Involvement of nipple and areola in early breast cancer

Morimoto, Takahiro; Komaki, Kansei; Inui, Kozo; Umemoto, Atsushi; Yamamoto, Hiroyuki; Harada, Kunihiko; Inoue, Kenji

doi:10.1002/1097-0142(19850515)55:10<2459::aid-cncr2820551025>3.0.co;2-l

Cited by 103 publications

(52 citation statements)

References 5 publications

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“…[1][2][3][4][5][6][7][8][9][10][11] The indications for NSM are clinically decided in consideration of these risk factors.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, centrally located tumors have been regarded as a contraindication of NSM in previous reports, whereas centrally located tumors were considered to be suitable for E-NSM in our study, except in cases with suspicious NAC involvement as assessed by physical examination and MRI. [1][2][3][6][7][8][9][10][11] The two NACs with nipple involvement accounted for 18% (2 of 11) of the breasts with suspicious extensions near the nipple as viewed by MRI. The other NACs without suspicious involvement on MRI examination (85 of 87, 98%) all tested negative for malignancy in the final histology examination.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8][9][10][11] However, many patients are dissatisfied with the reconstructed nipple for various reasons, including nipple projection, color matching, shape, size, texture, and position. 12 A nipple-sparing mastectomy (NSM) is a procedure that can be applied as part of a skinsparing mastectomy, in which the nipple-areola complex (NAC) is preserved for cosmetic reasons.…”

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confidence: 99%

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Early Results of an Endoscopic Nipple-Sparing Mastectomy for Breast Cancer

et al. 2009

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Background. Endoscopic mastectomy has been reportedly associated with smaller scars and greater patient satisfaction; however, few reports on this topic have been made. The purpose of this retrospective study was to examine the early results of endoscopic nipple-sparing mastectomy (E-NSM) and to investigate the safety of this procedure. Methods. Between January 2002 and December 2005, a total of 87 patients with breast cancer but without skin and nipple involvement, including two cases of bilateral breast cancer, underwent E-NSM. In case of bloody nipple discharge and suspicious extension near the nipple as assessed by magnetic resonance imaging, the major ducts within the nipple were cored (nipple coring). In other cases, nipple coring was not performed. Results. Of the 89 breasts in 87 patients, 42 had tumors of [2 cm and 80 were diagnosed as having invasive carcinoma. Lymph node involvement was observed in 36 procedures. The overall rate of nipple necrosis was 18% (16 of 89). The rate of nipple necrosis among the procedures with nipple coring was statistically higher than that among those without nipple coring (7 of 17, 41%, vs. 9 of 72, 13%) (P = .01). Nipple involvement was observed in 2.2% (2 of 89). After a median follow-up period of 52 months, distant metastasis was observed in nine cases; no local recurrences occurred in this series.Conclusions. E-NSM is an oncologically safe procedure and an acceptable method in selected patients requiring a mastectomy. The higher rate of nipple necrosis may have been the result of a technical problem, indicating the need for continued improvement in nipple coring procedures.The removal of the nipple as part of a mastectomy has been routinely performed on the basis of the presumed risk of occult nipple involvement, which reportedly occurs in 5.6% to 58% of cases.1-11 However, many patients are dissatisfied with the reconstructed nipple for various reasons, including nipple projection, color matching, shape, size, texture, and position.12 A nipple-sparing mastectomy (NSM) is a procedure that can be applied as part of a skinsparing mastectomy, in which the nipple-areola complex (NAC) is preserved for cosmetic reasons. 9,11,[13][14][15][16][17][18][19] For patients without skin and nipple involvement, NSM has evolved as an alternative to a mastectomy with a safe oncologic profile and a better cosmetic outcome. 9,11,[13][14][15][16][17][18][19][20][21] In the early 1990s, endoscopic surgery of the breast was first applied for the treatment of patients with capsular contracture after breast augmentation. 22 Since then, it has been used for aesthetic breast surgery, breast lump excision, and breast surgery for breast cancer. [23][24][25][26][27][28][29][30][31][32][33][34] The addition of endoscopy to NSM for patients with breast cancer has been reportedly associated with smaller scars and greater patient satisfaction.27-29 However, few reports on endoscopic nipple-sparing mastectomy (E-NSM) have been made, and most of these studies had relatively short followup peri...

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“…[1][2][3][4][5][6][7][8][9][10][11] The indications for NSM are clinically decided in consideration of these risk factors.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Early Results of an Endoscopic Nipple-Sparing Mastectomy for Breast Cancer

et al. 2009

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“…The terminal duct lobular unit has been identified as the location for the development of all breast cancer, and a 2008 study identified the presence of terminal duct lobular units in the nipples of 9% of patients (10,11). The rate of occult malignancy detected in the NAC in mastectomy specimens has varied widely with studies reporting an incidence of 1-31% (12)(13)(14)(15)(16). Over the years, a number of prospective and retrospective studies have demonstrated a cancer recurrence rate in the NAC of up to 2%, with local recurrence rates ranging from 1-6% (17)(18)(19).…”

Section: Introductionmentioning

confidence: 99%

Nipple-sparing mastectomies: Clinical outcomes from a single academic institution

Dull

Conant

Myckatyn

et al. 2017

Molecular and Clinical Oncology

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Abstract. Nipple-sparing mastectomies (NSMs) are increasingly used in the surgical treatment of patients with breast cancer and for prevention of breast cancer. The present study was performed to review the outcomes of patients undergoing NSMs at a single large university setting. A retrospective chart review was performed on all patients undergoing NSMs from 2008-2014. Charts were reviewed for demographic data and patient characteristics. Tumor and breast size, cancer recurrence and complications were also evaluated. Descriptive statistics were utilized to summarize the findings. From 2008From -2014 NSMs. The mean patient age was 44.4 years (range, 20-77). The average body mass index was 24 (range, 18-47). Breast weight was available for 106 specimens, with a mean weight of 475.5 g (range, 124.1-1,625.0 g). Seventy-three NSMs were performed for cancer and 124 were performed prophylactically. The mean tumor width was 1.38 cm (range, 0-6.0 cm), with an average nipple to tumor distance of 5.87 cm (range, 2.93-10.0 cm). Three (4%) patients required removal of the nipple areolar complex (NAC) due to pathological extension of the tumor. A total of 34 (17.2%) complications occurred, including infections, hematomas and nipple necrosis, with 9 requiring removal of the NAC and 13 requiring removal of the tissue expander or implant. Smokers had a 36.0% (9/25) complication rate, compared with 14.5% (25/172) of nonsmokers (P<0.05). During follow-up, one recurrence was noted, located on the chest wall. There were no recurrences in the NAC group. Therefore, NSMs may safely be performed without compromising oncologic outcomes or increasing complication rates in properly selected patients.

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“…Performance of conservative procedure necessitates the knowledge of frequency with which the nipple areola complex is involved in carcinoma of breast 6 Reported rates of neoplastic involvement of NAC by various studies range from 0% to 58% [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] . The proportion of breast carcinoma cases associated with nipple discharge ranges from 1.6% to 13%.…”

Section: Discussionmentioning

confidence: 99%