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A novel MRI-based predictive index can identify patients suitable for preservation of the nipple-areola complex in breast reconstructive surgery

Accurately predicting nipple-areola complex (NAC) involvement in breast cancer is necessary for identifying patients who may be candidates for a nipple-sparing mastectomy. Although multiple risk factors are indicated in the guidelines, it is difficult to predict NAC involvement (NAC-i) preoperativel...

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Bibliographic Details
Published in:European journal of surgical oncology 2021-02, Vol.47 (2), p.225-231
Main Authors: Seki, Hirohito, Sakurai, Takashi, Ishiguro, Yuki, Kanno, Masaki, Ikebata, Akiyoshi, Katsuki, Yusuke, Kaburagi, Takuji, Okumura, Takehiro, Karahashi, Tsuyoshi, Nakajima, Kenichiro, Shimizu, Ken
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Language:English
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Summary:Accurately predicting nipple-areola complex (NAC) involvement in breast cancer is necessary for identifying patients who may be candidates for a nipple-sparing mastectomy. Although multiple risk factors are indicated in the guidelines, it is difficult to predict NAC involvement (NAC-i) preoperatively even if these factors are evaluated individually. This study aimed to develop a more accurate and practical preoperative NAC-i prediction model using magnetic resonance imaging (MRI). All tumors in 252 patients were evaluated using postcontrast T1-weighted subtraction on MRI. The receiver operating characteristic curves identified cut-off values for tumor size and tumor-to-nipple distance (TND) as 4 cm and 1.2 cm, respectively. Multivariate analysis demonstrated that TND (p 
ISSN:0748-7983
1532-2157
DOI:10.1016/j.ejso.2020.08.010