Areola sparing mastectomy without preservation of nipple: A clinicopathological assessment and a case series.

Abstract

e12099 Background: Preservation of the nipple-areolar complex has gained worldwide popularity due to significantly improved cosmetic result of mastectomy, while 4% to 58% involvement of nipple and assumed increased recurrence risk made it controversial on the oncological safety of nipple sparing mastectomy. This study focuses on the oncological feasibility of areola sparing mastectomy without preservation of nipple by evaluating involvement of the areola and nipple separately in consecutive mastectomy specimens. Methods: During Aug 3, 2016 to Jan 25, 2017, consecutive specimens from women underwent traditional mastectomy were analyzed. Areolae and nipples were resected and sectioned separately. Involvement of nipple and areola and clinicopathological data were analyzed. The results of 4 patients underwent areola sparing mastectomy were studied. Results: The overall frequency of malignant involvement of the areola among the breasts was 3 of 127 (2.3%), which was significantly lower than that of the nipple (11 of 127, 8.7%, p = 0.03). In patients whose tumors were ≤3cm, outside areolar area, and without dimpling of areola or inflammatory appearance, the incidence of areolar involvement was low to zero. A total of 4 patients received areola sparing mastectomy by “nipple coring” and immediate implant based reconstruction. No patients desired nipple reconstruction. Cosmetic results were all good. Conclusions: Areolae were rarely involved in breasts with tumor ≤3cm, and without inflammatory skin, dimpling of areola or retro-areolar tumor. Areola sparing mastectomy might be oncologically safe and should be a potential treatment in selected patients.