Surgical Therapy for Women with Multiple Synchronous Ipsilateral Breast Cancer (MIBC): Current Evidence to Guide Clinical Practice

Abstract:
Purpose of ReviewBased on retrospective, historic data, surgeons have long recommended mastectomy as the surgical approach for women with multiple ipsilateral synchronous (multifocal or multi-centric) breast cancer (MIBC). In the modern era, however, local recurrence rates have significantly decreased due to improved imaging techniques and earlier detection through breast cancer screening, more accurate delivery of radiation, and the advent of targeted systemic therapies. Given the significant non-surgical advancements in the field of breast cancer care, the role of maximally invasive surgery in improving breast cancer outcomes has diminished. This raises the question as to whether the routine recommendation for mastectomy in MIBC is rooted in current evidence or archaic data. This review summarizes data regarding surgical options for women with MIBC.Recent FindingsThe incidence of MIBC is increasing as a result of improved imaging modalities and the use of breast MRI for breast cancer screening and staging. MIBC tends toward more aggressive biology and higher rates of nodal positivity but recent data contradict the notion that more aggressive surgery improves outcomes. Retrospective studies and meta-analyses performed in the current era of targeted therapy and more sensitive breast cancer detection have demonstrated equivalent rates of local regional recurrence (LRR) in women with MIBC undergoing breast-conserving therapy (BCT) when compared stage to stage with women with unifocal disease. Alliance Z11102, the first national, prospective trial of breast conservation in the MIBC population in the USA, demonstrated the feasibility of BCT in this patient population with acceptable rates of conversion to mastectomy in the MIBC cohort. Prospective data regarding LRR and cosmetic outcomes for women undergoing BCT from completed clinical trials continue to mature, and new randomized clinical trials investigating the biology and treatment of MIBC are under design.SummaryThe incidence of MIBC is increasing due to screening mammography, improved quality of imaging, and the utilization of breast MRI for breast cancer screening and staging. Local regional recurrence rates in women with unifocal disease have decreased due to earlier detection and improved regional and systemic therapy. As adjuvant therapy improves, the extent of surgery is less impactful on LRR and long-term survival. Current data demonstrate acceptable LRR in women undergoing BCT for MIBC for whom negative surgical margins are achieved and appropriate adjuvant therapy is administered. While additional prospective data regarding biology, LRR, cosmesis, and long-term survival in women with MIBC continue to be collected, current evidence supports the role of patient choice in deciding between breast conservation and mastectomy in this population.
Author Listing： David Linshaw;Jennifer E. Tonneson;Kari M. Rosenkranz
Volume： 11
Pages： 67-73
DOI： 10.1007/s12609-019-0309-z
Language： English
Journal： Current Breast Cancer Reports

Current Breast Cancer Reports

CURR BREAST CANCER R

影响因子：1.0 是否综述期刊：否 是否OA：否 是否预警：不在预警名单内 发行时间：- ISSN：1943-4588 发刊频率：4 issues per year 收录数据库：ESCI/Scopus收录 出版国家/地区：- 出版社：Springer Nature

期刊介绍

This journal aims to review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of breast cancer. By providing clear, insightful, balanced contributions by international experts, the journal intends to serve all those involved in the care of those with the disease. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as prevention, systemic therapy, and translational research. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.

本杂志旨在回顾最近发表的与乳腺癌的诊断、治疗、管理和预防相关的最重要的临床发现。通过提供国际专家清晰、有见地、平衡的贡献，该杂志打算为所有参与护理该疾病患者的人服务。我们通过任命国际权威机构担任关键主题领域的编辑来实现这一目标，如预防、系统治疗和转化研究。而版块编辑则会选择一些主题，让顶尖专家为这些主题撰写全面的评论文章，这些文章强调新的发展和最近发表的重要论文，并通过注释参考文献列表突出显示。一个国际编辑委员会审查年度目录，建议他们国家/地区特别感兴趣的文章，并确保主题是最新的，包括新兴的研究。还提供了该领域知名人士的评论。

