to 1.275], P = .353; 1-2 cm: HR, 0.577 [95% CI, 0.414 to 0.806], P = .001; ≥2 cm: HR, 0.535 [95% CI, 0.399 to 0.717], P < .001).Conclusion
MMBC predicts poorer survival than UBC. In node-negative MMBC, chemotherapy confers benefit only when tumor size is ≥1 cm, suggesting multifocality and multicentricity should guide chemotherapy decisions. Prospective studies are warranted to confirm findings and refine guidelines.
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BibTeX
@article{su2026tailoring,
title = {{Tailoring Escalated Adjuvant Chemotherapy for Multifocal and Multicentric Breast Cancer With Low Tumor Burden.}},
author = {Yonghui Su and Jiaqi Ying and Zhuozhao Zhan and Tingting Wu and Yena Yu and Wanxin Gao and Yizi Zheng},
journal = {JCO precision oncology},
year = {2026},
month = oct,
doi = {10.1200/po-26-00177},
url = {https://europepmc.org/article/MED/42842843},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Tailoring Escalated Adjuvant Chemotherapy for Multifocal and Multicentric Breast Cancer With Low Tumor Burden.
AU - Yonghui Su
AU - Jiaqi Ying
AU - Zhuozhao Zhan
AU - Tingting Wu
AU - Yena Yu
AU - Wanxin Gao
AU - Yizi Zheng
PY - 2026
DA - 2026/10/07
JO - JCO precision oncology
DO - 10.1200/po-26-00177
UR - https://europepmc.org/article/MED/42842843
AB - Purpose The prognostic significance of multifocal and multicentric breast cancer (MMBC) with low tumor burden remains controversial, and adjuvant chemotherapy guidelines for these patients are lacking.Materials and methods Female patients with cT1-T2 MMBC or unifocal breast cancer (UBC) diagnosed between 2010 and 2020 were identified from the SEER database. Propensity score matching (PSM) balanced baseline characteristics. Survival outcomes were evaluated using Kaplan-Meier and Cox proportional hazards models, with subgroup analyses stratified by tumor size in node-negative MMBC.Results After PSM, 9,751 matched pairs of patients with MMBC and UBC were included. Analyses showed MMBC had significantly worse overall survival (OS) and breast cancer-specific survival (BCSS) than UBC (both P < .001). Multivariate Cox regression confirmed chemotherapy improved OS (hazard ratio [HR], 0.583 [95% CI, 0.522 to 0.652]) and BCSS (HR, 0.830 [95% CI, 0.702 to 0.980]) in MMBC. In eligible cases, 1,731 matched pairs with and without chemotherapy were identified. Subgroup analyses showed that in node-negative MMBC, chemotherapy improved OS only when tumors were ≥1 cm (tumor <1 cm: HR, 0.804 [95% CI, 0.506 to 1.275], P = .353; 1-2 cm: HR, 0.577 [95% CI, 0.414 to 0.806], P = .001; ≥2 cm: HR, 0.535 [95% CI, 0.399 to 0.717], P < .001).Conclusion MMBC predicts poorer survival than UBC. In node-negative MMBC, chemotherapy confers benefit only when tumor size is ≥1 cm, suggesting multifocality and multicentricity should guide chemotherapy decisions. Prospective studies are warranted to confirm findings and refine guidelines.
SN - 2473-4284
ER -