What is Multifocal Breast Cancer?

Multifocal breast cancer is a subtype of breast cancer when two or more tumors start to form within the same breast. All the tumors originate from one parent tumor. Multifocal breast tumors may also be present in same quadrant or section of the breast.

It is different from multi-centric breast cancer. However, both these share similarities. In multi-centric cancer, multiple tumors develop in different quadrants of the breast. There is no standard pattern of prevalence of multifocal or multi-centric breast tumors. They can range between 6% to 60% of all breast cancers.

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The multifocal tumors of a breast are either invasive or noninvasive. Noninvasive cancers reside inside the milk ducts or the milk-producing glands of the breast. The invasive cancers can also grow from other parts of the breast and make their way to the breast as an invasion.

Different types of breast cancer

Many people don’t know but there are several types of breast cancer. These categories of breast cancer are based on the types of cells from which the cancer cell grows. Most of these breast cancers are carcinomas.

It means that they have started from epithelial cells, which are present at the line of breasts. Adenocarcinoma is one type of carcinoma that develops from the milk ducts or lobules of the breast. Breast cancer has these following types.

  • Ductal carcinoma in situ (DCIS) 

It is an infection that initiates inside the milk ducts. This particular type is also called noninvasive for the reason that it does not spread out of the milk ducts. But this cancer can increase the risk of an invasive breast cancer. Ductal carcinoma in situ is one of the most common types of noninvasive breast cancer. Among all the cases of breast cancer, up to 25% cases are Ductal carcinoma in situ.

  • Lobular carcinoma in situ (LCIS) 

It is also a non-invasive type of breast cancer. These cancer cells originate in milk-producing glands of the breast. Lobular carcinoma in situ (LCIS) increases the risk of getting affected by breast cancer again. Lobular carcinoma in situ (LCIS)  is rare in prevalence. It only affects 0.5% to 4% of all noncancerous breast biopsies.

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  • Invasive ductal carcinoma (IDC)

Invasive ductal carcinoma (IDC) is one of the most common types of breast cancer, which is prevalent in more than 80% of the reported cases. Invasive ductal carcinoma (IDC) starts in cells that line up the milk ducts in the breast. It spreads to the best part of the breast and also has a tendency to spread to the other body parts.

  • Invasive lobular carcinoma (ILC) 

Invasive lobular carcinoma (ILC) starts in the lobules of breast and later on it can spread to other parts of the body. It is not that common and only 10% or fewer cases of breast cancer are diagnosed with Invasive lobular carcinoma (ILC).

  • Inflammatory breast cancer

It is a rather rare form of the disease but it has an aggressive spread. It affects between 1% to 5% o all the cases of breast cancers.

  • Paget’s disease of the nipple

It is another type, which is rare to prevail. It starts from milk ducts but infects the nipple. Only 1% to 3% of the breast cancer cases are of this type.

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  • Phyllodes tumors 

It is a leaf-like the cancer cell that grows inside the breast. It is very rare to get these tumors. Most of the times, these tumors are not even cancerous but malignancy is possible for them. Phyllodes tumors are less than 1% of all breast cancer cases.

  • Angiosarcoma 

It is a type of infection that starts in the bloodline or lymph vessels. It is so rare that less than 0.05% cases of breast cancer are diagnosed with it.

How to diagnose multifocal breast cancer?

There are a number of methods used by the doctors to diagnose breast cancer. These methods include the following.

  • Clinical breast exam

This is a physical exam in which the doctor will feel your breasts and lymph nodes to check any lump or other abnormalities.

  • Mammogram

It is a test, which uses x-ray to know the changes in breasts. It screens them to diagnose cancer. How often should you get this test depends if you have a risk factor or family history of breast cancer. An unusual or abnormal mammogram may indicate a risk of breast cancer. However, it requires more testing for complete diagnosis.

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  • Magnetic resonance imaging (MRI)

This test uses strong magnets and radio waves, which create a detailed picture of the inside structure of the breast. MRI picks multifocal breast cancer in a better way than any other test i.e. ultrasound, mammography etc.

  • Ultrasound

An ultrasound test uses sound waves to identify any solid masses (tumors) to any other abnormality in breasts.

  • Biopsy

A biopsy is one way to confirm the breast cancer. The results of the biopsy are accurate and 100% trustworthy.    A doctor who will pick a small sample of the affected tissue from the breast does the biopsy. The sample of a lymph node is also taken, as it is the most likely area from which cancer cells spread. These specimens are studied under the microscope and by performing further testing. The results confirm the occurrence of breast cancer.

On the basis of some of these tests, the doctor will confirm if you have breast cancer or not. The results will also tell if cancer has spread to other parts or not. It will help your doctor to recommend you the most effective treatment.

When you have multifocal cancer, each tumor is measure separately during these tests. The stage of the cancer is estimated on the basis of the size of the largest tumor. Many medical professionals believe that this method is not the right way to estimate the cancer stage. It doesn’t take into account the total number of tumors present inside the breast. But still, this is the most practiced method to diagnose and study multifocal breast cancer.

What is the treatment for multifocal breast cancer?

The treatment option depends upon the stage of cancer of your body. If you are at an early stage of cancer, it means the tumors are only limited to the one quadrant of your breast. At this stage, a surgery like breast-conserving surgery or lumpectomy is an advised treatment. This surgery removes all the tumors and preserves the healthy tissues of the breast from it.

In any case, if some parts of the tumor are left, you will get radiation therapy to kill those remaining cells. Chemotherapy is another recommended treatment after surgery. When cancer cells are huge in size or are widely spread, they require mastectomy. It is a surgery, which removes the whole breast along with the lymph nodes if required.

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Is there any side effect of the treatment?

Treatments are to make the breast cancer leave your body. But sometimes, despite the survival aid, the treatments of breast cancer can have side effects. Some of these side effects may include the following.

  • Intense pain in the breast
  • scarring
  • inflammation in the breast or adjoining arm (lymphedema)
  • any change in the shape or size of the breast
  • bleeding from breast
  • infections

The side effects of radiation include the following.

  • Redness of skin
  • Itching on skin
  • peeling and irritation of the skin
  • fatigue and stress
  • swelling of the breast

The final word

Multifocal breast cancer is more likely to spread to lymph nodes then single tumor breast cancer. The outlook of the condition depends upon how many tumors do you have in each breast. Also, the size, age and spread of these tumors also matter.

It is necessary to self-examine your self every couple of months. Do not hesitate to consult the doctor if you feel or see any abnormality. The best treatment for cancer requires a timely diagnosis for which, you have to be careful about any unusual change in breast structure and shape.