Mammographic distance as a predictor of nipple-areola complex involvement in breast cancer

Abstract Background Although involvement of the nipple-areola complex (NAC) occurs in a minority of patients with breast cancer, standard skin-sparing mastectomy requires its removal. To assist in patient selection for NAC preservation we evaluated NAC involvement and correlated this with preoperati...

Full description

Saved in:
Bibliographic Details
Published in:The American journal of surgery 2008-03, Vol.195 (3), p.391-395
Main Authors: Loewen, Margaret J., M.D, Jennings, Jill A., M.D, Sherman, Stanley R., M.D, Slaikeu, Jason, M.D, Ebrom, Pierson A., B.S, Davis, Alan T., Ph.D, Fitzgerald, Timothy L., M.D
Format: Article
Language:English
Subjects:
Aged
Body Weights and Measures
Breast cancer
Breast Neoplasms - diagnostic imaging
Breast Neoplasms - pathology
ductal carcinoma in situ
Female
Humans
Logistics
Mammography
Mastectomy
Middle Aged
NAC
Nipple-areola
Nipple-areola complex
Nipple-sparing
Nipples - diagnostic imaging
Nipples - pathology
Retrospective Studies
Studies
Surgery
Tumors
Variables
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Background Although involvement of the nipple-areola complex (NAC) occurs in a minority of patients with breast cancer, standard skin-sparing mastectomy requires its removal. To assist in patient selection for NAC preservation we evaluated NAC involvement and correlated this with preoperatively available clinical data. Methods Patients with invasive breast cancer or ductal carcinoma in situ undergoing mastectomy from 1998 to 2005 were reviewed retrospectively. The NAC had been evaluated with multiple thin sections. Pathologic data including NAC involvement were analyzed. The mammographic tumor distance from the nipple was measured in 2 standard views. Results There were 302 patients enrolled, of which 10% were noted to have NAC involvement. This correlated negatively with tumor distance from the nipple ( P < .05). A logistic regression equation was derived from the data, with NAC involvement as the dependent variable and distance from the nipple as the independent variable. The equation predicted involvement of the NAC when the distance was less than 4.96 cm with a sensitivity of 82% and a negative predictive value of 97%. Conclusions A majority of patients are candidates for NAC preservation. The mammographic distance between the tumor and the nipple is independently predictive of NAC involvement and is useful as an equation variable.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2007.12.020