Prediction of nipple involvement in breast cancer after neoadjuvant chemotherapy: Should we rely on breast MRI to preserve the nipple?

Background Indications for nipple sparing mastectomy (NSM) is extending to post-neoadjuvant chemotherapy (NAC) setting. Eligibility for NSM with an optimum tumor-nipple distance (TND) after NAC is unclear. We examined predictive factors for nipple tumor involvement in patients undergoing total maste...

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Bibliographic Details
Published in:Breast cancer research and treatment 2023-10, Vol.201 (3), p.417-424
Main Authors: Ugurlu, M. Umit, Bugdayci, Onur, Akmercan, Ahmet, Kaya, Handan, Akin Telli, Tugba, Akoglu, Haldun, Gulluoglu, Bahadir M.
Format: Article
Language:English
Subjects:
Biopsy
Breast cancer
Breast carcinoma
Breast Neoplasms - diagnostic imaging
Breast Neoplasms - drug therapy
Breast Neoplasms - pathology
Cancer research
Carcinoma, Ductal, Breast - diagnostic imaging
Carcinoma, Ductal, Breast - drug therapy
Carcinoma, Ductal, Breast - pathology
Chemotherapy
Clinical Trial
Female
Humans
Invasiveness
Lymph nodes
Lymphatic system
Magnetic Resonance Imaging
Mastectomy
Mastectomy - methods
Medical records
Medicine
Medicine & Public Health
Neoadjuvant Therapy
Nipples - pathology
Oncology
Patients
Retrospective Studies
Tumors
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Summary:Background Indications for nipple sparing mastectomy (NSM) is extending to post-neoadjuvant chemotherapy (NAC) setting. Eligibility for NSM with an optimum tumor-nipple distance (TND) after NAC is unclear. We examined predictive factors for nipple tumor involvement in patients undergoing total mastectomy following NAC. Methods Clinical and pathological data from prospectively collected medical records of women with invasive breast carcinoma, who were undergone NAC and total mastectomy with sentinel lymph node biopsy and/or axillary lymph node dissection were analyzed. PreNAC and postNAC magnetic resonance imaging (MRI) views were examined and a cut-off TND value for predicting the negative nipple tumor status was determined. Results Among 180 women, the final mastectomy specimen analysis revealed that 12 (7%) had nipple involvement as invasive carcinoma. Patients with nipple involvement had more postNAC multifocal/multicentric tumors ( p : 0.03), larger tumors on preNAC and postNAC images ( p : 0.002 and p  
ISSN:0167-6806
1573-7217
DOI:10.1007/s10549-023-07041-8