年发文量 44
国人发稿量 -
国人发文占比 0%
自引率 0.0%
平均录取率 -
平均审稿周期 -
版面费 US$3280
偏重研究方向 ONCOLOGY-
期刊官网 https://www.springer.com/12609/?utm_medium=display&utm_source=letpub&utm_content=text_link&utm_term=null&utm_campaign=MLSR_12609_AWA1_CN_CNPL_letpb_mp
投稿链接 https://www.editorialmanager.com/CBCR

质量指标占比

研究类文章占比 OA被引用占比 撤稿占比 出版后修正文章占比
68.18% 12.28% - -

相关指数

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期刊预警不是论文评价，更不是否定预警期刊发表的每项成果。《国际期刊预警名单（试行）》旨在提醒科研人员审慎选择成果发表平台、提示出版机构强化期刊质量管理。

预警期刊的识别采用定性与定量相结合的方法。通过专家咨询确立分析维度及评价指标，而后基于指标客观数据产生具体名单。

具体而言，就是通过综合评判期刊载文量、作者国际化程度、拒稿率、论文处理费（APC）、期刊超越指数、自引率、撤稿信息等，找出那些具备风险特征、具有潜在质量问题的学术期刊。最后，依据各刊数据差异，将预警级别分为高、中、低三档，风险指数依次减弱。

《国际期刊预警名单（试行）》确定原则是客观、审慎、开放。期刊分区表团队期待与科研界、学术出版机构一起，夯实科学精神，打造气正风清的学术诚信环境！真诚欢迎各界就预警名单的分析维度、使用方案、值得关切的期刊等提出建议！

预警情况 查看说明

时间 预警情况
2024年02月发布的2024版 不在预警名单中
2023年01月发布的2023版 不在预警名单中
2021年12月发布的2021版 不在预警名单中
2020年12月发布的2020版 不在预警名单中

JCR分区 WOS分区等级：Q4区

版本 按学科 分区
WOS期刊SCI分区
WOS期刊SCI分区是指SCI官方（Web of Science）为每个学科内的期刊按照IF数值排 序，将期刊按照四等分的方法划分的Q1-Q4等级，Q1代表质量最高，即常说的1区期刊。
（2021-2022年最新版）
ONCOLOGY Q4

关于2019年中科院分区升级版（试行）

分区表升级版（试行）旨在解决期刊学科体系划分与学科发展以及融合趋势的不相容问题。由于学科交叉在当代科研活动的趋势愈发显著，学科体系构建容易引发争议。为了打破学科体系给期刊评价带来的桎梏，“升级版方案”首先构建了论文层级的主题体系，然后分别计算每篇论文在所属主题的影响力，最后汇总各期刊每篇论文分值，得到“期刊超越指数”，作为分区依据。

分区表升级版（试行）的优势：一是论文层级的主题体系既能体现学科交叉特点，又可以精准揭示期刊载文的多学科性；二是采用“期刊超越指数”替代影响因子指标，解决了影响因子数学性质缺陷对评价结果的干扰。整体而言，分区表升级版（试行）突破了期刊评价中学科体系构建、评价指标选择等瓶颈问题，能够更为全面地揭示学术期刊的影响力，为科研评价“去四唯”提供解决思路。相关研究成果经过国际同行的认可，已经发表在科学计量学领域国际重要期刊。

《2019年中国科学院文献情报中心期刊分区表升级版（试行）》首次将社会科学引文数据库（SSCI）期刊纳入到分区评估中。升级版分区表（试行）设置了包括自然科学和社会科学在内的18个大类学科。基础版和升级版（试行）将过渡共存三年时间，推测在此期间各大高校和科研院所仍可能会以基础版为考核参考标准。 提示：中科院分区官方微信公众号“fenqubiao”仅提供基础版数据查询，暂无升级版数据，请注意区分。

中科院分区 查看说明

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