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Invasive Ductal CA : Multifocal Tumors

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Multifocal & Multicentric Tumors: When the invasive breast carcinoma is multifocal (>1 focus in the same quadrant) or multicentric (invasive tumors in >1 quadrant), the aggregate gross diameters of all nodules combined give more accurate prognostic information than the single largest nodule. It is, however, recommended that the pathology report give the size of single largest invasive focus as well as aggregate size based on the measurement of all individual invasive foci combined.

It must be noted that AJCC Cancer Staging Manual recommends staging on the basis of single largest nodule. MRI offers a more accurate method of measuring tumor volume and may become an established part of clinical staging of breast cancers.

The image shows invasive breast carcinoma with multifocal satellite tumor nodules. There is a large tan white invasive tumor (center of the photo) with multifocal satellite tumor nodules (black arrows) in the adjacent breast parenchyma. Several satellite tumor nodules are involving the surgical resection margins. Image courtesy of: Jian-Hua Qiao, MD, FCAP, Los Angeles, CA, USA; Used with permission.

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