Clinicopathological study on the nipple-areolar complex involvement in operable breast carcinoma in 407 cases

Abstract

Objective To investigate the clinicopathological characteristics of nipple-areolar complex (NAC) involvement in patients with operable breast carcinoma and to determine the indications and risk factors of NAC-sparing modified radical mastectomy. Methods 407 female patients with primary breast cancer were included in the study.Data like tumor position, tumor size, the distance from the tumor to the margin of areolar (D) were recorded.NAC sample in vitro was collected and routine pathological examination was performed.Statistical methods were employed to analyze the relation between the clinicopathological factors and NAC involvement.Results The rate of NAC involvement was 13.27％ (54/407).NAC involvement had no statistically significant correlation with age or histological type, but had statistical correlation with tumor position, D value, tumor size, TNM stage, clinical manifestation of NAC, and status of axillary lymph nodes(P ＜ 0.05).Conclusions Tumor position, D value, tumor size, TNM stage, clinical manifestation of NAC and status of axillary lymph nodes are the major influential factors for NAC involvement.The indications of NAC-sparing modified mastectomy:1.in Ⅰ or Ⅱa TNM stage; 2.patients have strong will to preserve NAC or breast appearance; 3.noncentric tumor (D≥2 cm) ; 4.the maximum diameter of tumor should be less than 3 cm; 5.no abnormal manifestation like nipple discharge, eczematoid change or nipple inversion happened.6.no occult involvement in subareolar tissues was found by frozen pathology. Key words: Operable breast carcinoma; Nipple-areolar complex; Occult involvement